Potential of a new laser target system for percutaneous CT-guided nerve blocks: technical note.

A prototype of a laser target device was used for CT-guided nerve blocks in a preliminary series of nine interventions. The system provides guidance from any possible approach. High accuracy of needle insertion was achieved; the average deviation of the planned from the actual angle was 1.4 degrees. The target device is valuable for facilitating minimally invasive therapy and can decrease the time required for the procedure.

Cool ground for aid providers: towards better security management in aid agencies.

Although full statistics are lacking, there is an impression that aid personnel are increasingly at risk from random, criminal and even at times targeted violence. The argument here is that the current tendency to reduce an agency's vulnerability mainly through the use of protective procedures and devices may be necessary but is insufficient. Better practice in the management of security is an urgent need. Reducing vulnerability to attack is only one approach; deterring the threat of violence by counter-threat, or seeking increased acceptance for the agency's work and presence are two other approaches. Major skill development is required in the areas of conflict analysis and monitoring, threat assessment and incident analysis, since together these form the basis for appropriate security management. Improved analysis can then inform a conscious choice about which mixture of approaches is most appropriate in a specific context. The paper explores in some detail the factors that influence acceptance, but not the methods and basic principles in the use of counter-threat.

Childhood Immunisation in Rural Afghanistan: The EPI Programme, 1987-91.

A decade of outright war followed by civil strife and conflict has hindered the development of health care services for the population of rural Afghanistan. Despite the absence of a functional health care system and the fragmentation of the Afghan resistance, and despite widely held views to the contrary, it has proved possible to set up a technically valid and politically acceptable Expanded Programme of Immunisation (EPI). This paper discusses some of its technical and programmatic aspects and the rationale behind some of the very unusual choices made - such as the use of DPTP, the inclusion of girls 3-14 years old for TT immunisation, a vertical programme structure and a predominance of mobile and outreach strategies. The paper argues against the mindless use of global or handbook recipes. The keys to success have been strategic vision, intimate knowledge of the local context and pragmatic choices for options that are simple and effective.