Malnutrition and morbidity among children not reached by the national vitamin A capsule programme in urban slum areas of Indonesia.

OBJECTIVE: To determine whether vitamin A capsule programmes fail to reach children who are at higher risk of malnutrition and morbidity. Although it has been suggested that there are health disparities between children who are reached or not reached by these programmes, little quantitative work has been undertaken to characterize this relationship. STUDY DESIGN: As part of a national surveillance system, nutritional status and other factors were compared in 138,956 children, aged 12-59 months, who had and had not received vitamin A supplementation in urban slum areas in Indonesia. RESULTS: In total, 63.1% of children had received a vitamin A capsule within the previous 6 months. Among children who had and had not received vitamin A supplementation, respectively, the proportion with weight-for-age and height-for-age Z scores <-3 were 7.8% vs 8.6% (P<0.0001) and 9.4% vs 10.7% (P<0.0001), and with a history of diarrhoea in the previous week was 8.1% vs 10.7% (P<0.0001). In families where a child had or had not received vitamin A supplementation, the proportion with a history of infant death <12 months was 5.2% vs 7.2% (P<0.0001) and child death <5 years was 6.7% vs 9.2%, respectively (P<0.0001). Children who had not received vitamin A supplementation were also significantly more likely to be anaemic and have diarrhoea or fever on the survey day compared with children who had received supplementation. CONCLUSIONS: In the urban slums of Indonesia, children who do not receive vitamin A supplementation tend to be slightly more malnourished and ill, and are more likely to come from families with higher child mortality than children who receive vitamin A. Higher rates of child mortality in non-participating households suggest that reaching preschoolers could yield a disproportionate survival benefit. Importantly, children who are not reached by the vitamin A programme are also unlikely to be reached by vaccination and other services, emphasizing the need to identify and extend efforts to reach non-participants.

Return rates and partner notification in HIV-positive men seeking anonymous versus confidential antibody testing.

This study investigated whether HIV-positive men who seek confidential versus anonymous HIV counseling and testing differ in demographic variables, risk behaviors, return rates for posttest appointments, and agreement to partner notification. chi 2 tests were not statistically significant for return rates for post-test appointments or partner notification between the two groups. HIV-positive individuals in the confidential groups were more likely to utilize medical and follow-up services than those in the anonymous group. Anonymous and confidential counseling and testing both appear to achieve the public health objectives of HIV case finding and referral. Hypotheses are offered regarding what may be a progression of testing behaviors (i.e., from anonymous to confidential) with suggestions for future research are suggested.

Construct validity of the computerized version of the Category Test.

The purpose of the current study was to investigate the construct validity of the computer version of the Category Test (CT) in relation to the standard version. As part of a comprehensive neuropsychological assessment, outpatient rehabilitation clients completed either the standard CT (n = 49) or the computerized version (n = 56). Two principal component factor analyses were performed and the factor structures compared to a solution reported previously in the literature. Inspection of the factor loadings revealed a similarity between the computerized CT and standard CT groups as well as with the previously reported analysis. The results of this study suggest that regardless of the mode of administration the CT loads on a "spatial abilities", factor and provides support for the construct validity of the computerized CT as part of a comprehensive neuropsychological testing battery.

Characteristics of individuals using different HIV/AIDS counseling and testing programs.

OBJECTIVE: To describe clinically important differences in the characteristics of subjects using three distinct HIV counseling and testing settings: scheduled confidential, scheduled anonymous, and confidential walk-in. DESIGN: An HIV risk-assessment questionnaire was given to individuals prior to receiving HIV-antibody testing and counseling. METHODS: Demographic and behavioral data was analyzed for each of the three counseling and testing settings. RESULTS: Walk-in clinic subjects reported fewer high-risk sexual activities and other risk behaviors than subjects from the other two testing settings. They also included more individuals who were health-care workers and victims of sexual assault. CONCLUSIONS: The three distinct HIV counseling and testing settings each attracted populations with varying degrees of potential for HIV transmission. The results emphasize the importance of maintaining multiple approaches to HIV counseling and testing in order to reach increasingly diverse at-risk populations.

Effects of new 4-aminopyridine derivatives on neuromuscular transmission and on smooth muscle contractility.

The effects of new 4-aminopyridine (4-AP) derivatives were investigated in the isolated mouse phrenic nerve-hemidiaphragm preparation under single impulse stimulation and tetanic conditions. The basic 4-AP structure was modified in position 3 on the pyridine nucleus by introducing different substituents. Results were compared to those obtained with 4-AP and 3,4-diaminopyridine. The compounds were tested for their antagonistic effect against calcium antagonists and botulinum toxin A. The effect on smooth muscle was investigated on the isolated guinea-pig ileum. Physico-chemical parameters of the test compounds were determined by the partition coefficient and ionization constant. Finally structure-activity relationship analysis revealed that the activity was highly related to lipophilicity and the steric volume. So far 4-AP itself provided the most advantageous molecular structure.

Distribution of the 4-aminopyridine derivative 3-methoxy-4-aminopyridine in mice.

The tissue distribution of [14C]3-Methoxy-4-aminopyridine was studied after intravenous administration in mice using whole body and microautoradiography. Dense accumulation was found in cholinergically innervated, secretory organs. High radioactivity was detected in the adrenal medulla suggesting that the observed excitement and hyperglycemia are due to the stimulation of catecholamine secretion. [14C]3-Methoxy-4-aminopyridine quickly passes the blood brain barrier and predominantly accumulates in the hippocampus, the thalamic nuclei and the cortex.