Underdeveloped Parts Research Articles

Pattern and distribution of ocular morbidity in primary school children of rural Delhi.

A total of 679 primary school children drawn from developed southern parts and underdeveloped eastern parts of Delhi were examined for ocular morbidity. Their age range was 5-15 years and both sexes had almost equal representation. The prevalence of eye diseases was relatively high. Over 40 percent of all the children studied had one or more ocular problems. Trachoma (18%) was the most common ocular morbidity followed by vitamin A deficiency (10.6%), visual acuity < 6/9 (7.4%) and apparent/latent squint (7.4%). In most of these eye disorders, the majority of the children came from the underdeveloped eastern parts of Delhi. Ocular morbidity seems to be unevenly distributed in rural Delhi with a significantly worse picture in the underdeveloped eastern parts, across the river 'Yamuna'. Though blinding trachoma may cease to be a major problem in India, the country continues to have endemic pockets of its non-blinding form. One puzzling observation was that children with protein-energy malnutrition (PEM) did not show any specific vulnerability to ocular diseases. In fact, those with normal weight-height index were having a higher share of eye diseases. Though this issue needs to be explored further in the light of biological plausibility, it appears that children who do not have PEM are also exposed to ocular diseases at least with comparable risk.

The African Challenge

Africa's enslavement and colonization must never be forgotten when analyzing its present-day predicament. Africa's contribution in the primitive accumulation that led to the modern capitalist system can never be mystified. These developments have a direct and indirect relation to that country's current debt crisis and its immediate consequences in the global system. Africa's general weakness in the global system cannot be understood apart from these historical events. The enforced export of a large part of the African population in the form of slaves, combined with the destruction of its precolonial productive capacities, clearly placed Africa in very poor condition compared to other colonized continents. Once we comprehend these factors, it becomes understandable why Africa's position in the global economic system should have worsened with the passage of time. To be sure, Africa's economic performance in the immediate postindependence period was comparable to that of the other former colonial territories. Her performance between 1960 and 1967 was relatively impressive. Indeed, the record has revealed that, mixed as it was, the average rate of increase in the GNP of the 1960s had been 5 percent for all the developing countries. This was somewhat reduced by the relatively high rate of population growth of about 2.5 percent. Africa's overall rate of growth was very close to the rate in Asia and Latin America. Optimism about the prospects of Africa developing along certain capitalist lines was widely shared. The US economic historian W.W. Rostow in his anticommunist manifesto, The Stages of Economic Growth,1 saw no a priori reason why Africa should not advance along the same road of development that had been traversed by the industrial countries of the West. In the view of the Pearson Commission, which had been authorized by the World Bank to inquire into these early developments, the fears that had been expressed in some quarters to the effect that the economically underdeveloped parts of the

Management of chronic venous leg ulcers: A literature-guided approach

Venous leg ulcers are a chronic recurrent problem. This disorder has been described in rural, urban, developed, and underdeveloped parts of the world. About 1% of the population will be afflicted with a poorly healing lower extremity wound during their lifetime.1 Estimates of the prevalence of lower extremity wounds in Sweden2 and England3,4 are 0.12 and 0.19%, respectively. Approximately, 40 to 70% of these wounds are believed to have a venous component.2,4,5 Most of these patients were older than 50 and female.4,5 Chronic venous insufficiency with ulceration may occur in up to 3.6% of the population over the age of 15 in Brazil.6 In the 2-year period from 1990 to 1992 there were more than 1.3 million outpatient visits in the United States for venous ulcers.7 As many as 22% of the patients with venous ulcers also have concomitant large vessel arterial disease.4 Because of the chronic and recurrent nature of venous ulcers, these figures may grossly underestimate the prevalence of this disease. The actual costs attributed to this illness are therefore difficult to assess. In Scandinavia treatment was estimated to cost 25 million U.S. dollars in 1985.8 This does not include the loss of productivity and personal suffering that occurs because of this chronic affliction. On the basis of population demographics, estimated costs in the United States would probably be at least an order of magnitude greater.There has been a recent surge in interest in the treatment of these wounds. This has been supported by the advent of new treatments and technologies and a growing interest in gerontology. In 1992 alone more than 100 publications were concerned with venous ulcers. Although several excellent reviews on the treatment and etiology of venous wounds have been published in the past several years,9–16 no consensus exists on the treatment of these wounds. Furthermore, it is difficult to develop a standard care for the treatment of these wounds based on the conventional wisdom of these publications. A consensus standard care or best care would greatly facilitate the health care provided to these patients and would make it possible to have a benchmark against which to compare new treatment modalities. The purpose of this article is to review the recent English literature to develop a consensus standard treatment protocol based on data from published controlled trials.The information used in this article was obtained by a Medline-based search of the literature since 1966. A recent study evaluated this approach for medical problem solving.17 Key search terms were venous, ulcer, leg ulcer, chronic wound, treatment, debridement, compression, topical, and dressing. More than 1200 studies were identified. Literature was reviewed if it was in the English language, the patients studied had venous ulcers, and the trials described were conducted in a randomized controlled fashion. Articles were excluded if it was impossible to determine if the study was controlled and if it was not possible to determine which patients had venous ulcers in a study with more than one wound type. Categories for the protocol were based on typical recommendations for the treatment of patients with chronic wounds. These categories were removal of etiologic cause, wound debridement and infection control, wound cleansing, wound dressings, adjuvant agents (topical, device, or systemic), miscellaneous treatments, and surgical closure. The method section of the controlled trials was tabulated in an effort to determine what was deemed appropriate, standard care.

Exploring the use of a Systemic semantic description

Grammar has begun to resume a prominent place in language teaching, but there are possible problems associated with grammar‐oriented teaching. Form tends to dominate meaning, with all the well‐known problems associated with this. A partial solution to these problems can be found if (a) a meaning‐based grammar is used, and (b) grammar is taught only when it is clearly required and learnable. A Systemic model for a semantico‐grammatical approach is presented, along with an illustration of its usefulness in finding underdeveloped parts of the semanticogrammatical system and a description of a successful preliminary trial in treating them. Since the approach is in its early stages, strong claims are not made.

Extending APL

This paper explores certain underdeveloped parts of APL which ought to grow if APL is to qualify as implementation language for large and maintainable software systems. Following specific problems are discussed: * Integrating APL with other parts of information processing environment. • Operating systems. • Programs written in other languages. • Data bases. * Using independently developed functions and subsystems. • Problems with names. • Problems with space. * Execution control of object attributes. * Communications among functions. • Passing parameters. • Returning values. • Transferring control. * Information hiding modules. • Packaging related functions. • Packaging data with functions. • Local functions.

The repair of post-traumatic vaginal stenosis using local thigh flaps

Minor degrees of vaginal stenosis, especially lesions close to the vaginal introitus, can be dealt with safely and satisfactorily by local transposition flaps. The more extensive varieties of vaginal stenosis, sometimes amounting to virtual obliteration of the vagina by scar tissue, are a far greater surgical challenge. There are several causes of “post-traumatic” vaginal stenosis and the aetiological pattern in any reported series obviously reflect the geographical and social background of the patients and the surgical skills that are available locally. In the Western world, most cases of severe vaginal stenosis are likely to be the result of trauma to the pelvis and perineum following serious accidents, over-zealous repairs of rectocoele or cystocoele, particularly those repairs complicated by severe infection, and stenosis following treatment by radiotherapy and/or surgery for malignant disease involving the external genitalia, the rectum and the vagina, especially lesions extending into the pelvic floor. By contrast, the surgeon working in the tropics and in the under-developed parts of the world will see vaginal stenosis more often as a complication of vaginal damage due to prolonged obstructed labour and disastrous obstetrical management or the late effects of tropical infections such as lymphogranuloma. The efforts of native medicine men or so-called “healers” to cure infertility or punish infidelity may produce virtual obliteration of the vaginal cavity. A typical example of this severe stenosis is seen in some Middle Eastern countries following the deliberate insertion of crude rock salt into the vagina. Severe stenosis of this degree can be treated along the conventional lines advocated by McIndoe for congenital atresia of the vagina, but only on condition that the scar is completely excised before the insertion of a split skin graft. The amount of bleeding encountered often makes it prudent to do the operation in 2 stages, namely packing the vaginal cavity after the scar excision and grafting the defect some 7-10 days later at a second operation. Even under ideal conditions a complete “take” of the graft cannot be guaranteed and the post-operative co-operation demanded of the patient in keeping the grafted cavity dilated often results in a disappointing and inadequate reconstruction. Experience with 3 cases of vaginal stenosis suggests that the use of bilateral partially de-epithelialised thigh flaps could offer a solution to this problem.

The Survival of Communities: A Theoretical Perspective [and Comments and Reply

The theoretical concern of this essay is with economic structures that are considered to be causally prior to the perpetuation of underdevelopment. Industrial capitalism as a mode of production is briefly discussed to identify specific properties and processes that produce inequalities. The political economy of government intervention and of world commodity markets places regional policy within a realistic context in that government intervention is seen to be consistent with the investment priorities of the wider economic system. Such policy rarely results in change in structures of economic integration. Empirically, I examine the operations of Scotland's Highlands and Islands Development Board to show, in a case of marginality that is not extreme, that events are nevertheless dictated by the components of the wider economic system and not by development-agency initiative. The longer view is that the arguments made in this particular case should apply even more strongly to many underdeveloped parts of the...

Research, ethics and development

We argue that the transmission of “normal science” (in Kuhn's sense) is not enough to secure high-quality research, especially in the underdeveloped parts of the world. We survey some of the problems raised by the role of science (in a wide sense including the humanities and the social sciences) in development. A simple model for “research-practice complexes” is presented. It is suggested that research-practice complexes ought to fulfil the three basic criteria of efficiency, perceptiveness, and sensitivity. The role of joint paradigm discussions in research-practice complexes is particularly emphasized.

THE PHYSICAL FACTOR IN THE SYSTEM OF CONDITIONS DETERMINING THE LOCATION OF INDUSTRIAL PRODUCTION IN THE USSR

The generally accepted view that material-intensive industries tend to gravitate toward raw-material sources is analyzed in the case of the USSR. Primary processing is found to gravitate toward raw-material sources mainly in underdeveloped parts of the country. In the developed zone (European USSR, Urals, Transcaucasia), a significant spatial gap has developed between primary processing activities and raw-material sources as the original local resources become depleted and the industry must draw increasingly on long-haul raw materials. Several industrial groups are distinguished in terms of the pull of resource sites. In view of the current trend toward greater concentration of production (for cost-benefit reasons) and the growing volumes of production per establishment, primary processing establishments are usually dependent on more than one resource site, and this also tends to increase the length of haul. At the same time, the distribution of fuels, energy and water resources is assuming greater signif...

World Energy Resources: Survey and Review

T HE population explosion, particularly in the underdeveloped, or Third World, countries, is now almost certainly destined to double the world's inhabitants to 7 billion by the year 2000. In the face of this one has no real justification for treating lightly the views of the prophets of doom who foresee a rapid depletion of the planet's nonrenewable resources and an approaching global energy crisis. Population control and more positive management of expendable resources are mandatory and should be faced without delay by all governments. The energy problem has two major facets for which predictions are difficult, namely, the source of supply for the period twenty to fifty years ahead and the ecological consequences of the accelerated use of less accessible, finite resources and of the inevitable eventual wholesale development of nuclear power plants. At present the United States consumes nearly 35 percent of the world's energy, and even allowing for greater upsurges of population and increased standards of living elsewhere the proportion is unlikely to fall much below 25 percent by the year 2000. If by then the standard of living in the underdeveloped parts of the world should rise to that enjoyed by Americans today, the worldwide level of energy consumption would reach the awesome dimension of roughly loo times the present figure.1 During the last half century the world's total energy consumption has increased by more than five times. The scale of growth, the shifting patterns of production, consumption, and trade away from solid fuels toward petroleum, the increasing significance of natural gas, the advent of nuclear power, and the concern about future sources of supply and about the environmental impact of the extended use of these resources have all resulted in a voluminous literature,

On the Two Diverging-Sector Model of Social Development

A very old Egyptian proverb has it that is the mother of the world; but then, as Oscar Wilde pointed out, All women become like their mothers. That is their tragedy. The hypothesis put forward here is that ancient Egypt represents the social pattern toward which the contemporary world is moving. More precisely, it represents the earliest and clearest example of the two diverging-sector society. Sector E represents the everyday world and is the one that immediately strikes the visitor: the poor hygiene, the slums, the dirty streets, the broken pavements. There is nothing peculiar to Egypt in all this; it shares these symptoms with other underdeveloped parts of the world. But the other sector, T, is represented by that marvel of technology and engineering, the pyramids, man's earliest, most grandiose, and probably most durable largescale artifact. Today the advanced part of the world, led by its most technologically and economically developed society, the United States, is following the ancient Egyptian model. The E sector is steadily deteriorating: witness the increasingly dirty streets and spreading potholes, the declining hygienic standards, the creeping slums, the shoddy buildings, the power blackouts and water shortages, and the paralyzed public transport of New York and

Class, Property, and Authority: Dahrendorf's Critique of Marx's Theory of Class

The central concern of this paper is the conceptual interrelationship among property, and authority; the context is Dahrendorf's well-known critique of Marx's theory of class, wherein Dahrendorf contends that Marx erroneously specified the determinant of class, in part because of his alleged reliance on organismic analogies. After reviewing certain features of the structure of Marx's theory, the paper examines the foregoing and two related criticisms made by Dahrendorf, and concludes that the latter (1) overlooks crucial characteristics of Marx's theory, (2) engages in confused comparisons of organism and society in order to support part of his critique, (3) misrepresents Marx's usage of property, (4) obfuscates the concept of by equating it with domination, and therefore (5) constructs an alleged supersedent to Marx's theory of class that is actually grounded not in class or any other material difference but in the fabric of justifications (ideologies, derivations, etc.) that are socially provided the material differences. In his study of Class and Class Conflict in Industrial Society, Dahrendorf (1959) sets forth a number of criticisms of Marx's theory of class, in anticipation of his own intended supersedure of that theory. Three of these criticisms are the concern of this paper: first, and most important, Dahrendorf's critical remarks about Marx's conceptualization of class, in particular the relationship between and vis-a-vis the structural conditions of class formation; second, his criticisms of Marx's analysis of structural change; third, his contention that Marx claimed for his theory an improperly broad scope. We shall examine each of these charges, especially the first-mentioned, in some detail and attempt to show that they are host to serious misapprehensions of Marx's theory and to obfuscations of the concepts of and with respect to that theory.' In the section that follows, Dahrendorf's statements of criticism are presented briefly, and then in a subsequent section we address the particulars of each of his arguments. Inasmuch as his criticisms are faulted not only by the manner in which he employs the concept authority and interprets Marx's usage of property but also by certain failures in understanding the structure of Marx's theory of class, it will be necessary to interject some considerations of such matters as the logical characteristics of the Marxian theory. It should be stressed that our argument is not that all of Dahrendorf's points in critique are ill-founded-quite to the contrary in some instances, as for example, his (1959:145) recognition that Marx deliberately avoided in his structural analyses a corresponding concern with the relation between social roles and their personnel. One of the most underdeveloped parts of Marx's theory is (still) that which pertains to class behavior at the interpersonal level, especially the part of it that rests upon considerations of class consciousness.2 Similarly, we must agree at the outset about another important matter. Marx was political activist and polemicist as well as sociological * Special acknowledgement is due to Joseph Lopreato and Barclay Johnson, who provided helpful comments on an earlier draft of the paper. The author of course retains sole responsibility for any errors that may have been committed. 1 For present purposes, Dahrendorf's publications subsequent to Class and Class Conflict (1959) will be ignored (e.g., 1967a; 1967b; 1968), although in fairness it should be noted that he himself has questioned the 1959 formulation (cf. e.g., 1967b) . 2 Perhaps the deliberately avoided is a bit stretched, although it is arguable that Marx wittingly chose as a tactical concession to his polemics against the idealists a deliberate avoidance of issues regarding the causal significance of actor conceptions and attitudes.

Low-Wage Industrialization and Town Size in Rural Appalachia

LOW-WAGE INDUSTRIALIZATION AND TOWN SIZE IN RURAL APPALACHIA Neal G. Lineback* This study investigates the geographical trends and spatial patterns of low-wage manufacturing industry (1) in East Tennessee in order to formulate generalizations useful in explaining spatial diffusion of lowwage industry in Appalachia (2) and in other underdeveloped parts of the country. Appalachia, as a whole, has had a history of relatively slow overall economic growth, sporadic industrial development, and declines in the principal economic activities of agriculture and mining. (3) Unemployment , underemployment, surplus unskilled labor, outmigration, and a relatively low standard of living have been characteristic socioeconomic problems of the area. Manufacturing in general has not been as successful in Appalachia as in the nation as a whole. (4) Analysts with the Fantus Company, in writing for the Appalachian Regional Commission, noted: Many branches of manufacturing industry have been highly successful in the Appalachian Region. Others, however, have failed to achieve anticipated operating results, a sustained level of new investment, or optimum employment. Still others have suspended operations after a short period. This mixed history of accomplishments and failures—often involving the same branches or similar branches of industry—has not been satisfactorily explained by traditional statistical analysis, economic models or theories. (5) Even though manufacturing in general has not enjoyed the greatest success in Appalachia, it has the potential to solve many of the area's economic problems. Harvey Perloff stated: Economic expansion is in general associated with a relatively high rate of increase in employment in manufacturing and services. Thus, growth of total income and population has been associated in a general way with decline in the relative importance of agricultural employment and increases in the relative importance of manufacturing employment, both for the nation as a whole and for almost every state separately. (6) Attracting manufacturing to Appalachia, however, has been difficult because relatively few locational advantages exist there. It is true that *Dr. Lineback is assistant professor of geography at the University of Alabama. The paper was accepted for publication in April 1971. 2 Southeastern Geographer there are pockets of prosperity within the region where manufacturing is found in sizable concentrations, but these pockets are atypical. Most of the region is essentially rural (7) with few cities exceeding 50,000 persons. The industries which have been attracted to Appalachia—particularly rural sections—have been those whose locational demands have corresponded to the small range of advantages available in the region. Because of the narrow range of advantages, only a few industries have exhibited much growth potential. (8) Unemployed and underemployed labor appears to be Appalachian most available resource as well as its most valuable one. Much of the labor, however, lacks experience in manufacturing, and "... a socialization gap must be bridged between agriculture and extraction on the one hand and manufacturing on the other." (9) But manufacturing industries that are capable of utilizing low-skilled, poorly educated, and inexperienced labor at wage levels below the national average can perhaps bridge the socialization gap. Low-wage, labor-intensive industries also can stimulate a depressed economy. As Perloff observed, . . . not all regions have the relative advantages in regard to input-output access that makes it possible for them to attract such industries (growth industries); many can expect to grow only slowly on the basis of the industries for which they do have special advantages. Looked at in terms of relative advantages in resources, markets, human skills, amenities, climate, transport facilities and cost, and the rest of it, some areas can hope to grow only by attracting labor-intensive industries . . . (10) Carrier and Schriver found in Tennessee that, ". . . frequently, the Apparel and Related Products Industry (an often-mentioned low-wage, labor-intensive industry) was the harbinger of higher stages of manufacturing . . . ." (11) If low-wage manufacturing has a high growth potential in Appalachia, as all evidence indicates, a number of questions must be answered concerning the characteristics of the industry: What is low-wage industry? What are the locational characteristics of low-wage firms? What are the locational patterns of low-wage firms? Are low-wage firms increasing through relocation diffusion or through expansion diffusion. (12) AREA OF STUDY. East Tennessee was selected as the area...

The performance of a bicycle operated winnower-grader

A pedal operated bicycle is a very common mechanical device which is owned and used by even the peasant farmers in the underdeveloped parts of the world. The driving mechanism of the bicycle can be considered as a convenient means for converting human energy directly into rotary motion which can be utilized for mechanization purposes in circumstances where electricity or an internal combustion engine is neither available nor practicable due to fairly high capital and maintenance costs. In the present application, the use of a bicycle for driving a fan winnover-grader for small-scale farm work has been considered. The method used and the results obtained with four different crops have been described. The grading of the crops is carried out simultaneously with winnowing by a static unit and does not need any additional power.

Trade Challenges Confronting Commonwealth Countries

To discuss future trade strategy from a global point of view, having in mind the economic welfare and development of the world economy as a whole, it is as well to put the problem in perspective.1 The outstanding consideration is the sharp historical contrast between the world economic experience of the interwar years and that of the quarter-century which has elapsed since the end of World War n. The two decades between the first and second world wars were marked by an international monetary collapse, mass unemployment for nearly half that period, relatively slow economic growth, and virtual stagnation in most of the underdeveloped parts of the world. By contrast, the period since the end of World War n has been marked by the maintenance of high levels of employment without serious recessions, by rates of growth high by comparative historical standards, even in Britain which has grown relatively slowly compared with the rest of Europe, and by the diffusion of the process of economic growth and development, albeit haltingly, to areas of the world previously regarded as incorrigibly backward and stagnant. Such remarkable success in maintaining prosperity and promoting economic growth cannot plausibly be ascribed to any miraculous improvement in the techniques of economic management employed by governments. The evidence simply is not there. The most that can be said is that governments have not been foolish enough to precipitate or aggravate crises by inappropriate policies as happened after 1929. Instead the success

The neuropathology of ducky, a neurological mutation of the mouse

Ducky, a recessive autosomal mutation in mice, causes growth retardation, incoordination, excitability, seizures, and shortened lifespan. Neuropathological examination revealed dysgenesis of selective central nervous system regions. The most severely underdeveloped and deficient parts were the spinal cord, spinal ganglia and spinal nerves, the cerebellum and medulla oblongata. Among related structures the pons and trapezoid body, and dorsal root nuclei were greatly reduced in size, the degree of severity following this order. Also, there was Purkinje cell disease, characterized by deaths and losses, and axonal dystrophy and myelin deficiency were found in several fiber tracts, i.e., lateral lemniscus, and spinocerebellar, vestibulospinal and cerebellospinal tracts. Based on spino-medullo-cerebellar dysgenesis and consisting mainly of spinal and pontocerebellar hypoplasia combined with Purkinje cell atrophy, the symptoms in ducky could best be described collectively as a locomotor ataxia or dyskinesia. The seizure susceptibility was not explained.

VON THÜNEN AND URBAN SPRAWL

ABSTRACT In explaining agricultural patterns near urban areas, Von Thunen's theory is generally applicable where the primary force determining the pattern is transport cost to the market. When this is the case, the pattern of agricultural land use is one of decreasing intensity with distance from the city. Von Thunen's theory still applies in underdeveloped parts of the world, but his basic premise has been outdated in more developed areas. In many advanced industrialized parts of the world, the basic forces determining agricultural land use near urban areas are associated with urban expansion. Where these forces are in operation, the agricultural pattern quite often is one of increasing intensity with distance from the city, quite the reverse of the pattern generalized by Von Thunen's theory. A theory is developed to explain the agricultural pattern near such modern urban areas, and empirical evidence related to this theory is examined.

The effect of altitude on fertility in Andean countries

Abstract In papers previously published in this journal J. M. Stycos and D. M. Heer have shown that fertility is lower in the economically underdeveloped Indian-speaking parts of Peru, Ecuador and Bolivia than in the more prosperous Spanish-speaking parts. Stycos concluded that the reason for the fertility difference in Peru is the greater marital instability of the Indian speakers which decreased their total exposure to the risk of conception. Heer suggested instead that the causes of the difference may be voluntary. The present paper questions Heer's analysis, and offers the explanation that the difference may be attributed to the physiological effects of altitude.

Medical Care and Social Class in Latin America

Few services or commodities an individual may procure for himself or his family are as intimate and often critical as medical care. The way it is obtained involves not only decisions about money and judgments as to whether a given expenditure is worth the attainment of a certain degree of relief from pain or discomfort, but may be a matter of life or death. It is small wonder, therefore, that in any culture the pattern of procurement of medical care-both its financing and its scheme of provision-will vary with the social class of the person involved.l The class structure in Latin America and other economically underdeveloped parts of the world is more rigid, more sharply defined, than that in the mobile society of northern America. One need not hew strictly to a unidimensional definition of class-whether based on relationship to the means of production, educationaloccupational index, or status ranking-to recognize several different groupings of the population in Latin America, which differ in their standards of living, power, and relative claims on a nation's resources.2

Diabetes Mellitus in the Tropics

The author and his contributors have amassed a large amount of data concerning the problem of diabetes mellitus in the tropics. The number of tables are formidable but necessary to the author's purpose—a comprehensive survey of the frequency and problems of management of diabetes mellitus in those underdeveloped parts of the world which lie between the tropics of Cancer and Capricorn.This detailed study indicates that diabetes mellitus is increasing in frequency, probably because the Health Services are improving and the diagnosis made more frequently. The socio-economics of the countries surveyed are probably responsible for the problems of treatment; however, the principles of treatment are no different than in temperate climate. The relationship of obesity to diabetes is evident in the tropics as it is elsewhere.Among the many important observations made by the author two were of unusual interest.The one concerns the age of onset;namely, the early age of onset of maturity-type diabetes and the rarity with which diabetes develops in childhood and adolescence,the latter in spite of the fact that one third of the population is less than 15 years old.