Digital Commons Network^™

Strengthening Financial Sustainability Through Integration Of Voluntary Counseling And Testing Services With Other Reproductive Health Services, Rumeli Das, Kaushik Biswas, Pradeep Panda, M.E. Khan, Rick Homan

Reproductive Health

In West Bengal, India, the Child in Need Institute (CINI) operated an HIV/AIDS voluntary confidential counseling and testing center and a reproductive health clinic at separate locations. Concerns about lack of service coordination as well as cost and revenue considerations led CINI to integrate the two services. CINI conducted an operations research study to examine the impact of integration on utilization and revenues. The objective of the study was to examine whether integration of services would yield an increase in clients served and improve the financial position of the program. The study found that integrating services was associated with increased …

Provision Of Emergency Contraceptive Services Through Paraprofessionals In India, Shiv Kumar, Chander Shekhar, N.K. Gupta, Malabika Roy, M.E. Khan, Mary Philip Sebastian, Rukma Idnani, Ardash Bhargava, Vinita Salvi

Reproductive Health

In 2004, with funding for technical assistance provided by USAID, the Indian Council of Medical Research funded and collaborated with the Frontiers in Reproductive Health (FRONTIERS) program of the Population Council on a two-year study to assess the usefulness and effectiveness of using paraprofessionals in educating and providing emergency contraception (ECP) services to potential users. Based on the findings and advocacy efforts, the Indian Ministry of Health and Family Welfare introduced ECP as an over-the-counter medication beginning in September 2005. This made it possible for paraprofessionals in the National Family Planning Program to provide ECP services, making the method widely …

Developing And Testing Strategies For Increasing Awareness Of The Iud As A Contraceptive Option, Ricardo Vernon, M.E. Khan, Harriet Birungi, Ian Askew, William Stones

Reproductive Health

A workshop was held in England in 2004 to identify the most promising interventions for increasing access to the IUD and to generate protocols for small-scale operations research projects to be undertaken in selected countries. Participants were academics, policymakers, program staff, and service providers from Bangladesh, Ghana, Guatemala, Honduras, India, Kenya, and Nepal. The workshop objectives were to review international experiences with approaches to increase access to and use of the IUD; identify factors explaining the decline in IUD use in many countries; identify factors favoring client demand for IUD; review barriers to effective IUD service delivery; identify issues of …

Technical Assistance To The Institute Of Reproductive Health, Georgetown University In Researching Introduction Strategies For The Standard Days Contraceptive Method (Sdm), Saumya Ramarao, James R. Foreit

Reproductive Health

The Institute of Reproductive Health (IRH), Georgetown University tested the impact of introducing the standard days contraceptive method (SDM) with the technical assistance (TA) of Population Council staff. FRONTIERS technical assistance had the immediate effect of allowing IRH to carry out evaluations of the SDM in Asia and Latin America. The IRH studies also produced important lessons learned on strategies for the introduction of natural methods. IRH staff responsible for the India and Ecuador projects learned specific skills in cost-analysis and research instrument design.

Effect Of Introducing An 'Afternoon Pay Clinic' On Service Utilization And Cost Recovery (Nepal), Mahendra Pd. Shrestha, Rajesh Swar, Pradeep Panda, M.E. Khan, Rick Homan

Reproductive Health

An operations research study was initiated with financial and technical assistance from the FRONTIERS program to examine whether introducing an afternoon clinic at the Chhetrapati Family Welfare Center (CFWC) in Nepal with a substantially higher registration fee could improve cost recovery by adding more to program revenues than to program costs. The study showed, however, that premium pricing of afternoon services generated very little additional demand for services. Even with a premium price, the afternoon clinic could reach its cost recovery goal only if the volume of afternoon clients were to increase significantly. However, client perceptions about the ability of …

Assessing The Feasibility, Acceptability And Cost Of Introducing Postabortion Care In Health Centres And Dispensaries In Rural Tanzania, Monica Wanjiru, Ian Askew, Nzoya Munguti, Saumya Ramarao, Rick Homan, Reheme Kahando, John M. Pile

Reproductive Health

The EngenderHealth ACQUIRE Project has been supporting the Tanzanian Ministry of Health (MOH) since early 2005 to decentralize the management of postabortion care (PAC) services to primary healthcare facilities (health centers and dispensaries), with the intention of bringing services closer to women who are unable to access them at district hospitals. Findings from this study were provided to the MOH and ACQUIRE to address issues arising from introduction of the intervention; and in September 2006, to assess the feasibility, cost, and effectiveness of the intervention. Findings show that the intervention appears to have broadened service providers’ range of clinical skills …

Testing The Effectiveness Of The Men As Partners Program (Map) In Soweto, South Africa, Prudence Ditlopo, Saiqa Mullick, Ian Askew, Ricardo Vernon, Edwin Maroga, Sgidi Sibeko, Mokgethi Tshabalala, Rabbuh Raletsemo, Dean Peacock, Andrew Levack

Reproductive Health

This project was conducted to evaluate the effectiveness of the Men as Partners (MAP) program in South Africa in terms of: changing men’s gender attitudes, norms and behaviors; changing aspects of gender dynamics in relationships; reducing the prevalence of unwanted pregnancy risk behaviors at individual and community levels; and increasing male involvement in gender based violence (GBV) and HIV prevention and in HIV care and support activities. The intervention activities implemented were MAP workshops, public demonstrations, and participation in community action teams. The evaluation of the interventions showed that about 30% of the workshop participants had also attended other MAP …

Addressing The Needs Of Seasonal Migrants In Nashik, Maharashtra, Anjali B. Borhade

Reproductive Health

In order to identify the opportunities and options available to address the vulnerabilities of and socioeconomic needs of seasonal migrants, an intervention project was launched by the Disha Foundation, a nongovernmental organization in Nashik city, Maharashtra, India. This report intends to use the project experience as a case study to provide a blueprint for interventions for seasonal migrants to access a range of basic services in areas of destination and to exercise their rights to access available services. The report documents the array of strategies used to enable seasonal migrants to recognize their entitlement and to access available public sector …

Informed Consent In Sterilisation Services: Evidence From Public And Private Health Care Institutions In Chennai, Raja Lakshmi

Reproductive Health

The objective of this paper is to explore the experiences of women undergoing a particular form of fertility regulation, namely sterilization or tubal ligation, in a variety of facilities in Chennai, India. The paper examines specifically the nature of information provided to clients, the consent-taking process, the nature of its documentation, and the extent to which clients made an informed choice. The findings underscore that although all the women respondents did wish to practice a method of contraception, and did want to adopt sterilization, several limitations were noted in the process of providing informed consent: inadequate information was provided to …

Young People's Sexual And Reproductive Health In India: Policies, Programmes And Realities, K.G. Santhya, Shireen J. Jejeebhoy

Reproductive Health

This paper presents an overview of key policies and government programmes intended to reduce HIV vulnerability and improve sexual and reproductive health among young people in India, and identifies the extent to which these policies and programmes have addressed the gamut of unique sexual and reproductive needs of young women and men. It also explores the extent to which programmes have been adapted to accommodate state-level differences in the sexual and reproductive vulnerability of youth; the review takes the examples of two states, namely, Andhra Pradesh, characterised by both early marriage and high HIV prevalence, and Madhya Pradesh, characterised by …

Is It Time To Redesign Hospice? End-Of-Life Care At The User Interface, David J. Casarett

Center for Policy Research

Hospice is a system of end-of-life care that’s not used to its full potential. That is, hospice is not used in the way that would benefit patients and families as much as it could. My argument is that this is an issue of usability, or ergonomics—the science of design. I illustrate how to take what we have learned from the science of usability to make hospice more accessible and approachable, and to increase hospice use among those who would benefit from it. Underneath this discussion, though, there is a more fundamental question: Can we make hospice more usable or do …

Understanding The Personal And Clinical Utility Of Psychiatric Advance Directives: A Qualitative Perspective, Mimi M. Kim, Richard A. Van Dorn, Anna M. Scheyett, Eric E. Elbogen, Jeffrey W. Swanson, Marvin S. Swartz, Laura A. Mcdaniel

Faculty and Staff Publications

Psychiatric advance directives (PADs) are legal tools that allow competent individuals to declare preferences for future mental health treatment when they may not be capable of doing so as a result of a psychiatric crisis. PADs allow individuals to maintain self–determination during times when they are most vulnerable to loss of autonomy and in need of assistance to make their preferences known and honored. This article describes the content of twenty–eight open–ended, semi–structured qualitative interviews of adults with PADs who have experienced psychiatric crises. The qualitative analysis revealed three major themes from the interviews: (1) PADs as tools for empowerment …

From Adulterous Gametes To Heterologous Nation: Tracing The Boundaries Of Reproduction In Italy, Milena Marchesi

Reconstruction: Studies in Contemporary Culture

This article traces discursive and political attempts to discipline the reproduction of the Italian nation by analyzing the approval of a controversial law disciplining access to new reproductive technologies (NRTs) in 2004. The restriction of new reproductive technologies in Italy reflects a contemporary re-negotiation of gender ideologies and a renewed ascendance of the Vatican in Italian politics and society. Although abortion remains legal in Italy, the NRT legislation recognizes the embryo as a subject while in political discourse demographic alarmism slides into warnings of social disintegration. The debate over the threat posed by technologically assisted reproduction to Italian families and …

Occupational Therapy Assistant Mental Health Case-Based Learning Activities, Cassie Hilts

Occupational Therapy Capstones

Occupational Therapy Assistants (OTA) need to be skilled in clinical reasoning and able to apply principles, theories and approaches to functional problems (Neistadt, 1998; Royeen,1995; VanLeit, Crowe and Waterman, 2001). Occupational therapy assistant educational standards require that students be able to apply models of occupational performance and theories of occupation (Accreditation Council for Occupational Therapy Education, 2008). Research has shown that learners actively engaged in the learning process have increased satisfaction with their education (Robinson, 1994) and perform better on exams (Lord, 1997; Wilden, Crowther, Gubanich and Cannon, 2002). Scaffa and Wooster (2004) found self directed learning can significantly facilitate …

Get Involved: A Program For Kindergarten Students, Parents, & Teachers To Promote The Development Of Motor Skills For Daily School Occupations, Sarah Neall

Occupational Therapy Capstones

In the educational setting today, children are asked to acquire advanced academic skills at a faster pace and earlier age. Children entering the first years of school exhibit variances in their physical maturity levels, which affects both fine and gross motor skills and their performance in daily school occupations. Frequently, young children are unable to keep up with their kindergarten curriculum. Currently, the programs available to work on motor development in kindergarten age students focus solely on pre-writing skills and handwriting instruction. These programs lack information on motor skill development, home program activities, and specific occupations that kindergarten students are …

So You Want To Be An Interpreter, Janice H. Humphrey

Course Materials

This study guide contains guided learning activities, study questions and supplemental video clips to enrich the learning journey of students in diverse learning environments.

Unusual Case Of Senecio Sceleratus (Ragwort) Poisoning In An Ostrich (Struthio Camelus) In Zimbabwe, Ross G. Cooper

Turkish Journal of Veterinary & Animal Sciences

No abstract provided.

Health Systems And Maternal Mortality, Neonatal Mortality And Child Health: Review Of Selected Service Delivery Models, Md. Noorunnabi Talukder, Ubaidur Rob

Reproductive Health

Effective maternal and child health services at the community level in developing countries are rarely available. In many developing countries the health systems cannot provide quality maternal and child health care services due to lack of adequate human resources; shortages of equipment, drugs, and supplies; and absence of proper referral mechanisms. Strengthening health systems is central to improving maternal and child health. A variety of targeted interventions have been implemented in the health systems of developing countries. This study was conducted to identify the health service delivery models that have contributed to the reduction of maternal, infant, and child mortality …

Kenya: Begin Community Dialogue On Fgm/C By Discussing Cultural Justification, Frontiers In Reproductive Health

Reproductive Health

Female genital cutting is strongly supported among the Somali ethnic community in Kenya, and the severest form (infibulation) is primarily practiced. This type of cut is associated with increased incidence and seriousness of obstetric and gynecological problems relative to uncut women and those with less severe forms of FGM/C. As stated in this brief, efforts to encourage abandonment should begin with community discussion about the socio-cultural reasons for cutting. Simultaneously, health-care providers need training in how to manage complications of FGM/C. In 2004, FRONTIERS collaborated with UNICEF on a four-month diagnostic study on FGM/C practices among the Somali community in …

Senegal: Mainstreaming Adolescent Health: Building On Local Support Systems, Frontiers In Reproductive Health

Reproductive Health

In 1999, FRONTIERS began a three-year collaboration with the World Health Organization, the Center for Research and Training, the Population Training Group, and the Ministries of Health, Education, and Youth to test the feasibility, effectiveness, and cost of school-, clinic-, and community-based interventions to improve the reproductive health of youth aged 10–19. This adolescent reproductive health (ARH) study showed that the multisectoral, multidisciplinary approach increased knowledge about youth reproductive health among young people, the community, schools, and health-care providers. As noted in this brief, one of the guiding principles of the ARH study was to build sustainability through existing institutions, …

Predictability Of Cardiovascular Disease Event Rates By Common Carotid Artery Intima-Media Thickness In The Atherosclerosis Risk In Communties (Aric) Study, Mara Hollander

Loma Linda University Electronic Theses, Dissertations & Projects

Background: Carotid artery intima media thickness (IMT) is a non-invasive reliable predictor of the extent and severity of CVD. There is difficulty acquiring all measurements for validated three-site carotid IMT. More accessible one-site common carotid artery (CCA) IMT has not yet been validated with CVD events.

Purpose: This study will evaluate the diagnostic accuracy of one-site CCA IMT compared to three-site IMT in predicting cardiovascular disease (CVD) events. Assessment of whether the association of incremental one-site CCA IMT to a CVD event is significant with and without adjustment for traditional cardiac risk factors was made.

Methodology: Data from The Atherosclerosis …

Rate Change Effects On Acoustic Duration Measures On An Adolescent Who Stutters, Valerie Jean Courville

LSU Master's Theses

The purpose of this study was to determine if reduced rate techniques have an effect on speech motor coordination of an adolescent. A literature review revealed that a reduced rate technique consistently promoted more fluent speech; however, the cause of that increase in fluency is not known. This study proposed three specific questions to determine if there was a shortening of the /s/ phoneme in clustered contexts when compared to singletons, if reducing the rate would cause the adolescent to produce more adult-like shortening patterns, and if the reduced rate technique caused a decrease in stuttering events. One eleven year …

Governing Catastrophes: Security, Health And Humanitarian Assistance, David P. Fidler

Articles by Maurer Faculty

Recent catastrophes, and predictions of an increasing potential for more, have stimulated thinking about the best policy responses to these threats. This article explores how security concepts influence catastrophe governance. The article considers how globalization affects thinking about catastrophes and describes ways in which catastrophes have been conceptualized as governance challenges, such as the human rights approach to the provision of health and humanitarian assistance. The article explains how health and humanitarian assistance experienced ‘‘securitization’’ in the post-cold war period, a development that challenges rights-based strategies and creates complex and controversial implications for the prevention, protection and response functions of …

Expectation In Visual Symbolic Processing Of Environmental Symbols In People With Fluent Aphasia, Amanda Stead

LSU Master's Theses

The purpose of this study was to examine aspects of visual symbolic processing in those individuals with fluent aphasia, and how it compares to that of their lexical ability. Two groups of participants were examined: a group with fluent aphasia, and a group of non-neurologically damaged controls. Participants were administered four computer based expectation tasks, two of which were symbolic, and two which were lexical. Each task contained a simple and a complex level. Participants were required to determine if the final stimulus, within a set of four, was congruent or incongruent. The measures taken included both reaction time and …

Factors Associated With Atypical Moles In New Hampshire, Usa, L Titus-Ernstoff, J Ding, A. E. Perry, S. K. Spencer, B. F. Cole, M. S. Ernstoff

Dartmouth Scholarship

Only a few studies, conducted in Sweden, assessed factors associated with the presence of atypical moles in the general population. We conducted a population-based, case-control study in New Hampshire, USA, to identify factors associated with atypical moles. In our study, atypical moles affected 14% of the study population. The adjusted odds ratio (OR) was 0.34 (95% confidence interval (CI)=0.14-0.80) for those with the highest adulthood recreational sun exposure, relative to the lowest. The OR for any freckles, compared to none, was 2.24 (95% CI=1.18-4.25). We found a linear relationship between the number of benign moles and the presence of atypical …

Understanding Personal Carers' Experiences Of Caring For Older People In Pain, Kristi Holloway

Theses : Honours

Pain is a complex phenomenon that can be challenging for staff working in residential aged care facilities (RACFs) (Fisher et al., 2002; Twycross, 2002). A high prevalence of pain reported by older individuals has been reported and suggests that further study in this area is warranted (Higgins, Madjar & Walton, 2004). Research suggests that a significant barrier to effective pain management in the elderly is the provision of primary care by care staff who have little or no education about pain, pain assessment or pain management (Allcock, McGarry & Elkan, 2002). Studies have identified personal carers as being in a …

Outlook Magazine, Summer 2007

Outlook Magazine

No abstract provided.

Outlook Magazine, Spring 2007

Outlook Magazine

No abstract provided.

Parents As Advocates For Their Hearing Impaired Children Transitioning From A Private Setting To A Mainstream Setting, Elizabeth Anne Pitlyk

Independent Studies and Capstones

This project studied the experiences of parents whose hearing impaired children moved from private education settings into mainstream education.

Distortion Product Otoacoustic Emissions In The Bullfrog, Rachel E. Lohr

Independent Studies and Capstones

Recovery of distortion product otoacoustic emissions in the bullfrog after noise exposure does not correlate with hair cell damage noted on the amphibian papilla.