Medical Specialties Commons^™

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 …

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 …

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) …

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 …

Aplastic Anemia: Clinicohaematological Features, Treatment And Outcome Analysis, Rabia Wali, Zehra Fidoo, Salman Adil, Muhammad Ahmed Naqvi

Department of Pathology and Laboratory Medicine

Objective: To determine the clinicohaematological features, treatment and outcome of children diagnosed with aplastic anemia at a single institution.

Study Design: Observational study.

Place and Duration of Study: The Aga Khan University Hospital, Karachi, from January 1999 till December 2008.

Methodology: Medical records of children aged less than 15 years of age diagnosed with aplastic anemia were reviewed. Clinicohaematological features, treatment and its response to therapy and outcome were recorded. Results were described in percentages.

Results: Ninety patients were diagnosed to have aplastic anemia (AA); 65 were male during the study period. Age ranged from 1 to 15 years. Fever …

Differences In Breast Cancer Tumor Size, Stage, And Survival By Socioeconomic Position In Young Women, Julie Maureen Tomaska

Walden Dissertations and Doctoral Studies

Although the incidence of breast cancer in women under 40 years of age is somewhat rare, young women tend to present with cancer that is more advanced and with poorer prognostic characteristics. This research will be important to providers, women and their families and those seeking to clarify screening guidelines. The purpose of this quantitative, retrospective, cohort study was to evaluate differences in prognostic characteristics by socioeconomic position (SIP). The cohort was comprised of females aged 18 to 39 with a primary diagnosis of breast cancer. Data were obtained from the Surveillance, Epidemiology and End Results registry for all primary …

Development Of A Novel Metallo-Lipid Microparticle Delivery System For A Leishmania Mexicana Dna Vaccine Candidate, Joanna B. Valencia

Open Access Theses & Dissertations

ABSTRACT

Background and Significance.

The leishmaniases are an important group of neglected tropical parasitic diseases caused by parasitic protozoa of the genus Leishmania. International health authorities estimate that 350 million people around the world are at risk for contracting leishmaniasis. Two million new cases occur each year and 12 million people are presently infected worldwide. Leishmaniasis is endemic throughout the Americas region including all of Central America, most of South America, Mexico and southern Texas. Leishmania is also considered a threat to the military readiness of U.S. troops deployed to the Middle East or Latin America.

First- and second-line treatments …

Prenatal Programming Of Human Neurological Function, Curt A. Sandman, Elyssia Poggi Davis, Claudia Buss, Laura M. Glynn

Psychology Faculty Articles and Research

The human placenta expresses the genes for proopiomelanocortin and the major stress hormone, corticotropin-releasing hormone (CRH), profoundly altering the "fight or flight" stress system in mother and fetus. As pregnancy progresses, the levels of these stress hormones, including maternal cortisol, increase dramatically. These endocrine changes are important for fetal maturation, but if the levels are altered (e.g., in response to stress), they influence (program) the fetal nervous system with long-term consequences. The evidence indicates that fetal exposure to elevated levels of stress hormones (i) delays fetal nervous system maturation, (ii) restricts the neuromuscular development and alters the stress response of …

Physical Activity And Cognitive-Health Content In Top-Circulating Magazines, 2006–2008, Anna E. Greer, Sara J. Corwin, Daniela B. Friedman

All PTHMS Faculty Publications

Physical activity may promote cognitive health in older adults. Popular media play an important role in preventive health communication. This study examined articles discussing associations between physical activity and cognitive health in top-circulating magazines targeting older adults. 42,753 pages of magazines published from 2006 to 2008 were reviewed; 26 articles met inclusion criteria. Explanations regarding the link between physical activity and cognitive health were provided in 57.7% of articles. These explanations were generally consistent with empirical evidence; however, few articles included empirical evidence. Physical activity recommendations were presented in 80.8% of articles; a wide range was recommended (90–300 min of …

Prenatal Maternal Stress Programs Infant Stress Regulation, Elyssia Poggi Davis, Laura M. Glynn, Feizal Waffarn, Curt A. Sandman

Psychology Faculty Articles and Research

Objective: Prenatal exposure to inappropriate levels of glucocorticoids (GCs) and maternal stress are putative mechanisms for the fetal programming of later health outcomes. The current investigation examined the influence of prenatal maternal cortisol and maternal psychosocial stress on infant physiological and behavioral responses to stress.

Methods: The study sample comprised 116 women and their full term infants. Maternal plasma cortisol and report of stress, anxiety and depression were assessed at 15, 19, 25, 31 and 36 + weeks' gestational age. Infant cortisol and behavioral responses to the painful stress of a heel-stick blood draw were evaluated at 24 hours after …

Development Of Fetal Movement Between 26 And 36 Weeks’ Gestation In Response To Vibroacoustic Stimulation, Marybeth Grant-Beuttler, Laura M. Glynn, Amy L. Salisbury, Elyssia Poggi Davis, Carol Holliday, Curt A. Sandman

Psychology Faculty Articles and Research

BACKGROUND: Ultrasound observation of fetal movement has documented general trends in motor development and fetal age when motor response to stimulation is observed. Evaluation of fetal movement quality, in addition to specific motor activity, may improve documentation of motor development and highlight specific motor responses to stimulation.

AIM: The aim of this investigation was to assess fetal movement at 26 and 36-weeks gestation during three conditions (baseline, immediate response to vibro-acoustic stimulation (VAS), and post-response).

DESIGN: A prospective, longitudinal design was utilized.

SUBJECTS: Twelve normally developing fetuses, eight females and four males, were examined with continuous ultrasound imaging.

OUTCOME MEASURES: …

Cathepsin B: A Potential Prognostic Marker For Inflammatory Breast Cancer, Mohamed A. Nouh, Mona M. Mohamed, Mohamed El-Shinawi, Mohamed A. Shaalan, Dora Cavallo-Medved, Hussein M. Khaled, Bonnie F. Sloane

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

Inflammatory breast cancer (IBC) is the most aggressive form of breast cancer. In non-IBC, the cysteine protease cathepsin B (CTSB) is known to be involved in cancer progression and invasion; however, very little is known about its role in IBC.

Methods

In this study, we enrolled 23 IBC and 27 non-IBC patients. All patient tissues used for analysis were from untreated patients. Using immunohistochemistry and immunoblotting, we assessed the levels of expression of CTSB in IBC versus non-IBC patient tissues. Previously, we found that CTSB is localized to caveolar membrane microdomains in cancer cell lines including IBC, and …

Inhibition Of Cathepsin B Activity Attenuates Extracellular Matrix Degradation And Inflammatory Breast Cancer Invasion, Bernadette C. Victor, Arulselvi Anbalagan, Mona M. Mohamed, Bonnie F. Sloane, Dora Cavallo-Medved

Wayne State University Associated BioMed Central Scholarship

Abstract

Introduction

Inflammatory breast cancer (IBC) is an aggressive, metastatic and highly angiogenic form of locally advanced breast cancer with a relatively poor three-year survival rate. Breast cancer invasion has been linked to proteolytic activity at the tumor cell surface. Here we explored a role for active cathepsin B on the cell surface in the invasiveness of IBC.

Methods

We examined expression of the cysteine protease cathepsin B and the serine protease urokinase plasminogen activator (uPA), its receptor uPAR and caveolin-1 in two IBC cell lines: SUM149 and SUM190. We utilized a live cell proteolysis assay to localize in real …

Case-Control Study Of Sunlight Exposure And Cutaneous Human Papillomavirus Seroreactivity In Basal Cell And Squamous Cell Carcinomas Of The Skin, Michelle R. Iannacone

USF Tampa Graduate Theses and Dissertations

Non-melanoma skin cancer (NMSC), comprised of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), is the most common cancer in Caucasians. Ultraviolet radiation (UVR) exposure is the most important environmental risk factor for both BCC and SCC development. However, the precise relationship between UVR and the risk of NMSC is complex, and the relationship may differ by skin cancer type. It has been hypothesized that intermittent patterns and childhood sunlight exposure are important for BCC while continuous (chronic) and lifelong (i.e. childhood and adulthood) sunlight exposure is important for SCC. Epidemiologic studies have demonstrated that cutaneous human papillomavirus (HPV) …

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 …

The Determinants Of Colorectal Cancer Survival Disparities In Nevada, Lucas N. Wassira

UNLV Theses, Dissertations, Professional Papers, and Capstones

Different population groups across Nevada and throughout the United States suffer disproportionately from colorectal cancer and its after-effects. Overcoming cancer health disparities is important for lessening the burden of cancer. There has been an overall decline in the incidence of and mortality from colorectal cancer (CRC). This is likely due, in part, to the increasing use of screening procedures such as Fecal Occult Blood Test (FOBT) and/or endoscopy, which can reduce the risk of CRC mortality by fifty percent. Nevertheless, screening procedures are routinely used by only fifty percent of Americans aged fifty years and older. Despite overall mortality decreasing …

Roundtable On The National Health Security Strategy And At‐Risk Individuals, Behavioral Health, And Community Resilience, Daniel B. Fagbuyi, +Conference Participants

GW mHealth Collaborative

No abstract provided.

A Case Study Of Appendicitis At Antanimalandy Lutheran Hospital, Jennifer Gemmell

Independent Study Project (ISP) Collection

From the introduction:

The island of Madagascar houses a total of 19,159,000 people who spend only $34 per person per year on health care (“Madagascar,” 2008). The government claims to have “committed itself to the principle that good health is a right of each Malagasy citizen, and has made significant studies in the area of health care,” according to the country study for the Library of Congress. However, with political corruption, political crisis after political crisis, and lack of international support, the government does not dispense the funds necessary to support this commitment (Metz, 1994). For example, in 1976 the …

Preventive Care Utilization Among Black Women : Perceived Beliefs, Benefits And Barriers To Mammography Screening, Rowandalla Y. Dunbar

Loma Linda University Electronic Theses, Dissertations & Projects

Blacks, in comparison to other racial or ethnic groups, suffer higher rates of illness and death from many preventable or treatable diseases. Despite the significantly higher rates of mortality and disease, Blacks are least likely to utilize clinical preventive care services. Black women, who are more likely to have advanced breast cancer at time of diagnosis (Chu, Lamar, & Freeman, 2003) are least likely to seek mammography screening (National Health Interview Study, 2000). Allen, Bastani, Bazargan and Leonard (2002) examined predictors of mammography screening among women 40 years old and older residing in the South Central area of Los Angeles, …

Screening Of Hepatitis B And C Among People Visiting General Practice Clinics In A Rural District Of Sindh, Pakistan., Ameet Kumar, Saima Lalani, Asad Ali Khan Afridi, Ali Khan Khuwaja

Community Health Sciences

BACKGROUND:

Hepatitis B (HB), Hepatitis C (HC) and their risk factors are amongst the major health problems in developing countries including Pakistan. This study aimed to screen for HB and HC among people who visited General Practice clinics and also to identify the differences of screening positive cases by age and sex.

METHODS:

This was a retrospective study conducted in Tando Muhammad Khan city, one of the rural districts of Sindh. All together we reviewed 5989 laboratory reports of people for hepatitis B and C on consecutive basis from two laboratories. A pre-designed and structured perform was used to collect …

Using Hospital Discharge Abstract Data To Identify Incident Breast Cancer Cases And Assess Quality Of Care, Elaine J. Yuen, Daniel Z. Louis, Carol Rabinowitz, Vittorio Maio, L. Cisbani, R. Depalma, R. Grilli

College of Population Health Faculty Papers

No abstract provided.

The Importance Of Examining Movements Within The Us Health Caresystem: Sequential Logit Modeling, Chioun Lee, Stephanie L L. Ayers, Jennie Jacobs Kronenfeld, Jemima A. Frimpong, Patrick A. Rivers, Sam S. Kim

Dartmouth Scholarship

Utilization of specialty care may not be a discrete, isolated behavior but rather, a behavior of sequential movements within the health care system. Although patients may often visit their primary care physician and receive a referral before utilizing specialty care, prior studies have underestimated the importance of accounting for these sequential movements. The sample included 6,772 adults aged 18 years and older who participated in the 2001 Survey on Disparities in Quality of Care, sponsored by the Commonwealth Fund. A sequential logit model was used to account for movement in all stages of utilization: use of any health services (i.e., …

Concurrent Sexual Partnerships Do Not Explain The Hiv Epidemics In Africa: A Systematic Review Of The Evidence, Larry Sawers, Eileen Stillwaggon

Economics Faculty Publications

The notion that concurrent sexual partnerships are especially common in sub-Saharan Africa and explain the region’s high HIV prevalence is accepted by many as conventional wisdom. In this paper, we evaluate the quantitative and qualitative evidence offered by the principal proponents of the concurrency hypothesis and analyze the mathematical model they use to establish the plausibility of the hypothesis.

We find that research seeking to establish a statistical correlation between concurrency and HIV prevalence either finds no correlation or has important limitations. Furthermore, in order to simulate rapid spread of HIV, mathematical models require unrealistic assumptions about frequency of sexual …

Medical Ethics: A Slow But Sustained Revolution In Pakistan’S Healthcare, Muhammad Shahid Shamim, Muhammad Shahzad Shamim

Section of Neurosurgery

No abstract provided.

Primary Human Mammary Epithelial Cells Endocytose Hiv-1 And Facilitate Viral Infection Of Cd4+ T Lymphocytes, Stephanie M. Dorosko, Ruth I. Connor

Dartmouth Scholarship

The contribution of mammary epithelial cells (MEC) to human immunodeficiency virus type 1 (HIV-1) in breast milk remains largely unknown. While breast milk contains CD4(+) cells throughout the breast-feeding period, it is not known whether MEC directly support HIV-1 infection or facilitate infection of CD4(+) cells in the breast compartment. This study evaluated primary human MEC for direct infection with HIV-1 and for indirect transfer of infection to CD4(+) target cells. Primary human MEC were isolated and assessed for expression of HIV-1 receptors. MEC were exposed to CCR5-, CXCR4- and dual-tropic strains of HIV-1 and evaluated for viral reverse transcription …

The Role Of Unrealistic Optimism In Explaining Preventive Behaviors In High Versus Low Endemic Malaria Settings In Belize, Daniel G. Handysides

Loma Linda University Electronic Theses, Dissertations & Projects

Background: Of all the diseases an individual can encounter in the world, malaria is one of the most destructive. Simple measures like sleeping under a bednet would greatly reduce the burden (Abeku, 2007). When people estimate their risk relative to others, they are most often unrealistically optimistic, which may explain why those at risk often fail to perform behaviors, such as using a bednet that will reduce their risk. However, one study showed that people at high risk for malaria held pessimistic perceptions of their risk for the disease, but the reasons for this finding are unclear (Morrison, Ager, & …

Program Evaluation Of A Community-Based Door-Through-Door Medical Escort Service, Lauren A. Martin

Gerontology Institute Publications

This report summarizes the program evaluation findings of a Boston-based organization’s Medical Escort program. This “door-through-door” service strives to provide medical transportation, physical assistance, and emotional support to elders on their way to the doctor’s office, during medical appointments and on the way back home again. By offering added assistance the program attempts to remove environmental barriers associated with access to health care. This evaluation combines previously collected program statistics with surveys (32) from program volunteers and phone interviews (78) with recipients.