Medicine and Health Sciences Commons^™

The Benefits Of Breastfeeding: An Introduction For Health Educators, Sheila G. J. Clark, Timothy J. Bungum

Environmental & Global Health Faculty Research

Currently 16% of Americans breastfeed their children for at least 12 months as recommended by the AAP, which is well below the HP 2010 goal of 25%. Breastfed infants receive benefits that can improve their health throughout their lives. The benefits of breastfeeding for children include increased resistance to infectious diseases, such as gastroenteritis, respiratory tract infections, and ear infections. Breastfed children also display lower rates of chronic diseases including diabetes, obesity, asthma, and leukemia. The choice to breastfeed results in economic benefits from lower health care costs and from reduced spending on infant formula. The Healthy People 2010 targets …

Identifying Compliance Issues In The Community Health Care Clinic Environment, Faye K. Beery

Graduate Theses

This study explored the high number of failed appointments and follow-up appointments at a community health care children’s clinic. A thirty-seven item questionnaire was randomly given to 112 participants seeking health care at the clinic on a random basis. Based on literature reviews, five hypothesis were generated to examine reasons for failing to keep appointments for children: 1. Communication difficulties between healthcare personnel and parents regarding patient comprehension of instructions and bottle directions were anticipated. 2. Patient/physician/clinic relationships were expected to influence patient compliance. The need for more reminder calls for appointments was anticipated to be a factor in patient …

All The News That’S Fat To Print: The American "Obesity Epidemic" And The Media, Natalie Boero

Faculty Publications, Sociology

Increasingly the term epidemic is being used to describe the current prevalence of fatness in the United States. Skyrocketing rates of obesity among all groups of Americans, particularly children, the poor, and minorities, have become a major public health concern. Indeed, it is difficult to open a newspaper or magazine without encountering a discussion of the expanding American waistline and the health problems associated therewith. In this paper I use 751 New York Times articles on obesity to examine the media construction of the obesity epidemic. I show that there is not one dominant discourse (i.e. medicine) constructing this epidemic, …

Predictors That Affect The Caregiver's Health Status And The Role Of Social Support On The Caregiver's Health Status, Hong Wang

All-Inclusive List of Electronic Theses and Dissertations

This study examines whether the caregiver's self-rated health status is affected by the caregiver's demographic characteristics (age, education level, and income), caregiver's stressor (the number of ADL and IADL), mediating variables of the caregiver's appraisal (willingness to help non-family members, level satisfaction with life, and financial burden), of and mediating variable of social support (information and/or advice from other family members or friends). Data were drawn from Chronic Illness and Caregiving, a national telephone survey conducted by Harris Interactive Inc. on behalf of The Robert Wood Johnson Foundation, Johns Hopkins University, and Partnership for Solutions. The sample size of caregivers …

Next-Of-Kin Perceptions Of Physician Responsiveness To Symptoms Of Hospitalized Patients Near Death, Joel C. Cantor, Jan Blustein, Matthew J. Carlson, David A. Gould

Sociology Faculty Publications and Presentations

Many different medical providers visit critically ill patients during a hospitalization, and patients and family members may not feel any physician is truly in charge of care. This study explores whether perceiving that a physician was clearly in charge is associated with reports by surviving next of kin about the responsiveness of physicians to symptoms in hospitalized patients near the end of life. We conducted telephone interviews with surviving next of kin of adult patients (n = 1107) who died in one of five New York City teaching hospitals between April 1998 and June 1999 after a minimum 3-day inpatient …

Sibling Death In Childhood: An Evaluation Of The Literature Regarding Inclusion Of Minority Cultures, 1990–2002, Joyce Kay L. Cherry

Community & Environmental Health Theses & Dissertations

This evaluation seeks to determine the extent to which the professional literature concerning bereaved children in the United States includes African American, Hispanic American, and Asian American children whose siblings have died in childhood.

A literature search identifies 58 articles, published between 1990 and 2002, concerning children under age 19 living in the United States whose siblings have died. Articles are sorted by time frame and classified by type. There are 31 descriptive articles consisting of five literature reviews, five commentaries, five case studies, and 16 narratives; there are 27 research articles. Analysis determines the extent to which race, culture, …

Long-Term Care: Informed By Research, Francis G. Caro

Gerontology Institute Publications

Health services research has contributed to health policy and service developments that have led to major improvements in the quality of long-term care in the United States. This policy brief highlights a few areas in which publicly and privately funded research has informed the long-term care field.

United Power For Action And Justice: Breaking The Cycle Of Homelessness Reports - Policy Brief, Center For Urban Research And Learning, Christine George, Chiara Sabina, Aparna Sharma

Center for Urban Research and Learning: Publications and Other Works

This is a story of two groups of determined people with intersecting interests. Group one: a dozen leaders within United Power for Action and Justice who set out to prove their conviction, that homelessness is one symptom of a complex of issues that destabilizes individuals and communities. Group two: persons who are homeless and struggle daily to “fit in” to a landscape that is, more and more, structured to shut them out. In 2000, a cluster of leaders within United Power organized member institutions in the north and northwest suburbs of Chicago, and initiated a relationship with Congressman John Porter …

Population Mobility High-Risk Environments And The Diffusion Of Hiv/Stds: A Community Based Study In Southwest China, Hongyun Fu

Sociology & Criminal Justice Theses & Dissertations

Globally, population migration has been associated with the spread ofHIV/STDs in many countries. A similar trend has been observed in China from the very beginning of the HIV epidemic, but empirical research is very limited. Furthermore, the previous studies mainly focused on the micro impact of migration on individual migrant's risky behaviors. The impact of population mobility on the general population, especially on non-migrant residents, has been ignored. Using data collected from a specially designed community level survey, which was conducted in a province in the Southwest of China, this study examines the macro-level association between temporary migration and the …

Killing For The State: The Darkest Side Of American Nursing, Dave Holmes, Cary H. Federman

Department of Justice Studies Faculty Scholarship and Creative Works

The aim of this article is to bring to the attention of the international nursing community the discrepancy between a pervasive ‘caring’ nursing discourse and the most unethical nursing practice in the United States. In this article, we present a duality: the conflict in American prisons between nursing ethics and the killing machinery. The US penal system is a setting in which trained healthcare personnel practices the extermination of life. We look upon the sanitization of death work as an application of healthcare professionals’ skills and knowledge and their appropriation by the state to serve its ends. A review of …

Introduction Of A Waterless Alcohol-Based Hand Rub In A Long-Term Care Facility, Lona Mody, Mcneil A. Shelly, Rongjun Sun, Bradley Suzanne, Carol A. Kauffman

Sociology & Criminology Faculty Publications

OBJECTIVE:

To examine the impact of introduction of an alcohol-based hand rub on hand hygiene knowledge and compliance and hand colonization of healthcare workers (HCWs) in a long-term-care facility (LTCF).

METHODS:

Two floors of an LTCF participated. Ward A used the hand rub as an adjunct to soap and water; ward B was the control. HCWs' hands were cultured using the bag-broth technique for Staphylococcus aureus, gram-negative bacilli (GNB), Candida, and vancomycin-resistant enterococci (VRE). HCWs completed a questionnaire at baseline and after an educational intervention and introduction of rub.

RESULTS:

Hand hygiene practices, knowledge, and opinions did not change after …

"Are You Beginning To See A Pattern Here?" Family And Medical Discourses Shape The Story Of Black Infant Mortality, Elaine R. Cleeton

The Journal of Sociology & Social Welfare

Postmodern and poststructuralist theorizations of the interrelations of the particular and the universal have identified women's bodies to be the last frontier for scientific discovery leading to and satisfying the modern compulsion to stabilize and control life from birth to death. This institutional ethnography of one city's response to an elevated infant mortality rate among the babies of African American urban, impoverished women explores their discursive transformation from single mothers who cannot begin prenatal care before the second trimester because too few physicians will treat Medicaid patients, into sexually-immoral, illegaldrug- using women who deliberately harm their babies. The study locates …

Expanding Self-Direction In Services For The Aged And People With Disabilities, Ruth A. Burgess

Theses, Dissertations and Capstones

Medicaid-funded long-term care services are traditionally delivered in nursing homes. States may apply for waivers which allow them to provide home and community based services with Medicaid funds. Because these services are by definition an alternative to nursing home care, waiver services are generally based upon a medical model which emphasizes medical deficits and tends to restrict consumers’ movements to inside the home. Recent developments such as the Olmstead Decision and federal New Freedom Initiatives have caused states to recognize that consumers desire and have a legal right to be part of a community rather than institutionalized or homebound. These …

Nsucommuniversity Link - January 2003, Nova Southeastern University

NSU Digital: Communiversity

No abstract provided.

Reproductive Health Services In Kwazulu Natal, South Africa: A Situation Analysis Study Focusing On Hiv/Aids Services, Lewis Ndhlovu, Catherine Searle, Robert A. Miller, Andrew A. Fisher, Ester Snyman, Nancy L. Sloan

HIV and AIDS

This Horizons report examines the readiness of reproductive health services in South Africa, which are primarily geared to women, to deliver HIV and AIDS treatment, care, and prevention services. The goal of the study was to obtain information from a representative sample of provincial health care facilities offering reproductive health services in KwaZulu Natal to meet the growing demand for HIV/AIDS-related services. Ninety-eight hospitals, community health centers, and clinics participated in the situation analysis that identified gaps in service delivery and determined priorities for service integration. Results of the study were presented to a large audience of Department of Health, …

Empowering Communities To Respond To Hiv/Aids: Ndola Demonstration Project On Maternal And Child Health: Operations Research Final Report, Hope Humana, Linkages, National Food And Nutrition Commission, Ndola District Health Management Team, Horizons Program, Zambia Integrated Health Project

HIV and AIDS

A pre–post intervention study conducted in Zambia by Horizons and local NGOs and governmental organizations demonstrated that HIV voluntary counseling and testing (VCT) and infant feeding counseling (IFC) to mothers attending maternal and child health (MCH) clinics are vital components of any mother-to-child transmission (MTCT) reduction strategy, whether or not antiretrovirals (ARVs) are available. These interventions enable mothers to make informed and healthy decisions. Data from the Ndola Demonstration Project yielded encouraging results from efforts to improve the capacity of mothers to make informed decisions about their own health and the health of their infant. The interventions succeeded in raising …

Aids, Orphans, And Development In Sub-Saharan Africa: A Review Of The Dilemma Of Public Health And Development, Joe Lugalla

Institute for Educational Development, East Africa

HIV/AIDS is having devastating consequences on families, young children, and other vulnerable social groups. In this paper, I review the impact of HIV/AIDS on families and development in sub-Saharan Africa. I begin by showing the magnitude of the problem and the factors that have led to rapid spread of HIV/AIDS in this sub-continent. I discuss gender inequality, poverty, social inequality, and globalization, and show how these facilitate the rapid spread of the epidemic. I show how AIDS is creating a mass of orphans on the one hand, and how it is impacting development and creating new public health contradictions on …

Improving Postpartum Care Among Low Parity Mothers In Palestine, Center For Development In Primary Health Care (Cdphc)

Reproductive Health

In an effort to improve the health status of Palestinian women and their children in the West Bank and Gaza, USAID, in collaboration with the Palestinian Ministry of Health and a number of NGOs, designed and funded a 28-month pilot activity, the Pilot Health Project (PHP), that was expected to have a positive impact on the health of women and children. This report describes the results of the intervention designed to measure the effectiveness of a second home visit on low-parity women in 1) improving their knowledge and practices regarding their own health as well as the health of their …

Microfinance And Households Coping With Hiv/Aids In Zimbabwe: An Exploratory Study, Carolyn Barnes, Erica Keogh, Nontokozo Nemarundwe, Loveness Nyikahadzoi, Ellen Weiss

HIV and AIDS

This study, conducted in Zimbabwe, sought to better understand the relationship between a microfinance program, Zambuko Trust, and how microentrepreneurs’ households cope with the impact of HIV/AIDS. The study examined how HIV/AIDS is affecting Zambuko’s operations and what microfinance institutions (MFIs) can do to lessen the impact of HIV/AIDS on their clients and operations. The findings indicate several small yet important ways that MFI programs help microentrepreneurs and their families respond to these impacts through access to credit and business management training. Participation in a microfinance program led to income smoothing and better financial management, which can help households mitigate …

Seniors Count Follow-Up Study, Nina M. Silverstein, Heather Connors, May Jawad

Gerontology Institute Publications

Seniors Count is an ongoing outreach initiative under the direction of Boston Mayor Thomas M. Menino with the leadership and support of Joyce Williams, Boston's Commissioner on Affairs of the Elderly. The program's purpose is to "identify and reach out to those members of the city's elderly population who live in private housing arrangements and help provide them with the information and services they [may] need" (Boston Commission on Affairs of the Elderly, 2002). Since the program's inception in 1999, it has reached over 5,500 community-dwelling elders in the City of Boston (Boston Commission on Affairs of the Elderly, 2002). …

Evidence-Based Development Of Health And Family Planning Programs In Bangladesh And Ghana, James F. Phillips, Tanya C. Jones, Frank K. Nyonator, Shruti Ravikumar

Poverty, Gender, and Youth

This paper describes two initiatives that have used experimental studies to guide the development of community-based health and family planning programs. In Bangladesh and Ghana, factorial experiments were implemented in stages. An exploratory phase developed a service system for community-based health care; an experimental phase assessed the demographic impact of the system; a replication phase examined the transferability of the experimental program to a non-research setting; and a scaling-up phase facilitated the extension of the new system to the national health care program. All stages were guided by research, with questions, mechanisms, and outcomes shifting as the process developed. Large-scale …

Determinants Of Old-Age Mortality In Taiwan, Zachary Zimmer, Linda G. Martin, Hui-Sheng Lin

Poverty, Gender, and Youth

Relationships among socio-demographic characteristics, general assessments of health, and old-age mortality are well established in developed countries. There is also an increasing focus on the connection between early-life experiences and latelife health. This paper tests these and other associations using representative survey data from Taiwan on the population aged 60 and older in 1989, 1993, and 1996 that have been linked to data on deaths between 1989 and 1999 from a national death registry. The study also explores the possible influence of Taiwan’s Universal Health Insurance Program, instituted in 1995, and whether or not the survival of some groups of …

Estimating Mean Lifetime, John Bongaarts, Griffith Feeney

Poverty, Gender, and Youth

The life expectancy implied by current age-specific mortality rates is calculated with life table methods that are among the oldest and most fundamental tools of demography. We demonstrate that these conventional estimates of period life expectancy are affected by an undesirable “tempo effect.” The tempo effect is positive when the mean age at death is rising and negative when the mean age is declining. Estimates of the effect for females in three countries with high and rising life expectancy range from 1.6 years in the United States and Sweden to 2.4 years in France for the period 1980-95.

Completing The Fertility Transition In The Developing World: The Role Of Educational Differences And Fertility Preferences, John Bongaarts

Poverty, Gender, and Youth

This study summarizes patterns of educational differentials in wanted and unwanted fertility at different stages of the fertility transition based on data from DHS surveys in 57 less developed countries. As the transition proceeds, educational differentials in wanted fertility tend to decline and differentials in unwanted fertility tend to rise. An assessment of fertility patterns in more and less developed countries with low fertility concludes that these differentials are likely to remain substantial when less developed countries reach the end of their transitions. This finding implies that the educational composition of the population remains a key predictor of overall fertility …

The Ghana Community-Based Health Planning And Services Initiative: Fostering Evidence-Based Organizational Change And Development In A Resource-Constrained Setting, Frank K. Nyonator, John Koku Awoonor-Williams, James F. Phillips, Tanya C. Jones, Robert A. Miller

Poverty, Gender, and Youth

Research projects demonstrating ways to improve health services often fail to have an impact on what national health programs actually do. An approach to evidence-based policy development has been launched in Ghana that bridges the gap between research and program implementation. The Community-based Health Planning and Services (CHPS) initiative employs strategies tested in the successful Navrongo experiment to guide national health reforms that mobilize volunteers, resources, and cultural institutions to support community-based primary health care. Over the 1999 to 2002 period, 100 out of the 110 districts in Ghana adopted a CHPS initiative. This paper reviews features of the initiative …

Primary Schooling In Sub-Saharan Africa: Recent Trends And Current Challenges, Cynthia B. Lloyd, Paul C. Hewett

Poverty, Gender, and Youth

At the dawn of the twenty-first century we estimate that more than 37 million young adolescents aged 10-14 in sub-Saharan Africa will not complete primary school. Our estimates are based on data from nationally representative Demographic and Health Surveys from 26 countries, collectively representing 83 percent of the sub-Saharan youth population. This number is nearly twice the entire population of children aged 10-14 in the United States, virtually all of whom will complete primary school. Reducing the number of uneducated African youth is a primary objective of the United Nations as laid out in the Millennium Development Goal for education, …

The Feasibility Of Computer-Assisted Survey Interviewing In Africa: Experience From Two Rural Districts In Kenya, Paul C. Hewett, Annabel Erulkar, Barbara Mensch

Poverty, Gender, and Youth

This paper explores the use of an audio computer-assisted self-interviewing (audio-CASI) methodology in a household survey of adolescents in two districts of Kenya. Computer software was developed as part of a research project comparing audio-CASI with traditional methods of interviewing about sensitive behaviors, including sexual initiation, risky sexual behavior, coerced sex, and drug and alcohol use. The paper describes the experience of carrying out a household-based study using computers and explores the technical challenges faced by the data collection teams. Few problems emerged with the computer hardware and software, despite the difficult interviewing conditions. The adolescent respondents easily adapted to …

Condom Use And Abstinence Among Unmarried Young People In Zimbabwe: Which Strategy, Whose Agenda?, Ravai Marindo, Steve Pearson, John B. Casterline

Poverty, Gender, and Youth

This paper compares the views about abstinence and condom use expressed by young people in Zimbabwe in focus-group discussions with the views underlying national policies and religious and traditional beliefs. Young people’s decisions to adopt one or the other of these risk-reduction strategies may not necessarily indicate genuine individual choices, but rather their deference to adults’ interests as they understand those interests. Policymakers and traditional and Christian leaders promote abstinence as the exclusive strategy for all young people, whereas nongovernmental organizations and the private sector promote condom use. Evidence from the focus-group discussions indicates that adolescents are aware of this …

Wage Work And Marriage: Perspectives Of Egyptian Working Women [Arabic], Sajeda Amin, Nagah Hassan Al Bassusi

Poverty, Gender, and Youth

This paper explores young working women’s perceptions of marriage and work in contemporary Egypt at a time when an increase in age at marriage was evident from national survey data. Data from two nationally representative labor surveys, the Labor Force Sample Survey of 1988 and the Egypt Labor Market Survey of 1998, show that working conditions and employment opportunities declined significantly for young women even as their educational attainment increased. Indepth interviews were conducted with young women working in a range of salaried jobs in three locations: a rural village in Mansoura, a periurban district near Cairo, and in the …

Population And Development: An Introductory View, Geoffrey Mcnicoll

Poverty, Gender, and Youth

A brief overview of the relationships between population change and economic development, written for readers unfamiliar with the subject. The paper touches on the scale and pace of world development, the economic consequences of population size and rate of growth, patterns of demographic transition, and the scope for policy measures aimed at speeding that transition.