Medicine and Health Sciences Commons^™

Promoting Reproductive Health Services In Rural Communities In Honduras, Irma Mendoza, Ricardo Vernon

Reproductive Health

Using the results of a previous operations research study, the Ministry of Health of Honduras recently changed the National Women’s Health Service Delivery Guidelines to explicitly authorize nurse auxiliaries to insert IUDs, deliver Depo-Provera, and take Pap smears. These services are new to the rural communities served by rural health centers (RHCs). The objective of this project was to test whether the demand for these newly introduced services would increase if a promotional brochure was distributed in the surrounding communities by the RHC’s clients among potentially interested friends in these communities. The study found that the intervention that was tested …

An Assessment Of Youth Centres In South Africa, Annabel Erulkar, Mags Beksinska, Queen Cebekhulu

Reproductive Health

Within South Africa there is much interest in expanding youth center programs, particularly in the nongovernmental sector, in part because of recognition that the HIV/AIDS crisis is disproportionately affecting young South Africans. This study was designed to give implementing agencies and donors a broad view of how the youth centers function, who they reach, and the quality of information and services. The assessment underscored the importance of monitoring the performance of programs and understanding who is being reached with what interventions. Youth centers that focus on providing recreational facilities attract a large number of clients, often boys who are repeat …

An Assessment Of The Zimbabwe National Family Planning Council's Community Based Distribution Programme, Baker Ndugga Maggwa, Ian Askew, Caroline S. Marangwanda, Ronika Nyakauru, Barbara Janowitz

Reproductive Health

Since its inception, the Zimbabwe National Family Planning Council’s (ZNFPC) community-based distribution (CBD) program has made significant and well-documented contributions to the demand for and use of family planning in Zimbabwe. Data from several studies have shown, however, a steady decline in this contribution and that the CBD agents spend more time resupplying existing clients than recruiting new acceptors. Moreover, the CBD program urgently needs to be able to address the AIDS crisis in the country. ZNFPC has undertaken this review to guide it in making appropriate decisions about the future direction of the program, allowing CBDs to have a …

An Assessment Of The Alternative Rites Approach For Encouraging Abandonment Of Female Genital Mutilation In Kenya, Jane Chege, Ian Askew, Jennifer Liku

Reproductive Health

Maendeleo Ya Wanawake (MYWO), with technical assistance from the Program for Appropriate Technology in Health (PATH), has been implementing an Alternative Rite of passage programme as part of its efforts to eradicate the practice of female genital mutilation (FGM) in five districts in Kenya. This study addressed the factors that influence some families and individuals to adopt the Alternative Rite while others, exposed to the same messages discouraging FGM, decide not to. It also evaluated the effect of the training component of the Alternative Rite on the girls who participated.

Strengthening Social Science Research On Women's Health: Lessons Learned From A Capacity Building Programme, M.E. Khan, Bella C. Patel, John Townsend

Reproductive Health

The International Conference on Population and Development in 1994 led to an upsurge in interest in implementing reproductive health (RH) programs worldwide. The urgency to act has led to the development of disparate activities in several developing countries including India. While programs have been growing in numbers, their quality is in question. A fundamental problem has been lack of capacity at all levels of the health service system to respond to the paradigm shift articulated by the advocates of the reproductive health and rights agenda. To redesign programs, considerable research must be undertaken to understand the health needs and sociocultural …

A Noninvasive Test For Vesico-Ureteric Reflux In Children, R. A. Mevorach, B. Cilento, S. Zahorian, C. Badgett, R. Walker, A. Atala, S. Iannello, M. Meyer

Electrical & Computer Engineering Faculty Publications

Objective To report the development and testing of a device for the noninvasive diagnosis of vesico‐ureteric reflux (VUR) which avoids the need for urethral catheterization (currently required to reliably determine the presence of VUR), and which thus avoids the anxiety of parents and patients that causes many families to refuse such evaluation.

Patients and methods Fifty‐four children (49 girls and five boys, mean age 7.2 years, range 4–14) previously evaluated as having VUR volunteered to participate; no child was symptomatic at the time of the study. Refluxing units were known to be present by voiding cysto‐urethrography (within 1 year, mean …

Synaptopodin Expression In Idiopathic Nephrotic Syndrome Of Childhood., Tarak Srivastava, Robert E. Garola, J M. Whiting, Uri S. Alon

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Synaptopodin is a proline-rich protein intimately associated with actin microfilaments present in the podocytes' foot processes. We investigated for synaptopodin expression in children with idiopathic nephrotic syndrome (INS), including minimal change disease (MCD), diffuse mesangial hypercellularity (DMH), and focal segmental glomerulosclerosis (FSGS); in children with congenital nephrotic syndrome of the Finnish type (CNF); and in normal kidney tissue. In particular, we examined whether an association exists between synaptopodin expression in podocyte cells and the response to steroids in INS, and whether synaptopodin expression can predict FSGS upon the initial kidney biopsy in children who progress from MCD or DMH …

Master Of Medical Science Distance Learning Program, Nova Southeastern University

Health Professions Divisions Course Catalogs and Course Descriptions

No abstract provided.

Female Genital Tuberculosis Revisted, R N. Qureshi, S Samad, R Hamid, S F. Lakha

Department of Obstetrics & Gynaecology

Objective: To assess the clinical presentation of genital tuberculosis and to study various modes of diagnosis and treatment.SETTING: The Aga Khan University Hospital (AKUH), Karachi.
Method: A retrospective case review of all index female cases of genital tuberculosis, admitted to AKUH over twelve years of period.
Result: A total of 40 cases of genital tuberculosis were reported during this time period. Majority of cases were between 25-45 years. The commonest presenting symptoms were infertility (42.5%) and abdominal pain (42%). Others included fever, ascites, irregular vaginal bleeding, oligomenorrhea, chest pain and pain in the flanks. Main mode of treatment was antituberculous …

Developmental Coordination Disorder: A Discrete Disability, Beth P. Hands, Dawne Larkin

Health Sciences Papers and Journal Articles

Children with Developmental Coordination Disorder (DCD) have a motor learning disability that reduces their ability to interact with the environment and compromises their social and emotional development. Accordingly, these children should be given the extra assistance and consideration given to children with other learning difficulties. Even though many countries have well developed policies to support students at educational risk, children with movement difficulties are not widely considered to be members of this category. This paper argues for a change in education policy and practice in order to better support children with DCD or Motor Learning Disability (MLD). Improved teacher education …

Special Studies Program Of The Pilot Health Project: West Bank And Gaza, Mahmoud Shaheen, Laila Nawar, Dale Huntington, Sahar Hegazi

Reproductive Health

The Special Studies Program was implemented as part of the Pilot Health Project in the West Bank and Gaza to provide small grants to Palestinian researchers, research organizations, and advanced graduate students to conduct research that examines critical reproductive health topics related to maternal and child health care, including family planning. The research implemented under the Special Studies Program covered a range of topics including male involvement in reproductive health, clients' satisfaction with family planning programs, the relationship between early marriage and the delivery of premature infants, factors affecting compliance for iron supplementation, and diabetes mellitus during pregnancy. The research …

Diverse Realities: Understanding Sexually Transmitted Infections And Hiv In India, Sarah Hawkes, K.G. Santhya

Reproductive Health

Sexually transmitted infections (STIs), including HIV, currently have high salience on the health care agendas of many countries, including India. Strategies for their control are ideally based on a number of well-recognised principles. These include: assessments of the burden of disease; the availability of interventions at policy and programme levels, to influence behaviour change and technical ‘solutions’; and the calculated cost-effectiveness of these interventions. In the case of India, data to inform these principles are often lacking in the case of STI control. In this paper we have reviewed the evidence base for STI control in the Indian context. The …

Wrist And Hand Injuries In The Athlete, Timothy L. Uhl, Philip Blazar, Greg Pitts, Kelly Ramsdell

Physical Therapy Faculty Publications

Athletes subject themselves to considerable disability. No matter the sport, the hand and upper extremity are among the most commonly injured sites. Frequently, the most debilitating complications of these conditions are the result of misdiagnosis or delayed diagnosis. Unfortunately, many patients with these delayed and misdiagnosis injuries need to be treated with surgical procedures. To compound the dilemma in treating hand and wrist injuries in this population, one needs to appreciate the athletic personality and the mentality that wishes to dismiss hand injuries as minor. It is essential to educate athletes by clearly communicating the risks and complications inherent to …

"Geographical Morality" Revisited: International Relations, International Law, And The Controversy Over Placebo-Controlled Hiv Clinical Trials In Developing Countries, David P. Fidler

Articles by Maurer Faculty

No abstract provided.

Physician Assisted Suicide Perceptions Among Patients Presenting To Family Physicians At A Teaching Hospital In Karachi, Pakistan, Waris Qidwai, H. Qureshi, S. S. Ali, M. Alam, S. I. Azani

Department of Family Medicine

Objective: To study the perceptions on physician assisted suicide, among patients presenting to family physicians, at a teaching hospital in Karachi, Pakistan.
Method: The study was carried out at the Community Health Center of The Aga Khan University Hospital, Karachi, between December 1999 and May 2000. The principal and co-investigators filled a pre-coded and pre­tested questionnaire consisting of important demographic characteristics and bio-medical ethics issues. A system of convenience sampling was used and a written consent was taken from respondents over the age of 16 years, who agreed to participate. The data were managed by using the Epi …

Book Review. Gostin On Public Health Law, David P. Fidler

Articles by Maurer Faculty

No abstract provided.

2000-2001 Nhrd Summary Report, Part 1, Unm Health Sciences Library & Informatics Center

Native Health Database project records

Summary report for the NHRD.

Mainecare Managed Care Performance Report Sfy 2000, Catherine Ormond, Tina Gressani, Maureen Booth

Disability & Aging

No abstract provided.

Cognitive Differences In Chart Reading: A Comparison Of Nurses And Physicians, Todd R. Johnson, Vimla L. Patel, James P. Turley

Faculty, Staff and Student Publications

This pilot study compares the mental models of a patient constructed by nurses and physicians while reading an electronic medical record. Preliminary results suggest that the participants' summaries were both quantitatively and qualitatively different. The physician made more inferences and focused on deeper relationships in the record, whereas the nurse focused on the descriptive surface structure of the record.

Religious Faith And Mental Health Outcomes, Thomas G. Plante, Naveen K. Sharma

Psychology

In this chapter we review recent research regarding the relationship between religious faith/spirituality and mental health outcomes, as well as provide directions for future research and discussion. The specific aspects of mental health and illness that we focus on include well-being, depression, anxiety, substance abuse, and schizophrenia. We also briefly discuss research pertaining to religious faith and personality disorders, eating disorders, somatoform disorders, and bipolar disorder.

Cigarette Sources For Teens By Grade: Implications For Prevention And Intervention, Netra M. Thakur, Michael P. Rosenthal, Priscilla Latta, Jamie L. Robinson, James Diamond

Department of Family & Community Medicine Faculty Papers

Objective: To identify at-risk teen populations and their sources of cigarettes, in order to help target future efforts in prevention of teen smoking. Methods: Analysis of smoking behavior questions for students in grades 6, 7, 9 and 12 from the 1997 Pennsylvania Biennial Youth Risk Survey. Results: Current smoking prevalence was 20.9% overall. The number of ninth grade smokers was almost five times higher than the number of sixth grade smokers (30.6% vs. 6.6%). Seventy-three percent of the teens identified friends as a source of tobacco. Stores became the most common source for twelfth graders only. Conclusion: Teenage smoking remains …

Beyond Pain Management: A Primer For Providing Quality End-Of-Life Care, Linda P. Tomko, Terri L. Maxwell

Department of Family & Community Medicine Faculty Papers

Providing excellent care for a dying patient is something all patients deserve. Hospices and palliative care centers exist in many areas to aid primary care physicians and patients through this difficult time. It is important to remember that most patients want to prepare for death, if at all possible. Everyone does this in his or her own way, but oftentimes concern about pain and symptom management interfere with this very involved and valuable process. Being prepared to treat these symptoms as well as addressing your patient's emotional needs is imperative. Referral to a hospice, if possible, will only strengthen the …

Substitution De Solvants : Étude De Cas D'Implantation, Denis Bégin, Michel Gérin

Rapports de recherche scientifique

Introduction

Les solvants sont parmi les substances dangereuses les plus utilisées en milieu de travail. La substitution permet d’éliminer un solvant toxique ou inflammable en le remplaçant par un produit moins dangereux ou en changeant de procédé. Pour implanter la substitution en entreprise il faut également tenir compte des dimensions environnementales, de coût et de faisabilité technique ainsi que des facteurs humains et organisationnels. Le présent travail visait à étudier la démarche d’implantation de la substitution par des études de cas concrets dans des entreprises québécoises.

Méthode

Une démarche en neuf étapes inspirée de travaux précédents a été appliquée aux …

2000 Navajo Middle School Youth Risk Behavior Survey, Navajo Area Indian Health Service

Native Health Database Full Text

The Navajo Area Indian Health Service, Health Promotion Program administered a modified version of the New Mexico 2000 Middle School Youth Risk Behavior Survey in April, 2000. The survey was developed to monitor priority health-risk behaviors that contribute to the leading causes of mortality, morbidity, and social problems, among youth and adults in the United States. These behaviors fall into six categories: (1) behvaiors that result in unintentional and intentional injuries, (2) tobacco use, (3) alcohol and other drug use, (4) sexual behaviors that result in HIV infection, other sexually transmitted diseases (STDs), and unintended pregnancies, (5) dietary behaviors, and …

Ups And Downs Of Mucosal Cellular Immunity Against Protozoan Parasites, Lloyd H. Kasper, Dominique Buzoni-Gatel

Dartmouth Scholarship

No abstract provided.

Anatomical Variations Of Internal Jugular Vein As Seen By "Site Rite Ii" Ultrasound Machine--An Initial Experience In Pakistani Population, Hameedullah, M. A. Rauf, Fazal Hameed Khan

Department of Anaesthesia

Objective: To determine the anatomical variations of the internal jugular vein (IJV) in Pakistani adult population with the help of Site Rite II ultrasound machine.
Material and Method: The right IJV relation to the carotid artery was visualized at four different landmarks (angle of the mandible, thyroid cartilage, cricoid cartilage, and the supraclavicular area). Size of IJV in comparison to carotid artery was also seen.
Results: In 49 cases the IJV was found in aberrant relation to carotid artery at the angle of the mandible (p value
Conclusion:Care should be taken while cannulating IJV at the angle of the …

Persistent Productive Epstein‐Barr Virus Replication In Normal Epithelial Cells In Vivo, Dennis M. Walling, Catherine M. Flaitz, C. Mark Nichols, S. David Hudnall, Karen Adler-Storthz

Faculty, Staff and Student Publications

Productive Epstein‐Barr virus (EBV) replication characterizes hairy leukoplakia, an oral epithelial lesion typically occurring in individuals infected with human immunodeficiency virus (HIV). Serial tongue biopsy specimens were obtained from HIV‐infected subjects before, during, and after valacyclovir treatment. EBV replication was detected by Southern hybridization to linear terminal EBV genome fragments, reverse‐transcriptase polymerase chain reaction amplification of EBV replicative gene transcripts, immunohistochemical detection of EBV replicative protein, and in situ hybridization to EBV DNA. EBV replication was detected in both hairy leukoplakia and normal tongue tissues. Valacyclovir treatment completely abrogated EBV replication in vivo, resulting in resolution of hairy leukoplakia when …

Preliminary Evaluation Of A Guideline Classification System, Elmer Bernstam, Nachman Ash, Mor Peleg, Samson Tu, Edward H. Shortliffe, Robert A. Greenes

Faculty, Staff and Student Publications

In a previous paper, we presented a proposed expansion of the National Guideline Clearing-house (NGC) classification1. We performed a preliminary evaluation of the classification based on 100 guidelines randomly selected from the NGC collection. We found that 89 of the 100 guidelines could be assigned to a single guideline category. To test inter-observer agreement, twenty guidelines were also categorized by a second investigator. Agreement was found to be 40-90% depending on the axis, which compares favorably with agreement among MeSH indexers (30-60%)2. We conclude that categorization is feasible. Further research is needed to clarify axes with poor inter-observer agreement.

Focus Group Evaluation For Web-Based Courses, James P. Turley, Meena Hussein, Doris L. Ross

Faculty, Staff and Student Publications

No abstract provided.

A Low-Cost Intervention For Cleaner Drinking Water In Karachi, Pakistan, S Luby, M Agboatwalla, A Raza, J Sobel, E Mintz, K Baier, M Rahbar, S Qureshi, Rumina Hassan, F Ghouri

Community Health Sciences

Objective: To pilot test an inexpensive, home-based water decontamination and storage system in a low-income neighborhood of Karachi.Methods: Fifty households received a 20-L plastic water storage vessel with a high-quality spout and a regular supply of diluted hypochlorite solution. Twenty-five control households were recruited. Water samples were collected at baseline and during unannounced follow-up visits 1, 3, 6, and 10 weeks later.Results: Baseline drinking water samples among intervention households were contaminated with a mean 9397 colony-forming units (cfu)/100 mL of thermotolerant coliforms compared with a mean 10,990 cfu/100 mL from controls. After intervention the mean concentration of thermotolerant coliforms decreased …