Digital Commons Network^™

Referral Mechanism Improves Uptake Of Art Services For Hiv+ Fp Clients, Population Council

Reproductive Health

An operations research intervention by the Population Council in Kenya aimed to design a referral framework for linking HIV‐positive family planning (FP) clients to treatment and care in selected health facilities. The project also assessed the acceptability and effectiveness in increasing the number of eligible HIV‐positive FP clients receiving HIV care and treatment services. This summary details the effort to improve the linkage between FP services and comprehensive care centers that led to a dramatic increase in the proportions of HIV-positive clients in FP clinics who go on to receive HIV/AIDS treatment and care services at the same facility. Recommendations …

Maternal And Neonatal Health Services In Sudan: Results Of A Situation Analysis, Nahla G. Abdel-Tawab, Maha El-Rabbat

Reproductive Health

This project brief is based on the results of a situation analysis (SA) study that was done collaboratively by the Population Council and Sudan Ministry of Health (MOH) with funds from UNFPA, UNICEF, and Packard Foundation. The analysis showed an uneven distribution of reproductive health (RH) staff across Sudan, and nurses and nurse midwives are the key in RH services. There was also limited access to family planning services. Antenatal care was limited, and pregnant women in the study seldom received counseling on birth spacing or birth preparedness. Birth attendants also lacked adequate knowledge and skills. Emergency obstetric care was …

Self-Examination For Breast And Testicular Cancers: A Community-Based Intervention Study., Khairunnisa Shallwani, Rozina Ramji, Tazeen S. Ali, Ali Khan Khuwaja

Department of Radiation Oncology

The prevalence of cancers is growing rapidly in all parts of the word and Pakistan is no exception. Prevention is the best option to tackle this rising epidemic and screening, early detection and health awareness programs are cornerstones in this regard. A community-based interventional study was therefore her conducted to assess the effect of health education intervention about knowledge and practice of self-breast examination (SBE) among women and self-testicular examination (STE) among men. A total of 127 (70 females and 57 males) adults (>or=18 years) from an urban community of Karachi, Pakistan were included after giving informed consent. Interventions …

Introducing A Multi-Site Program For Early Diagnosis Of Hiv Infection Among Hiv-Exposed Infants In Tanzania, Harriet Nuwagaba-Biribonwoha, Bazghina Werq-Semo, Aziz Abdallah, Amy Cunningham, John G. Gamaliel, Sevestine Mtunga, Victoria Nankabirwa, Isaya Malisa, Luis F. Gonzalez, Charles Massambu, Denis Nash, Jessica Justman, Elaine J. Abrams

Publications and Research

Background: In Tanzania, less than a third of HIV infected children estimated to be in need of antiretroviral therapy (ART) are receiving it. In this setting where other infections and malnutrition mimic signs and symptoms of AIDS, early diagnosis of HIV among HIV-exposed infants without specialized virologic testing can be a complex process. We aimed to introduce an Early Infant Diagnosis (EID) pilot program using HIV DNA Polymerase Chain Reaction (PCR) testing with the intent of making EID nationally available based on lessons learned in the first 6 months of implementation.

Methods: In September 2006, a molecular biology laboratory at …

The Female Athlete, Dilip R. Patel, Donald E. Greydanus, Hatim A. Omar

Pediatrics Faculty Publications

The female athlete has today became an accepted part of sports in elementary school, junior high, senior high, and college. This chapter covers various aspects of the prepubertal and pubertal female athlete. An historical perspective will be presented and selected comments provided on psychological and physiologic aspects of the female athlete. Concepts of adolescent gynecology are reviewed, including breast concerns and menstrual dilemmas in relation to sports activity. Exercise during pregnancy is also considered. Iron deficiency anemia and stress urinary incontinence

Fmic Annual Report 2010 | English, French Medical Institute For Mothers And Children

French Medical Institute for Mothers and Children (FMIC) Archives

No abstract provided.

The Mozambique Eyecare Project: Implementing A Model That Addresses Uncorrected Refractive Error In Lusophone Africa., Stephen Thompson, Diane Wallace

Conference Papers

BACKGROUND

Optometric education and resources are drastically deficient in most of Africa, more so in Lusophone Africa where the problem is compounded by language barriers which isolate these countries from related developments in Africa and/or the developed world.

The Mozambique Eyecare Programme is a multi-partner collaboration between The International Centre for Eyecare Education (ICEE), Universidade Lúrio in Mozambique, Technological University Dublin, and the University of Ulster in Ireland, designed to address the need for optometric education in Lusophone Africa.

AIM

This paper aims to document the current situation with regards to human resource development in eyecare in Mozambique and offer …

Safety, Tolerability, And Efficacy Of Fixed Combination Therapy With Dorzolamide Hydrochloride 2% And Timolol Maleate 05% In Glaucoma And Ocular Hypertension, Nicholas P Bell, José L Ramos, Robert M Feldman

Faculty, Staff and Student Publications

Glaucoma is a collection of diseases characterized by multifactorial progressive changes leading to visual field loss and optic neuropathy most frequently due to elevated intraocular pressure (IOP). The goal of treatment is the lowering of the IOP to prevent additional optic nerve damage. Treatment usually begins with topical pharmacological agents as monotherapy, progresses to combination therapy with agents from up to 4 different classes of IOP-lowering medications, and then proceeds to laser or incisional surgical modalities for refractory cases. The fixed combination therapy with the carbonic anhydrase inhibitor dorzolamide hydrochloride 2% and the beta blocker timolol maleate 0.5% is now …

Innovative Mental Health Services In Rural Minnesota: Community-Based Mobile Crisis Response Services, Rebecca A. Zuehlke

All Graduate Theses, Dissertations, and Other Capstone Projects

The purpose of this research project was to explore the relationship between the frequency of service utilization of the Community-based Mobile Crisis Response Services (MCR) provided by the Southwestern Mental Health Center (SWMHC) and the frequency of service utilization of emergency holds and civil commitments in Jackson and Cottonwood counties by month for the 2009 calendar year.

The specific research question proposed was: Is there a relationship between the frequency of Community-Based Mobile Crisis Response Services and the frequency of emergency holds and civil commitments in Jackson and Cottonwood Counties?

The significance of this research project was to explore statistically …

Independent Living Outcomes Evaluation Project, Craig J. Padgett

All Graduate Theses, Dissertations, and Other Capstone Projects

This project developed specific examples of skills and resources for three example categories of ILST and developed recommendations for enhancing the creation of goals. It was important to develop indicators into a tiered structure for reinforcing those skills and resources into knowledge through an added educational component. Methodology was developed and necessary instrumentation and processes were designed for implementation. And, an informed consent was designed for any organization providing Independent Living Skills Training (ILST).

Application Of X-Ray Diffraction To Material Analysis And Medical Imaging, Wei Zhou

Legacy Theses & Dissertations (2009 - 2024)

Powder diffraction is commonly used to determine the structures of both inorganic and organic materials. The angle and intensity of the diffraction (also called coherent scatter) peak depends on the nanostructure of the material. When no x-ray optic is used, the peak width broadens, and hence the resolution worsens, as the sample area is increased. However, a small sample area gives low diffracted signal intensity, particularly for thin films and for organic materials, which have low diffraction cross sections. X-ray optics can be used in x-ray powder diffraction to increase the diffraction intensity, thus decreasing exposure times. For a small …

Oncolog Volume 55, Number 01, January 2010, Bryan Tutt, Bita Esmaeli

OncoLog MD Anderson's Report to Physicians (All issues) Archives

• Ocular Cancer: Tumors of the eye threaten sight and often indicate presence of extensive disease
• Eye Care for Cancer Patients
• Doctors Team Up to Battle Retinoblastoma
• Compass Winter 2010: Ductal Carcinoma In Situ: Choosing Treatment for a Common Group of Early, Confined Breast Cancers
• Toward Tomorrow
• House Call: Three Targets for New Year's Resolutions

Radical Nephrectomy With Ivc Thrombectomy (Level-Iii) Conducted On Veno-Veno Bypass, Tariq S. Hakky, Lucas R. Wiegand, Devannand Mangar, Angel Alsina, Philippe E. Spiess

Urology Faculty Publications

Introduction: We report a 43 year old man who was diagnosed with a level-I thrombus and was managed on oral sunitinib for two months by a community Urologist. The thrombus progressed to a level-III and he subsequently developed a pulmonary embolus, which required oral anticoagulation. He was then referred to our facility for definitive surgical care. A computed tomography scan demonstrated a 12 by 15 centimeter right renal mass and on magnetic resonance venography of the abdomen a tumor-thrombus extending into the infradiaphragmatic inferior vena cava was noted. Pre-operatively consults with hepatobiliary, vascular, and chest surgeons were obtained.

Methods: The …

Access For Laparoendoscopic Single Site Surgery, Sharona B. Ross, C. Whalen Clark, Connor A. Morton, Alexander S. Rosemurgy

Surgery Faculty Publications

Laparoscopic surgery is the standard of care for many abdominal and pelvic operations and is widely applied today. LESS (Laparo-Endoscopic Single Site) surgery, originally attempted in the 1990s, is an advanced minimally invasive approach that allows laparoscopic operations to be undertaken through a small (<15 mm) incision in the umbilicus, a preexisting scar. The presence of a preexisting scar allows LESS surgery to be essentially scarless, which is the key benefit to LESS operations. Herein, we review our experience with over 500 LESS operations and discuss the key techniques to establishing access to the peritoneal cavity. We review the options for obtaining access, available instrumentation, common challenges and solutions for access. We conclude that LESS surgery is safe and provides outcomes with superior cosmesis relative to conventional laparoscopy. LESS surgery should be embraced, as patient demand is rapidly increasing.

The Role Of The Arts Toward Healing Trauma And Building Resilience In The Palestinian Community, Yousef Al-Ajarma

Expressive Therapies Dissertations

This study has investigated the sources of resilience in a sample of Palestinians who experienced the first Intifada and are now studying in the United States. The study found that family and community support, the pursuit of an education, and participation in artistic activities all contribute to individual resilience among Palestinians. In addition, political awareness and activity are another source of resilience, because they help individuals living under the Occupation to find meaning in their life and make sense of their struggles. Currently, young people in Palestine are at risk of developing psychological trauma from exposure to the violence of …

Hiv Prevention Through Sport: The Case Of The Mathare Youth Sport Association In Kenya., Wim Delva, Kristien Michielsen, Bert Meulders, Sandy Groeninck, Edwin Wasonga, Pauline Ajwang, Marleen Temmerman, Bart Vanreusel

Obstetrics and Gynaecology, East Africa

Sport has become a popular tool for HIV prevention, based on claims that it can foster life skills that are necessary to translate knowledge, attitudes and behavioural intentions into actual behaviour. Empirical evidence of the effectiveness of sport-based HIV prevention programmes is, however, sorely lacking. We therefore conducted a cross-sectional survey assessing sexual behaviour and the determinants thereof among 454 youth of the Mathare Youth Sport Association (MYSA) in Kenya and a control group of 318 non-MYSA members. Multiple (ordinal) logistic regression models were applied to measure the association between MYSA membership and attitudes, subjective norms and self-efficacy related to …

‘Maternal Intensive Care’: A Systematic Literature Review, An-Sofie Van Parys, Hans Verstraelen, Kristien Roelens, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Objective: The objective of this systematic literature review is to review current scientific knowledge on the definition of and the indications for maternal/obstetric intensive care (MIC).

Methods: We conducted a extensive search in OVID MEDLINE, EMBASE, COCHRANE, CINHAL and CEBAM using the keywords: maternal/obstetric intensive care, subacute care, intermediate care, postacute care, critical care, sub intensive care, progressive patient care, postnatal care, perinatal care, obstetrical nursing, neonatology, pregnancy, maternal mortality/morbidity and pregnancy complication. A total of 180 articles and one guideline were identified and supplemented by a hand search. After title, abstract and full text evaluation, the articles and guideline …

Behavioral Health Self-Efficacy Of Nurses In A Rural Emergency Department, Alyssa Schlager

All Graduate Theses, Dissertations, and Other Capstone Projects

This project aims to provide a resource manual for the Waseca area which will be utilized by the emergency department‟s nursing staff. As described above, the need for nursing staff to know how to work with, handle, and appropriately refer behavioral health patients is an essential piece of emergency department nursing. After receiving an orientation on the composition of the new resource manual, emergency department nursing staff will have a better understanding of what to do when the social worker is not present as well as feel more comfortable with their knowledge related to behavioral health patients.

This project has …

Assessing Abortion-Related Experiences And Needs In Four Districts Of Maharashtra And Rajasthan, 2006, Shireen J. Jejeebhoy, A.J. Francis Zavier, Shveta Kalyanwala

Poverty, Gender, and Youth

Recognizing the urgent need to enable rural women to acquire accessible and high-quality abortion services in India, a consortium of organizations—including the Population Council—has come together with the goal of increasing access to legal, safe, and comprehensive abortion services, including postabortion family planning, in the public health system, especially among the rural poor. One of its key activities was to develop a comprehensive and evidence-based abortion care model suitable for rural women. The aim of this report is to shed light on community-level perspectives about abortion services and probe the experiences of women who had undergone abortion, to better understand …

Increasing Postpartum Contraception In Rural Uttar Pradesh: Implications For Behavior Change Communication, Population Council

Reproductive Health

The Population Council conducted a formative study in rural Uttar Pradesh, India to assess the level of adoption of postpartum contraception for spacing among low parity women, identify the facilitating factors and barriers to the adoption of this target behavior, and identify programmatic and behavior change communications (BCC) initiatives that could accelerate the adoption of postpartum contraception for spacing and improve the service delivery system, if required, to facilitate the process. Barriers included low awareness of consequences of closely spaced births, misconceptions about contraceptive methods, lack of counseling by health workers, reluctance to include husbands, and programmatic emphasis on limiting …

Mainstreaming Emergency Contraception Pills In Kenya, Jill Keesbury, Monica Wanjiru, Katherine Maina

Reproductive Health

To improve access to emergency contraception (ECP) and ensure that adequate information is provided to all users, the Kenyan Ministry of Public Health and Sanitation, the Population Council, and Population Services International-Kenya undertook a three-year effort to mainstream ECP in Kenya. This brief presents the results of this initiative and discusses strategies for further strengthening ECP provision. Kenya has emerged as a leader in ECP programming in the region and has demonstrated that it is possible to strengthen ECP services in both the public and private sectors while at the same time increasing public awareness, knowledge, and use of the …

Training Service Providers Increases Tb Screening In Postnatal Care, Population Council

Reproductive Health

This document summarizes a Population Council operations research project undertaken in collaboration with the Kenya Ministry of Health to develop and pilot-test an intervention to improve TB screening, case detection, treatment, and care among postnatal clients. The intervention demonstrated that it is feasible to use postnatal care services as a platform to increase TB screening and case detection. Training providers, giving them job-aids, and strengthening client flow within the facility also improved the overall quality of care that the clients received. The actual number of cases of TB detected was extremely low, however; thus the report recommends that the Ministry …

Assessing The Feasibility Of Home Administration Of Misoprostol In The Prevention Of Postpartum Hemorrhage In Rural Pakistan, Ali M. Mir, Abdul Wajid, Sadaf Gull

Reproductive Health

This report details an operations research project carried out by the Population Council as part of the Pakistan Initiative for Mothers and Newborns. The overall goal of the project was to test the feasibility of administering misoprostol for the prevention of postpartum hemorrhage (PPH) in a home setting through community‐based healthcare providers, including traditional birth attendants (TBAs), or family members, in two districts of Pakistan. Furthermore, it aimed to identify common side effects of misoprostol and determine the reduction in demand for referral due to PPH after oral ingestion of misoprostol. The results provide a useful addition to the literature …

The Pregnancy Cycle Approach To Safe Motherhood, Saumya Ramarao, Sarah Raifman

Reproductive Health

The Population Council's Reproductive Health program partnered with the Maternal Health Task Force (MHTF), the Partnership for Maternal, Newborn and Child Health (PMNCH), and the PAC Consortium, to address the UN Millenium Development Goal of improving maternal health, and reducing child mortality. Specifically this brief examines the pregnancy cycle approach whereby women’s needs from facilitating a desired pregnancy to successful parturition are addressed in a range of settings—home, community and health facility. This brief covers the different stages including abortion and postabortion care, antenatal care, delivery, and postpartum and beyond.

Introducing And Pilot-Testing The National Guidelines On Integrating The Management Of Stis/Rtis Into Reproductive Health Settings In Kenya, Wilson Liambila, Saiqa Mullick, Ian Askew, Nathalie Broutet, Bartilol Kigen, Cosmas Mutunga, Daniel Sande, Nimrod Garama, Benjamin Tsofa, Christine Awuor, Ibrahim Mohammed

Reproductive Health

This report evaluated a project in ten Kenyan health facilities. It examined the feasibility, acceptability and effect of introducing reproductive tract infection and sexually transmitted infection (RTI/STI) guidelines on the quality of care provided, and the incremental costs of integrating these services into existing reproductive health (RH) services; it also disseminated the results and lessons learnt within Kenya. Overall, the results showed that integration of activities to screen for and manage STIs/RTIs into RH services is feasible, acceptable to clients and providers, and effective in improving the range and quality of services offered to clients.

Emergency Contraception: Idea To Program, Saumya Ramarao, John Townsend, Sarah Raifman

Reproductive Health

This report summarizes the role of the Population Council in generating evidence, providing technical leadership, and demonstrating at scale that emergency contraception (EC) can be easily integrated into national family planning programs and other reproductive health services. Since the 1990s, the Population Council, along with other partners, has contributed to the changes seen in the provision and availability of EC, now available in over 140 countries around the world. While much progress has been made in the campaign for access to EC, the Council is committed to improving existing methods of service delivery and to leading advocacy efforts and research …

Our Grandparents, Our Parents, Our Future Selves: Optimizing Function In Old Age., Thomas Michael Gill

Center for Policy Research

Most of my research at Yale University School of Medicine over the past several years has focused on identifying older adults at risk of functional decline and disability, identifying events that may precipitate the transition from functional independence to disability, and developing strategies to postpone or reduce frailty and disability. As a result of the Precipitating Events Project (PEP) and other research conducted by the Yale Center on Aging/Pepper Center, we now realize that age is only a proxy for other factors that lead to disability, and that some of these factors can be modified to reduce the risk of …

Community Mobilization For Postabortion Care In Kenya: Baseline Evaluation Report, Chi-Chi Undie, Saumya Ramarao

Reproductive Health

Maternal health complications, including those arising from unsafe abortion and miscarriage, are a leading cause of morbidity among women in Kenya. These realities necessitate interventions to prevent unintended or unwanted pregnancies and to ensure access to quality care for women with postabortion complications. In response to this need, the RESPOND Project designed an intervention package aimed at increasing awareness and use of postabortion care (PAC) services and improving family planning, reproductive health, and maternal health outcomes. As part of the intervention, RESPOND works with districts and communities to: strengthen service delivery points to provide PAC services; conduct community mobilization to …

Prenatal Beta-Endorphin As An Early Predictor Of Postpartum Depressive Symptoms In Euthymic Women, Ilona S. Yim, Laura M. Glynn, Christine Dunkel Schetter, Calvin J. Hobel, Aleksandra Chicz-Demet, Curt A. Sandman

Psychology Faculty Articles and Research

After delivery, many women experience symptoms of postpartum depression (PPD), and early identification of women at risk is therefore important. The opioid peptide [beta]-endorphin has been implicated in non-puerperal depression but its role in the development of PPD is unknown.

Understanding Caretakers' Dilemma In Deciding Whether Or Not To Adhere With Referral Advice After Pre-Referral Treatment With Rectal Artesunate, D.O. Simba, D.C. Kakoko, M. Warsame, Zul Premji, M.F. Gomes, G. Tomson, E. Johansson

Pathology, East Africa

Background: Malaria kills. A single rectal dose of artesunate before referral can reduce mortality and prevent permanent disability. However, the success of this intervention depends on caretakers' adherence to referral advice for follow-up care. This paper explores the dilemma facing caretakers when they are in the process of deciding whether or not to transit their child to a health facility after pre-referral treatment with rectal artesunate.

Methods: Four focus group discussions were held in each of three purposively selected villages in Mtwara rural district of Tanzania. Data were analysed manually using latent qualitative content analysis.

Results: The theme «Caretakers dilemma …