Community health workers at the dawn of a new era: 6. Recruitment, training, and continuing education.

Background: This is the sixth of our 11-paper supplement entitled "Community Health Workers at the Dawn of New Era". Expectations of community health workers (CHWs) have expanded in recent years to encompass a wider array of services to numerous subpopulations, engage communities to collaborate with and to assist health systems in responding to complex and sometimes intensive threats. In this paper, we explore a set of key considerations for training of CHWs in response to their enhanced and changing roles and provide actionable recommendations based on current evidence and case examples for health systems leaders and other stakeholders to utilize.

Toward universal coverage in Afghanistan: A multi-stakeholder assessment of capacity investments in the community health worker system.

Global efforts to scale-up the community health workforce have accelerated as a result of the growing evidence of their effectiveness to enhance coverage and health outcomes. Reconstruction efforts in Afghanistan integrated capacity investments for community based service delivery, including the deployment of over 28,000 community health workers (CHWs) to ensure access to basic preventive and curative services. The study aimed to conduct capacity assessments of the CHW system and determine stakeholder perspectives of CHW performance.

Menninger: renewing the vision of success.

Organizations without vision struggle to find hope and remain mere organizations, surviving but not living, hitting temporary targets, but not moving toward their potential.

Human resource development: new assessments and new directions.

The National Health Plan (NHP) 2001-2010 required a health workforce situation analysis and strategy to match the NHP's priorities and strategies. This paper is based on the work that was done in 2001 to support the preparation of a Health Human Resource Development Strategy for Papua New Guinea (PNG). The analysis showed that changes in health sector financing, population growth and changing health needs had created many human resource problems and challenges.

The journal of comparative pathology from 1943 to 2008.

The account of the Journal's first 53 years (Pattison, 1988), also reproduced in this issue, closed by noting the interruption of publication brought about by wartime exigencies and the death in 1941 of its founder and owner, Sir John McFadyean (Fig. 1). The present article considers the further development of the Journal from that time to the present day, a period of 65 years.

Assessment of the efficacy of tilmicosin as a treatment for Mycoplasma gallisepticum infections in chickens.

This study involved two experiments which examined the efficacy of 'in water' tilmicosin medication for the treatment of experimental Mycoplasma gallisepticum (MG) disease. The first experiment investigated tilmicosin concentrations of 50, 100, 200 and 400 mg/l administered for 5 days. In the second experiment, dose levels of 50, 75 and 100 mg/l tilmicosin administered for either 3 or 5 days were investigated.

A challenge for monitoring iodine deficiency disorders in rural Nepal.

Developing a strategy for monitoring iodine deficiency disorders (IDD) remains a big challenge in rural Nepal where great variations could exist in IDD status. To explore the possibility of variation in urinary iodine excretion (UIE) level in rural settings, we carried out a detailed study of UIE among 586 school children of 20 schools in five villages. Our data revealed statisitically significant differences in UIE values among rural villages and schools in the same villages.

Narrowing of sex differences in infant mortality in Massachusetts.

Objectives: To examine whether the improved survival of preterm infants has influenced the known male excess in infant mortality.

Study Design: We analyzed sex-specific infant mortality using linked birth and death certificates for all 619,811 live born infants in Massachusetts between 1989 and 1995.

Results: Between 1989 and 1995 the male excess in infant mortality decreased by 50%, from 1.

Evaluation of the efficacy of Alpron disinfectant for dental unit water lines.

Aims: To assess the efficacy of a disinfectant, Alpron, for controlling microbial contamination within dental unit water lines.

Methods: The microbiological quality of water emerging from the triple syringe, high speed handpiece, cup filler and surgery hand wash basin from six dental units was assessed for microbiological total viable counts at 22 degrees C and 37 degrees C before and after treatment with Alpron solutions.

Results: The study found that the use of Alpron disinfectant solutions could reduce microbial counts in dental unit water lines to similar levels for drinking water.

Preconception homocysteine and B vitamin status and birth outcomes in Chinese women.

Background: The associations between homocysteine, B vitamin status, and pregnancy outcomes have not been examined prospectively.

Objective: We assessed the associations of preconception homocysteine and B vitamin status with preterm birth and birth of low-birth-weight (LBW) and small-for-gestational-age (SGA) infants in Chinese women.

Design: This was a case-control study of women aged 21-34 y.

Preconception folate and vitamin B(6) status and clinical spontaneous abortion in Chinese women.

Objective: To assess the association between preconception homocysteine and B vitamin status and risk of clinical spontaneous abortion in women from Anqing, China.

Methods: All women were aged 21-34 years, had never smoked, and were primigravid. Patients (n = 49) were women with a clinically recognized pregnancy who experienced a fetal death before 100 days' gestation.

Anemia and deficiencies of folate and vitamin B-6 are common and vary with season in Chinese women of childbearing age.

Little is known about the micronutrient status of Chinese women of childbearing age. We assessed nonfasting plasma concentrations of folic acid, vitamin B-12, vitamin B-6 (as pyridoxal-5'-phosphate), hemoglobin (Hb), ferritin and transferrin receptor (TfR) in 563 nonpregnant textile workers aged 21-34 y from Anqing, China. All women had obtained permission to become pregnant and were participating in a prospective study of pregnancy outcomes.

Oral contraceptives and women's health in Japan.

Japan approved the use of low-dose oral contraceptives (OCs) in June 1999, after more than 35 years of debate. The debate leaves a legacy of misinformation about and various sources of resistance to OCs. Benefits are expected to include greater control for women over their fertility and a reduction in the high rates of unplanned pregnancies and abortions.

Comparison of the efficacies of three fluoroquinolone antimicrobial agents, given as continuous or pulsed-water medication, against Escherichia coli infection in chickens.

This study compared the efficacy of continuous or pulsed-water medication with enrofloxacin, danofloxacin, and sarafloxacin in eight groups of 90 chicks each by using an infectious bronchitis virus-Escherichia coli model of colisepticemia. The model produced lesions of typical those occurring in birds with severe colisepticemia; for the infected, nonmedicated birds the mortality was 43.5% and the morbidity was 89%, 17.

Comparative in vitro activity of doxycycline and oxytetracycline against porcine respiratory pathogens.

Minimum inhibitory concentrations of doxycycline and oxytetracycline were determined against 55 Pasteurella multocida strains, 59 Actinobacillus pleuropneumoniae strains and 26 Mycoplasma hyopneumoniae strains isolated from the respiratory tract of pigs. An additional set of 76 P multocida strains isolated from pneumonic pigs was tested for their minimum inhibitory concentrations of doxycycline. The P multocida and A pleuropneumoniae strains were isolated in France and the minimum inhibitory concentrations were determined by an agar dilution method.

An evaluation of a training course in the short-term management of violence.

Few comprehensive studies have been carried out regarding the nature and extent of violence towards staff in the caring professions. Scarcer still are studies which have thoroughly evaluated the impact of training in the management of violent and aggressive behaviour. Against this background, the following paper describes an evaluation of a 10-day in-service education course in the short-term management of violence.