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To evaluate the investigative approach towards osteoarthritis of latinamerican physicians, we reviewed the literature. After a manual and electronic search of Latin american medical publications (1980 to 1990) and of 9 Mexican medical journals (1976 to 1990), we reviewed all papers about osteoarthritis. We found 60 such papers (40 from Mexico and 20 from 7 other countries) and analyzed their goals and methods. The common subject was "treatment with nonsteroidal antiinflammatory drugs" (52%), followed by "quality of attention" (25%); "other treatments" (12%) and "epidemiology" (10%). The most common methodologic design was "series of cases" (28%), followed by "editorials" (17%); "controlled clinical trials" (17%), "interview collected data" (17%), "monographies" (10%) and "comparative cohorts" (8%). An innovative and positive aspect is the presence of 25% of studies on "quality of life", "cost-benefits" and "quality of attention". Most studies used insufficiently valid designs and we did not find studies designed to establish causality or to look for the validation of diagnostic tests or prognostic factors, which we propose as methods and fields to study from now on.

The cost-effectiveness of a health intervention is an estimate of the relation between what it costs to be provided, and the improvement in health which results from such intervention. Health may improve because the incidence of illness or injury is reduced, because death is avoided or delayed, or because the duration or severity of disability is limited. The calculation of this health benefit combines objective factors, such as the age at incidence and whether or not the outcome is death, with subjective factors such as the severity of disability, the judgement as to the value of life lived at different ages, and the rate at which the future is discounted. The construction and interpretation of the estimate are explained. Also, the paper examines whether the concept of cost-effectiveness is consistent with ethical norms such as equity, and concludes that they are not in conflict. Finally, it addresses the question of how to incorporate cost-effectiveness into a health sector reform, and possible ways to implement it.

"The purposes of this paper are to analyze the Argentine legislation between 1870 and 1989 that has directly or indirectly affected the dynamics and structure of population, as well as to reveal the ideology of population policies supported by hegemonic social forces. This analysis takes into consideration the different development strategies that have been implemented. Our study explores the way in which the different governments have approached the issue of population, and, more specifically, it analyzes the relation between public policies, population policies, development strategies, and political processes represented in State laws." (SUMMARY IN ENG), (excerpt)

"The paper starts with a brief analysis of the sources and the quality of the data and the mortality indices [for trends in adult mortality from chronic diseases in Chile]....A comparison is made of mortality among the 13 regions of the country and an attempt is made to relate the observed differences to some environmental and life-style factors. Rural-urban and educational differences of mortality by cause of death are also analyzed. The paper ends by comparing mortality by chronic disease in Chile with that of other countries of the Latin American region, noting some difficulties [in] such a comparison and proposing hypotheses for future studies." (SUMMARY IN ENG), (excerpt)

"This paper examines the adult-mortality transition in Costa Rica and its determinants. The risk of dying declined by 80% for young adults and by 40% for old adults from 1920 to 1990. The fastest decline took place in the 1950s for young-adult ages and in the late 1980s for old-adult ages.... By 1990, about 40% of Costa Rican deaths are caused by accidents and violence at young-adult ages and by cardiovascular diseases at old ages. Infectious and nutritional-related conditions (especially respiratory tuberculosis and malaria) account for three-fourths of the adult-mortality decline between 1951 and 1971, but only for 30% since that year on." (SUMMARY IN ENG), (excerpt)

The changes in health conditions that have occurred in most of the countries of Latin America in the second half of the twentieth century are analyzed. "This paper analyzes the main mechanisms involved in the epidemiologic transition, which are: changes in risk factors, fertility decline and improvements in health care technology." The authors use a mortality profile ratio, obtained by dividing the mortality rate due to infectious and parasitic diseases over the mortality rate due to cardiovascular diseases and neoplasms, to analyze trends in 15 countries. "Three distinct groups can be recognized. Each of them represents a different transitional experience. Such experiences are discussed in detail, including a new 'protracted polarized model' of the epidemiologic transition, which characterizes several Latin American countries. Finally, evidence is provided to illustrate the relationship among economic development, fertility change, and mortality profiles." (SUMMARY IN ENG), (excerpt)

"The paper presents the Latin American demographic situation and trends since 1950, with special emphasis on differential mortality across and within countries.... The large declines in mortality, specially those at young ages, are linked to changes in epidemiological profiles which imply a greater relative importance of non-transmissible diseases and a lesser role of infectious and parasitic diseases. Population ageing also contributes to these changes due to the increased fraction of adult and elderly population. In the majority of countries, excessive mortality due to avoidable causes is still present among the poor." (SUMMARY IN ENG), (excerpt)

"This paper reports some results of analyzing migratory dynamics in the Metropolitan Area of Mexico City, which ever since the 1970-1980 decade have affected other regions of the country, mainly the State of Mexico. The analysis describes different types and modes of migratory movement: metropolitan (from Mexico City), inter-county (within each state), and interstate (between Mexico City and other states). Data was provided by the XI Population and Household Census of 1990." (SUMMARY IN ENG), (excerpt)

"This paper begins by reviewing some conceptual frameworks for the study of female mortality and indicates some of its application problems. Next it presents results of mortality of women in reproductive-age classified by age, causes of death, and socio-demographic traits (marital status, schooling, and occupation) for ten states [in Mexico] differentiated according to level of development and well-being. The data suggests differences according to age, marital status, and schooling. Finally, testing of the mutual independence and partial independence hypotheses indicates that age, marital status, and schooling correlate to the degree of development of each state." (SUMMARY IN ENG), (excerpt)

"In a recent paper, Lee and Carter developed a new method for analyzing and forecasting time series of age specific mortality, and applied it to the U.S. population. In this paper, we extend that method to deal with various problems of incomplete data common in Third World populations, and then apply the method to forecast mortality in Chile." (SUMMARY IN ENG), (excerpt)

"Given the importance of information on the population age structure when planning short, medium and long-term needs within the different social strata, this paper is a proposal to deepen...the study of changes in the population pyramids.... Based on the most recent methodologies a study of age discontinuities is carried out and a method of follow-up by cohorts is suggested, taking the 15-19 and 20-24 age groups as an example. The purpose is to show that, as a...cohort ascends in the age pyramid, new and different necessities arise and also different responses are demanded on the part of the social system." Data are for Brazil as a whole and for the state of Sao Paulo. (SUMMARY IN ENG), (excerpt)

"This paper reports on an attempt to use census data from Brazil in 1970 and 1980 to investigate a rise in household headship by unmarried mothers 15-49.... Demographic analysis can be useful in decomposing the change into that due to a changed propensity of women 15-49 years of age to be unmarried, to have children if unmarried, and to head their own household if an unmarried mother. This was further analyzed in terms of age, marital status (whether single, divorced/separated or widowed), region of residence, and urban-rural status....However, the research encountered data problems that make firm conclusions impossible...." This is a translation of a paper originally presented at the 1992 Annual Meeting of the Population Association of America. (SUMMARY IN ENG), (excerpt)

Post-harvest problems are important constraints to the expansion of production of food in many Latin American countries. Besides problems of bulkiness, perishability and seasonal production patterns, the necessity of reducing transportation costs, increasing rural employment, and finding new markets for processed products, requires the development of processing technologies. Possible processed products include a vast range of alternatives. Given limited time and resources, it is not always feasible to carry out detailed studies. Hence a practical, low-cost methodology is needed to evaluate the available options. This paper presents a series of methods to evaluate different processing possibilities. It describes in detail each method including a rapid initial assessment, market and consumer research, farm-oriented research, costs and returns analysis and finally, some marketing and promotion strategies.

"The purpose of this paper is to bring together some of the general problems that arise in the study of international migration between Paraguay and the countries of the Southern Common Market (with special reference to Argentina, which is the most frequent destination of Paraguayan migration).... The paper first reviews the known information about the emigration of Paraguayans, in general, and to Argentina, in particular, with some references to immigration to Paraguay from bordering countries, as well....A brief survey is made of the impact of the Southern Common Market (Mercosur) on employment and migration, and, finally, some specific problems related to the economic analysis of these migrations are discussed....", (excerpt)

"The objective of this paper is to discuss the role that three of the proximate determinants of fertility (marriage, contraception and post-partum insusceptibility) have played in fertility change in Latin America and the Caribbean. First we look at issues of data availability and comparability on measures of the proximate determinants from retrospective surveys. Most of the data utilized come from the World Fertility Survey (WFS) and the Demographic and Health Surveys (DHS) projects. Second, we present results from the most widely applied model for assessing the impact that these proximate determinants have on fertility, that of Bongaarts....Finally, we compare the results from the application of the Bongaarts model with those from an alternative method proposed by Moreno. Both models show that increased use of contraception is by far the most important reason for fertility decline, with marriage and post-partum insusceptibility making much smaller contributions. However, the second model suggests that the role of the marriage and post-partum insusceptibility factors is much smaller than is shown by the Bongaarts model." (SUMMARY IN ENG), (excerpt)

"This paper reviews survey-based data regarding contraceptive prevalence and methods employed in Latin America and the Caribbean, with an emphasis on changes in the mix of methods over time. The most striking recent trend is the rise in use of female sterilization.... By contrast, use of male sterilization remains negligible in most countries. The oral contraceptive pill is by far the most popular of the temporary methods, though its prevalence has more often declined than increased in recent years. Together female sterilization and the pill make up around [two-thirds] of contraceptive practice in Latin America and the Caribbean." (SUMMARY IN ENG), (excerpt)

The paper refers to pneumonia in children under five years of age in Latin America, and covers the following toplos: morbidity, predisposing and risk factors, mortality and costs. It emphasizes the magnitude, tendency and advances in the control of the problem. High pneumonia morbidity and mortality rates are observed, with slow tendency to decrease in the majority of the countries of the Region, with some exceptions. The paper points out the importance of the National Programs of Control of Acute Respiratory Infections (ARI), specifically of pneumonia, following the guide lines of the PAHO/WHO. Special mention is made of the diagnosis, ambulatory standardized treatment and cost-effectiveness under the strategy of the Primary Health Care. The preventive measures are important, including the health education of parents and the training of the community health workers. The principal goal is to obtain a decrease of one third in the mortality of pneumonia in children, within the present.

"This document discusses the impact of the social institutions in the childbearing experience of...families and the reproduction of...society. Despite the difficulties of empirically demonstrating the association of the macro and micro spheres, the paper presents evidence of the relationship, introducing the case of Ecuador, based on broad indices of fertility and child mortality.... The analysis utilizes the Demographic and Health Survey (DHS), individual and community questionnaire." (SUMMARY IN ENG), (excerpt)

"This paper presents the results of exploratory efforts to examine the determinants of the structure of households in urban areas of Mexico, focusing on those of women with young children.... The empirical analysis uses two cross-sectional national surveys of Mexico, the 'Encuesta Nacional Demografica' 1982 and the 'Encuesta Nacional de Fecundidad y Salud' 1987...." (SUMMARY IN ENG), (excerpt)

In this paper the paths taken by developing countries to improve the health and well-being of their populations in a context of diminishing resources is discussed. Emphasis is placed on Latin American countries and the objective is to clarify the changing nature of the relationship between health and social well-being in the 1970s and 1980s. In the second part of the paper three viable and different political scenarios to confront this problem are presented: 1) survival without well-being; 2) survival and eradication of extreme poverty, and 3) survival, eradication of extreme poverty, and selective reconversion of the poor.

In this paper the role of efficiency in health care delivery is discussed. In the first part several definitions of efficiency are presented and the most common efficiency analysis are described. In the second part of the paper some experiences aimed at improving the efficiency of health care delivery in England, Latin America and Mexico are discussed. Finally, the author presents four proposals for the improvement of efficiency of health care delivery in Mexico: monetary reward associated to performance, alternative organization of health services, investment in management training for health manpower, and operational research in the health systems.

In this paper the concepts and criteria related to health coverage are discussed in the context of the organization of national health systems. The main international agreements based on WHO/PAHO proposals are also described. The relationship between primary health care and health coverage is analyzed and the evolution of the programs for the extension of health coverage in Mexico are discussed, with emphasis on the problems of overlap and definition of the universe in the several institutions of the health sector. Finally, the author reviews the problems to measure coverage in order to guarantee social and operative efficiency of the Mexican health system.

"The purpose of this paper is to assess urban research in Mexico during the 1980s.... The study is divided into three sections: 1) continuing themes; 2) new themes on urban issues; [and] 3) state policies regarding urban issues. The author notes that in the 1980s, research was conducted for the purpose of analyzing urban realities more explicitly.... She also offers a description of studies that attempt to link state policies, the actors involved, and their impact (or lack of it) on urbanization processes, and discusses the regulatory functions carried out by the state." (SUMMARY IN ENG), (excerpt)

"The paper examines the relationship between medium and short-term changes in aggregate economic activity, and national morbidity and mortality rates by certain causes. Although overall mortality conditions have continued to improve during the economic crisis of the nineteen-eighties in the three countries studied, mortality by some causes...[has] discontinued [its] decline and [has] even increased [its] rates in some recent years.... The short-term changes in mortality in Costa Rica and Chile are generally lower than in Guatemala, but tend to be more systematic in their inverse relationship with economic fluctuations in the former. Many of the causes studied affect young and older adults, which are groups that have so far received little attention in evaluations of the health effects of economic crises in the region." (SUMMARY IN ENG), (excerpt)

Using data for Latin America, "this paper analyses the [potential] of using social policies in connection with policies to affect demographic behaviour.... It shows that there is a coincidence between the interests of the countries, as expressed by the national governments, and the demographic wishes of couples.... It shows that to a certain extent, it is possible to...[implement] social and population policies that are relatively independent from the economic situation. The document also discusses the role of social scientists...[and central and local governments] in the elaboration and execution of policies in general, and socio-demographic polices in particular...." (SUMMARY IN ENG), (excerpt)

This paper discusses the conditions that force the countries in Latin America and the Caribbean to design and produce vaccines for the most common infectious diseases in the Region on a regional basis. The authors discuss as well the goals and strategies of the Regional System for the Production of Vaccines in Latin America, its possible structure and economic feasibility.

A methodological experiment was conducted as part of the Demographic and Health Surveys (DHS) project to determine whether different approaches to measuring the same variables would yield similar results. The experiment consisted of the use of a new questionnaire, incorporating variants of many of the traditional approaches to the collection of demographic and health data. The experimental questionnaire was applied in 2 countries, Peru and the Dominican Republic at the same time as the standard survey. The most salient feature of this new questionnaire pregnancies, contraceptive practice, and postpartum, marriage, employment, and migration information. In this paper, the authors evaluate whether the use of the calendar in the experimental questionnaire improved the quality of the resulting information on contraception in the DHS surveys from the abovementioned countries. Specifically, the author determine whether the monthly calendar led to better estimates of contraceptive prevalence, failure, and discontinuation, and discuss the advantages and drawbacks of the calendar over the more standard approach. Results from this evaluation suggest that the major advantages of the calendar over the more standard questionnaire are 3-fold: it allows for more complete reports of use for periods prior to the survey; it allows for a detailed study of contraceptive use patterns; and it obtains information which is more internally consistent with other types of information. On the bases of these findings, the DHS project will include a calendar in the new standard questionnaire to be used in the 2nd round of surveys (DHS II).

Both high rates of labor force growth and large dependency ratios are forecast in this paper for the countries of Latin America in the 1990s. The author concludes that "population and employment problems must be given high priority in bilateral negotiations and/or with international organizations when deciding upon structural adjustment strategies." (SUMMARY IN ENG), (excerpt)

This paper defines the concepts of deconcentration and decentralization in terms of the different approaches and doctrines that relate to the two processes. In addition, it describes the two types of deconcentration, functional and territorial, stressing the importance of implementing both types and placing special emphasis on the role of space both in the structure of health service administration and in the distribution of authority between the State and the decentralized agencies. Finally, the relationship between deconcentration, democracy, community participation, and social benefits is analyzed, and possible ways to shift responsibility to decentralized agencies are suggested.

"In this paper, the author analyzes the evolution of migration to Mexico City based on information generated by the National Survey on Migration to Urban Areas.... The findings support the hypothesis that there has been a decrease in the intensity of in-migration towards capital. The rural origin of the migrants prevails; the majority of these are young people coming from the states closest to the city, with low levels of schooling. An increase is observed in out-migration from Mexico City to other major cities in the country...." (SUMMARY IN ENG), (excerpt)

The characteristics and limitations that investigators in developed countries should take into account in conducting biomedical research on human subjects in regions such as Latin America and the Caribbean are reviewed. The authors first cite international ethical principles that have been established in the developed countries to serve as a guide in dealing with the ethical problems that arise in this type of research. These principles should always be borne in mind by every investigator, regardless of the country where the research is being done. The paper goes on to briefly review some of the circumstances in certain Latin American and Caribbean countries that could pose practical limitations for direct application of the ethical principles described.

This paper analyzes the methodology proposed by FAO/WHO/UNU 1985 to determine energy requirements and recommendations for population groups. The physiological basis for individual requirements and the components to estimate the energy expenditure of population groups, are presented. This new approach requires a detailed knowledge of the distribution of the population by sex, age and level of physical activity. In the absence of physical activity data the distribution by employment category may be used. Our study suggests characterizing the population through the use of biotypes, according to sex, age and level of physical activity. This new approach also requires the knowledge of weight and height of a representative sample of the population. The planner should also consider a desirable level of physical activity for the population, and decide if the energy recommendation should optimize the weight and height of individuals to promote improved physical well being and health status. The application of this approach to a specific country in Latin America revealed that the available data are insufficient for an adequate estimation of energy needs of the population. Nevertheless, results suggest that the energy gaps for urban sedentary groups are less than those calculated using the traditional FAO/WHO 1973 reference pattern. The energy needs of the countries in the Region will increase as the infant population improves physical development more in accordance with the full expression of their genetic endowment. Further increases in energy needs are estimated as the general population increases the level of discretionary physical activity.

This paper makes a socio-historical analysis of the determinants of health on the basis of the different ideas that are held about it. It examines the methodological and practical part played by these different ideas in the past and in the present, and the conclusion is reached that health is a sociobiological process historically determined. With the foregoing definition as a starting point, the author reviews the validity of primary care as a "key" strategy for attaining the goal of health for all by the year 2000.

This paper describes and analyzes the main characteristics identified in seasonal Guatemalan workers who migrate every year to coffee plantations in the Sosonusco region in the state of Chiapas. Stress is placed on the disadvantageous working and living conditions of said population in their original areas of residence, as a necessary referent for understanding the nature and function of seasonal migratory work as a part of a social sector whose living conditions are marked by poverty. The data utilized for the analysis were obtained through a survey carried out in the 1986-1987 harvest season, in which 591 migrants working in 13 ejido or privately-owned productive units in the municipalities of Tapachula and Union Juarez were interviewed.

Changes in the relationship between population factors and the development process in Mexico from 1940 to the present are reviewed. The authors show how the development that occurred up to about 1970 both absorbed and encouraged rapid population growth. They then describe how the emergence of problems concerning this relationship led to the development of a population policy during the 1970s. "The paper then takes up the implementation of that policy and the determinants of the fertility decline that took place afterwards, and closes with a brief review of the implications that demographic considerations have for Mexico's future." (SUMMARY IN ENG), (excerpt)

The situation of Mental Health in Latin America is analyzed. Urgently creating a system able at handling the psychiatric disease increase in the years to come is a conclusion this paper strongly aims at. The beginning of Psychiatry is reviewed, and the importance of Psychiatry at the General Hospital is outlined as well as its rapprochement toward the community, which led to a better control and prevention in the field of Mental Health. A definition of Psychiatry is proposed, as a branch of Medicine which stands in between mental hospitals and communities. Active teamwork, coupled with the physician's work and the tasks other members of the health personnel are engaged in, has led to a more integrated approach onto the ill thus benefiting not only patients but also the whole community.

"This paper describes the historical evolution of five populations and analyzes the circumstances under which data on maternal and paternal orphanhood of couples at the moment of marriage were collected and compiled." The data, which concern historical populations in Mexico, Chile, Peru, Brazil, and Argentina, are used to construct life tables for male and female adults. Consideration is given to mortality differentials by sex. (summary in ENG), (excerpt)

In infant mortality estimates, using the Coale-Trussell procedure with information from 2 successive population censuses of a country, reveals differences in the levels for the overlapping years of periods. This paper deal with this problem using the 1974 and 1982 censuses of Ecuador. The contribution of his analysis consists in demonstrating that infant mortality in a given year--estimated from a specific age group--is a weighted average between zero mortality--women declaring no deaths among their children and mortality with a value different from zero--women declaring some child dead. The weighing values are the age structure of women according to the condition of having dead children and corrected by the mean parity of the corresponding age group. Looking at the structure--women with or without dead children--of both censuses, a strong increase in the proportion of women without dead children occurred in 1982 as compared with the proportion in 1974. In order to eliminate this lack of comparability a reweighing was introduced in the 1982 information. New estimates were obtained, and these are much closer to the estimates obtained from the 1974 census.

This paper analyzes in detail the principal patterns of the organization or structure of medical care observed in Latin American countries. It reviews the salient features of their structures and examines the major strategies adopted for reorganizing them to respond to new operating requirements. The authors state the conceptual basis and the components of the structure of medical care services and their nature, and then discuss different organizational models both of health systems as a whole and of operating units within them. The four organizational models considered are public or government service, social security, group medicine, and private medicine. The aspects selected for review in these four models are financing, remunerations, the investment in technology, the local service units, the formal structure of the services, the user's participation, information for decision-making, equity and economic efficiency, and the capacity to deliver benefits. The paper emphasizes throughout the patent need for change at all levels of the structure of the services so as to attain the goals of coverage expansion and health for all by the year 2000. These changes must take account of factors deriving from population growth and the changes in the systems made necessary by the present state of the services. A few considerations are also presented on the principal problems that will confront health services in the process and, lastly, there is emphasis on the importance of health services research to establish the facts in each particular situation, and on the need to redirect the training of the manpower needed to attain the established goals.

"This paper examines characteristics of recent rural-urban out-migrants leaving households in the Sierra of Ecuador. A large, household survey focussing specifically on migration is utilized, allowing detailed crosstabulations by sex and origin-destination combination and providing information about migrants generally not found in more generic surveys or censuses. Differences are noted between migrants and non-migrants in basic demographic characteristics, reasons for migrating, and economic activities prior to and subsequent to moving. Differences in the characteristics of migrants moving between various types of place of origin and place of destination are also noted." (SUMMARY IN ENG), (excerpt)

"The paper analyzes some problems related to the census measurement of internal migration according to the three following aspects: The lack of agreement between the proposed objectives and the type of question made; questionnaire design errors and enumeration errors; and inadequate data elaboration." The geographic focus is on Latin America. Problems concerning data on place of birth or place of previous residence and how these can affect the calculation of migration trends are considered. (SUMMARY IN ENG), (excerpt)

"This paper presents six indirect techniques for estimating the degree of death coverage as applied to vital statistics information in Venezuela between 1960 and 1982, collected by two public institutions, namely, the 'Oficina Central de Estadistica e Informatica' (OCEI) and the Ministry of Health and Social Assistance (MSAS).... The results show remarkable improvements in the death registry coverage for both institutions, that amount to 97 or 98 per cent at the beginning of the 80's. Nevertheless, great differences can be observed between them regarding both structure and volume of deaths by sex and age." Among the problems discussed are the impact of immigration and errors in age reporting. (SUMMARY IN ENG), (excerpt)

"The paper analyzes the demographic aspects of the aging of the population in Latin America. Aging is still incipient in the great majority of countries of the region, but it will become generalized and will be accentuated especially after the year 2000. The dependency relationship will continue to decrease until higher levels of aging are reached; the proportion of the aged in the potentially dependent population will increase and the relationship between the population from 15 to 59 years of age and over 60 will decrease. "At present, the proportion of single women [over 60] is much higher than that of single men. From the information on participation in the labour force and the access that the aged have to income or pension benefits, the paper also shows that most of the aged that continue to work do so because they require an income for subsistence. "The paper finally includes some conclusions on the causes and consequences of the aging of the population and the actions that would be necessary to broaden knowledge for the formulation of policies." (summary in ENG), (excerpt)

This paper was presented as a working document to the Second Meeting of the PAHO/WHO Program of Textbooks for the Integrated Teaching of Internal Medicine and its Specialties (Washington, D.C., 13-18 December 1976). The need to place the medical student in his environment from the first as an active member of the health team is stressed, and several considerations about the usual obstacles to this proposal are advanced. Reference is made to the subject of curricular integration as related to the length of medical studies and to the traditional use of the hospital in the teaching of internal medicine. The second part of the document reports on the results of the PAHO survey on how internal medicine is taught in Latin America, in which 84 faculties and schools in 15 countries of the Region participated.

This paper intends to present to all the medical profession, but more specifically to the Medican and Latin American medical workers and authorities, the main purposes that arm and give structure to a new concept of teaching and learning medicine called, "Integral General Medicine" (also known as "Plan A-36"). This plan in basically conceived for México and most of Latin American countries, but may be applied to any other. The main idea is to keep the students in close contact with the community in order to achieve the best of their knowledge, both theoretically and practically, since the very early stages of their entrance to the medical school. The whole scholarship curriculum is described with reference to every one of the four academic years that accomplish the program.

The purpose of this paper is to carry out an analysis of the term leukoplakia since its introduction in 1877 and to expose the most accepted concepts and present classification within specialists. For this purpose attention will be paid to definitions established in the international seminary developed in Malmö City, Sweden, in June 1983. A group of observations on present status of research and diagnostic methods and its limitations to pre-establish when a lesion of this type is going to evolve toward malignancy, is included. An important part of this paper is devoted to the linguistic analysis of leukoplakia and leukoplasia expressions. An extensive argumentation demonstrating the systematic impropriety in the Spanish Language of translating the English term "leukoplakia as leukoplasia, is presented. There is in Spanish the accurate translation, given by the expression leukoplakia, which is not only the adequate one for the exactness of its translation but also the one more conceptually adjusted to contemporary definition universally accepted, that is to say, a white plaque. Finally, a comment on importance of incorporates to our language the exact translation of scientific words, not only to fit it to present science, but also to a better fulfillment of its function in allowing the communication within Latin American researches themselves and with the world scientific community, is exposed.

The paper attempts at a general assessment of mental health conditions in Latin America. Starting from methodological considerations the author points out at the difficulties for obtaining reliable data, gathered with compatible basis and the basical hindrances for building the concepts of health and illness, and for finding indicators reflecting the real health and welfare levels. The available data are discussed, together with their significance and scope. Stress is laid upon the meaning of prevalence and assistance data, which reflect only the problems of one sector of the population. The meaning of suicide and homicide is also discussed, and their use as indicators, together with data on occident rate, is suggested. The prevalence of alcoholism, psychosis and neuroses is examined, together with their role in the procedures for assessing mental health levels. Mental retardation and epilepsy are also considered. The author examines also human, technical and physical resources and facilities devoted to mental health, as well as training of personnel in the field. On the basis of statistical figures, it is showed a general deficit in all areas. As a conclusion, the author stresses the need to pay more attention to mental health problems and proposes a series of criteria in that sense.

"The paper refers to the amount and some characteristics of the Spanish, Italian and Portuguese immigration to Chile during the period 1860-1930. It is compared with [movements to] Argentina, Brazil, Cuba and Uruguay.... Different information sources are used and in spite of data weakness, the low preference for Chile of the European migratory flows is ratified as compared with those to Argentina.... It is pointed out that the migratory flows to Latin America, in particular to Chile, are associated, on the one hand, with the favourable... European [immigration] policy in this country and on the other hand with the huge European emigration overseas during that period." (SUMMARY IN ENG), (excerpt)

This paper focuses on the need of every researcher to be informed on advances in his field. It reviews the means available for keeping abreast of developments in a specific area of scientific inquiry. In the author's view, articles in reference journals on a specific specialty are the best source of information. However, the interval between the writing and publication of a scientific paper is sometimes long, which poses a considerable impediment to the use of the traditional media as a means of keeping up. He also examines the limitations of information in biomedical research and reviews the characteristics of this research in Latin America. Finally, he makes a number of recommendations for improving scientific communications and making the most of the services of national and international information dissemination systems.

The list of vitamins recognized as essential in human nutrition is extensive. Only some of them, however, are attributed an important role in public health. The present paper deals with three of these selected because their deficiencies still prevail in important sectors of population in the Latin American Region: vitamin A, vitamin C and vitamin D. For each vitamin the paper discusses the scientific bases for their requirements, as well as pragmatic considerations to be taken into account for the derivation of recommended dietary intakes. Reference is made to the logic of applying the concepts of nutrient density when developing guidelines for the design of diets for the family and the community. Adequate nutrient density means that when a diet is consumed in sufficient amounts to satisfy energy requirements, the needs for essential nutrients are also being met. For the above reasons, the principle of expressing the recommended levels of intake of vitamin A and C per 1,000 kilocalories has been followed. This is not the case with vitamin D which, in view of its special feature of being synthesized endogenously, is not really a vitamin in the strict sense of the term and, therefore, a rational and consistent relationship with the energy of the diet cannot be established.