The Primary Care Spend Model: a systems approach to measuring investment in primary care.

Increased investment in primary care is associated with lower healthcare costs and improved population health. The allocation of scarce resources should be driven by robust models that adequately describe primary care activities and spending within a health system, and allow comparisons within and across health systems. However, disparate definitions result in wide variations in estimates of spending on primary care. We propose a new model that allows for a dynamic assessment of primary care spending (PC Spend) within the context of a system's total healthcare budget. The model articulates varied definitions of primary care through a tiered structure which includes overall spending on primary care services, spending on services delivered by primary care professionals and spending delivered by providers that can be characterised by the '4Cs' (first contact, continuous, comprehensive and coordinated care). This unifying framework allows a more refined description of services to be included in any estimate of primary care spend and also supports measurement of primary care spending across nations of varying economic development, accommodating data limitations and international health system differences. It provides a goal for best accounting while also offering guidance, comparability and assessments of how primary care expenditures are associated with outcomes. Such a framework facilitates comparison through the creation of standard definitions and terms, and it also has the potential to foster new areas of research that facilitate robust policy analysis at the national and international levels.

Magnetic nanoparticle labeling of astrocytes derived for neural transplantation.

Astrocytes are a major transplant cell population to promote neural repair in a range of pathological conditions. In this context, the development of robust methods to label neural transplant populations (for subsequent detection and cell tracking in vivo) is key for translational applications. Magnetic iron oxide nanoparticles (MNP)-based vector systems offer a range of advantages for neural cell transplantation, notably, as contrast agents for magnetic resonance imaging, which allows for MNP-labeled cells to be detected using minimally invasive methods. Additionally, MNPs have other key features such as safety, the potential for linking with genetic material/drugs, and magnetic cell targeting. Therefore, MNPs can potentially be developed as a multipurpose nanoplatform for neural cell transplantation. The feasibility of labeling astrocytes derived for transplantation with MNPs has not been assessed to date. Here, we have established simple protocols to safely label astrocytes with MNPs; the survival and differentiation of labeled cells was assessed in three dimensional neural tissue arrays. Additionally, we have established the major mechanisms of MNP uptake by astrocytes.

Development of a clockwork light source to enable cervical inspection by village health workers.

BACKGROUND: Cervical cancer can often be prevented by screening and may be curable if identified and treated in its early stages. However, 80% of new cases occur in less-developed countries where cervical cancer screening programmes are small-scale or non-existent. This is a human tragedy of great proportion, with many of those affected being young mothers. There is some evidence that cancerous or precancerous lesions may be detected by visual inspection with acetic acid (VIA) and field studies indicate that this technique is effective, safe and acceptable to women. However, the provision of a light source for inspection of the cervix presents a major problem in less-developed countries, where candles and torches often provide the only means of illumination. Our objective was to develop a light source based on clockwork technology, that required no batteries or external power source. METHODS: We adapted the design of a commercially available clockwork torch to provide a light source for cervical inspection. The light source was then tested under laboratory conditions in a comparison with other illumination methods typically used in this application. RESULTS: The light source gave illuminance levels greater than those produced by any other method tested, and also had considerable advantages in terms of ease of use and safety. CONCLUSION: This design is small, compact, effective and safe to use and promises a better and more affordable means of visualising the cervix. Further field trials of VIA are now required which incorporate this light source.