Improvement of diagnosis of malaria using an innovated LED Light box and microscopy in VanuatuA case report of the field trial and problems / 国際保健医療

 Malaria is a parasitic disease of major health significance that arrests the development of the tropical countries.We assembled an innovated LED light box for diagnosis of malaria, and examined for availability of the LED light box in the clinics of malaria endemic area in Solomon islands in the previous study. In the present study, we tried to use the LED light box for the practical use in the clinics with diagnostic service of malaria in Vanuatu (next country of Solomon Islands) for 1 year, and verified the availability and problems of the continual use of the LED light box.We identified the advantage of the use of LED light box in the diagnosis of malaria using microscopy. On the other hand, additional training of basic electricity is needed for microscopists who have little experience for electronics in the course of training of mictroscopists for the practical use of the LED light box.

EFFECTS OF THE BREATHING MODE CHARACTERIZED BY PROLONGED EXPIRATION ON RESPIRATORY AND CARDIOVASCULAR RESPONSES AND AUTONOMIC NERVOUS ACTIVITY DURING THE EXERCISE / 体力科学

<b>PURPOSE</b> : The purpose of this study was to clarify the effects of prolonged expiration (PE) on respiratory and cardiovascular responses and autonomic nervous activity during the exercise.<b>METHODS</b> : Twenty-five healthy men (22±1years) were classified according to the breathing mode during the exercise : 2-second inspiration and 4-second expiration in 1 : 2 group, 3-second inspiration and 3-second expiration in 1 : 1 group and normal breathing in control group. The 6-minute exercise was performed at anaerobic threshold (AT) and 60%AT using a cycle ergometer as an exercise protocol. Respiratory rate (RR) and tidal volume (TV) were measured by the expired gas analysis. The power of low- (LF) and high-frequency components (HF) was analyzed from a Holter electrocardiogram to assess the heart rate variability. <b>RESULTS</b> : RR and LF/HF were significantly lower, TV and HF were significantly higher during the exercise of 60%AT and AT in the 1 : 1 and 1 : 2 groups than in the control group (P<0.05 or P<0.01). The increase of HR was significantly lower and that of HF was significantly higher during the exercise at 60%AT in the 1 : 2 group than in the 1 : 1 group (P<0.05). <b>CONCLUSION</b> : PE activated the parasympathetic nervous activity and consequently restrained an excessive increase of HR during the exercise at 60%AT.

A Field Trial of an Educational Program for Malaria Study in Primary Schools of Solomon Islands Using an Innovated LED Light Box and Microscopy / 国際保健医療

 Malaria is a parasitic disease of major health significance that arrests the development of the tropical countries, and the developmental education on malaria for the local residents has crucial effects for the successful control of malaria. In the present study, we tried to innovate an effective education program for a community primary school in a malaria endemic area of Solomon islands. The integrated program was consisted mainly with practical exercises of the surveillance of mosquito larvae that transmit malaria parasites, identification of the species of mosquito larvae and the mapping of the breeding sites and the localization of the residence of village people under the cooperation of the local residents and teachers. We successfully established a risk map showing the approximate localization of <i>Anopheles</i> larvae that transmits malaria. An impressive observation of mosquito larvae was performed with microscope equipped with LED light box in the dark classroom without electric power equipments. Though no students have ever observed the mosquito larvae and few students have some knowledge for malaria, all students replied that they learned about malaria with a deep interest by the educational program. Thus, this educational program is shown to be promising for the health education in the schools of malaria endemic area.

Human Resource Development in International Medical Cooperation in the United Kingdom / 国際保健医療

Medical doctors in the United Kingdom who wish to work overseas have severe problems such as job security on return, childcare, and uncertain career due to lack of institutionalised career path in the field of international medical cooperation. The same applies in Japan. It is, however, different from Japan that media for job opportunities and career related information have been far developed.<br>Recently, Department of Health, the UK has started to encourage human resource development in the field, which hold out the hope to extricate from severe situation of human resources in the future.

An Assessment of the Effectiveness of Practical in Parasitology for Undergraduate Students Using the Results of Practical Examination / 医学教育

We assessed the effectiveness of practical instruction in parasitology for undergraduates at Jichi Medical School by examining grades on a practical examination. Two hundred six second-year medical students in 1997 and 1998 (103 students in each year) were enrolled in this study. The students took written and practical examinations at the end of the program. We found that grades on the practical examination were correlated with grades on the written examination (r=0.5664; p<0.001). The discrimination index ranged from 0.23 to 0.78. The percentage of correctly identified species was significantly higher when students studied live specimens than when they used other methods (p<0.0001 in both 1997 and 1998). The highest rates of correct identification (more than 90%) were for <I>Anisakis</I> species larvae and <I>Enterobius vermicularis</I> eggs in 1997 and for <I>Anisakis</I> species larvae, <I>E. vermicularis</I> eggs, and <I>Anopheles</I> mosquitoes in 1998. Results of neither written nor practical examinations differed significantly between students who chose biology at the entrance examination and those who did not. Our results suggest that undergraduates would gain a better understanding of parasitology by studying live specimens.