Medicine and Health Sciences Commons^™

A Survey Of Selected Representations Of The Stroke And Aphasia Quality Of Life Scale-39 Items, Dara Lynn Elizabeth Deroche

LSU Master's Theses

This research was designed to gain information that could be used in the future to improve quality of life measures for people with aphasia. Aphasia is a language disorder resulting from stroke or traumatic brain injury. People with aphasia exhibit difficulty producing and understanding verbal and written language. Existing quality of life measures, while valid and reliable for those with mild to moderate aphasia, are often unable to be used for those with severe aphasia. The written text is too complex for them to comprehend. Other studies have been done supporting the idea that pictures aid in the comprehension of …

The Effects Of Runx2 Deficiency In Cartilaginous And Mineralized Craniofacial Element, David Summerford

All ETDs from UAB

The development of the orofacial structure in mammals is a highly ordered process that is coordinated activity of epithelial and mesenchymal cells. Chondrocytes and osteoblasts work in close association for development of many cartilaginous skeletal structures and cartilaginous orofacial structures. Two major orofacial structures are the palate and the temporomandibular joint (TMJ). The transcription factor, Runx2, is obligatory for differentiation of mesenchymal cells into chondrocytes and osteoblasts. However, specific contributions of chondrocyte in cartilaginous and mineralized structures of the craniofacial skeleton are not known. Thus, the objective of this study was to discover the regulatory role of Runx2 in chondrocyte …

Individual, Socio-Cultural And Structural Factors Associated With Cervical Cancer Screening And Treatment In Tanzania, Renicha Tomeka Mccree-Hale

All ETDs from UAB

Most African countries including Tanzania have limited cervical cancer screening and treatment programs. Only about 5% of women have ever been screened for cervical cancer. A constellation of individual and structural factors contributes to the challenge of cervical cancer screening and treatment in countries that bear significant burdens of disease. Yet, little is known about country specific factors that may constrain or facilitate scale up of health services. This dissertation is an attempt to identify and understand the country specific individual and structural barriers along with facilitators to cervical cancer screening and treatment in Tanzania. Individual, institutional and structural level …

Limited Transplantation Of Antigen-Expressing Hematopoietic Stem Cells Induces Long-Lasting Cytotoxic T Cell Responses And Effect Of Altered Suppressive Myeloid Population On Hiv-Disease Progression, Warren L. Denning

All ETDs from UAB

While each type of cancer and chronic viral infection has its own specific pathology, they share two common mechanisms of immune evasion. The first mechanism is the exhaustion or deletion of antigen-specific T cells. The second mechanism is the formation of an immunosuppressive environment responsible for the block of T cell function. Elicitation of antigen-specific T cells be accomplished by immunotherapy in place of conventional treatments such as HAART and chemotherapy. In addition, immunotherapy can alleviate the side-effects associated with long-term use of conventional therapies while reducing the total cost. The results presented here provide an alternative to conventional methods …

Psychometric Testing Of The Children's Resourcefulness Scale, Jaclene A. Zauszniewski, Abir K. Bekhet, Elizabeth Bonham

College of Nursing Faculty Research and Publications

PROBLEM: Resourcefulness is known to reduce depression in adults, but its effects on children are less well known, possibly for lack of a psychometrically sound measure.

METHODS: This study examined the reliability and validity of the 32-item Children's Self-Control Scale (C-SCS), which measures resourcefulness, in 122 school-aged children.

FINDINGS: Standard scale refinement methods produced a 10-item scale with α = .72 and correlations with the C-SCS (r = .86), positive thoughts (r = .38), and depressive symptoms (r = –.32). Factor analysis revealed two factors: problem-solving and delay of gratification.

CONCLUSIONS: The 10-item scale may be …

Advancing Nursing Education Science: An Analysis Of Nln's Grant Program 2008-2010, Joanne R. Duffy, Marilyn Frenn, Barbara Patterson

College of Nursing Faculty Research and Publications

The National League for Nursing has responded to the increasing need for nursing education research through its grant program. Significant growth in proposals has intensified competition for funds and challenged the Nursing Education Research Advisory Council’s review process. The purpose of this article is to explore the NLN’s nursing education research proposals from 2008 to 2010 in order to improve performance and provide guidance to future nursing education researchers. Beginning with the 2008 grant cycle, a database was developed to assist in performance improvement. A total of 113 proposals were submitted; of those, 24 were funded for a success rate …

Dog Models Of Naturally Occurring Cancer, Donna O. Mccarthy

College of Nursing Faculty Research and Publications

Studies using dogs provide an ideal solution to the gap in animal models for natural disease and translational medicine. This is evidenced by approximately 400 inherited disorders being characterized in domesticated dogs, most of which are relevant to humans. There are several hundred isolated populations of dogs (breeds) and each has a vastly reduced genetic variation compared with humans; this simplifies disease mapping and pharmacogenomics. Dogs age five- to eight-fold faster than do humans, share environments with their owners, are usually kept until old age and receive a high level of health care. Farseeing investigators recognized this potential and, over …

Relationship Between Satisfaction With Service Recovery And Its Drivers, Aygul Isayeva

Khazar Journal of Humanities and Social Sciences

Service failures are inevitable. Customers tend to complain when they happen. Given that we are able to make customers complain, what actions should we take? This study is aimed at shedding the light on the relationship between satisfaction with service recovery (SSR) and its antecedents - disconfirmation, encompassing the relationship between expectations and performance, and dimensions of perceived justice. As a result, a literature review was carried out in order to reveal how previous research has treated this topic. Based on existing theory and subjective pre-assumptions, 4 hypotheses were proposed. Preliminary findings support the hypotheses.

A P4p Model For Increased Utilization Of Maternal, Newborn And Child Health Services In Bangladesh, Md. Noorunnabi Talukder, Ubaidur Rob, Laila Rahman, Ismat Ara Hena, A.K.M. Zafar Ullah Khan

Reproductive Health

In Bangladesh, maternal health programs are not yet reaching the desired level of facility-based obstetric care service. Most deliveries are conducted by untrained persons at home, demonstrating inequity in access to recommended maternal health care services and underutilization of existing obstetric and newborn care services. Suboptimal performance by providers is a key barrier to improving availability and quality of maternal, newborn, and child health (MNCH) services. To increase use of facility-based services, an operations research study of “pay-for-performance” (P4P) incentives for providers and subsidization of consumer costs was initiated in 2010. The study, part of the Government of Bangladesh–United Nations …

Innovative Financing Through Pay-For-Performance For Providers To Improve Quality Of Care In Bangladesh: Transforming Research Into Action, Md. Noorunnabi Talukder, Laila Rahman, Ismat Ara Hena

Reproductive Health

To improve access to, and use of, facility-based obstetric and newborn care services in rural areas, the Government of Bangladesh is implementing two innovative performance-based financing programs: demand-side financing (DSF) and pay-for-performance (P4P). Both programs have contributed to the increase in institutional deliveries, yet not enough women receive the recommended care during pregnancy and delivery. DSF and P4P are implemented in parallel and have their own merits and limitations. As described in this brief, a two-day workshop was organized in 2011 in Dhaka to identify the lessons learned and limitations of P4P and DSF models and scopes for cross-learning. Both …

Strengthening Union Level Facility For Providing Normal Delivery And Newborn Care Services: Facility Assessment Report, Md. Noorunnabi Talukder, Ubaidur Rob, A.K.M. Zafar Ullah Khan, Amar Krishna Baidya, M. Mostafizur Rahman Khan, Nargis Sultana

Reproductive Health

In Bangladesh, first-level fixed-facility services—provided at the union level through Health and Family Welfare Centers (HFWCs)—are designed to improve maternal and child health by making services available in rural areas. However, most HFWCs do not have the capacity to provide normal delivery services. HFWCs could help women receive free normal delivery services within a convenient distance from their home, if they were strengthened with necessary human resources, infrastructure, and equipment. The Population Council, with financial assistance from the UK Department for International Development (DFID), carried out a policy and research systems study to strengthen union HFWC’s provision of normal delivery …

Strengthening Union Level Facility For Providing Normal Delivery And Newborn Care Services: Workshop Report, Ubaidur Rob, Md. Noorunnabi Talukder, A.K.M. Zafar Ullah Khan

Reproductive Health

In Bangladesh, a network of government health facilities providing maternal and child health services has been established. In rural areas, first-level fixed-facility service is provided at the union level through Health and Family Welfare Centers (HFWCs). These facilities are designed to improve maternal and child health by making services available to the people in rural areas, however a full range of reproductive health services for women is not available in those facilities. At present, no evidence exists to support whether or not HFWCs can safely and cost-effectively provide normal deliveries. There is a need for a policy research initiative that …

Costing And Economic Analysis Of Strengthening Union Level Facility For Providing Normal Delivery And Newborn Care Services In Bangladesh, Sushil Ranjan Howlader

Reproductive Health

For a long time, the reduction of the maternal mortality ratio has constituted a major challenge for the health, nutrition, and population sector of Bangladesh. The objectives of this Population Council study is to estimate the costs of the additional inputs required for strengthening Health and Family Welfare Centers (HFWC) for providing normal delivery and newborn care services, the cost-effectiveness, and the financial implications of the addition of capacity. Results clearly show that the benefit-cost ratio for the intervention will be quite high. Some additional measures on the demand side should thus adopted. Intensive behavior change communication activities including interpersonal …

Innovative Financing Through Pay-For-Performance For Providers To Improve Quality Of Care In Bangladesh: Transforming Research Into Action, Md. Noorunnabi Talukder, Ubaidur Rob, Laila Rahman, Ismat Ara Hena

Reproductive Health

To improve access to and use of facility-based obstetric and newborn care, the Government of Bangladesh is implementing two innovative performance-based financing programs, namely demand-side financing (DSF) and pay-for-performance (P4P). With the purpose of identifying the lessons learned, limitations of the P4P and DSF models, and scopes for cross learning, a two-day workshop was organized in Dhaka. This workshop report, prepared by the Population Council, resulted in several recommendations to modify DSF and P4P schemes. In Bangladesh, the need for continuing performance-based financing programs to meet MDGs and other health indicators is beyond argument, but it is urgently required to …

Using Evidence To Improve Primary Health Care In Thai Nguyen Province, Population Council

Reproductive Health

In partnership with a number of local stakeholders, the Population Council Viet Nam is working to improve the evidence base available to health authorities and to use that evidence to improve health in Thai Nguyen Province. Building on cooperation between the Population Council and the Thai Nguyen Health Department, the project detailed in this report has three main elements: 1) developing a computerized information system to generate regular reports; 2) supporting research in the province to better understand health problems, health-seeking behavior, and health services; and 3) increasing the capability of managers and providers to better use the evidence generated. …

Shaping Demand And Practices To Improve Family Health Outcomes In Northern India: A Framework For Behavior Change Communication, Population Council

Reproductive Health

An initiative from the Population Council could help in developing a comprehensive communication strategy to improve reproductive, maternal, newborn, and child health, and nutrition outcomes in Uttar Pradesh and other northern states of India. The identification of key barriers to and facilitating factors for selected target behaviors that have a direct bearing on maternal and child health could go a long way in packaging specific messages for different stakeholders, such as women, husbands, elder family members, opinion makers in the community, and frontline health workers. One of the key deliverables of this publication is to fill an important knowledge gap …

Survey Of Domestic And Work Life Experience And Reproductive Health Of Women Workers Of Selected Industrial Compounds In Ha Noi, Nguyen Thi Van Anh, Nguyen Hong Phuong

Reproductive Health

The Population Council Viet Nam and local stakeholders undertook a collaborative project in Ha Noi entitled “Improving the health care response to gender-based violence.” The study’s objectives were: 1) to assess the knowledge and experience of female workers about gender-based violence; 2) to assess knowledge and practice of women workers on reproductive health focusing on abortion; and 3) to make recommendation for the Ha Noi Health Service to improve the women workers’ knowledge on gender-based violence, choice of contraceptive method, reproductive health care, and abortion. The women factory workers, who have higher levels of education than their peers in the …

Increasing Access To Safe Abortion In Rural Maharashtra: Outcomes Of A Comprehensive Abortion Care Model, Shireen J. Jejeebhoy, A.J. Francis Zavier, Rajib Acharya, Shveta Kalyanwala

Reproductive Health

This assessment of a Comprehensive Abortion Care (CAC) model was conducted by the Population Council on behalf of the Consortium for Safe Abortions in India. The goal of the Consortium is to increase access to legal, safe, and comprehensive abortion services, including post-abortion family planning, in the public health system, and especially among the rural poor. This report describes the CAC model implemented in Aurangabad district, Maharashtra, and examines the extent to which the model improved (a) the availability and quality of abortion services in public sector facilities, and (b) women’s awareness and experiences with regard to abortion services. It …

Increasing Access To Safe Abortion In Rural Rajasthan: Outcomes Of A Comprehensive Abortion Care Model, Shireen J. Jejeebhoy, A.J. Francis Zavier, Rajib Acharya, Shveta Kalyanwala

Reproductive Health

This report describes an assessment by the Population Council of the Comprehensive Abortion Care (CAC) model implemented in Tonk district, Rajasthan. Findings highlight that at the time of the baseline survey, the availability of abortion services was limited; also evident was the poor quality of abortion-related care. Given this context, and given the short duration of implementation, the changes achieved by the intervention are promising. The district-level CAC model succeeded in strengthening facilities, training providers, and increasing women’s access to safe abortion services at the Primary Health Centre level. Community-level activities were less successful, attributable to a considerable extent to …

Expanding Access To Safe Abortion And Post-Abortion Care: Recommendations Of A South Asia Regional Consultation, Population Council

Reproductive Health

A South Asia Regional Consultation, organized by the Population Council with representation from governments and key stakeholders of Bangladesh, India, Nepal, and Pakistan, was held in New Delhi, to discuss ways of expanding women’s access to safe abortion services. The Consultation deliberated on ways of expanding the provider base for safe induced abortion so as to overcome inadequate and inequitable access to safe abortion. They also looked to expand access to services for the management of incomplete abortion and complications of unsafe abortion that persist in the region and, thereby, to reduce morbidity and mortality resulting from unsafe abortion. In …

Introduction Of Medical Abortion In Ghana, Emmanuel Kuffour, Selina F. Esantsi, Placide Tapsoba, Gloria Quansah Asare, Ian Askew

Reproductive Health

To significantly expand women’s access to modern family planning and comprehensive abortion care services a provisional license was awarded to Marie Stopes International-Ghana by the Ghana Food and Drugs Board for the introduction and provision of the first medical abortion regimen (mifepristone and misoprostol) in Ghana. The Population Council conducted this study to document the introduction process; findings from the study will provide much needed evidence to inform policy decisionmaking and the scale-up phase. Overall the study has shown that medical abortion is a viable option for Ghanaian women--an overwhelming number of those who have benefitted from the procedure are …

Female Genital Mutilation Practices In Kenya: The Role Of Alternative Rites Of Passage. A Case Study Of Kisii And Kuria Districts, Habil Oloo, Monica Wanjiru, Katy Newell-Jones

Reproductive Health

This research was undertaken by the Population Council to better understand female genital mutilation (FGM) as currently practiced by the Kuria and Kisii communities in Kenya. The study investigated current attitudes and practices in relation to FGM, awareness and attitudes toward the alternative rite of passage (ARP), and factors which encourage individuals to make decisions to abandon FGM. The findings show that FGM is still a celebrated public event among the Kuria, whereas in Kisii, it is a private family affair. The study suggests that the success of ARP as an approach to abandoning FGM is strongly dependent on the …

Using Community Health Workers Can Lead To Positive Sexual Behavior Outcomes Among People Living With Hiv, Population Council

Reproductive Health

This operations research summary reports on the use of community health workers (CHWs) in Kenya to influence sexual behavior outcomes of people living with HIV/AIDS. Results of the Population Council’s APHIA II project indicate that using community-based health workers to provide information and counsel people living with HIV as well as make referrals for antiretroviral therapy can lead to increased uptake of ART among those eligible but not on treatment, and to positive sexual behavior outcomes. HIV prevention and care programs should therefore work with CHWs to increase the reach and impact of their activities.

Comprehensive Responses To Sexual Violence In East And Southern Africa: Lessons Learned From Implementation, Jill Keesbury, Ian Askew, Monica Wanjiru, Grace Chiyaba, Kate Wilson, Felly Nkweto Simmonds

Reproductive Health

The Population Council has provided technical assistance and conducted research to strengthen the evidence base on sexual and gender-based violence (SGBV) programming in sub-Saharan Africa, where countries have begun to recognize the importance of both preventing violence and responding to the needs of SGBV survivors. These activities have created an active network of partners from across sub-Saharan Africa, who are developing, implementing, and evaluating core elements of a comprehensive, multisectoral response model. This brief reports how network partners have significantly increased the evidence base on program responses: a range of successful approaches have been demonstrated for improving comprehensive services within …

Scaling Up The Provision Of Family Planning Messages In Antenatal And Postpartum Services In Upper Egypt, Nahla G. Abdel-Tawab, Sally Saher

Reproductive Health

An operations research study by the Population Council’s FRONTIERS program in 20 facilities in Upper Egypt showed that integration of birth spacing messages into antenatal and postpartum care was feasible, acceptable to women and their husbands, and was associated with increased postpartum contraception. This report describes the initial and scale-up phases, their outcomes, challenges, and recommendations for improvement. In addition to successfully scaling up the program, the main achievement was securing the support and investment of senior MoHP officials at the central level, as well as the support and commitment of managers and supervisors at governorate and district levels. The …

The Prevention And Management Of Hiv And Sexual And Gender-Based Violence: Responding To The Needs Of Survivors And Those-At-Risk, Sarah Raifman, Ian Askew, Sajeda Amin, Jill Keesbury, Saiqa Mullick, Judith A. Diers, Meiwita P. Budiharsana, Chi-Chi Undie, Mary Zama, Mantshi Menziwa, Sherry Hutchinson, Naomi Rutenberg

Reproductive Health

The Population Council seeks to understand the social, economic, political, and physical context of risks for sexual and gender-based violence and HIV. Among the top priorities of Council research are supporting and evaluating efforts to prevent violence and HIV, including creating safe spaces for adolescent girls, and working with men and boys to change gender norms within the community; and comprehensively responding to the needs of survivors (including those who are HIV-infected) by strengthening health systems and integrating services. The purpose of this guide is to provide practical guidance on the steps necessary to establish and strengthen sexual violence (SV) …

Community Health Workers And The Media Can Be Effective In Providing Health Information To Married Adolescent Girls In The Community, Population Council

Reproductive Health

Past research has found that married adolescent girls in Nyanza Province, Kenya, face higher risks of HIV infection than unmarried but sexually active girls their age in the province and other parts of the country. To address this challenge, the Population Council’s APHIA II Operations Research Project, in collaboration with Well Told Story and the Ministry of Public Health and Sanitation, developed a study to assess the effectiveness of an intervention designed to increase married adolescent girls’ access to comprehensive reproductive health and HIV information and services in Homa Bay and Rachuonyo districts. The study found that using interactive communication …

Community Health Workers Can Effectively Provide Information And Referrals To People Living With Hiv In Their Communities, Population Council

Reproductive Health

A number of studies reported high levels of sexually transmitted infections among people living with HIV (PLHIV). Unfortunately, prevention interventions targeting PLHIV in the community are not common in Kenya, and most PLHIV who are not on ART have limited access to prevention information and risk-reduction counseling. The Population Council’s APHIA II Operations Research Project conducted a research project to address these gaps. This study was conducted in 2010 in collaboration with the International Center for Reproductive Health and the National AIDS and STI Control Programme. The findings show that the intervention had a number of positive outcomes and concludes …

A Pay-For-Performance Innovation Integrating The Quantity And Quality Of Care In Maternal, Newborn And Child Health Services In Bangladesh, Laila Rahman, Ubaidur Rob, Riad Mahmud, Azizul Alim, Ismat Ara Hena, Md. Noorunnabi Talukder, Md. Hafizur Rahman

Reproductive Health

The Population Council explored the possibilities of introducing a Pay-for-Performance (P4P) scheme in Bangladesh to improve maternal, newborn and child healthcare (MNCH) services. Based on the consultation and with guidance from the Government of Bangladesh, the Population Council and UNICEF provided technical assistance to the Directorate General of Health Services (DGHS) to test two P4P strategies for MNCH service providers to improve service volume and quality of care, and for poor clients to receive services subsidized through vouchers or coupons. The first strategy is a combination of pay-for-performance for providers and subsidized coupons for poor pregnant women, newborns, and under-five …

Focus On Male Youths In Addressing Alcohol And Drug Abuse Risk In The Context Of Hiv Prevention Among Young People, Population Council

Reproductive Health

Research evidence shows that people who abuse alcohol are more likely to engage in behavior that puts them at risk of HIV infection, including having unprotected sex. In 2010, the Population Council’s APHIA II Operations Research Project collaborated with the Support for Addictions Prevention and Treatment in Africa Centre in Kenya on research to identify factors associated with alcohol and drug use among out-of-school youth in Kibera, to identify specific factors contributing to HIV risk, and to assess the impact of an intervention to link youths with an alcohol and drug abuse problem to counseling and rehabilitation services. A key …