Digital Commons Network^™

Scaling Up A Successful Counseling Model In Guatemala, Guatemalan Association Of Female Physicians (Agmm)

Reproductive Health

This project aimed to improve clients’ ability to make an informed choice of contraceptive methods by scaling up the use of the balanced counseling strategy in public service delivery institutions in Guatemala. To reach this end, the project provided technical assistance to Calidad en Salud (Quality in Health), the leading reproductive health project in Guatemala, to train service providers in public institutions about the counseling methodology. The project successfully introduced the balanced counseling strategy in Guatemala and, as a result, has improved the informed choice of contraceptives in the country.

Effects Of Igss' Job Aids-Assisted Balanced Counseling Algorithms On Quality Of Care And Client Outcomes, Federico R. Leon, Carlos Brambila, Marisela De La Cruz, John H. Bratt, Gustavo Gutierrez, Veronica Davila, Carlo Boniato, Alex Rios

Reproductive Health

This study identified a need to improve the quality of care at the main maternity hospital of the Social Security Institute (IGSS) in Guatemala. Problems included very short counseling sessions, counseling not focused on clients’ needs, redundancy in the role of physicians and social workers as providers, skewed method mix, and low client return rate for method resupply. The intervention, using Balanced Counseling Algorithms, changed the counseling behavior of physicians and social workers and enhanced the quality of family planning care. The report includes recommendations for continuing these improvements: monitoring provider implementation of the job aids–assisted Balanced Counseling Algorithms, monitoring …

Integrating Adolescent Livelihood Activities Within A Reproductive Health Program For Urban Slum Dwellers In India, Dale Huntington, Mary Philip Sebastian, Barbara Mensch, Wesley H. Clark, Aditya Narain Singh, Sohini Roychowdhury, M.E. Khan, Nirmala Selvam, Bella C. Patel, Sandhya Barge, Y.P. Gupta, Lovleen Johri, Gita Biswas, Manohar Shenoy

Reproductive Health

The Population Council’s Frontiers in Reproductive Health (FRONTIERS) program and Policy Research Division, in collaboration with CARE India, conducted an operations research study in Allahabad, Uttar Pradesh to examine the feasibility and impact of adding livelihood counseling and training, savings formation activities, and follow-up support to an ongoing reproductive health program for adolescents. The short-term objective of the study was to foster development of alternative socialization processes for adolescent girls that encourage positive sexual and reproductive health behaviors. The study also aimed to produce a replicable model for CARE and other agencies to use in adding livelihood activities to adolescent …

Promotion Of Lactation Amenorrhea Method Intervention Trial, Kazakhstan, Shamil Tazhibayev, Toregeldy Sharmanov, Ayan Ergalieva, Oksana Dolmatova, Orynkul Mukasheva, Aina Seidakhmetova, Raikhan Kushenova

Reproductive Health

In order to expand the benefits of breastfeeding as a birth spacing option for women in the Republic of Kazakhstan, the Kazakh Academy of Nutrition at the Academy of Preventive Medicine in Almaty conducted an operations research study to test the effectiveness of lactational amenorrhea method (LAM) promotion among women in Kazakhstan, as part of the Population Council’s Frontiers in Reproductive Health Small Grants Program. Results show that the intervention programs implemented in experimental baby-friendly hospitals (BFHs) and ordinary hospitals (OHs) improved women’s knowledge, skills, and desire to breastfeed The report concludes that training activities should be strengthened and all …

Developing A Supervision Instrument For Postabortion Care In Guatemala, Bolivia And Mexico, Carlos Brambila

Reproductive Health

The main objective of this project was to develop and test a supervision instrument and corresponding guidelines to collect information about postabortion care (PAC) services and to provide constructive feedback to service providers and program managers. The instrument and guidelines were designed to be used by technical supervisors to monitor performance and engage providers in continuous quality improvement of PAC services. As part of the project activities, existing postabortion care supervision practices were reviewed and analyzed, and, during a one-week workshop in December 2002, an international technical committee produced a first version of the instrument and guidelines. These materials were …

Culturally Appropriate Information, Education And Communication Strategies For Improving Adolescent Reproductive Health In Cusco, Peru, Marco Florez-Arestegui Cornejo, Rosalinda Barreto Silva

Reproductive Health

The project Culturally Appropriate Information, Education and Communication Strategies for Improving Adolescent Reproductive Health in Cusco, Peru was designed in response to the evident lack of information and education on adolescent reproductive health in the country and, in particular, in the rural areas of the department of Cusco. Research revealed that a great need for sexual and reproductive health information still exists among indigenous adolescents in the rural areas of the region and that sexual education programs have to be sustainable. This report recommends that the Ministry of Education train more teachers in sexual and reproductive health topics, taking into …

Improving Health Care Providers' Knowledge, Attitudes, And Practices In Reproductive Health In Rural Romania, Elaine Claire Himelfarb

Reproductive Health

To support new health reform initiatives undertaken by the Romanian Ministry of Health and Family, and in support of the USAID Romania strategy for improving women’s reproductive health, Project Concern International/Romania (PCI/R) was awarded a two-year grant to implement a reproductive healthcare project, Healthy Parents-Healthy Children (HP-HC). This project trained family physicians and nurses in rural dispensaries in techniques to improve pre- and postnatal care, including training on modern contraception, cervical and breast cancer screening, treating menopause and its symptoms, and the encouragement of healthy lifestyles. The goal of this OR project was to test the efficacy of interventions to …

Tulane University Final Report, M. Celeste Marin, Anastasia J. Gage, Suhaila Khan

Reproductive Health

The Frontiers in Reproductive Health (FRONTIERS) program is a 10-year cooperative agreement between the United States Agency for International Development (USAID) and the Population Council in partnership with Family Health International and Tulane University School of Public Health and Tropical Medicine. This report summarizes the main activities undertaken by Tulane University under its subagreement with the Population Council on the FRONTIERS project from 1998–2004. As a partner, Tulane furthered progress toward all three of the program’s intermediate results: contributing innovative interventions tested to improve reproductive health through the small grants program; helping research staff take a more proactive approach to …

Etude Expérimentale Sur L'Offre De Services À Base Communautaire De Santé De La Reproduction Au Sénégal: Une Étude De Cas Dans Le District Sanitaire De Kébémer, Diouratie Sanogo, Mady Cisse, Adama Ndoye, Laty G. Ndoye, Ousmane Faye, Balla Mbacke Mboup

Reproductive Health

La Division de la Santé de la Reproduction (DSR) du Ministère de la Santé et de l'Action Sociale du Sénégal, en partenariat avec le programme FRONTIERS in Reproductive Health du Population Council et le Management Sciences for Health, a mené une étude visant à déterminer l'acceptabilité et la faisabilité des modèles de services à base communautaire expérimentés du point de vue de leur acceptabilité, de leur faisabilité, de leur efficacité, de leur performance, et de leur coût et rentabilité. L'objectif général de cette étude était de contribuer à l'élaboration d'un programme intégré rentable visant à accroître l'accessibilité et la disponibilité …

Safe Motherhood Demonstration Project, Western Province: Final Report, Charlotte E. Warren, Wilson Liambila

Reproductive Health

Since March 2000, the Population Council and the University of Nairobi have been assisting the Kenya Ministry of Health to implement Safe Motherhood activities in Western Kenya. The purpose of this project was to increase utilization of quality maternal services in the selected districts and, in an effort to improve pregnancy outcomes, focused on improving quality of antenatal care, essential obstetric care, clean and safe delivery, postpartum care, postabortion care, and management issues at all levels. In addition, the project focused on strengthening referral practices and addressing factors responsible for delays by pregnant women in making decisions on when, where, …

Determinants Of Prenatal Care And Supplement Use: The Case Of Honduras, Catherine E. Henze

Theses and Dissertations

Context: Literature suggests that prenatal care and prenatal supplement use improves pregnancy outcomes. However, we do not know the factors associated with prenatal care and supplement use in Honduras.Objective: To identify characteristics of Honduran women who are the least and most likely to use prenatal care and supplements.Methods: Data from a 2001 Honduras cross-sectional survey of women was used to assess their use of prenatal care and supplements. All data was weighted, resulting in a sample size of n = 5647 women who had a live birth since January 1996. Bivariate and multivariate analyses were used to examine factors associated …

Étude Des Facteurs Environnementaux Et Physiologiques Contribuant À La Variabilité Biologique : Caractérisation De La Relation « Exposition - Indicateur Biologique D'Exposition » Pour Le N-Hexane, Geneviève Hamelin, Robert Tardif, Ginette Truchon

Rapports de recherche scientifique

Jusqu'à tout récemment, l'American Conference of Governmental Industrial Hygienists (ACGIH) recommandait d'utiliser la mesure de la 2,5-hexanedione (2,5-HD) totale (2,5-HD libre + autres conjugués glucuronides) comme indicateur biologique de l'exposition (IBE) au n-hexane (n-HEX). En 2001, l’ACGIH a cependant proposé de recourir plutôt à la mesure de la 2,5-HD libre uniquement et la valeur du nouvel indicateur serait de 3.5 µmol/L. Le choix de cette mesure se justifie puisque la 2,5-HD libre est le métabolite responsable des effets neurotoxiques associés à l'exposition au n-HEX. De plus, la mesure de la 2,5-HD libre permet une meilleure discrimination entre individus exposés et …

Évaluation De La Contrainte Au Dos En Milieu De Travail : Développement Préliminaire D'Une Méthode Visant À Déterminer La Cinématique Tridimentionnelle Du Corps Humain À L'Aide D'Un Minimum De Caméras Vidéo, Alain Delisle, André Plamondon, Pierre Desjardins, Salazar Erik, Denis Gagnon, Christian Larivière

Rapports de recherche scientifique

Le besoin de mesurer quantitativement le chargement mécanique qui contribuerait aux affections vertébrales en milieu de travail est un prérequis essentiel à l’évaluation des risques de lésions. Parmi les outils disponibles utiles à mesurer ces charges, on retrouve la vidéo qui permet de reconstruire des marqueurs sur des sujets à partir de plusieurs caméras, ce qui est rarement possible en milieu de travail. Pour rendre cette technique plus attrayante, il faut faciliter le mode d’acquisition tridimensionnelle (3D) en réduisant le nombre de caméras à une seule. L'objectif principal du présent projet était donc d’explorer la faisabilité de n’utiliser qu’une seule …

The Effect Of Stack Height, Stack Location And Rooftop Structures On Air Intake Contamination: A Laboratory And Full-Scale Study, Ted Stathopoulos, Louis Lazure, Patrick Saathoff, Amit Gupta

Rapports de recherche scientifique

Cliquez ici pour la version française de ce rapport

La dispersion des émissions d'une cheminée située sur le toit d'un bâtiment de faible élévation en milieu urbain a été étudiée sur le terrain et en soufflerie. Les principaux buts de l'étude étaient lessuivants :

1. évaluer l'influence de divers paramètres sur la concentration du panache aux emplacements types de prises d'air neuf ; parmi ces paramètres figurent la hauteur de la cheminée, le facteur d'impulsion, la turbulence, etc. ;
2. évaluer les modèles de dilution récemment adoptés par l'American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE),
3. évaluer le degré de précision …

Impacts D'Un Abaissement De La Valeur D'Exposition Admissible Au Formaldéhyde : Coûts D'Un Programme De Protection Respiratoire, Guy Perrault, Marc Baril, Pierre Lefebvre

Rapports de recherche scientifique

Ce document est une annexe du rapport Impacts d'un abaissement de la valeur d'exposition admissible au formaldéhyde (R-386)

This document is an annex to the report Impacts d'un abaissement de la valeur d'exposition admissible au formaldéhyde (R-386)

Impacts D'Un Abaissement De La Valeur D'Exposition Admissible Au Formaldéhyde : Industrie De La Fabrication De Meubles En Bois, Nicole Goyer, Denis Bégin, Michèle Bouchard, Sophie Buissonnet, Gaétan Carrier, Olivia Gely, Michel Gérin, Jérôme Lavoué, Pierre Lefebvre, Nolwenn Noisel, Guy Perrault, Brigitte Roberge

Rapports de recherche scientifique

Ce document est une annexe du rapport Impacts d'un abaissement de la valeur d'exposition admissible au formaldéhyde (R-386)

This document is an annex to the report Impacts d'un abaissement de la valeur d'exposition admissible au formaldéhyde (R-386)

Impacts D'Un Abaissement De La Valeur D'Exposition Admissible Au Formaldéhyde : Industrie Des Services Funéraires, Nicole Goyer, Denis Bégin, Michèle Bouchard, Sophie Buissonnet, Gaétan Carrier, Olivia Gely, Michel Gérin, Pierre Lefebvre, Nolwenn Noisel, Eddy Pellerin, Guy Perrault, Brigitte Roberge

Rapports de recherche scientifique

Ce document est une annexe du rapport Impacts d'un abaissement de la valeur d'exposition admissible au formaldéhyde (R-386)

This document is an annex to the report Impacts d'un abaissement de la valeur d'exposition admissible au formaldéhyde (R-386)

Making Motherhood Safer In Egypt, Karima Khalil, Farzaneh Roudi-Fahimi

Reproductive Health

Fewer Egyptian women die of maternal causes today than they did 10 or 15 years ago, due in large part to the national safe motherhood program. Nevertheless, maternal mortality is still relatively high, and the country faces challenges in reducing it further. Many of these challenges involve addressing the delays women face when they need essential obstetric care. In Egypt and other countries, most maternal deaths could be avoided if women had timely access to high-quality emergency obstetric services. Although Egypt’s level of maternal mortality is relatively high by international standards, recent evidence suggests that a woman’s lifetime risk of …

Muscular Fitness And All-Cause Mortality: Prospective Observations, Shannon J. Fitzgerald, Carolyn E. Barlow, James B. Kampert, James R. Morrow Jr., Allen W. Jackson, Steven N. Blair

Faculty Publications

Background: The beneficial effects of cardiorespiratory fitness on mortality are well known; however, the relation of muscular fitness, specifically muscular strength and endurance, to mortality risk has not been thoroughly examined. The purpose of the current study is to determine if a dose-response relation exists between muscular fitness and mortality after controlling for factors such as age and cardiorespiratory fitness.

Methods: The study included 9105 men and women, 20-82 years of age, in the Aerobics Center Longitudinal Study who have completed at least one medical examination at the Cooper Clinic in Dallas, TX between 1981 and 1989. The exam included …

The Impact Of Alabama's Family Planning Demonstration Program On Access To Care And Contraceptive Method Choice Among Low -Income Women., Deren E. Bader

All ETDs from UAB

No abstract provided.

Variations In Family And Child Level Factors Associated With Emergency Room Visits Among Infants And Toddlers In An Early Head Start-Eligible Cohort., Keecha Sonia Harris

All ETDs from UAB

No abstract provided.

Mary T'S: A Restaurant Providing Healthy Food Options, Mary T. Savner

Seton Hall University Dissertations and Theses (ETDs)

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Identifying And Enabling Core Management Competencies And Compliance Factors In High Reliability Organisations : A Study In Organisational Risk Management Psychology And Training: A Small N Modified Grounded Theory Qualitative Analysis, Patrick S. Maher

Theses: Doctorates and Masters

High reliability entities governed by statutory regulations are required to comply with safety guidelines and specifications. When fatalities or serious injuries occur in otherwise preventable accidents these entities are routinely exonerated from any responsibility by claiming to have ‘systemic management problems’ and their managing coalitions have been able to hide behind the ‘corporate veil’. This thesis maintains that the core managerial competencies needed to prevent preventable accidents, can be acquired through training, particularly if their mastery is mandated by a strong regulatory and compliance regime. The cases chosen for analysis revealed ten core managerial and organisational competencies and compliance as …

Mental Health Of Incarcerated Juveniles In Nevada: Final Report, Nevada Institute For Children's Rerearch And Policy, University Of Nevada, Las Vegas, Jennifer Petsonius, Denise Tanata, Michelle Chino Dr

Nevada Institute for Children's Research and Policy Reports

The prevalence of mental health problems in the juvenile offender population is substantially higher than that of the general population (Cocozza & Skowyra, 2000). Studies estimate that one in five juvenile offenders has serious mental health problems, which is nearly twice the rate of occurrence of mental illness in children and adults in the general population (NMHA Fact Sheet #l). However, there have been several methodological problems encountered in previous research. These include the use of inconsistent definitions and measurements of mental illness; the use of biased, nonrandom samples, a reliance on retrospective case report data, and the use of …

Mémento Sur L'Utilisation Des Pompes Et Des Débitmètres, Yves Cloutier, Louis Lazure

Rapports de recherche scientifique

No abstract provided.

Uncertainty And The Value Of Diagnostic Information With Application To Axillary Lymph Node Dissection In Breast Cancer, Giovanni Parmigiani

Johns Hopkins University, Dept. of Biostatistics Working Papers

In clinical decision making, it is common to ask whether, and how much, a diagnostic procedure is contributing to subsequent treatment decisions. Statistically, quantification of the value of the information provided by a diagnostic procedure can be carried out using decision trees with multiple decision points, representing both the diagnostic test and the subsequent treatments that may depend on the test's results. This article investigates probabilistic sensitivity analysis approaches for exploring and communicating parameter uncertainty in such decision trees. Complexities arise because uncertainty about a model's inputs determines uncertainty about optimal decisions at all decision nodes of a tree. We …

Survival Model Predictive Accuracy And Roc Curves, Patrick Heagerty, Yingye Zheng

UW Biostatistics Working Paper Series

The predictive accuracy of a survival model can be summarized using extensions of the proportion of variation explained by the model, or R^2, commonly used for continuous response models, or using extensions of sensitivity and specificity which are commonly used for binary response models.

In this manuscript we propose new time-dependent accuracy summaries based on time-specific versions of sensitivity and specificity calculated over risk sets. We connect the accuracy summaries to a previously proposed global concordance measure which is a variant of Kendall's tau. In addition, we show how standard Cox regression output can be used to obtain estimates of …

Semiparametric Estimation Of Time-Dependent: Roc Curves For Longitudinal Marker Data, Yingye Zheng, Patrick Heagerty

UW Biostatistics Working Paper Series

One approach to evaluating the strength of association between a longitudinal marker process and a key clinical event time is through predictive regression methods such as a time-dependent covariate hazard model. For example, a time-varying covariate Cox model specifies the instantaneous risk of the event as a function of the time-varying marker and additional covariates. In this manuscript we explore a second complementary approach which characterizes the distribution of the marker as a function of both the measurement time and the ultimate event time. Our goal is to flexibly extend the standard diagnostic accuracy concepts of sensitivity and specificity to …

Barriers To Lesbian Health Care, Paula Bowles

Masters Theses & Specialist Projects

The primary purpose of this research was to examine a sample of sixteen lesbian women regarding the barriers to lesbian health-care. From this information several interpretive findings regarding lesbian health-care are made. Data were gathered via indepth interviews with each individual lesbian. The data suggest that most lesbian women do not reveal their sexual orientation to their primary-care physician for fear of reprisal. Most of the women interviewed do feel they receive adequate health-care from their physician. The women who participated in this project did so confidentially and were assigned pseudonyms. They were asked questions on a variety of topics, …

Inadequate Physician Knowledge Of The Effects Of Diet On Blood Lipids And Lipoproteins., Mary M. Flynn, Chris N. Sciamanna, Kevin C. Vigilante

College of Population Health Faculty Papers

BACKGROUND:To assess the nutrition knowledge of physicians on the basic effects of diet on blood lipids and lipoproteins.

METHODS:Anonymous mailed dietary knowledge surveys to 6000 randomly selected physicians in the United States licensed in either Internal Medicine or Cardiology.RESULTS:Response rate: 16% (n = 639). Half of the physicians did not know that canola oil and 26% did not know olive oil were good sources of monounsaturated fat. Ninety-three percent (84% of cardiologists vs. 96% of internists; p < 0.001) did not know that a low-fat diet, in general, would increase blood triglycerides. Approximately three-quarters (70% of cardiologists vs. 77% of internists; p < 0.01) did not know a low-fat diet would decrease HDL-c and almost half (45%) thought that a low-fat diet would not change HDL-c.

CONCLUSIONS:If physicians are to implement dietary and cholesterol management guidelines, they will likely need to become more knowledgeable about nutrition.