Making strides towards better mental health care in Peru: Results from a primary care mental health training.

Our program attempted to improve attitudes and confidence of Peruvian primary care physicians (PCPs) providing mental health care. The training program underwent an evaluation to determine impact of sustained confidence in performing medical and psychiatric procedures, and application of learned skills. Fifty-two Peruvian primary care practitioners were trained at the Harvard Program in Refugee Trauma (HPRT) over a two-week period. There was significant improvement in PCPs' confidence levels of performing psychiatric procedures (counseling, prescribing medications, psychiatric diagnosis, assessing the risk for violence, and treating trauma victims) when comparing baseline and post-two-week to one year follow-up. When comparing post-two-week and one-year follow-up quantitative measures, confidences levels went slightly down. This may be an implication that the frequency of trainings and supervisions are needed more frequently. In contrast, qualitative responses from the one-year follow-up revealed increase in victims of violence clinical care, advocacy, awareness, education, training, policy changes, accessibility of care, and sustainment of diagnostic tools. This study supports the feasibility of training PCP's in a culturally effective manner with sustainability over time.

Measurements of fusion reactions of low-intensity radioactive carbon beams on 12C and their implications for the understanding of X-ray bursts.

The interaction between neutron-rich nuclei plays an important role for understanding the reaction mechanism of the fusion process as well as for the energy production through pycnonuclear reactions in the crust of neutron stars. We have performed the first measurements of the total fusion cross sections in the systems (10,14,15)C+(12)C using a new active target-detector system. In the energy region accessible with existing radioactive beams, a good agreement between the experimental and theoretical cross sections is observed. This gives confidence in our ability to calculate fusion cross sections for systems which are outside the range of today's radioactive beam facilities.

Adsorption of a Hard Sphere Fluid in a Disordered Polymerized Matrix: Application of the Replica Ornstein-Zernike Equations

A model of hard spheres adsorbed in disordered porous media is studied using the associative replica Ornstein-Zernike (ROZ) equations. Extending previous studies of adsorption in a hard sphere matrices, we investigate a polymerized matrix. We consider an associating fluid of hard spheres with two intracore attractive sites per particle; consequently chains consisting of overlapping hard spheres can be formed due to the chemical association. This is the generalization of the model with sites on the surface of Wertheim that has been studied in the bulk by Chang and Sandler. The matrix structure is obtained in the polymer Percus-Yevick approximation. We solve the ROZ equations in the associative hypernetted chain approximation. The pair distribution functions, the fluid compressibility, the equation of state and chemical potential of the adsorbed fluid are obtained and discussed. It is shown that the adsorption of a hard sphere fluid in a matrix at given density, but consisting of longer chains of overlapping hard spheres, is higher than the adsorption of this fluid in a hard sphere matrix.

[Health priorities: problems to resolve and new challenges]. / Prioridades de salud: problemas por resolver y nuevos retos.

In the last 25 years we have witnessed revolutionary changes in the field of health, particularly in the low and middle income countries. This paper discusses some of the new problems which need to be solved and some of the challenges which lie ahead. Among the former we can mention the financing of health care services and the provision of health care to an aging population. Among the latter we include the need for improvement of the quality of health services and the training of appropriate health manpower.

La evaluación en los programas de vacunación / Evaluation and its role in vaccination programs

In evaluating vaccination porgrams it should be borne in mind that planning and evauation are inseparably linked and that specific objectives must be clearly defined from the inception of the program, for without them evaluation will have little meaning. The principal task of evaluation is to determine whether or not an immunization program has succeeded in reducing the incidence of the disease in question, which requires the continuing surveillance of the status of the disease. That procedure may be termed "primary evaluation" and should be followed by a "secondary evaluation" consisting of certain procedures designed to check results

Among secondary evaluation procedures, the following are the most critical: 1) vaccine efficacy, which should be verified beyond any doubt before its application; 2) vaccine coverage, which related the principal objective of the program and requires the establishment of a reliable checking system; and 3) surveillance system, which includes such important evaluation aspects as a check of the number of cases reported, and of the promptness and frequency with which control measures are taken

Further evaluation procedures are the cost-benefit analysis, and the establishment of a reporting system of minimum information required for evaluation. It is pointed out, however, that in checking and comparing results there is no substitute for personal observation in ... (AU)