Developing a plan for primary health care facilities in Soweto, South Africa. Part I: Guiding principles and methods

The new political era in South Africa offers unique opportunities for the development of more equitable health care policies. However, resource constraints are likely to remain in the foreseeable future, and efficiency therefore remains an important concern. This article describes the guiding principles and methods used to develop a coherent and objective plan for comprehensive primary health care facilities in Soweto. The article begins with an overview of the context within which the research was undertaken. Problems associated with planning in transition are highlighted, and a participatory research approach is recommended as a solution to these problems. The article goes on to describe how the research methods were developed and applied in line with the principles of participatory research. The methods were essentially rapid appraisal techniques which included group discussions, detailed checklists, observation, record reviews and the adaptation of international and local guidelines for service planning. It is suggested that these methods could be applied to other urban areas in South Africa and elsewhere, and that they are particularly appropriate in periods of transition when careful facilitation of dialogue between stakeholders is required in tandem with the generation of rapid results for policy-makers.

Developing a plan for primary health care facilities in Soweto, South Africa. Part II: Applying locational criteria

This article is the second of a two-part series describing the development of a ten-year plan for primary health care facility development in Soweto. The first article concentrated on the political problems and general methodological approach of the project. This second article describes how the technical problem of planning in the context of scanty information was overcome. The reasoning behind the various assumptions and criteria which were used to assist the planning of the location of facilities is explained, as well as the process by which they were applied. The merits and limitations of this planning approach are discussed, and it is suggested that the approach may be useful to other facility planners, particularly in the developing world.

Care by parents in hospital

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Radioiodinated 1-(diethylaminopropyl)-4-phenylpiperazine: a potential brain imaging agent

The preparation of radioiodinated 1-(diethylaminopropyl)-4-phenylpiperazine, an analog of HIPDM, and its tissue distribution in rats are described. The precursor undergoes facile electrophilic radioiodination with radionuclides of iodine at the no-carrier-added level to give isolated yields in the 69-85% range. Biodistribution studies indicate that the radiochemical is well extracted by the brain (1.68-1.79% ID) and activity is substantially retained for 4 h (greater than 67%). Brain-to-blood ratios during the 0.25-4.0 h period were 15-23:1. The brain uptake and retention as well as the high brain-to-blood ratios suggest the potential use of this agent for regional cerebral blood flow imaging.

Determination of Aflatoxins in Peanut Butter, Using Two Liquid Chromatographic Methods: Collaborative Study

Two methods for determining aflatoxins in peanut butter, one using normal phase and the other reverse phase liquid chromatography (LC), were studied by 8 and 10 collaborators, respectively. Fluorescence detection was used for the determinative step in both methods. For reverse phase LC, aflatoxins B1 and G1 were converted to B2a and G2a; for normal phase LC, a silica gel-packed flow cell was placed in the irradiating light path of the detector. The samples included spiked and naturally contaminated peanut butter with total aflatoxin levels from about 5 to 20 ng/g and controls in a balanced pair design. For the normal phase LC method, recoveries of B1, B2, G1, and G2 from spiked samples averaged 79, 92, 74, and 88%, respectively; for the reverse phase method, the recoveries were 103, 104, 89, and 163%. For the normal phase LC method, pooled repeatabilities were 20, 23, 28, and 17% for B1, B2, G1, and G2, respectively; for the reverse phase method, the repeatabilities were 19, 22, 38, and 31%. For the normal phase method, pooled reproducibilities were 34, 33, 39, and 34% for B1, B2, G1, and G2, respectively; for the reverse phase method, the reproducibilities were 32, 46, 51, and 52%. Both methods show an improved limit of detection and better within-laboratory precision over current AOAC methods; however, between-laboratory precision is no better, and the reverse phase method shows evidence of interferences being measured. For these reasons and because of no benefits of present value, neither method was submitted for adoption as official first action.

Spectrophotometric Determination of Sulfites, Benzoates, Sorbates, Ascorbates, and Added Blood in Ground Beef: Collaborative Study

A method for the determination of sulfite, benzoate, sorbate, ascorbic acid, and added blood in ground beef reported previously was studied collaboratively. Eleven laboratories reported results on 18 samples analyzed for the preservatives plus 6 samples analyzed for added blood. Average recoveries for sulfite added at the 0.02 and 0.04% levels were 44.3 and 70.6%, respectively; average recoveries for benzoate at 0.02 and 0.05% were 83.5 and 85.9%; average recoveries for sorbate at 0.01 and 0.02% were 82.7 and 87.3%; average recoveries for ascorbic acid at 0.02 and 0.04% were 71.0 and 69.8%. Only 5 of the 11 collaborators reported accurate results on the 6 samples for added blood, and further study of this procedure is recommended. The preservative method has been adopted as official first action.

Biological evaluation of polymers. I. Poly(methyl methacylate)

A series of poly(methyl methacrylate) formulations differing widely in chemical and physical properties was employed for the evaluation of primary screening methods for the assessment of acute toxicity. Materials and USP extracts of materials were tested in parallel. Tissue culture, hemolysis, intradermal irritation, systemic toxicity, muscle implant and histopathologic responses were determined for each of 27 formulations. A determination of the nonvolatile methanol extractable components was carried out on each formulation. The formulations varied with respect to percent, w/w, methyl methacrylate, N,N-dimethyl-p-toluidine, stannous octoate, 3, 4-diamino-toluene and, also, with respect to curing conditions. Volatile components, primarily methyl methacrylate, of three selected formulations were determined quantitatively by vacuum distillation and mass spectrographic analysis. Statistical analysis of the primary data indicated a significant correlation of residue weight (methanol extractable) with hemolytic activity (r = 0.93) and with the cumulative biological response (r = 0.9). Multiple linear regression analysis of residue weights with hemolysis and intradermal irriation responses gave the highest overall correlation (r = 0.96). Hemolytic activity and tissue culture responses were significantly correlated (r = 0.87). It was concluded that the observed variation of biological test results reflected significant differences in the toxicity of the test materials. The poly(methyl methacrylate) series examined was relatively low in toxicity and the biological tests examined, particularly the in vitro tests, were found to be responsive to formulation and curing conditions which indicated their suitability for primary toxicity screening.