Social science & medicine. Part D, Medical geography最新文献

Following the discovery of Schistosomiusis mansoni on the island of Puerto Rico in 1904, studies based on fecal samples were done to determine the extent of the problem. By 1953 a Bilharzia Control Unit had been established within the Puerto Rico Department of Health and a snail control project was instituted in an attempt to disrupt the transmission cycle of the schistosome parasite. Considerable attention was given to the study of the ecologies of transmission foci in order to better understand the interrelationships among people, snails, and schistosomes. During the 1960s the useful but limited method of fecal sampling was replaced by the intradermal skin test using schistosome antigen. Three surveys using the intradermal test had been carried out by 1976. and they revealed a changing pattern in the prevalence of schistosomiasis on the island. The various control programs and social factors responsible for this shift are assessed in terms of their contributions to the total program of control. Unlike many other control programs, the Puerto Rican effort has not stressed chemotherapy but rather has relied on measures such as snail control, improvements in water supplies, and better sanitation. Since the initial intradermal test of 1963, prevalence of schistosomiasis has declined from 12% to approximately 5% in 1976. While undeniably successful, the continuance of snail control as a major factor in the total control program is questionable, as cost analyses indicate that new chemotherapeutic measures might do the job more quickly and cheaply than snail control.

Black-boned, black-skinned and black-meated chickens of many feather types and colors originated in Southeast Asia; the Southern Chinese, especially, used it in their folk medicine in ancient times. Many uses of this same Asiatic-type, melanotic chicken (BB-BMC) are currently shared by Mayan language groups in Latin America. The arbitrariness of the cures, most of which relate to illnesses considered to be induced by witchcraft, linked with a distinctive biological entity BB-BMC indicates that the assemblage of traits qualifies it as valid for testing the diffusion model. I have found that Amerinds in Mayan language groups possess many more of these folk medicine traits than Amerinds in other language and cultural groups. Away from the Mayan hearth in Guatemala, fewer Chinese like medicinal traits are found; but the fact that the intervening cultures effectively lack knowledge of cures with BB-BMC suggests presence of the cures prior to the dispersal and separation of Maya speakers. The BB-BMC's presence from the Mexican-U.S. border to Southern Chile indicates that the lack of folkloric medicine using BB-BMC is not associated with its absence but with the lack of a belief system related to it. Since belief systems of these types have to be carefully taught, a connection with the peoples of what is now Southern China or Southeast Asia was likely in pre-Columbian times. Certainly the early Iberians with their fear of the Inquisition and of becoming bewitched on board ships would not have allowed BB-BMCs and curers on their vessels. They had to have arrived earlier from Asia, since chickens were given as gifts to Spaniards by the 1520s–1540s on contact in several places in North and South America.

Subjective evaluations of alternative general hospitals, by residents of a lower socioeconomic status community in Porto Alegre, Brazil, are analyzed to explain hospital selection. The study is based on consumer spatial behavior research in geography. Thirty-six hospital attributes are identified through a triadic procedure applied to residents in their homes. Subsequently, the seven hospitals most widely known by the community are evaluated, using the elicited attributes and a one-to-seven scale, by all members of three random stratified samples of approximately 45 people each. Four similar important dimensions of hospital differentiation and evaluation are identified through the use of J. Douglas Carroll's INDSCAL model. A clear pattern of perceived relative utility of alternative hospitals, based on the four dimensions, is exhibited by the residents. However, utilization among alternative hospitals is found to be negatively correlated with expressed preferences. The power of community residents to choose is significantly limited through institutional and cultural, rather than financial, constraints. Community residents use hospitals of perceived lower ‘quality’ rather than more proximate, perceived higher ‘quality’ hospitals.

A discriminant-function analysis was applied to the set of 169 cases introducing variola minor into the corresponding households during the 1956 epidemic occurring in the capital city of Braganca Paulista County, Brazil. The analysis was aimed at discovering how well the four groups of households whose introductory cases were either an adult, a JT-school pupil, a JG-school pupil or a preschooler could be distinguished on the basis of six selected variables: (1, 2) relative location (x,y coordinates of the dwelling): (3) time (in days) from onset of the first case of the epidemic; (4) whether vaccinated or not; (5) total susceptible population in the household, and (6) distance from the residence of an introductory case to the residences of the case which started the chain. Prior allocation of introductory cases to school-attendance status groups was justified since discriminant-function analysis was able to distinguish among the four groups.

Cluster analysis was applied to the same data, in order to partition the cases into as homogeneous groups as possible, regardless of their actual status as pupils, adults or preschoolers. The results suggest that the simple division of cases by school-attendance status, while significant, was probably not the most meaningful. A cluster analysis was further applied to cases (excluding those from two schools), using only three variables: (1, 2) relative location and (2) time from onset. This analysis proved useful as a means of identifying many of the real subchains of contagion.

As Latin American countries attempt to expand their health care delivery systems, they face severe economic constraints, rapidly growing and urbanizing populations, widespread social disruption, and environmental degradation. The World Health Organization has established the goal of “health for all by the year 2000”. As who's Regional Office for the Americas, the Pan American Health Organization is charged with fostering efforts towards this goal within the Americas. PAHO is increasingly emphasizing a multi-disciplinary approach. One product of this is the new Center for Human Ecology and Health.

An analysis of published data on causes of mortality for six age groups in the Departments of Caldas, Quindío and Risaralda, Colombia, shows that prior to age 45 most deaths are from causes susceptible to public health programmes. However, improvements in sanitation and in the control of infectious diseases will be beneficial mainly to children and the elderly. To reduce the high death rate among young adults, social and economic measures are needed. Shortages of medical personnel are reflected in a high proportion of deaths without prior medical attention and also in inaccurate recording of causes of death. Social security improvements help those who are covered but have a negative effect on those outside the system.

It has been thought that throughout the South American tropical lowlands sources of vegetable protein such as maize and beans have been unimportant to the subsistence economies of Amerindian cultures. Such cultures subsist upon a binary economic system based on cultivated carbohydrates and protein obtained from hunting and fishing. This model is called into question by evidence from fieldwork carried out among the Macusi Indians of northern Amazonia. The Macusi depend on maize, beans, and other vegetable proteins during the rainy season when water levels are high and fishing is unproductive. For the Macusi and many other riverine groups, fishing heavily outweighs hunting as an animal protein source. In an examination of several cultures in the South American tropical lowlands, it is found that vegetable proteins enter the diet during the rainy season. Wet season vegetable protein use may represent a selective adoption of maize and other Mesoamerican crops by tropical lowland groups, who use them to overcome seasonal scarcities of animal protein. Interpretations of the culture history of the South American tropical lowlands assuming an unimportant role for maize and other vegetable protein sources are challenged. The diversity of environments suitable for maize cultivation in the tropical lowlands of South America is stressed, along with the complex patterns of human adaptation to the tropical environment

Schistosomiasis, one of the most widespread parasitic diseases in the world, is increasing in incidence and prevalence. This increase has been linked to agricultural and water resource development programs. The primary purpose of this research is to examine the conditions which permit the disease to be transmitted within a new focus, Pentecoste, Ceará, Brazil.

Information provided in patients' dockets at two hospitals in Kingston, Jamaica, was used to analyze the spatial distribution of undernutrition in the Kingston/St Andrew Metropolitan Area. Simple and stepwise multiple regression models were utilized incorporating measures of standard of living, infant feeding practices, family stability, unemployment of mothers, family size and age of mothers. Unemployment of mothers proved to be by far the most important variable, accounting for 87% of the variation. All others were relatively unimportant.