Ranjit N. Ratnaike

The Importance of Health Education in Programs to Control Diarrhea: Experiences in an Australian Aboriginal Community

Abstract Diarrhea in young children is still a major health problem in developing countries, despite the worldwide commitment to the goal of “Health for All by the Year 2000.” Oral Rehydration Therapy (ORT), environmental upgrading, and mass immunization are the major strategies which have been broadly utilized to manage diarrhea These strategies often have been singularly unsuccessful or only partially successful because health education of the local people has not been included in the intervention package. Health education, either alone or in conjunction with other types of programs to manage diarrhea, is essential and ultimately can be more effective in reducing the prevalence and morbidity of diarrheal diseases than other programs used singularly. The health education program we introduced to control diarrhea in an Australian Aboriginal community was successful. As a result of the intervention, significant decreases were observed in the proportion of Aboriginal children under five years of age with di...

A Community Health Education System to meet the health needs of Indo-Chinese women

This paper presents a Community Health Education System which is cost-effective, sustainable, strongly community-based, and directed at improving the health status of rural women in Indochina (Kampuchea, Laos and Vietnam). The system is developed through a series of steps which are concerned with the education of Community Health Education Units (in national ministries of health) and, at the village level, among community health workers, womens groups, and other women. The ultimate aim is the establishment of a community health education program in Indochinese villages.

Drug-associated nutritional problems in older persons

Nutrient inadequacies, especially in older persons, impact adversely on health, increasing the risk of acute and chronic disease and prolonging recovery from illness. Malnutrition is a condition due to an inadequate calorie and micronutrient intake that fails to meet the basic requirements for body maintenance, growth and development. Malnutrition often occurs in older people in acute hospital settings, among residents in nursing homes and in long-term care. Malnutrition in institutionalized older people is as high as 40–50%.

Dysphagia: implications for older people

Dysphagia is defined as difficulty in swallowing solids or liquids and is distinct from odynophagia, which is pain on swallowing. Dysphagia occurs in a range of conditions that affect the oral, pharyngeal and oesophageal phase of swallowing. The problem of dysphagia assumes greater importance in older persons. Some people may not be able to communicate that a problem exists. In others the lack of nutrition due to dysphagia compounds existing undernutrition, a common problem in institutionalized older persons. This paper discusses dysphagia in the context of the older person and outlines the normal mechanism of swallowing, the important clinical distinction between oropharyngeal dysphagia and oesophageal dysphagia, the aetiology of dysphagia and issues of management.

Erythrocyte Ammonia in Liver Disease

This study reports the relevance of plasma and erythrocyte ammonia concentrations in patients with liver disease. Three groups of subjects were studied: group 1, 47 normal subjects; group 2, 73 patients with liver disease; and group 3, 14 patients with portal-systemic encephalopathy (PSE). The difference in plasma ammonia concentrations between groups 1 and 2 was not significant, but for erythrocyte ammonia this was significant (p less than 0.05). Group 3 subjects had significantly elevated plasma (p less than 0.001) and erythrocyte ammonia (p less than 0.001) compared with the other two groups (Mann-Whitney U-test). In group 3, two patients had plasma ammonia values within the reference range, whereas six patients had values within the range of group 2 subjects. However, none of group 3 subjects had erythrocyte ammonia concentrations within the range of either group 1 or 2. A cut-off level of 65 mumol/l was assigned to differentiate group 3 from group 2 subjects. We conclude that erythrocyte ammonia measurement is a better biochemical index of PSE than plasma ammonia.

Diarrhoea: an update

Introduction Illnesses such as acute and especially chronic diarrhoea are personally incapacitating to older people, more so in those with physical and mental impairment or other acute or chronic illnesses. Diarrhoea is also socially restrictive: diarrhoea adversely impacts on the individual’s and carer’s quality of life.