Medical Specialties Commons^™

Maternal And Neonatal Health Services In Sudan: Results Of A Situation Analysis, Nahla G. Abdel-Tawab, Maha El-Rabbat

Reproductive Health

This project brief is based on the results of a situation analysis (SA) study that was done collaboratively by the Population Council and Sudan Ministry of Health (MOH) with funds from UNFPA, UNICEF, and Packard Foundation. The analysis showed an uneven distribution of reproductive health (RH) staff across Sudan, and nurses and nurse midwives are the key in RH services. There was also limited access to family planning services. Antenatal care was limited, and pregnant women in the study seldom received counseling on birth spacing or birth preparedness. Birth attendants also lacked adequate knowledge and skills. Emergency obstetric care was …

The Female Athlete, Dilip R. Patel, Donald E. Greydanus, Hatim A. Omar

Pediatrics Faculty Publications

The female athlete has today became an accepted part of sports in elementary school, junior high, senior high, and college. This chapter covers various aspects of the prepubertal and pubertal female athlete. An historical perspective will be presented and selected comments provided on psychological and physiologic aspects of the female athlete. Concepts of adolescent gynecology are reviewed, including breast concerns and menstrual dilemmas in relation to sports activity. Exercise during pregnancy is also considered. Iron deficiency anemia and stress urinary incontinence

Innovative Mental Health Services In Rural Minnesota: Community-Based Mobile Crisis Response Services, Rebecca A. Zuehlke

All Graduate Theses, Dissertations, and Other Capstone Projects

The purpose of this research project was to explore the relationship between the frequency of service utilization of the Community-based Mobile Crisis Response Services (MCR) provided by the Southwestern Mental Health Center (SWMHC) and the frequency of service utilization of emergency holds and civil commitments in Jackson and Cottonwood counties by month for the 2009 calendar year.

The specific research question proposed was: Is there a relationship between the frequency of Community-Based Mobile Crisis Response Services and the frequency of emergency holds and civil commitments in Jackson and Cottonwood Counties?

The significance of this research project was to explore statistically …

Independent Living Outcomes Evaluation Project, Craig J. Padgett

All Graduate Theses, Dissertations, and Other Capstone Projects

This project developed specific examples of skills and resources for three example categories of ILST and developed recommendations for enhancing the creation of goals. It was important to develop indicators into a tiered structure for reinforcing those skills and resources into knowledge through an added educational component. Methodology was developed and necessary instrumentation and processes were designed for implementation. And, an informed consent was designed for any organization providing Independent Living Skills Training (ILST).

The Role Of The Arts Toward Healing Trauma And Building Resilience In The Palestinian Community, Yousef Al-Ajarma

Expressive Therapies Dissertations

This study has investigated the sources of resilience in a sample of Palestinians who experienced the first Intifada and are now studying in the United States. The study found that family and community support, the pursuit of an education, and participation in artistic activities all contribute to individual resilience among Palestinians. In addition, political awareness and activity are another source of resilience, because they help individuals living under the Occupation to find meaning in their life and make sense of their struggles. Currently, young people in Palestine are at risk of developing psychological trauma from exposure to the violence of …

Assessing Abortion-Related Experiences And Needs In Four Districts Of Maharashtra And Rajasthan, 2006, Shireen J. Jejeebhoy, A.J. Francis Zavier, Shveta Kalyanwala

Poverty, Gender, and Youth

Recognizing the urgent need to enable rural women to acquire accessible and high-quality abortion services in India, a consortium of organizations—including the Population Council—has come together with the goal of increasing access to legal, safe, and comprehensive abortion services, including postabortion family planning, in the public health system, especially among the rural poor. One of its key activities was to develop a comprehensive and evidence-based abortion care model suitable for rural women. The aim of this report is to shed light on community-level perspectives about abortion services and probe the experiences of women who had undergone abortion, to better understand …

Increasing Postpartum Contraception In Rural Uttar Pradesh: Implications For Behavior Change Communication, Population Council

Reproductive Health

The Population Council conducted a formative study in rural Uttar Pradesh, India to assess the level of adoption of postpartum contraception for spacing among low parity women, identify the facilitating factors and barriers to the adoption of this target behavior, and identify programmatic and behavior change communications (BCC) initiatives that could accelerate the adoption of postpartum contraception for spacing and improve the service delivery system, if required, to facilitate the process. Barriers included low awareness of consequences of closely spaced births, misconceptions about contraceptive methods, lack of counseling by health workers, reluctance to include husbands, and programmatic emphasis on limiting …

Mainstreaming Emergency Contraception Pills In Kenya, Jill Keesbury, Monica Wanjiru, Katherine Maina

Reproductive Health

To improve access to emergency contraception (ECP) and ensure that adequate information is provided to all users, the Kenyan Ministry of Public Health and Sanitation, the Population Council, and Population Services International-Kenya undertook a three-year effort to mainstream ECP in Kenya. This brief presents the results of this initiative and discusses strategies for further strengthening ECP provision. Kenya has emerged as a leader in ECP programming in the region and has demonstrated that it is possible to strengthen ECP services in both the public and private sectors while at the same time increasing public awareness, knowledge, and use of the …

Training Service Providers Increases Tb Screening In Postnatal Care, Population Council

Reproductive Health

This document summarizes a Population Council operations research project undertaken in collaboration with the Kenya Ministry of Health to develop and pilot-test an intervention to improve TB screening, case detection, treatment, and care among postnatal clients. The intervention demonstrated that it is feasible to use postnatal care services as a platform to increase TB screening and case detection. Training providers, giving them job-aids, and strengthening client flow within the facility also improved the overall quality of care that the clients received. The actual number of cases of TB detected was extremely low, however; thus the report recommends that the Ministry …

Assessing The Feasibility Of Home Administration Of Misoprostol In The Prevention Of Postpartum Hemorrhage In Rural Pakistan, Ali M. Mir, Abdul Wajid, Sadaf Gull

Reproductive Health

This report details an operations research project carried out by the Population Council as part of the Pakistan Initiative for Mothers and Newborns. The overall goal of the project was to test the feasibility of administering misoprostol for the prevention of postpartum hemorrhage (PPH) in a home setting through community‐based healthcare providers, including traditional birth attendants (TBAs), or family members, in two districts of Pakistan. Furthermore, it aimed to identify common side effects of misoprostol and determine the reduction in demand for referral due to PPH after oral ingestion of misoprostol. The results provide a useful addition to the literature …

The Pregnancy Cycle Approach To Safe Motherhood, Saumya Ramarao, Sarah Raifman

Reproductive Health

The Population Council's Reproductive Health program partnered with the Maternal Health Task Force (MHTF), the Partnership for Maternal, Newborn and Child Health (PMNCH), and the PAC Consortium, to address the UN Millenium Development Goal of improving maternal health, and reducing child mortality. Specifically this brief examines the pregnancy cycle approach whereby women’s needs from facilitating a desired pregnancy to successful parturition are addressed in a range of settings—home, community and health facility. This brief covers the different stages including abortion and postabortion care, antenatal care, delivery, and postpartum and beyond.

Introducing And Pilot-Testing The National Guidelines On Integrating The Management Of Stis/Rtis Into Reproductive Health Settings In Kenya, Wilson Liambila, Saiqa Mullick, Ian Askew, Nathalie Broutet, Bartilol Kigen, Cosmas Mutunga, Daniel Sande, Nimrod Garama, Benjamin Tsofa, Christine Awuor, Ibrahim Mohammed

Reproductive Health

This report evaluated a project in ten Kenyan health facilities. It examined the feasibility, acceptability and effect of introducing reproductive tract infection and sexually transmitted infection (RTI/STI) guidelines on the quality of care provided, and the incremental costs of integrating these services into existing reproductive health (RH) services; it also disseminated the results and lessons learnt within Kenya. Overall, the results showed that integration of activities to screen for and manage STIs/RTIs into RH services is feasible, acceptable to clients and providers, and effective in improving the range and quality of services offered to clients.

Emergency Contraception: Idea To Program, Saumya Ramarao, John Townsend, Sarah Raifman

Reproductive Health

This report summarizes the role of the Population Council in generating evidence, providing technical leadership, and demonstrating at scale that emergency contraception (EC) can be easily integrated into national family planning programs and other reproductive health services. Since the 1990s, the Population Council, along with other partners, has contributed to the changes seen in the provision and availability of EC, now available in over 140 countries around the world. While much progress has been made in the campaign for access to EC, the Council is committed to improving existing methods of service delivery and to leading advocacy efforts and research …

Community Mobilization For Postabortion Care In Kenya: Baseline Evaluation Report, Chi-Chi Undie, Saumya Ramarao

Reproductive Health

Maternal health complications, including those arising from unsafe abortion and miscarriage, are a leading cause of morbidity among women in Kenya. These realities necessitate interventions to prevent unintended or unwanted pregnancies and to ensure access to quality care for women with postabortion complications. In response to this need, the RESPOND Project designed an intervention package aimed at increasing awareness and use of postabortion care (PAC) services and improving family planning, reproductive health, and maternal health outcomes. As part of the intervention, RESPOND works with districts and communities to: strengthen service delivery points to provide PAC services; conduct community mobilization to …

Hormone And Adpokine Alterations Across Eleven Weeks Of Training In Division I Collegiate Throwers: An Exploratory Study, W. Guy Hornsby, Christian R. Carter, Guy Gregory Haff, Micheal R. Ramsey, Andy R. Dotterweich, N. Travis Triplett, Charles A. Stuart, Margaret E. Stone, Michael H. Stone

ETSU Faculty Works

Conceptually, it is important to understand the underlying physiological mechanisms of any training program model. This understanding aids the coach/sport scientist in making better choices in manipulating variables in formulating the training model. These underlying mechanisms can be associated with training variable manipulation and fatigue management aspects as well as the overall health of the athlete. Hormone and cytokine concentrations can be linked to alterations resulting from the manipulation of training variables and to subsequent alterations in performance (Haff et al., 2008; Ishigaki et al., 2005; Jurimae et al., 2010; Stone et al., 2007). For example, alterations in the testosterone: …

Acute Musculoskeletal Sports Injury And Topical Nsaid, Amit M. Deokar, Shawn J. Smith, Hatim A. Omar

Pediatrics Faculty Publications

The objective of this chapter is to summarize the current standards of pain management in minor sports related musculoskeletal injuries. We also address the topical form of non-steroidal anti-inflammatory drug as an effective pain management option in an out-patient setting. Design: Quantitive systematic review of randomized controlled trials. Methods: The data was obtained through literature review of articles published in the last 10 years. In addition, FDA information on non-steroidal anti-inflammatory medications was also reviewed. The patient population studied in the articles included children and adults. Conclusion: Current standards of managing pain resulting from sports injuries involve a number of …

Down Syndrome And Sexuality, Maria José Carvalho Sant'anna, Bruna Marques Bononi, André Chao Vasconcellos De Oliveira, Tadeu Silveira Renattini, Carla Franchi Pinto, Maria Lucia Passarelli, Veronica Coates, Hatim A. Omar

Pediatrics Faculty Publications

In recent years important gains and changes have been observed in the life of teenagers with Down syndrome (DS) with increased inclusion into society. This chapter will discuss adolescence and sexuality in teenagers with DS from a descriptive study of 50 patients with DS between the ages of 10 and 20 years. The mean age was 13.5 years, 50% females. 86% went to school with 62.2% in school for over six years. Of the patients that attended school, 60% went to special education school and only 10% read and wrote correctly. In evaluation of autonomy, 66% took shower, 78% performed …

Quality Of Life And Adolescents In Rural Kentucky, Hatim A. Omar, Søren Ventegodt, Joav Merrick

Pediatrics Faculty Publications

In many rural areas in Kentucky, adolescents lack the basic assets for a good quality of life, such as having caring adults, a safe place and useful activities after school. In this chapter we analyze data from middle and high school students referred to a comprehensive school based health promotion center (SBHPC). From August 2006 to February 2008, a total of 382 students (200 female, 182 male, aged 12-18 years) were referred to the SBHPC for help. Only two (0.5%) students had two parents living with them and 12 (3.1 %) had safe, organized after school activities. 19.9% of the …

Quality Of Life And Persons With Intellectual Disability: Can We Measure Qol In This Population?, Søren Ventegodt, Hatim A. Omar, Flemming Struve, Tove K. Nielsen, Isack Kandel, Joav Merrick

Pediatrics Faculty Publications

Quality of life (QOL) has been discussed by professionals working with persons with intellectual disability (ID) for some time, but since QOL is concerned with subjective well-being, satisfaction and happiness, how is it possible to measure, when the person in question is unable to communicate? Consciousness is believed to be an internal and personal thing, but we have done the simple experiment to ask observers to rate QOL of another person, also in sub dimensions like self-assessed physical and mental health, relationship with self, self-assessed sexual ability, self-assessed social ability, and we have found that people are able to assess …

Behavioral Health Self-Efficacy Of Nurses In A Rural Emergency Department, Alyssa Schlager

All Graduate Theses, Dissertations, and Other Capstone Projects

This project aims to provide a resource manual for the Waseca area which will be utilized by the emergency department‟s nursing staff. As described above, the need for nursing staff to know how to work with, handle, and appropriately refer behavioral health patients is an essential piece of emergency department nursing. After receiving an orientation on the composition of the new resource manual, emergency department nursing staff will have a better understanding of what to do when the social worker is not present as well as feel more comfortable with their knowledge related to behavioral health patients.

This project has …

Prenatal Beta-Endorphin As An Early Predictor Of Postpartum Depressive Symptoms In Euthymic Women, Ilona S. Yim, Laura M. Glynn, Christine Dunkel Schetter, Calvin J. Hobel, Aleksandra Chicz-Demet, Curt A. Sandman

Psychology Faculty Articles and Research

After delivery, many women experience symptoms of postpartum depression (PPD), and early identification of women at risk is therefore important. The opioid peptide [beta]-endorphin has been implicated in non-puerperal depression but its role in the development of PPD is unknown.

Assessing Gaps In Services For Geriatric Patients With Mental Health Needs, Angela Nelson

All Graduate Theses, Dissertations, and Other Capstone Projects

Older adults in southwest Minnesota have limited options regarding mental health services. Sanford Tracy Medical Center and Sanford Westbrook Medical Center sought to identify the needs of this population so they can better serve their patients. The following research questions were asked: Do local service providers feel gaps in services exist for older adults experiencing mental health needs in the rural southwestern Minnesota communities of Tracy and Westbrook and the surrounding areas? Do area service providers feel that geriatric patients would benefit from a mental health intervention implemented within the primary healthcare setting? A survey of area geriatric service providers …

Communalism Predicts Prenatal Affect, Stress, And Physiology Better Than Ethnicity And Socioeconomic Status, Cleopatra M. Abdou, Christine Dunkel Schetter, Belinda Campos, Clayton J. Hilmert, Tyan Parker Dominguez, Calvin J. Hobel, Laura M. Glynn, Curt A. Sandman

Psychology Faculty Articles and Research

The authors examined the relevance of communalism, operationalized as a cultural orientation emphasizing interdependence, to maternal prenatal emotional health and physiology and distinguished its effects from those of ethnicity and childhood and adult socioeconomic status (SES). African American and European American women (N = 297) were recruited early in pregnancy and followed through 32 weeks gestation using interviews and medical chart review. Overall, African American women and women of lower socioeconomic backgrounds had higher levels of negative affect, stress, and blood pressure, but these ethnic and socioeconomic disparities were not observed among women higher in communalism. Hierarchical multivariate regression analyses …

Effect Of Donor Ethnicity On Kidney Survival In Different Recipient Pairs: An Analysis Of The Optn/Unos Database., C O. Callender, W S. Cherikh, P Traverso, A Hernandez, Tolulope A. Oyetunji, D Chang

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Previous multivariate analysis performed between April 1, 1994, and December 31, 2000 from the Organ Procurement Transplant Network/United Network for Organ Sharing (OPTN/UNOS) database has shown that kidneys from black donors were associated with lower graft survival. We compared graft and patient survival of different kidney donor-to-recipient ethnic combinations to see if this result still holds on a recent cohort of US kidney transplants.

METHODS: We included 72,495 recipients of deceased and living donor kidney alone transplants from 2001 to 2005. A multivariate Cox regression method was used to analyze the effect of donor-recipient ethnicity on graft and patient …

Telemedicine And Advanced Technology Research Center: Quarterly Report, July 18, 2009 To October 17, 2009, Bea Babbitt

Telemedicine & Advanced Technology Research Center

Development of a P.O.I. and a Blended Learning Ecology for use in Combat Lifesaver Skills Training for the Army.

Ethnic Disparities In Cervical Cancer Survival Among Texas Women, Ann L. Coker, Christopher P. Desimone, Katherine S. Eggleston, Arica L. White, Melanie Williams

CRVAW Faculty Journal Articles

Objective: The aim of this work was to determine whether minority women are more likely to die of cervical cancer. A population-based cohort study was performed using Texas Cancer Registry (TCR) data from 1998 to 2002.

Methods: A total of 5,166 women with cervical cancer were identified during 1998–2002 through the TCR. Measures of socioeconomic status (SES) and urbanization were created using census block group-level data. Multilevel logistic regression was used to calculate the odds of dying from cervical cancer by race, and Cox proportional hazards modeling was used for cervical cancer-specific survival analysis.

Results: After adjusting for age, SES, …

Patient/Physician Communication In Type 2 Diabetes-Related Health Behavior Change, Barbara Marie Thomas

Loma Linda University Electronic Theses, Dissertations & Projects

Adult type 2 diabetes is an increasing problem in the United States and affected over 16 million Americans in 2004. Most patients are treated in primary care settings and managed medically, but controlling insulin resistance through activity and diet is considered the greatest challenge for the next 30 years (Katen, et al., 2007). Understanding how physicians and patients communicate about health behaviors is necessary for developing the most effective strategies for facilitating health behavior change in this population. In the current study, adults with type 2 diabetes (n= 87) from the Loma Linda University Diabetes Treatment Center (LLUDTC), …

Sexuality And Persons With Down Syndrome. A Study From Brazil, Bruna Marques Bononi, Maria José Carvalho Sant'anna, André Chao Vasconcellos De Oliveira, Tadeu Silveira Renattini, Carla Franchi Pinto, Maria Lúcia Passarelli, Verônica Coates, Hatim A. Omar

Pediatrics Faculty Publications

In recent years, important gains and changes have been observed in the life of teenagers with Down syndrome (DS) with increased inclusion into society. This review will discuss adolescence and sexuality in teenagers with DS from a descriptive study of 50 patients with DS between the ages of 10 and 20 years. The mean age was 13.5 years, 50% females; 86% went to school with 62.2% in school for over six years. Of the patients that attended school, 60% went to special education school and only 10% read and wrote correctly. In an evaluation of autonomy, 66% took showers, 78% …

Assessing Stakeholder Opinions Of Medical Review Of Impaired Drivers And Fitness To Drive: Recommendations For Massachusetts, Nina M. Silverstein, Kelli Barton

Gerontology Institute Publications

Driving is the main mode of travel for Americans age 65 and older, and although older adults are generally found to be safe drivers, aging often brings about functional limitations and an increase in medications that can impede safe driving and fitness to drive (Rosenbloom, 2003; Kissinger, 2008; Adler & Silverstein, 2008). Effective licensing policies and Medical Advisory Board practices are critical components in identifying medically at-risk drivers and may even have a role in the transition to alternative transportation options; yet, states vary greatly in their approach to licensing and renewal practices and in the utilization, composition, and function …

Posttraumatic Spiritual Growth: A Phenomenological Study Of Cancer Survivors, Ryan Myles Denney

Dissertations

A small but growing body of research has sought to investigate the specific role of religion and spirituality in posttraumatic growth. Recently investigations have begun to focus on spiritual growth following trauma, specifically that of cancer patients and survivors. The purpose of this qualitative study was to investigate how having cancer effects the spiritual growth of cancer survivors across a multidimensional conceptualization of spirituality (Hill 2005; Tsang & McCullough, 2003). The researcher investigated the lived experience of thirteen cancer survivors with posttraumatic spiritual growth using a phenomenological method of data analysis. Participants reported experiencing spiritual growth across the following domains …