Medicine and Health Sciences Commons^™

Increasing Use Of The Iud Through Community And Clinic Based Education Activities In Rural Honduras, Ivo Flores Flores, Elida Rosa Aguilar Fonseca, Rosa Merlen Flores, Ricardo Vernon, Jorge Solorzano, Suyapa Pavon, Marco Tulio Falck, Alba Lidia Sanchez

Reproductive Health

This document presents the results of an operations research project implemented by the Ministry of Health in Honduras with technical and administrative assistance from the Population Council’s Frontiers in Reproductive Health (FRONTIERS) program, ASHONPLAFA, and EngenderHealth, and funding from USAID. The project tested a strategy to inform communities about the availability of the IUD in nearby health centers and about the method’s most salient attributes. The main conclusion is that communication of messages about a specific contraceptive method, while also communicating messages about other contraceptive methods, through printed materials (flyers, brochures, and posters) and interpersonal messages (individual talks and counseling) …

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 …

Academic - Practice Bridges: Implications For Lecturers When The Complexities Of Change Meets The Higher Education And Nurse Education Systems, Adrianne Jones

Theses : Honours

Government, industry, enterprises and the community expect the Vocational and Educational Training (VET) system to provide up-to-date educational programs that provide pathways from school-based learning to the higher education facilities such as universities and to employment opportunities. Reforms in the VET sector over the past ten years have had a significant impact on the work of staff employed in the area. Educators now operate in more competitive markets and face increased demands for higher quality and more relevant training programs from clients. Understanding and keeping up with the changes and working in new and more flexible ways have been major …

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 …

Changes In Formal-Informal Caregiving In Elderly Stroke Survivors, Holly Anne Beard

Health Services Research Dissertations

The purpose of this study is to determine the extent to which the Andersen and Aday Model of Health Services Use to predict cross-sectional and longitudinal differences in the caregiving source among stroke survivors (n=477) over a six-year period. This study involves a secondary analysis of a longitudinal panel study focusing upon three waves of interview data from the HAS/AHEAD study spanning 1998 through 2002. Multinomial logistic regression was utilized to examine caregiving source cross-sectionally at each wave. Clustered multinomial logistic regression was used to examine relationships between predictor variables in the model and caregiving source across waves while holding …

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 …

Preparing For The Future: An Evaluation Of Alternative Methods For Estimating The Needed Capacity Of Nursing Home Beds In Kentucky, Michelle D. Woods

MPA/MPP/MPFM Capstone Projects

Due to the aging of the generation known as “Baby Boomers”, the nation is expected to witness extraordinary growth in the total population ages 65 and over. Population projections provided by the United States Bureau of the Census suggest that this segment of the population will double in size to 72 million by the year 2030. In order to prepare for the anticipated increase elderly Americans, policy officials have been analyzing the potential effects on the nation’s long-term care system. Although Baby Boomers can expect to live longer than their predecessors, as they age, it is predicted that this generation …

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, …

National Security And Environmental Laws: A Clear And Present Danger?, Hope M. Babcock

Georgetown Law Faculty Publications and Other Works

Without question, life in the United States has changed significantly since September 11, 2001. The attacks launched from within the United States in broad daylight against non-military targets and innocent civilians, followed by the intentional dispersal of the biological agent anthrax, ushered in an era of uncertainty and fear in this country unlike any in recent memory. The visible manifestations of this fear are still with us--concrete barriers and the closing of public spaces around public buildings, heightened security at airports and train stations subjecting people to invasive searches of their persons and belongings, the sudden, seemingly random appearance of …

An Exploratory Study Of Pet Raising And Health Of The Elderly People In Hong Kong, Cheung Ming, Alfred Chan, Kam Wing, Kevin Cheung, Lam Fat Lo

APIAS Monograph 專題論文

Introduction:

Pets such as dogs, cats and fish were popular in many other countries (Marx et al., 1988; Gammonley, 1991; Brodie & Biley, 1999; PIAS, 2002). In Hong Kong, pet owners increased to 0.26 million (Census and Statistics Department, 2006). Dating back to 1980s, a research study reported the association between pet ownerships and health benefits for humans (McNicholas et al., 2005). According to the report, domesticated pets brought a sense of companionship and provided pet owners with pleasure. These pets could be tools for enhancing human social relationship and could also provide their owners with emotional comfort. Recent studies …

Does Verbal Communication Impairment Affect Quality Of Life In Amyotrophic Lateral Sclerosis Patients?, Jason Michael Duff

PCOM Psychology Dissertations

The purpose of this study was to examine the self-perceived QOL in ALS patients. Literature will be presented on the incidence, prevalence, prognosis, diagnosis and management of ALS, QOL studies for ALS, the role of the multidisciplinary team, the impairments and dysfunction that ALS patients experience, communication issues, and the development of ALS specific instruments to measure QOL. The "bulbar dysfunction" that ALS patients experience in salivation management, speech, and swallowing were examined in detail. The objectives of this research study were to investigate the following hypotheses: 1. QOL will differ among ALS patients with varying levels of speech, swallowing, …

The Psychology Of Motivation In Sport, Nicholas Salomone

Whittier Scholars Program

The purpose of this paper is to give a general overview of motivation theory in sport psychology. Beginning with self-confidence in sport, the basic models will be presented, showing how each built upon the last to create a more and more comprehensive and reliable structure for the measurement and evaluation of motivational style. From there, the models of causal attribution, which have evolved from Heider’s 1958 unidimensional structure to Weiner’s revised multidimensional models, will be covered. Nicholls’ (1984) goal perspective theory will then be discussed with emphasis on types of goal orientation and their positive and negative connotations. The self-determination …

Do Auditory Simulations Of Noise-Induced Hearing Loss Change Young Adults' Attitudes Towards Noise Exposure?, Claire Roockley

Theses : Honours

Noise-induced hearing loss (NIHL), or hearing damage from regular exposure to loud noise, can profoundly affect a person's hearing capabilities and overall well-being. Many individuals continue to expose themselves to hazardous levels of noise, and, in turn, put themselves at risk of developing a NIHL. This review critically examines the existing literature presented on NIHL. Emphasis is placed on the increasing prevalence of NIHL in young adults from exposure to loud recreational noise. The effectiveness of current educational strategies that have been employed to reduce or prevent the occurrence of NIHL in this cohort is also examined. Research indicates that …

Senate Bill (Sb) 172: Governance Of Nutrition In Kentucky Public Schools: Implementation Analysis Final Report, Bill Brumbach

MPA/MPP/MPFM Capstone Projects

This report is intended to evaluate the implementation of Senate Bill (SB) 172 in Kentucky's public schools. This law requires that all schools in Kentucky implement strict nutrition standards that apply to all foods sold during the school day. This report highlights the different methods used by selected schools in implementing the requirements in SB 172. In performing my analysis, I traveled to different schools in central and southeastern Kentucky to assess how these select schools were meeting the requirements of the law. Site visits allowed me to discuss implementation strategies with school administrators and aided in my understanding of …

Snapshot 2007: Maine Workers With Disabilities, Maine’S Commission On Disability And Employment, Choices Ceo Project

Disability & Aging

No abstract provided.

Factors Associated With Employment Among Latinos Living With Hiv/Aids, Shaun Michael Burns, Lydia R. L. Young, Suzanne Maniss

Counseling Faculty Publications

This investigation explored the utility of various demographic, health-related, and psychological variables in predicting employment among Latinos living with HIV/AIDS. Results of an analysis of variance indicated that employed participants were younger, evinced significantly greater CD4 counts, physical and mental health functioning, and internal locus of control beliefs than those who were unable to work due to disabilities. A backward binary logistic regression demonstrated that age, CD4 count, internal locus of control, and mental health functioning contributed to the explanatory power of the final model. This model correctly classified group membership 72% of the time, 78% of participants who were …

The Impact Of College Student Immersion Service Learning Trips On Coping With Stress And Vocational Identity, Brad A. Mills, Richard B. Bersamina, Thomas G. Plante

Psychology

This study examined the impact of service learning immersion trips on vocational identity and coping with stress among college students. Fifty-one students (15 males, 36 females) who participated in immersion trips and 76 students (25 males, 51 females) in a non-immersion control group completed a series of questionnaires directly before and immediately after both fall and spring break immersion trips, and during a four-month follow up. Results suggest that, after returning from an immersion trip, students report a greater ability to cope with stress and a somewhat stronger sense of vocational identity relative to students who do not participate in …

Grânulos De Amido E Fitólitos Em Cálculos Dentários Humanos: Contribuição Ao Estudo Do Modo De Vida E Subsistência De Grupos Sambaquianos Do Litoral Sul Do Brasil, Verônica Wesolowski, Sheila Maria Ferraz Mendonça De Souza, Karl Reinhard, Gregório Ceccantini

Karl Reinhard Publications

Este artigo tem por objetivo apresentar os resultados da recuperação e análise de micro-vestígios vegetais retidos em cálculos dentários de grupos de pescadores-coletores do litoral sul do Brasil. Apresenta também os resultados das relações mantidas entre grânulos de amido e cárie, e entre fitólitos e desgaste dentário.

Através da dissolução química de cálculos dentários foram recuperados microvestígios vegetais em todos os indivíduos estudados. Foi evidenciado o consumo de alimentos amiláceos em todas as séries esqueléticas estudadas, demonstrando independência entre dieta com aporte de produtos vegetais e utilização de cerâmica. Foram encontrados resultados sugestivos de padrões de escolha de alimentos diferenciados …

Child Sexual Abuse, David J. Hansen, Kathryn R. Wilson

Department of Psychology: Faculty Publications

Although definitions can vary across legal, clinical, and research contexts, sexual abuse is commonly defined as sexual acts between a youth and an older person (e.g., by 5 years or more) in which the dominance of the older person is used to exploit or coerce the youth. Behaviors may include noncontact (e.g., exposure) and contact (e.g., intercourse) offenses.