Medicine and Health Sciences Commons^™

Levels, Trends And Determinants Of Contraceptive Use Among Adolescent Girls In Kenya, Francis Obare, Harriet Birungi, Chi-Chi Undie, Monica Wanjiru, Wilson Liambila, Ian Askew

Reproductive Health

In Kenya, recent trends in contraceptive use among currently married women aged 15–49 years show that after experiencing a stall between 1998 and 2003, the contraceptive prevalence rate (CPR) increased between 2003 and 2008–2009. Although the increase in CPR after 2003 is encouraging, there is limited understanding of how these changes affected adolescents, especially girls, given the unique sexual and reproductive health challenges that they face. This report is based on a secondary analysis of the Kenya Demographic and Health Surveys (KDHS) data to understand the trends, differentials, and determinants of contraceptive use among adolescent girls aged 15–19 years in …

Integrating Tuberculosis Case Finding And Treatment Into Postnatal Care, Charity Ndwiga, Harriet Birungi, Chi-Chi Undie, Shiphrah Kuria, Joseph Sitienei, Sam Ochola

Reproductive Health

Under the USAID funded FRONTIERS program, the Population Council conducted a study in six health facilities in Western Kenya that demonstrated that screening for TB within an antenatal care (ANC) setting is feasible and acceptable among the service providers. However, a major challenge remains: although TB detection is encouraged among ANC clients within the maternal and child health clinics in the country, providers in these settings fail to appreciate the need for a continuum of care from pregnancy through to the postnatal period. In order to address this gap, the APHIA II Operations Research Project developed and tested an intervention …

Making Hiv Services More Responsive To Young Children And Infants In Nyanza, Monica Wanjiru

Reproductive Health

Health workers in Kenya often miss opportunities to discuss pediatric HIV with clients and to track exposed children in order to initiate treatment. To address this problem, the Population Council’s APHIA II Operations Research Project collaborated with the Christian Health Association of Kenya, Catholic Relief Services, and the Kendu Adventist Hospital to improve HIV testing and treatment services for children at the hospital. The project recommended that pediatric HIV services be strengthened and included as an essential service at all levels of healthcare facilities in order to reach more children, including as one of the roles of the community health …

Operationalizing And Scaling Up Hiv/Rh Referrals In Kenya: The Way Forward, Aphia Ii Or Project In Kenya

Reproductive Health

This policy brief describes the APHIA II Operations Research Project through which the Population Council and Kenya’s Ministry of Health (MOH) developed and tested an approach to systematically link HIV-positive family planning (FP) clients to treatment and care services. Key activities included provider training and testing of a referral package which showed how, where, when, and who is to make and receive referrals. This referral package consisted of a directory listing all facilities in the vicinity available for services including HIV counseling and testing, FP, STIs, tuberculosis, and well-child checks; and referral forms directing clients to appropriate receiving clinics. The …

Service Improvements And Community Education Lead To Increase In Uptake Of Hiv Services For Infants And Young Children, Population Council

Reproductive Health

The Population Council’s APHIA II Operations Research Project in Kenya collaborated with Kendu Adventist Hospital and the Christian Health Association to launch a study to examine the effect of improved services and awareness-creation on the uptake of HIV testing and treatment services for children and infants exposed to HIV. The study showed that community education and improvements in individual case tracking can increase the proportion of infants exposed to HIV who are tested for HIV and put on appropriate treatment. The policy brief recommends that health facilities streamline services to ensure that as many exposed infants as possible are identified …

Sexual And Reproductive Health Needs Of Adolescents Living With Hiv In Kenya, Harriet Birungi, Francis Obare, Jane Harriet Namwebya, Ibrahim Mohammed, Margaret Gitau, Margaret Makumi

Reproductive Health

The objective of this study was to assess the sexual and reproductive health needs of adolescents living with HIV in Kenya with a view to identifying and developing interventions that integrate these needs within the existing HIV/AIDS treatment, care, and support programs in the country. The study was a result of collaboration between Population Council, APHIA II Rift Valley and Coast (Family Health International), the National AIDS and STI Control Programme, and APHIA II Nairobi and Central (Pathfinder International). Major findings indicate that many of the adolescents living with HIV are vulnerable, and that programmatic gaps exist in addressing the …

Ten Years Of The Kenya Adolescent Reproductive Health Project: What Has Happened?, Humphres Evelia, Monica Wanjiru, Francis Obare, Harriet Birungi

Reproductive Health

This evaluation by the Population Council’s APHIA II Operations Research Project sought to find out whether the adolescent sexual and reproductive health (ASRH) and HIV/AIDS activities in Kenya had been sustained over a 10-year period when the project was replicated and scaled up to cover seven provinces in the country. The evaluation had three main objectives: 1) to determine the extent to which activities of the Kenya Adolescent Reproductive Health Program (KARHP) have continued at national, provincial, and district levels; 2) to determine whether desired sexual and reproductive health outcomes (knowledge, behavior, and practices) have been sustained among in- and …

Increasing Access To Family Planning (Fp) And Reproductive Health (Rh) Services Through Task-Sharing Between Community Health Workers (Chws) And Community Mid-Level Professionals In Large-Scale Public-Sector Programs: A Literature Review To Help Guide Case Studies, James R. Foreit, Sarah Raifman

Reproductive Health

This literature review covers case studies related to community-based distribution of family planning programs, and community health worker (CHW) programs that included family planning and other reproductive health services. It offers essential processes and implications for additional operations research which look at constraints and factors critical to introducing new program procedures or strengthening existing ones.

Integrating Alcohol Risk Reduction Into Htc Services, Population Council

Reproductive Health

This brief describes how screening for alcohol abuse and hosting long-term support groups through HIV testing and counseling centers (HTC) is one way to decrease high-risk sexual and alcohol behaviors among people who have tested for HIV. Findings from program activities funded by Population Council, Liverpool VCT and Support for Addiction Prevention and Treatment in Africa Center (SAPTA) found that screening HTC clients for alcohol abuse and referral to active support and counseling services is feasible. Follow up using SMS is also recommended. However, the lack of a control group in this study may hinder drawing direct causality between the …

Informe Años Dos Movil.Com: Evaluación De La Línea Final Resumen De Hallazgos Principales, Annik Sorhaindo, Xipatl Contreras, Kate S. Wilson, Sandra G. Garcia

Reproductive Health

This report highlights the findings of the endline evaluation of a two-year leadership project aimed at indigenous youth in Oaxaca, Mexico: Movil.com. Movil.com is a community project headed by peers and built on elements of other models. It is similar to a cascaded peer education and training model, in which nuclear leaders are trained who, in turn, train facilitators of larger groups. The Population Council office in Mexico evaluated the project at the request of the social organization that implements it, the Rosales Castellanos Women's Study Group, an NGO that has worked for more than 30 years with indigenous communities …

Accuracy Of Computed Tomography In Diagnosing Malignancy In Solitary Pulmonary Lesions, Imaad-Ur-Rehman, Wasim Memon, Yousuf Husen, Waseem Akhtar, Raafay Sophie, Muhammad Akbar Baig

Department of Radiology

OBJECTIVE: To evaluate accuracy of Computed Tomography (CT) for diagnosing malignancy in solitary pulmonary lesions (SPLs).

METHODS: A prospective cross-sectional study was conducted from 20-01-2007 to 30-06-2008 at the Radiology department, Aga Khan University Hospital (AKUH) Karachi. Fifty-three patients with solitary pulmonary lesions (SPLs) seen in prior chest x-rays or chest CT scans were referred to radiology department for CT guided biopsy. CT scan was performed for each patient prior to biopsy and CT evaluation of the SPLs was performed followed by CT guided Biopsy. Histopathological diagnosis of the lesion was taken as the gold standard.

RESULTS: CT was found …

Elbow Extension Predictsmotor Impairment And Performance After Stroke, Crystal L. Massie, Stacy L. Fritz, Matthew P. Malcolm

Faculty Publications

Background and Purpose. Kinematic motion analysis has helped to characterize poststroke reaching strategies with the hemiparetic arm. However, the relationships between reaching strategy and performance on common functional outcome measures remain unclear. Methods. Thirty-five participants were tested for motor performance and motor impairment using the Wolf Motor Function Test (time and functional ability measure) and Fugl-Meyer assessment, respectively. Kinematic motion analysis of a forward reaching paradigm provided potential predictors of reaching strategy including shoulder flexion, elbow extension, and trunk displacement. A stepwise linear regression model with three potential predictors was used in addition to Pearson-product moment correlations. Results …

Acquired Cytogenetic Changes In Adult Twins Discordant For A History Of Childhood Sexual Abuse, Jenni Brumelle

Theses and Dissertations

The primary study aim was to evaluate the latent biological effect of childhood sexual abuse (CSA) on adults by quantifying acquired cytogenetic changes and cortisol levels in identical twins who were discordant (N=22) or concordant (N=2) for a history of CSA. Although the difference scores for cortisol values between discordant identical co-twins were not significantly different from zero, a trend was observed for the twins exposed to intercourse, the most severe form of CSA, to have a blunted cortisol awakening response. Acquired cytogenetic changes were assessed by scoring telomere lengths and somatic cell abnormality frequencies via a cytokinesis-block micronucleus (MN) …

Hiv Protease Inhibitors Trigger Lipid Metabolism Dysregulation Through Endoplasmic Reticulum Stress And Autophagy, Beth Shoshana Zha

Theses and Dissertations

HIV protease inhibitors (PI) are core components of Highly Active Antiretroviral Therapy (HAART). HIV PIs are extremely effective at suppressing viral load, but have been linked to lipodystrophy and dyslipidemia, which are major risk factors for cardiovascular disease. Recent studies indicate that activation of endoplasmic reticulum (ER) stress is an important cellular mechanism underlying HIV PI-induced dysregulation of lipid metabolism. However, the exact role of ER stress in HIV PI-associated lipodystrophy and dyslipidemia remains to be identified. Hepatocytes and adipocytes are important players in regulating lipid metabolism and the inflammatory state. Dysfunction of these two cell types is closely linked …

Synthesis, Screening And Cocrystallization Of Adenosine Based Inhibitors With Methyltransferases, Ermc' And Ksga, Matthew Baker

Theses and Dissertations

Antibiotic resistance threatens to throw mankind back into an era when infectious disease was the predominant cause of death. In an effort to mitigate this danger, we targeted ErmC’ and KsgA. Both methylate N6-adenosine of ribosomal RNA, though each serve different roles in their bacterial host. ErmC’ dimethylates A2058 on 23S rRNA, conferring resistance to MLSB antibiotics (macrolides, lincosamides, streptogramin B). KsgA aids in ribosome assembly, binding inactive 30S until dimethylating A1518/A1519 of 16S rRNA. Like most methyltransferases, ErmC’ and KsgA use cofactor S-adenosylmethionine (SAM) as their methyl source, which binds adjacent to their specific adenosine substrate. ErmC’ inhibitors could …

Biobehavioral Relationships And Health Related Quality Of Life In Persons With End Stage Renal Disease On Hemodialysis, Avis Allen

Theses and Dissertations

The study of immune status and biobehavioral measures is limited in professional nursing. The purpose of the pre-pilot study was to describe levels of cytokines prior to, during, and after dialysis, examine changes in cytokine levels from immediate pre-dialysis to immediate post-dialysis, and to compare cytokine patterns prior to and after dialysis. A within subject descriptive study was conducted as part of a larger pilot study to describe levels of cytokines prior to, during, and after dialysis, examine changes in cytokine levels from immediate pre-dialysis to immediate post-dialysis, and to compare cytokine patterns prior to and after dialysis. Serum cytokine …

Development And Characterization Of Novel Monoclonal Antibodies For Studying Prion Pathogenesis, Chu-Chun Weng

University of Kentucky Master's Theses

Monoclonal antibodies (mAbs) recognizing different regions of PrP are potential tools in the study of prion diseases and immunotherapy. We used shuffled recombinant prion protein containing elk and mouse PrP as antigen to produce monoclonal antibodies in mice. We found that mAb 5C6 mapped to a discontinuous epitope comprised of amino acid 132 and 158 (mouse numbering). Monoclonal anibody 9E9 which maps to a unique N-terminal epitope at amino acid preferentially recognized cervid PrP. In contrast, the epitope of mAb 9H9 is located in the C-terminus and only reacted with mouse and hamster. The epitope for mAb 7H11 appears to …

Course And Outcome Of Obstetric Patients Admitted To A University Hospital Intensive Care Unit, F. Githae, Vitalis Mung’Ayi, William Stones

Anaesthesiology, East Africa

Background: Obstetric Critical Care is an important service in the reduction of maternal morbidity and mortality, but few developing country data are available.

Objectives: To review all maternity patients admitted to the ICU over a seven year period to determine the causes and outcomes of these admissions and the frequency and causes of maternal morbidity and mortality.

Design: Retrospective patient file and ICU chart review.

Subjects: ICU Charts and medical files of obstetric patients admitted to the ICU at The Aga Khan University Hospital between (November 2003 – November 2010) were reviewed.

Setting: The ICU at The Aga Khan University …

Attention To Clinical Processes Proves To Increase Patient Satisfaction, Greta L. Strauss Bs, Rdms, Michele Brown Rn, Bsn, Ocn, Jackie Kobeski Bs, Rt(M), Tamina L. Tannous Bsba

Patient Care Services / Nursing

No abstract provided.

Enhancing Patient Safety During Central Catheter Insertion Through Interprofessional Division Of Education, Cindy Umbrell Msn, Rn, Cns, Ccrn, Barbara Hemphill Nsb, Rn, Ccrn

Patient Care Services / Nursing

No abstract provided.

The Utilization Of A Respiratory Care Journal Club To Facilitate State Continuing Division Of Educational Credits, Kenneth Miller Med, Rrt-Nps, Linda Cornman Bs, Rrt-Nps, Steven Pyne Rrt, Angela Lutz Bs, Rrt-Nps

Patient Care Services / Nursing

No abstract provided.

Electronic Health Records; Delivering The Right Information To The Right Health Care Providers At The Right Time., William M. Tierney

Center for Policy Research

No abstract provided.

Transdermal And Oral Dl-Methylphenidate-Ethanol Interactions In C57bl/6j Mice, Guinevere Hannah Bell

MUSC Theses and Dissertations

The persistence of attention-deficit/hyperactivity disorder (ADHO) into adulthood has been increasingly recognized over the past few decades and the stimulant drug dl-methylphenidate (MPH) has remained a first-line pharmacotherapeutic agent in the treatment of ADHD. Many adult ADHD patients who are prescribed MPH report concomitant use with ethanol. In humans, coadministration of dl-MPH and ethanol results in pharmacokinetic and pharmacodynamic drug - drug interactions. Ethanol elevates biological concentrations of the pharmacologically active d-MPH isomer and yields the metabolic transesterification product ethylphenidate (EPH). EPH appears to be formed through the actions of carboxylesterase 1 (CES1) which exhibits I-MPH substrate enantioselectivity in both …

End-Of-Life Decision-Making In Critical Care: Minimising The Suffering, Deborah Sundin

ECU Research Week

No abstract provided.

Introducing Mandatory Training Systems? Investigating The Introduction Of Compulsory Pre-Site Construction Training, Sue Bahn, Llandis Barratt-Pugh

ECU Research Week

No abstract provided.

Exercise As Medicine For Cancer, Robert Newton, Daniel Galvao, Prue Cormie, Michael Baker, Carolyn Mcintyre

ECU Research Week

No abstract provided.

[Introduction To] Heroes: What They Do & Why We Need Them, Scott T. Allison, George R. Goethals

Bookshelf

Abraham Lincoln, Princess Diana, Rick in Casablanca--why do we perceive certain people as heroes? What qualities do we see in them? What must they do to win our admiration? In Heroes, Scott T. Allison and George R. Goethals offer a stimulating tour of the psychology of heroism, shedding light on what heroism and villainy mean to most people and why heroes--both real people and fictional characters--are so vital to our lives. The book discusses a broad range of heroes, including Eleanor Roosevelt, Walt Kowalski in Gran Torino, Senator Ted Kennedy, and explorer Ernest Shackleton, plus villains such …

Comparison Of Research Case Definitions For Carpal Tunnel Syndrome, Alexis Descatha, Ann-Marie Dale, Alfred Franzblau, Justin Coomes, Bradley A. Evanoff

Occupational and Health Faculty Publications

No abstract provided.

Variability And Misclassification Of Worker Estimated Hand Force, Ann Marie Dale, Amanda E. Rohn, Amanda Patton, John Standeven, Bradley A. Evanoff

Occupational and Health Faculty Publications

No abstract provided.

A Concept Mapping Needs Assessment Of Young Families With Parental Cancer, Richard P. Durant

Antioch University Dissertations & Theses

The purpose of this research is to investigate the support needs of young families living with and beyond a parental diagnosis of cancer. The sample includes 56 participants comprised of 31 professional stakeholders and 25 patient stakeholders affiliated with the Charles R. Wood Cancer Center. It was hypothesized there would be differences in how the groups of stakeholders rated needs in terms of importance, satisfaction, and utilization. Differences in ratings are thought to be barriers to effective program development. While not a formal research hypothesis, it was anticipated other program development barriers germane to naturalistic clinical settings would emerge from …