Medicine and Health Sciences Commons^™

The Meeting Of Pain And Depression: Comorbidity In Women, Marta Meana

Psychology Faculty Research

The higher prevalence of depression in women is coupled with a higher prevalence of pain complaints. Growing evidence suggests that the comorbidity of these conditions is also proportionately higher in women than men. This paper critically reviews the empirical findings relating to gender differences in comorbid pain and depression as well as findings in support of hypothesized etiologic factors that could explain why women may be more susceptible than men to comorbidity. The empirical evidence for biogenic, psychogenic, and sociogenic explanatory models is presented, and an integration of these models is proposed as a guideline to both research and clinical …

Cardiac Rehabilitation: Gender Differences In Factors Influencing Participation, Lani Lieberman, Marta Meana, Donna E. Stewart

Psychology Faculty Research

This study investigates gender differences in the barriers and incentives that are most influential in the coronary patient's decision to participate in cardiac rehabilitation (CRPs) and suggests strategies to counter these barriers. Patient surveys were administered to consecutive English-speaking attenders and referred nonattenders to a cardiac rehabilitation center at a university healthcare system in Toronto, Canada. A survey questionnaire, constructed from a literature review and advice from key informants, examined potential factors affecting decisions to engage in CRPs. One129 attenders at a CRP and 61 referred nonattenders completed the questionnaire. Physician recommendation was reported to be the most important factor …

Educational Attainment, Non-English Language Usage, And Ability To Communicate In English In 30 Massachusetts Cities/Towns, Edward C. Besozzi, Carole C. Upshur

Gastón Institute Publications

Data regarding an individual's ability, or the ability of members of a household to speak English, primary language spoken at home, educational attainment, and the level of literacy proficiency should be taken into consideration when designing and implementing policies regarding health care initiatives and the publication of health care information. This report highlights data collected from three sources: 1) The National Adult Literacy Survey; 2) The 1990 Federal Census; and 3) The Massachusetts Institute for Social and Economic Research.

Affect And Marital Adjustment In Women’S Rating Of Dyspareunic Pain, Marta Meana, Irv Binik, Sainir Khalife, Deborah Cohen

Psychology Faculty Research

OBJECTIVE: To investigate the extent to which depressive symptomatology, anxiety, and marital adjustment mediate pain ratings in women suffering from dyspareunia.

METHOD: Seventy-six women with dyspareunia were administered the depression and anxiety scales of Derogatis's Brief Symptom Inventory and the McGill Pain Questionnaire. They also underwent a manual-visual gynecological examination, an ultrasound, and a colposcopy in an attempt to identify potential evidence and type of organicity.

RESULTS: Depressive symptomatology, anxiety, and marital adjustment together accounted for a significant amount of the variance in pain ratings, although only anxiety and marital adjustment were independent predictors of pain ratings in the entire …

Prevalent Low Income Status In Canadian And United States Metropolitan Areas, 1980 And 1990, Kevin M. Gorey

Social Work Publications

As compared to Toronto’s poor people, three to four-fold as many of upstate New York’s poor live in severely impoverished neighborhoods, areas where 40% or more of the residents have annual incomes below the federally established low income or poverty criterion. However, the prevalence of such extremely degraded living conditions increased similarly (two-fold) on both sides of the Canadian-US border during the 1980s. This urban problem, of the concentration of poor people, seems to predominantly be an inner-city problem in the US, whereas it was found to be nearly equivalently extant in the inner-city, mid-suburban and outlying suburban areas of …

Experiencing Physical Violence During Pregnancy: Prevalence And Correlates, Vilma E. Cokkinides, Ann L. Coker

CRVAW Faculty Journal Articles

Violence during pregnancy directly impacts the mental and physical health of pregnant women. We assessed the prevalence and correlates of physical violence around the time of pregnancy in a representative sample of 6,718 women in South Carolina. Physical violence, defined as "being physically hurt by husband or partner" or "being involved in a physical fight" was reported by 10.9% of recently pregnant women. These were correlates of violence: experiencing increased numbers of stressful life events, being unmarried, having increased parity, being on Medicaid, and having an unwanted pregnancy. Screening to identify violence in pregnancy in health care settings is vital …

Violence Against Women In Sierra Leone: Frequency And Correlates Of Intimate Partner Violence And Forced Sexual Intercourse, Ann L. Coker, Donna L. Richter

CRVAW Faculty Journal Articles

Violence against women is a significant public health problem which impacts women, men, and children. Little is known about the frequency or correlates of violence against women in Africa. In this cross-sectional study, we found that 66.7% of 144 women surveyed in a study of AIDS knowledge, attitude, and behaviours, report being beaten by an intimate male partner and 50.7% report having ever been forced to have sexual intercourse; 76.6% of women report either forced sex or intimate partner violence. Circumcised women were most likely to report intimate partner violence and forced sexual intercourse. To improve the health of women …

Manuel De Recherche Opérationnelle En Matière De Planification Familiale, Andrew A. Fisher, John E. Laing, John E. Stoeckel, John Townsend

Reproductive Health

Le Manuel de recherche opérationnelle en matière de planification familiale, publié pour la première fois en anglais par le Population Council en 1984, se basait sur des projets de recherche en Asie. Cette seconde édition contient des sections révisées et développées. Le cas échéant, des exemples d'Amérique latine et d'Afrique ont été ajoutés. Le chapitre d'introduction comprend une exposé actualisé sur le processus de la recherche opérationnelle (RO) en matière de santé et planification familiale. De nouveaux chapitres concernent le choix du type d’intervention à tester dans une étude RO ainsi que les principaux éléments constituant un programme d'intervention. Le …

Assessing The Quality Of Reproductive Health Services, Raeda Al Qutob, Salah Mawajdeh, Laila Nawar, Salama Saidi, Firas Raad

Reproductive Health

This paper offers a broad definition of quality of care and presents a comprehensive conceptual framework for the assessment of quality of reproductive health services and methodological approaches for its measurement. It presents three studies that were conducted between 1990 and 1991 by members of the regional Reproductive Health Working Group from Egypt, Jordan, and Tunisia. The studies provide examples of applications of the framework and its measurement using multiple data sources. Selected findings are presented to illustrate comparative results between countries. Based on the lessons learned from the studies, examples of reproductive health interventions that may improve the quality …

Seminar On Male Involvement In Reproductive Health In Egypt: Summary Of Research Findings And Future Directions, Nahla G. Abdel-Tawab

Reproductive Health

As more work in the area of male involvement in reproductive health (RH) is expected in Egypt, it is important that researchers and donor agencies become aware of existing studies, topics covered, and main research findings so duplication can be avoided. It is also important that policymakers and program managers learn about the results of existing studies so they can use those results in designing more effective policies to increase male involvement in Egypt. To address this need, the Population Council’s ANE OR/TA Project organized a seminar on “Disseminating Results of Research on Male Involvement in Reproductive Health in Egypt” …

Strengthening The Research Capacity Of Planned Parenthood Association Of Ghana, Robert A. Miller

Reproductive Health

The Planned Parenthood Association of Ghana (PPAG) is one of the most active nongovernmental organizations delivering reproductive health (RH) services in Ghana, focusing particularly on youth issues and services. USAID suggested to the Population Council’s Africa OR/TA Project II staff that PPAG might benefit from technical assistance. A large and well-funded IPPF program to promote sexual health among youth of the Volta Region offered a good opportunity to begin OR work. Earlier, the program was envisioned as a demonstration educational program of five years duration. Further discussions suggested that this program was unlikely to be duplicated anywhere, because of its …

Youth Centres In Ghana: Assessment Of The Planned Parenthood Association Of Ghana Programme, Evam Kofi Glover, Annabel Erulkar, Joana Nerquaye-Tetteh

Reproductive Health

The sexual and reproductive health of adolescents has become a major public concern, particularly with the advent of HIV/AIDS. Many organizations have tried to find strategies to reach youth with reproductive health (RH) information and services through various service delivery models. One such model has been the multipurpose youth center approach. Multipurpose youth centers typically include recreational or vocational services as entry points for RH and family planning (FP) information and services. There is some evidence in a variety of African settings (notably Kenya and Zimbabwe) suggesting that these centers are underutilized and not cost-effective. As a result, the Planned …

Reproductive Health Operations Research, 1995–1998, James R. Foreit, Federico R. Leon, Ricardo Vernon, Timothy D.N. King, Deborah L. Billings, A.B Friedman, Janie Benson

Reproductive Health

This book presents in-depth reports on promising new interventions that have been developed and important programmatic changes that have been achieved by operations research in Latin America between 1995 and 1998. The INOPAL III project has made advances in five areas including access and quality of services, integration of family planning and other reproductive health services, financial sustainability, post-abortion care, and emergency contraception. Each of these topics are represented by at least three studies conducted in two or more countries. The operations research projects discussed under each topic are not replications of a single study. They use different research designs …

Creating Linkages Between Incomplete Abortion Treatment And Family Planning Services In Kenya: What Works Best?, Julie Solo, Achola Ominde, Margaret Makumi, Deborah L. Billings, Colette Aloo-Obunga

Reproductive Health

Unsafe abortion constitutes a major public health problem throughout the world, leading to high levels of maternal morbidity and mortality. Abortion accounts for roughly one-third of maternal mortality in the world. Millions of other women experience short- and long-term morbidity, such as infertility and pain. The concept of postabortion care (PAC) has gained wide acceptance as a means to improve services provided to women with complications from spontaneous or unsafely induced abortions. One way to improve emergency treatment is through introducing manual vacuum aspiration (MVA), which has been shown to be safer and less costly than dilation and curettage (D&C). …

Workshop Report: Launching Of The Revised Reproductive Health Policy Guidelines And Standards, Division Of Primary Health Care, Kenya Ministry Of Health

Reproductive Health

The Government of Kenya recently revised its Policy Guidelines and Standards for family planning (FP) and other reproductive health (RH) services to encourage service providers to undertake a more comprehensive approach to service delivery. Some of the recommendations, especially those relating to the integration of STI/HIV/AIDS services into MCH/FP services, and to safe motherhood, include new practices and procedures. A number of research studies have been conducted in Kenya and elsewhere that provide data pertinent to many of these recommendations, and the Division of Primary Health Care (DPHC) used the results to provide a framework within which the guidelines were …

Towards Safe Womanhood: Supporting Safe Motherhood Initiatives And Women's Participation In Development, Meiwita B. Iskandar

Reproductive Health

Improvement in a woman’s quality of life is a prerequisite for development of human resources, because the quality of children’s physical and mental development is inextricably tied to the health and welfare of women as future mothers. If a mother is well protected during the pregnancy, birth, and postpartum period, the risk of illness and other problems in fetuses and newborn babies will be reduced. On the other hand, if a woman does not survive the pregnancy, birth, and postpartum period, her fetus or newborn will also be threatened. This paper provides a situation analysis of pregnant women, women in …

Needs And Risks Facing The Indonesian Youth Population, Desti Murdijana

Reproductive Health

Youth are the leaders of tomorrow, but right now they face a formidable collection of problems that will determine the quality of their future lives and the lives of us all. Education, jobs, substance abuse, violence, sexuality, and marriage are examples of adolescent issues that demand special attention from researchers, youth activists and advocates, parents, and policymakers. In attempting to address these complex issues, we must be willing to confront ignorance, controversy, and cultural obstacles. Clear and focused policy and strategies must play a basic role in tackling these issues facing Indonesian adolescents. This paper provides a concise situation analysis …

Fertility And Reproductive Preferences In Post-Transitional Societies, John Bongaarts

Poverty, Gender, and Youth

Conventional theories have little to say about the level at which fertility will stabilize at the end of the transition although it is often assumed that replacement fertility of about 2.1 births per woman will prevail in the long run. However, fertility has dropped below the replacement level in virtually every population that has moved through the demographic transition. If future fertility remains at these low levels populations will decline in size and age rapidly.This paper attempts to contribute to the understanding of levels and trends of post-transitional fertility by examining the causes of discrepancies between reproductive preferences and observed …

Involving Private Medical Practitioners In Family Planning Services In Bangladesh, Abu Yusuf Choudhury, Ubaidur Rob, Sharif M.I. Hossain

Reproductive Health

The project "Involving Private Medical Practitioners (PMPs) in Family Planning Services" is an innovative initiative to involve PMPs in protecting the reproductive health (RH) of couples, attract private investment in the family planning (FP) sector, and eventually reduce the increasing financial pressure on the government. The project was implemented in two phases. In phase I, qualified PMPs from urban areas were given training on FP. In phase II, nonqualified PMPs were given training on FP. PIACT Bangladesh, a local NGO, conducted two pilot projects to involve the PMPs in FP. The first one was to involve qualified PMPs in urban …

The Life Saver: The Mother Friendly Movement In Indonesia, Abdullah Cholil, Meiwita B. Iskandar, Rosalia Sciortino

Reproductive Health

The focus of this book is the Mother Friendly Movement in Indonesia, a collective effort to reduce maternal mortality. The idea of documenting the Mother Friendly Movement or Gerekan Sayang Ibu (GSI) was originally suggested by Her Excellency Mien Sugandhi, the State Minister for the Role of Women, Republic of Indonesia, in the belief that the Indonesian experience in reducing maternal mortality would be relevant to other countries struggling with the same problem. The authors were entrusted with producing an illustrated monograph on the pilot projects implemented in eight districts from June to December 1997. Besides extensively monitoring these activities, …

Advances And Challenges In Postabortion Care Operations Research: Summary Report Of A Global Meeting, Dale Huntington

Reproductive Health

The Global Meeting on Postabortion Care: Advances and Challenges in Operations Research was held at the Population Council’s New York office on January 19–21, 1998, to review progress made by three regional operations research (OR) projects in improving delivery of postabortion care. The resources of the three OR contracts were pooled, and, in collaboration with Ipas and the Ebert Program, approximately 65 researchers, senior program managers, and government officials from Africa, Latin America, the Middle East, and Southeast Asia were convened. Three objectives guided the planning of the meeting: review progress in the development of OR methodologies pertaining to postabortion …

Ethnicity And Child Mortality In Sub-Saharan Africa, Martin Brockerhoff, Paul C. Hewett

Poverty, Gender, and Youth

Analysis of recent survey data reveals large differentials in child mortality among ethnic groups in countries throughout sub-Saharan Africa. These disparities correspond with the prominence of specific ethnic groups in the national political economy. In many countries where heads of state since independence have come from one or two ethnic groups-as in Côte d’Ivoire, Kenya, and Niger-these groups have experienced levels of early child mortality at least one-third lower than those of other groups. In other countries where there have been several transitions in state control, as in Ghana and Uganda, descendants of precolonial kingdoms such as Ashanti and Buganda …

The Problem Of Verbal Reports In Recreation Research: Review, Recommendations, And New Directions, Bill Borrie

Society and Conservation Faculty Publications

Recent work of cognitive and social psychologists has questioned the ability of subjects to accurately remember and report their experiences. This has particular significance for recreation research as the survey questions we ask of visitors change from more stable visit and group characteristics to reports of conditions, experiences and feelings. Strategies exist to encourage accurate recall, particlarly by minimizing the delay between event and report such as is provided by the Experience Sampling Method.

Workshop On Youth Across Asia, John Townsend, Ann P. Mccauley, Kokila Agarwal

Reproductive Health

The issues facing youth across Asia are as diverse as the cultures they represent. Issues involving schooling, employment, sexuality, and marriage take on increased significance for young people aged 10–24 in every country. Decisions made by youth and their families will dramatically affect their individual welfare. Few programs outside of public education systems exist at a sufficiently large scale to assist youth. Decisions to stay in school, opportunities to learn skills and manage resources, the exercise of sexual responsibility, and the process of family formation all impact both personal welfare and community development. Gender-equality issues compound many of the problems. …

The Changing Social Environment For Adolescents In Kassena-Nankana District Of Northern Ghana: Implications For Reproductive Behavior, Barbara Mensch, Daniel Bagah, Wesley H. Clark, Fred N. Binka

Poverty, Gender, and Youth

This study reports on a primarily qualitative investigation of adolescent reproductive behavior in the Kassena-Nankana District, a rural isolated area in northern Ghana, where traditional patterns of marriage, family formation, and social organization persist. The study is based on in-depth interviews and focus groups with adolescents, parents, chiefs and traditional leaders, teachers, youth leaders, and health workers, supplemented by quantitative data from the 1996 wave of a panel survey of reproductive-aged women conducted by the Navrongo Health Research Centre. The social environment faced by adolescent boys and girls in the Kassena-Nankana District and its links to reproductive behavior are described. …

The Uncharted Passage: Girls' Adolescence In The Developing World, Barbara Mensch, Judith Bruce, Margaret E. Greene

Poverty, Gender, and Youth

Adolescence is a formative time of transition to adulthood. What happens between the ages of 10 and 19 shapes how girls and boys live out their lives as women and men—not only in the reproductive arena, but in the social and economic realm as well. Yet, despite its impact on human development, adolescence has been sidelined as a research and policy subject in developing countries. While all adolescents deserve our attention, the needs of adolescent girls in the developing world are particularly pressing. This monograph focuses on these girls, presenting statistics to examine the social and economic context of their …

La Familia En La Mira: Nuevas Perspectivas Sobre Madres, Padres E Hijos, Judith Bruce, Cynthia B. Lloyd, Ann Leonard, Patrice L. Engle, Niev Duffy

Poverty, Gender, and Youth

A pesar de la retórica de los últimos años que lamenta la pérdida de la "familia tradicional," las familias jamás se han podido encajonar en modelo único. "Familia" puede referirse a la gente que se ha vinculado entre sí por matrimonio o parentesco, o a los que pretenden descender de antecesores comunes. Las personas pueden formar y extender familias, ya sea mediante la adoptación o crianza de niños, o definiendo como familiares a gente no emparentada o mediante el establecimiento de sociedades consensuales. Las familias son tan adaptables como diversas, pues se reconfiguran a sí mismas en el transcurso de …

Migration, Sexual Behavior And Hiv Diffusion In Kenya, Martin Brockerhoff, Ann E. Biddlecom

Poverty, Gender, and Youth

The association of migration with the spread of AIDS in sub-Saharan Africa is well documented, yet the social and behavioral mechanisms underlying this relationship remain poorly understood. Using data from the 1993 Kenya Demographic and Health Survey, this paper examines whether migrants are more likely than nonmigrants to have multiple recent sexual partners and not to use condoms with those partners. Results indicate that migation is a critical factor in high-risk sexual behavior and that its importance varies by gender and by the direction of movement. Independent of marital and cohabitation status, social milieu, awareness of AIDS, and other crucial …

Women's Lives And Rapid Fertility Decline: Some Lessons From Bangladesh And Egypt, Sajeda Amin, Cynthia B. Lloyd

Poverty, Gender, and Youth

In some of the more traditional parts of the world, fertility is falling steadily, sometimes rapidly, in environments where women’s lives remain severely constrained. The recent experiences of Bangladesh and Egypt, both predominantly Muslim countries, are illustrative in this regard. Since the late 1970s, rural and urban areas in both countries have experienced steady declines in fertility, with recent declines in rural Bangladesh similar to those in rural Egypt, despite lower levels of development and higher rates of poverty. This paper provides an in-depth exploration of the demographic transition in these two societies as seen through the dual lens of …

On The Quantum And Tempo Of Fertility, John Bongaarts, Griffith Feeney

Poverty, Gender, and Youth

Demographers have known since the 1940s that standard measures of period fertility, such as the widely used total fertility rate, are distorted by changes in the timing of childbearing. Period fertility rates are depressed during years in which women delay childbearing and inflated in years when childbearing is accelerated. This problem is usually ignored because there has been no generally accepted method for solving it. This study proposes a method for removing the tempo distortions from the total fertility rate. The key assumption of the method is that period effects, rather than cohorts effects, are the primary force in fertility …