Healthcare professionals' experience of teenage pregnancy and motherhood in Haiti

OBJECTIVES

The aim of this study was to explore healthcare professionals' experience of pregnant and motherhood in adolescence in Haiti.

METHODS

The methodology for collecting and analyzing qualitative data was based on John Dewey's social survey. The study was conducted in nine health institutions in the North and North-East departments of Haiti from October 2020 to January 2021. Data were collected through individual semi-structured interviews with 15 healthcare professionals. All interviews were audio-recorded. The recordings were listened to carefully and transcribed in verbatim form. After checking and validation, the verbatims in Word format were exported to QDA Miner software version 6.0.5 for coding. The data were analyzed using Paillé and Mucchielli thematic analyses.

RESULTS

Health professionals such as gynecologists, nurses, midwives, nursing assistants, matrons and health workers took part in the study. These study participants indicate that teenage pregnancy and motherhood are social and public health problems whose negative consequences affect teenage girls, children, healthcare professionals, the healthcare system, and Haitian society in general. The services offered to adolescent girls are medical, educational, psychological, economic, and social in nature. When caring for pregnant adolescents during the transition to motherhood, healthcare professionals face many challenges that are linked to the socio-economic status and physiological reality of adolescents, as well as the healthcare system.

CONCLUSIONS

Programs involving home care visits should also be set up to offer ongoing support to pregnant or parenting teenagers. The distribution of food aid or materials such as clothing, hygiene products and baby kits should also be considered.

Vulnerability analysis of Haitian adolescent girls before pregnancy: a qualitative study

OBJECTIVES

This article aims to analyze the vulnerabilities experienced by Haitian adolescent girls before their pregnancy.

METHODS

A qualitative research design was developed from Dewey's social survey. From October 2020 to January 2021, semi-structured interviews were conducted with 33 pregnant adolescents living in Haiti's North and North-East departments. Thematic data analysis was performed using the qualitative data analysis software QDA miner, 6.0.5.

RESULTS

The adolescent girls interviewed were between 14 and 19. The study showed that adolescent girls experienced economic and social hardship, gender issues, and barriers to contraceptive use before pregnancy. These girls have experienced restrictive conditions that make them vulnerable to risky sexual practices and unwanted pregnancy.

CONCLUSIONS

The results have indicated that Haitian adolescent girls' vulnerabilities before their pregnancy result from economic, social, and cultural injustices to which they are exposed from early childhood. These adolescent girls are also highly vulnerable to sexual exploitation and rape, as well as pregnancy. It is essential to address these issues when implementing programs aimed at improving the living conditions of adolescents in Haiti, including the prevention of early and unwanted pregnancy.

The Case for Space Sexology

Space poses significant challenges for human intimacy and sexuality. Life in space habitats during long-term travel, exploration, or settlement may: detrimentally impact the sexual and reproductive functions of astronauts, restrict privacy and access to intimate partners, impose hygiene protocols and abstinence policies, and heighten risks of interpersonal conflicts and sexual violence. Together, this may jeopardize the health and well-being of space inhabitants, crew performance, and mission success. Yet, little attention has been given to the sexological issues of human life in space. This situation is untenable considering our upcoming space missions and expansion. It is time for space organizations to embrace a new discipline, space sexology: the scientific study of extraterrestrial intimacy and sexuality. To make this case, we draw attention to the lack of research on space intimacy and sexuality; discuss the risks and benefits of extraterrestrial eroticism; and propose an initial biopsychosocial framework to envision a broad, collaborative scientific agenda on space sexology. We also underline key anticipated challenges faced by this innovative field and suggest paths to solutions. We conclude that space programs and exploration require a new perspective - one that holistically addresses the intimate and sexual needs of humans - in our pursuit of a spacefaring civilization.

[French translation, cultural adaptation and assessment of preliminary psychometric properties of the Protective Behavioral Strategies for Marijuana Scale]

OBJECTIVE

Young adults (18- to 24-year-olds) constitute the age group with the highest proportion of cannabis users. In the context of legalization, it is important to promote lower-risk cannabis use. The Protective Behavioral Strategies for Marijuana Scale (PBSM-17) identifies strategies used by consumers. However, this scale is not available in French and is not adapted to the Canadian context. This article presents the process that led to the translation, cultural adaptation and evaluation of the preliminary psychometric properties of PBSM-17.

METHOD

The methodological study was carried out in six steps. The first four steps led to the translation towards French and adaptation of the scale. A validation among 12 young people contributed to establish the criterion equivalency (step 5). The evaluation of psychometric properties (step 6) was carried out among 211 bilingual university students (61 % women; mean age 22 years old).

RESULTS

The French version presents satisfactory preliminary psychometric properties: internal consistency is acceptable (α = 0.88); criterion equivalency was established between the French and the original English version (t (210) = 1.04, p = 0.30; 95% CI [-0.20, 0.63]). The scores obtained on both versions by the same participant were found to be strongly correlated (r = 0.95, p <0.001).

CONCLUSION

The results support the use of the French version of PBSM-17. The proposed protective strategies can be used as a measurement tool and represent behaviors that can be targeted in a lower-risk cannabis use context.

[Intersectionality to better understand women's health issues]

Intersectionality, a theory for understanding women's health issue. Intersectionality offers the possibility of holistic analyzes to understand and act on women's health issue. It facilitates the exploration of the different dimensions of social inequalities in health, which are both at the level of institutions and of the individual experiences of people who live at the intersection of multiple dimensions of domination and power.

Psychometric properties of the French and English short form of the Protective Behavioural Strategies for Marijuana Scale in Canadian university students

BACKGROUND

The Protective Behavioural Strategies for Marijuana (PBSM-17) scale serves to identify and measure strategies employed by young adults before, during or after cannabis use. After the adaptation and translation of the PBSM-17 into French, a methodological study was conducted to evaluate the psychometric properties of this French version (FV) and of the original English version (EV) in a sample of bilingual Canadian university students.

METHODS

A total of 211 cannabis users (mean age=22.1 years) completed a sociodemographic questionnaire, a question on frequency of cannabis use (four categories: 1-3 times a month, once a week, more than once a week, everyday) and both versions (FV and EV) of the PBSM-17.

RESULTS

Both versions had similar internal reliability (α=0.91; α=0.88). The one-factor solution explained 36.46% of the variance for the FV and 42.26% for the EV. As hypothesised, greater use of protective behavioural strategies was related to lower frequency of cannabis use. One-way ANOVA test results revealed a statistically significant difference in use of strategies by frequency of cannabis use for both the FV (F(3, 207)=27.38, p<0.001) and EV (F(3, 207)=29.32, p<0.001). Post hoc comparisons showed that everyday users employed fewer strategies on average than lower-frequency users.

CONCLUSION

The FV and EV of the PBSM-17 demonstrated satisfactory psychometric properties. The proposed FV of the PBSM-17 is a reliable instrument that could be used for research and clinical purposes. Protective behavioural strategies can serve as indicator of lower-risk cannabis use and could be targeted in prevention interventions.

Vulnerabilities and Strengths of Pregnant Haitian Adolescents and their Families During Transition to Motherhood

BACKGROUND AND OBJECTIVE

Teenage pregnancy is considered a social and health problem because of its multifaceted consequences for pregnant teens, their family and society. The objectives of this article are 1) to describe the vulnerabilities encountered by pregnant teenagers and their relatives throughout the time of transition from pregnancy to motherhood and 2) to identify the strengths that are mobilized by these individuals during this period.

METHODS

The qualitative data collection and analysis methodology was based on John Dewey's Social Inquiry. Participants were recruited from nine health institutions in the North and Northeast departments of Haiti. Data were collected through individual semi-structured interviews, which were audiotaped, transcribed, and exported for coding after verification and validation. The data were analyzed using the thematic analysis of Paillé and Mucchielli.

RESULTS

A total of 50 interviews were conducted with 33 pregnant teenagers (aged 14 - 19 years) and 17 relatives. This research identified vulnerabilities and strengths experienced by the adolescent participants and their relatives during the motherhood transition.

CONCLUSION AND GLOBAL HEALTH IMPLICATIONS

The experiences, challenges, and vulnerabilities associated with the teenage-motherhood transition and the needs of pregnant teens, partners, and parents were identified in this study. The results indicated that more attention must be given to psychosocial and material support programs for pregnant adolescents and their loved ones during the motherhood transition and after-childbirth period. When logically and effectively implemented, the study results and suggested recommendations can be used as tools for reaching local and global public-health initiatives in Haiti.

Télésanté en contexte de pandémie et de déconfinement : pratiques infirmières innovantes et partenariats pour des communautés équitables, sécuritaires et durables

La télésanté connait un essor fulgurant en ce contexte de pandémie. Or, en cette période d’insécurité mondiale, la santé préventive reprend ses droits. En période de déconfinement, la discipline et la cohésion sociale peuvent se relâcher. Cette enquête sociale vise à décrire un programme d'intervention à distance, réalisé en partenariat avec des locataires de logement communautaire, des infirmières et des étudiantes pour soutenir la littératie en santé au temps de la COVID-19. Le Programme de déconfinement en toute sécurité vise à renforcer les mesures préventives et de soutien avec des groupes en contexte de vulnérabilités économiques et sociales à l’aide de la télésanté. Les infirmières ont développé des pratiques cliniques et psychosociales et renforcé la littératie en santé, soutenant les mesures de santé publique post-COVID-19, surveillant l’éclosion de nouveaux foyers et apaisant les souffrances issues du confinement. À l’aide de cibles de performance des systèmes de santé et d’une perspective de justice sociale, nous avons documenté les défis, les leviers et les menaces à l’usage des pratiques à distance en prévention. Vecteur d’une approche intégrée, la télésanté préventive peut cibler simultanément, la lutte contre les maladies non transmissibles et transmissibles et les inégalités. La pandémie de COVID-19 renvoie à un nouvel équilibre des enjeux qui exige un accompagnement et des pratiques de santé communautaire engagées et critiques.

Primary Healthcare management strategies in socially vulnerable territories exposed to violence

OBJECTIVE

To identify management strategies used by the Family Health Strategy teams of a Basic Health Unit in organizing work in socially vulnerable territories exposed to violence.

METHOD

A single case study with a qualitative approach in a family health unit located in the southern region of Brazil. Data collection was conducted through individual interviews with 27 health professionals from August to September 2017 and a focus group with 18 participants in April 2018. Data organization and processing was performed with the support of the IRAMUTEQ software program and subsequently the content analysis technique.

RESULTS

The five classes characterized strategies used by professionals to provide care to the population considering their experience in facing violent situations. A guideline was developed and validated in the focus group to guide the management and organization of work in these services.

CONCLUSION

It was evidenced that professionals develop strategies which include strengthening the team as a form of collective protection, welcoming focused on comprehensive care and bonding, even without the support of specific public policies for these situations. The population is allied to facilitate access to care for vulnerable people and alerts professionals to critical situations in the territory.

Perceived outcomes and SWOT analysis of a virtual community of practice in Burkina Faso

Background

In Burkina Faso, maternity is a risk. Global Affairs Canada funded the initiative PASME-2 with World University Service of Canada, Laval University and Farm Radio International to improve maternal outcomes. A preventative program was co-developed in phases. Phase 3 received funding from Social Sciences and Humanities Research Council in partnership with the Centre for International Cooperation in Health and Development (CCISD) and TIESS, a liaison and transfer expert in Québec, to support local teams towards sustainable practice changes. This research aimed at documenting the partnership experience, digital literacy, perceived direct and indirect outcomes.

Methods

A participative co-design approach, allowed the engagement of several stakeholders in the process. Two active phases where 16 health professionals engaged actively in the VCoP, according to the final agreed-upon Constitutional Chart, are presented. The phases pilot-tested two different technology tools.

Results

16 interviews post-phase 1 and 16 interviews post-phase 2 were conducted. Implementation issues as perceived by users are discussed and include: feasibility, challenges, needs, animation, relevance to care, communication and sharing, use and perspectives. Perceived outcomes focus on professional preventative practice changes, skills, family outcomes, challenges to practice integration, knowledge and practice exchanges.

Conclusions

The phases of experimentation demonstrate that strategies can be put in place to counter the digital literacy challenges and to engage users in new ways of communicating, sharing on the platform about health practices and taking valuable time to do it. Overcoming technology constraints is essential especially in lower resource settings. The most practical life experiences and cases lead to more engagement and innovations. Support from management and upper directorate is significant.

Key messages

Partnership from several stakeholders is key to implementing a VCoP. Experimenting and sharing solutions is influenced by the capacitating environment that the VCoP can provide with recognition from administration and as a professional development activity.

Co-designing a virtual community of practice (VCoP) for maternal and child health in Burkina Faso

Background

In Burkina Faso, maternity is a risk. Global Affairs Canada funded the initiative PASME-2 with World University Service of Canada, Laval University and Farm Radio International to improve maternal outcomes. A preventative program was co-developed. Phase 1 included to train the Health Ministry training coordinators. Phase 2 related to the training of nearly 100 health professionals. Phase 3 received funding from Social Sciences and Humanities Research Council in partnership with the Centre for International Cooperation in Health and Development and TIESS, a liaison and transfer expert in Québec, to support local teams towards sustainable practice changes.

Results

On the first objective, to describe the co-development of this living lab are presented. We share our perspective of the co-designing challenges, tools, and solutions. We will demonstrate the VCoP platform and environment. Method. A participative co-design approach, allowed the engagement of several stakeholders in the process. Results. Four workshops were organised. Seventeen maternal and child care health professionals took part in the initial 8-month development phase.

Results

Four steps of the six phases of Gusche innovation design are presented with associated products and results. Implementation challenges, critical decisions, role of face-to-face meetings, technology factors, digital literacy and solutions are presented.

Conclusions

Implementing a technology innovation in low income setting with limited access to the web and to technologies is a challenge. Its advantages are greater: access to evidenced-base care, facilitating professional development, creating a safe space and leading to emerging problem-solving collective solutions. Conceived as a capacitating environment (Sen) and supporting strength-based (Gottlieb) care through partnership, this VCoP becomes a driver of action to maintain preventative health competence and to share experiences and ways of knowing.

Key messages

The digital space crosses the borders and can contribute to human development and expansion of safe, evidenced-based and culturally appropriate professional practices. Working in partnerships, interprofessional and intersectoral, with public and community groups can create synergies that will unfold in greater health equity.

Community-based health agents practices in Burkina Faso

Background

It is estimated that around 25% of the world's infant mortality is in West Africa where undernutrition accounts for more than 50% of the underlying causes of under-5 mortality. Malnutrition rates have decreased slightly, especially compared to the targets set for 2025. Since Alma-Ata's declaration in 1978, community participation in primary health care has been one way of reducing health inequalities. WHO recommended the integration of community health workers (CHW) into the health system and their inclusion in the human resources planning strategy. We observed a decline of programs involving CHW in the 1990s, then a definite revaluation since the 1990s and specifically, since 2012. They provide health education, as well as referral for a range of services, and provide support and assistance to communities and families through preventive health, easier access to curative health services as well as social services. The specific objectives of this project include: to describe the roles and functions of CHW in Burkina Faso, to identify the workers' needs, to explore the changes in the system and to identify the conditions related to their deployment.

Methods

A qualitative case study allowed to describe the processes and also facilitated the discovery of key elements related to the experiences of community agents, considering the elements of complexity and context.

Results

Our results include activities in promotional services, preventive services, curative services and health data management. In addition, we will shed light on their feelings and experiences related to integration into the system, on the strategies they use, on the advantages that bring their role as community workers, their concerns and finally, we will share their perception of their impact. Some recommendations are proposed in regards to training and supervision.

Key messages

CHW are major players in health systems by creating a bridge between health and social service providers and communities with reduced access. CHW contributes to social justice by facilitating access, promoting recognition and creating empowering processes through increased participation.

Liaison nurse activities at hospital discharge: a strategy for continuity of care

Objective

to describe the activities developed by the liaison nurses for the continuity of care after hospital discharge.

Method

descriptive, qualitative study, based on the theoretical reference. Strength Based Care. The sample comprised 23 liaison nurses. The data was collected through a semi-structured questionnaire via Survey Monkey electronic platform and analyzed through the content analysis technique, with pre-defined categories.

Results

among the liaison nurses, nine (39.14%), between 35 and 44 years of age; 17 (73.91%) were female; 15 (65.22%) were working eleven years or more nurse and 11 (47.82%), were between six and ten years old as a liaison nurse. The professionals participate in the identification of the patients who need care after hospital discharge, coordinate the planning of the hospital discharge and transfer the patient’s information to an extra-hospital service.

Conclusion

the activities developed by the liaison nurses focus on the needs of the patient and the articulation with the extra-hospital services, and can be adapted to the Brazilian context as a strategy to minimize the discontinuity of care at the time of hospital discharge.

[Knowledge transfer and appropriation processes of nursing students and African settings of care: a multiple case study]

BACKGROUND

in this era of globalisation and international academic training, many nursing programs offer the possibility of intercultural placement to their students in their initial training. The rise of this phenomena is ubiquitous throughout all Canadian universities, leading to increased student mobility at the international level with increased placements being organised at the international level, on several continents.

PURPOSE

this exploratory study aims at better understanding the processes of knowledge transfer and appropriation during international and intercultural placements in nursing in African countries.

FRAMEWORK

the models of empowerment and the Cycle of knowledge to practice have guided this study.

METHOD

a multiple case study has been conducted with six settings of care from two countries of Africa. Individual interviews were conducted with the nursing students (n = 11) and with the African nurses supervisors (n = 9), and group interviews with the local partners (n = 2). Direct and participant observations were also done by the nursing students while they were in Africa in the summer and by the two principal investigators when they spent a week in the settings of care, the following fall. RESULTS : advantages of this learning activity were noted, especially in regards to personal and professional growth of the nursing students and in regards to knowledge transfer to the host settings. DISCUSSION : four themes emerged and led to recommendations as to the importance of: 1) bidirectional communication, continuity of projects between cohorts of nurses, and support at distance and on site, 2) reinforcement of the emancipatory sociopolitical knowing 3) diversity of care and community sites and expositions, and 4) different phases of the Cycle of knowledge to practice.

Avaliação de um programa de acompanhamento pré-natal em meio carente

A medicina tradicional e os programas em saúde pública não conseguiraram prevenir as conseqüências desfavoráveis da gravidez de alto risco em mulheres carentes. O objetivo desta pesquisa é descrever e avaliar o processo de emancipação de um grupo de gestantes carentes, de um grupo de mães da mesma comunidade e de profissionais da saúde que participam de um programa de acompanhamento pré-natal. Análises qualitativas de entrevistas individuais e coletivas levaram ao aparecimento de uma proposta de teoria de nível intermediário sobre o acompanhamento pré-natal, na qual são revelados elementos facilitadores e limitadores ao processo de implantação. Se a saúde pública deve concentrar-se nos problemas de justiça social, deveremos rever os modelos de parceria e de complementaridade para pensar, provavelmente, em nos direcionarmos para outros modelos.

Delivering cognitive-behavior therapy for panic disorder with agoraphobia in videoconference

Delivering psychotherapy by videoconference could significantly increase the accessibility of empirically validated treatments. The aim of this study was to compare the effectiveness of cognitive-behavior therapy (CBT) for panic disorder with agoraphobia (PDA) when the therapy is delivered either face-to-face or by videoconference. A sample of 21 participants was treated either face-to-face or by videoconference. Results showed that CBT delivered by videoconference was as effective as CBT delivered face-to-face. There was a statistically significant reduction in all measures, and the number of panic-free participants among those receiving CBT by videoconference was 81% at post-treatment and 91% at the 6-month follow-up. None of the comparisons with face-to-face psychotherapy suggested that CBT delivered by videoconference was less effective. These results were confirmed by analyses of effect size. The participants reported the development of an excellent therapeutic alliance in videoconference as early as the first therapy session. The importance of these results for treatment accessibility is discussed. Hypotheses are proposed to explain the rapid creation of strong therapeutic alliances in videoconferencing.

Outbreak of head pediculosis during SFINCSS-99 isolation experiment

This short case report presents the development and treatment of a head lice outbreak during a space simulation experiment. The confinement experiment was conducted from July 1999 to March 2000 at the State Research Center of the Russian Federation Institute for Biomedical Problems in Moscow. Following a symptom period of up to 9 wk before diagnosis and treatment, 3 wk of treatment were required to remove all nits from those infected. Recommendations are made with regard to prevention of such infections during space missions. Treatment altered performance and comfort of crews, took time out of other duties, and even affected relations between crewmembers. The case is made for the development of a public health agenda in space research and medical space programs.

Discrepancies between meta-analyses and subsequent large randomized, controlled trials

BACKGROUND

Meta-analyses are now widely used to provide evidence to support clinical strategies. However, large randomized, controlled trials are considered the gold standard in evaluating the efficacy of clinical interventions.

METHODS

We compared the results of large randomized, controlled trials (involving 1000 patients or more) that were published in four journals (the New England Journal of Medicine, the Lancet, the Annals of Internal Medicine, and the Journal of the American Medical Association) with the results of meta-analyses published earlier on the same topics. Regarding the principal and secondary outcomes, we judged whether the findings of the randomized trials agreed with those of the corresponding meta-analyses, and we determined whether the study results were positive (indicating that treatment improved the outcome) or negative (indicating that the outcome with treatment was the same or worse than without it) at the conventional level of statistical significance (P<0.05).

RESULTS

We identified 12 large randomized, controlled trials and 19 meta-analyses addressing the same questions. For a total of 40 primary and secondary outcomes, agreement between the meta-analyses and the large clinical trials was only fair (kappa= 0.35; 95 percent confidence interval, 0.06 to 0.64). The positive predictive value of the meta-analyses was 68 percent, and the negative predictive value 67 percent. However, the difference in point estimates between the randomized trials and the meta-analyses was statistically significant for only 5 of the 40 comparisons (12 percent). Furthermore, in each case of disagreement a statistically significant effect of treatment was found by one method, whereas no statistically significant effect was found by the other.

CONCLUSIONS

The outcomes of the 12 large randomized, controlled trials that we studied were not predicted accurately 35 percent of the time by the meta-analyses published previously on the same topics.

Prenatal peer counseling: an answer to the persistent difficulties with prenatal care for low-income women

Our intention in this article is to provide the reader with the theoretical framework of prenatal peer counseling. A second article describing a prenatal peer program that is functional in the province of Quebec will be presented subsequently with its outcomes and recommendations. However, before planning the implementation of such a program or even assessing its effectiveness, one must understand how peer counseling can be used as an assistive strategy and why it is perceived to be a community approach worth considering with pregnant women from poor socioeconomic backgrounds. This approach addresses most problems encountered when prenatal programs fail to meet the specific needs of these women. Principles of the therapeutic community and its derivatives are put forward to lay the theoretical foundation of prenatal peer counseling. The studies reviewed show that psychosocial variables associated with pregnancy outcome and poverty such as anxiety, social support, and self-esteem can be positively influenced through a prenatal peer counseling program. We strongly recommend that nurses working with low-income families consider prenatal peer counseling as an empowering strategy for mothers within a given community.

[First case of human toxocariasis (?) with adult worms in the circulatory system, detected by the presence of embryonated eggs in hemolysis concentration]

Ascarids's eggs were found by blood concentration in a Cameroonese patient with hypereosinophilia. Eggs, similar to those of Toxocara canis or cati, were present in 6 blood concentrations carried out during 7 weeks. These eggs (70-75 x 100-112 microns) contained embryos and hatching of 437-504 microns long larvae was sometimes observed. The presence of adult worms in a well oxygenated localization (e.g.; the left ventricle) was supposed. A pleural effusion was also observed but the low number of eosinophils in the pleural fluid (3%) eliminated the responsibility of the parasite. The treatment by thiabendazole for an associated strongyloidosis was well tolerated but inefficient. On the contrary, the treatment by diethylcarbamazine, well tolerated, induced the disparition of the circulating eggs. This result was confirmed by 6 blood concentrations carried out during 6 months.

Growth of poliovirus using alginate entrapped-anchorage dependant Vero cells

Obligatory anchorage dependant Vero cells were successfully grown in gelatinous-like macrocarriers made of calcium alginate. Entrapped single cells were immobilized within the polymerized alginate matrix divide to form large spherical clumps of cells. A cell density of 17 x 10(6) cells/ml of alginate with over 95% viability was obtained after 14 days in spinner flasks. When subjected to poliovirus type I infection, spherical masses of Vero cells progressively showed extensive cytopathic effect but remained entrapped in the alginate matrix of the macrocarriers. Virus was released into a cellular debris free-like supernatant and reached a peak titer of 10(8.0) TCID50/ml after 72 hours.

[The role of mefloquine in the prevention of malaria]

The use of Méfloquine in the prophylactic treatment of malaria has, up to now, been hampered by the standpoint adopted by the WHO, the Conseil Supérieur d'Hygiène and some specialists, for whom Méfloquine should be administered only for short stays in areas of strong chloroquine-resistance. This policy, which prevents many travellers and overseas residents from benefitting from one of the most effective prophylactic treatments on the market today, thereby indirectly causing a number of pernicious cases of malaria, is based on the unfounded, unproved premise that wide use of this drug would foster the development of méfloquine-resistance or on side-effects, which are in fact rarely of any consequence and always curable. The efficacity of this drug should ensure that it is used for the basic prophylactic treatment of malaria in chloroquine-resistant areas, whatever the degree of this resistance and the length of stay involved, on condition that care is taken as to the tolerance of this drug in the early stages of treatment.

Growth of a murine coronavirus in a microcarrier cell culture system

The growth of the murine coronavirus MHV-A59 on murine DBT cells adapted to dextran-made Cytodex 1 microcarriers was studied in comparison with cells grown on plastic dishes. With a microcarrier concentration of 5 g/l in spinner flasks, a density of 3 x 10(6) cells/ml was reached in 7 days. Under these conditions, cells supported virus growth to the same extent as when they were grown on the plastic substratum. This was shown by a similar development of virus-induced syncytia, the release of an equivalent number of infectious progeny virions per cell, similar recoveries observed after concentration and purification and an identical appearance of the purified virus under the electron microscope. On the other hand, the technical convenience of microcarriers and the ease of scale-up emphasize their potential for the growth of coronaviruses.

[Study of specific immunoglobulins (total, IgG, IgM, IgA, IgE) in indirect immunofluorescence and ELISA in 40 patients with trichinosis followed over a 9-month period]

The evolution of the classes of specific immunoglobulins (IgG, IgM, IgA, IgE) of 40 cases of human trichinosis was followed over a nine month period by means of an indirect immunofluorescence test (IF) and ELISA. Specific IgG and IgM appear between 4 and 6 weeks after infection and were still demonstrable after 9 months (respectively in 87.5% and 38.5% of the patients with IF, in 85% and 87.5% with ELISA). Specific IgA were mainly seen on the 2nd month and specific IgE were detected in 37.5% of the patients on the 4th month. In this outbreak, specific antibodies seem to appear later than in a second outbreak observed a few weeks later.

Two outbreaks of trichinosis caused by horsemeat in France in 1985

Two outbreaks of trichinosis occurred in France in August and October of 1985 and 1,073 cases in all were identified. In the first outbreak, two localities were involved: the town of Melun and the 14th district of Paris. To determine the origin of the contamination, three case-control studies were carried out: among patients' families, among the populations of these two areas, and among the inmates in the prison of Melun. In the second outbreak, cases again occurred in Paris but in a different district (the 12th), in the city's suburbs, and in other towns scattered throughout France. Although no parasites were found in any of the meat examined in either outbreak, results of the study indicate that infection was due to horsemeat consumption and led to the incrimination of two carcasses, one imported from a slaughterhouse in the United States and the other from West Germany. These findings led the French Ministry of Agriculture to order the inspection for trichinosis of all meat from horses slaughtered both in France and in countries exporting horsemeat to France.

Optical fiber probe to measure local void fraction profiles

A fiber optic probe for measuring the local void fraction in a two-phase (air-water) flow has been developed. The liquid-gas and gas-liquid interfaces are detected by the normal reflections of IR laser light at the tip of a multimode fiber. The probe and its associated electronic circuitry were calibrated by using the averaged void fraction measured by a quick closing valve system. The void profiles obtained by this method were compared with those obtained by a conductivity local probe. The proposed optical system shows a better sensitivity at high void fractions.

Investigation of power oscillations along tapered monomode fibers

An abruptly tapered fiber can be essentially divided into three different regions: one beating region in its central, quasi-cylindrical part, lying between two coupling regions, where the slopes are large. In this paper we report two experiments which help to visualize and analyze the beating region. We show that, in this region, there are principally two modes present, HE(11) and HE(12), both excited with large amplitudes.

Liquid-crystal-clad tapered fibers

The capability of changing the optical output of a tapered single-mode fiber by using a liquid crystal as an electrelectrooptical medium is shown.

[Comparison of immune response in patients with bilharziasis (S. mansoni) from Africa south of the Sahara and Antilles]

Retrospective study has been conducted in the parasitic and tropical diseases department of the hospital Cochin, based on observations made between 1966 and 1985 on antibody rates in sera of 709 bilharziasis patients (S. mansoni). This study shows a great difference of immunologic reaction between the group of patients from French West Indies (458 patients) and the one of the group of patients from Africa South of Sahara (189 patients). Such an observation leads the authors to suppose a difference between strains of schistosomes from Black Africa and French West Indies.