Public Health Commons^™

Ethnic Identity And Body Ideal In Adolescent Girls, Erin E. Ramirez

Loma Linda University Electronic Theses, Dissertations & Projects

Adolescence is a period characterized by physical growth and maturation (Cobb, 1995). This normal biological process moves most American girls away from the thin ideal body shape that is dominant within the United States. Ethnic differences in ideal body size have in fact been found in several studies; but they have been shown based on ethnic group membership, not ethnic identification. The specific relationship of ethnic identity and body ideal for Mexican American, African American, and Anglo American adolescent females has not been clearly defined; Lopez, Blix, and Blix (1995) have hinted at the role of ethnic identification (through the …

Female Genital Cutting Among The Somali Of Kenya And Management Of Its Complications, Guyo W. Jaldesa, Ian Askew, Carolyne Njue, Monica Wanjiru

Reproductive Health

The Somali community living in Kenya (and in their native Somalia) has practiced the severest form of female genital cutting (FGC)—infibulation—for centuries. To understand the context within which the practice takes place, and how its complications are managed, the Population Council’s Frontiers in Reproductive Health Program undertook a diagnostic study that confirmed that FGC is a deeply rooted and widely supported cultural practice. Several closely related reasons are used to sustain the practice: religious obligation, family honor, and virginity as a prerequisite for marriage; an aesthetic preference for infibulated genitalia was also mentioned. The study also found that the health …

Clioquinol And Pyrrolidine Dithiocarbamate Complex With Copper To Form Proteasome Inhibitors And Apoptosis Inducers In Human Breast Cancer Cells, Kenyon G. Daniel, Di Chen, Shirley Orlu, Qiuzhi Cui, Fred R. Miller, Q Ping Dou

Wayne State University Associated BioMed Central Scholarship

Abstract

Introduction

A physiological feature of many tumor tissues and cells is the tendency to accumulate high concentrations of copper. While the precise role of copper in tumors is cryptic, copper, but not other trace metals, is required for angiogenesis. We have recently reported that organic copper-containing compounds, including 8-hydroxyquinoline-copper(II) and 5,7-dichloro-8-hydroxyquinoline-copper(II), comprise a novel class of proteasome inhibitors and tumor cell apoptosis inducers. In the current study, we investigate whether clioquinol (CQ), an analog of 8-hydroxyquinoline and an Alzheimer's disease drug, and pyrrolidine dithiocarbamate (PDTC), a known copper-binding compound and antioxidant, can interact with copper to form cancer-specific proteasome …

The Role Of Aromatase Inhibitors In Ameliorating Deleterious Effects Of Ovarian Stimulation On Outcome Of Infertility Treatment, Mohamed Fm Mitwally, Robert F. Casper, Michael P. Diamond

Wayne State University Associated BioMed Central Scholarship

Abstract

Clinical utilization of ovulation stimulation to facilitate the ability of a couple to conceive has not only provided a valuable therapeutic approach, but has also yielded extensive information on the physiology of ovarian follicular recruitment, endometrial receptivity and early embryo competency. One of the consequences of the use of fertility enhancing agents for ovarian stimulation has been the creation of a hyperestrogenic state, which may influence each of these parameters. Use of aromatase inhibitors reduces hyperestrogenism inevitably attained during ovarian stimulation. In addition, the adjunct use of aromatase inhibitors during ovarian stimulation reduces amount of gonadotropins required for optimum …

Women's Participation In Disaster Relief And Recovery, Ayse Yonder, Sengul Akcar, Prema Gopalan

Poverty, Gender, and Youth

Too little attention has been given to the gender-differentiated effects of natural disasters, that is, women’s losses relative to men’s, how women’s work time and conditions change (both in terms of care-giving and income-generating work), or how disaster-related aid and entitlement programs include or marginalize affected women. The detailed case studies from three earthquake-stricken areas in India and Turkey that are contained in this issue of SEEDS help fill this information gap. They provide examples of how low-income women who have lost everything can form groups and become active participants in the relief and recovery process. Readers learn how women …

Kutibu Majeraha, Kutia Matumaini: Ushirikiano Wa Watanzania Dhidi Ya Fistula Obstetrikia, Thoraya Ahmed Obaid, Erica Chong

Poverty, Gender, and Youth

This edition of Quality/Calidad/Qualité describes a partnership formed to combat obstetric fistula in Tanzania. The Bugando Medical Center, the Women’s Dignity Project, the Tanzania Midwives Association, and the government cooperated on an extensive program for surgical repair, prevention, and policy research and activities. Lessons learned: 1) Fistula programs need to address social as well as medical issues. 2) Most repairs are successful, making an enormous difference in women’s lives. 3) Relatively little funding is necessary to start up a fistula program. 4) Fistula programs are vehicles for broader conversations about gender and poverty.

Willingness-To-Pay For Services Provided By The Clinical Services Improvement Project (Csi) In Egypt, John H. Bratt, Nahla G. Abdel-Tawab, Magdi A. Ibrahim, Mohammed Edress

Reproductive Health

Willingness-to-pay (WTP) surveys are increasingly used in reproductive health programs to predict the impact of price changes on revenues, utilization, and client profile. The FRONTIERS program worked with the Clinical Services Improvement (CSI) project and the Cairo Demographic Center to carry out a WTP survey in six CSI clinics in Egypt. The survey found that most clients would be willing to pay higher prices for CSI services, and WTP did not vary much by client economic status. However, predictive validity was low when all reasons for client discontinuation were included. WTP surveys have the potential to be useful tools for …

An Assessment Of Trends In The Use Of The Iud In Ghana: National Results Dissemination And Utilization, Ivy Osei, John Gyapong, Monica Wanjiru, Ian Askew

Reproductive Health

The overall aim of this study was to inform the Ghana Health Service, USAID, and other partners involved in providing family planning services in Ghana about future directions that could be taken to reinvigorate the IUD within the context of a family planning service based on the principles of free and informed choice. The Health Research Unit conducted the study, with technical assistance from FRONTIERS and funding from USAID. The findings showed that the declining interest in and use of the IUD as a family planning method could be attributed to several factors, including negative perceptions and false beliefs about …

Improving The Ghanaian Safe Motherhood Programme, Ivy Osei, Bertha Garshong, Gertrude Banahene, John Gyapong, Placide Tapsoba, Ian Askew, Clement Ahiadeke, Richard Killian, Edward Bonku, Perle Combary, William Sampson

Reproductive Health

Prior to the Ghana Ministry of Health scaling up the country’s Safe Motherhood program, they requested support from the Population Council’s USAID-funded Frontiers in Reproductive Health program to undertake an operations research study to evaluate and compare the cost-effectiveness of two training approaches and other performance improvement interventions. The study measured and compared changes in provider knowledge and skills and the costs of implementing a three-week residential vs. self-paced learning (SPL) approach. The SPL approach costs more per trainer than the traditional residential approach, both in financial costs alone and when opportunity costs are added, however, a cost-effectiveness analysis showed …

Systematic Screening To Integrate Reproductive Health Services In India, N.P. Das, Urvi Shah, Varsha Chitania, Pratibha Patel, M.E. Khan, Anurag Mishra, James R. Foreit

Reproductive Health

This study, conducted in large public clinics and small health posts in the city of Vadodara, India, tested the effectiveness of a systematic screening technique in integrating reproductive health services at the provider level. The objective was to determine if women screened during clinic visits received more services, appointments, and referrals per visit than women who were not screened. Results show that in experimental group clinics the number of services per visit increased while control clinics experienced a slight decrease; the effect of systematic screening was smaller in health posts than in clinics. In experimental posts, services per visit increased …

Nursing Staff Dynamics And Implications For Maternal Health Provision In Public Health Facilities In The Context Of Hiv/Aids, Loveday Penn-Kekana, Duane Blaauw, Khin San Tint, Desiree Monareng, Jane Chege

Reproductive Health

This study, carried out in Limpopo, KwaZulu-Natal, and Mpumalanga provinces in South Africa, aimed to document nursing staff dynamics in maternal health services, and to explore the factors associated with these dynamics. The study found that a high percentage of nursing staff working in public facilities were demotivated, burnt out, and were considering leaving the facility where they were working. A range of factors, both financial and nonfinancial, were associated with nurses considering going overseas: inadequate pay, poor promotion, feeling unsupported by management, and having bad relationships at work were all associated with lack of organizational commitment. As a result …

Feasibility Of Introducing A Comprehensive Package Of Antenatal Care Services In Rural Public Clinics In South Africa, Jane Chege, Ian Askew, Nzwakie Mosery, Mbali Ndube-Nxumalo, Busi Kunene, Mags Beksinska, Janet Dalton, Ester Snyman, Wilem Sturm, Preshny Moodley

Reproductive Health

The Maternal, Child and Women’s Health Unit, in collaboration with the Population Council’s FRONTIERS in Reproductive Health (FRONTIERS) program, the Reproductive Health Research Unit of the University of Witwatersrand, and the Department of Medical Microbiology and Infectious Diseases of the Nelson Mandela School of Medicine, University of Natal, developed and then pilot-tested this revised model in KwaZulu-Natal, South Africa. The project’s objective was to develop and test an improved and integrated antenatal care program for public-sector clinics that would increase the range and quality of services received by pregnant women and improve their reproductive health behavior and status. Various problems, …

Using Systematic Screening To Increase Integration Of Reproductive Health Services Delivery In Senegal, Diouratie Sanogo, Ricardo Vernon, James R. Foreit, Awa M. Coll-Seck, Colonel Adama Adoye, Laty G. Ndoye, Cheikh Bamba Diop, Balla Mbacke Mboup, Omar Sarr

Reproductive Health

This study tested the systematic screening technique to increase the integration of reproductive health services in Senegal. The study took place in four urban health posts in the city of Dakar and three rural health posts in the district of Kebemer. A before and after design tested the hypothesis that the use of the systematic screening tool would result in more services received per client visit. In Dakar, services per visit increased significantly by 20 percent, while in Kebemer, services per visit also increased significantly by 35 percent. The study also examined several techniques to improve provider compliance with the …

African American Breast Cancer Health Disparities, Theresa Lynn Gaul

Honors Program Theses

Health disparities are "the differences in the incidence, prevalence, mortality, and burden of cancer and related adverse health conditions that exist among specific population groups in the United States" (National Cancer Institute [NCI], 2002). Racial and ethnic minorities experience serious disparities in health access and outcomes. Disparities in the burden of death and illness experienced by African Americans in particular, as compared with our nation's population as a whole, are particularly striking. There are a variety of factors contributing to these inequalities. The purpose of this report is to examine these factors and the consequential effects on the African American's …

Cultural Value Orientations, Attributions, And Breast Cancer Screening Behaviors, Patricia M. Flynn

Loma Linda University Electronic Theses, Dissertations & Projects

Discrepancies in breast cancer screening behavior exist among various ethnic groups in the United States (Jacobs & Lauderdale, 2001), with Latino American women reporting particularly low screening rates in comparison to Anglo American women (ACS, 2002). Research indicates that behavior is in part influenced by aspects of culture and relevant psychological processes (Betancourt & Lopez, 1993; Betancourt & Fuentes, 2001). This study was designed to investigate the relations among cultural values, attributional processes, and breast cancer screening behavior among Anglo and Latino women. This study also investigated the influence of acculturation among Latino women in relation to the other study …

Psychological Factors Associated With Anticipatory Nausea And Vomiting, Melinda L. Nielsen

Loma Linda University Electronic Theses, Dissertations & Projects

Many cancer patients experience adverse chemotherapy-related side effects. The present study examined the relationships among disease variables (i.e. stage of cancer, type of breast cancer), medical treatment variables (i.e. toxicity of chemotherapy regimen, strength of antiemetic treatment), psychological variables (i.e. health locus of control, anxiety sensitivity, desire for control, coping strategies), and anticipatory nausea and vomiting in women with breast cancer. One hundred women with breast cancer completed the Multidimensional Health Locus of Control Scale - Form C, the Anxiety Sensitivity Index, the Krantz Health Opinion Survey, the Coping Inventory for Stressful Situations, and the Morrow Assessment of Nausea and …

Effects Of A Tailored Follow-Up Intervention On Health Behaviors, Beliefs, And Attitudes, Alissa D. Jacobs, Alice S. Ammerman, Susan T. Ennett, Marci K. Campbell, Katherine W. Tawney, Semra Aytur, Stephen W. Marshall, Julie C. Will, Wayne D. Rosamond

Health Management & Policy

Background: The high rates of relapse that tend to occur after short-term behavioral interventions indicate the need for maintenance programs that promote long-term adherence to new behavior patterns. Computer-tailored health messages that are mailed to participants or given in brief telephone calls offer an innovative and time-efficient alternative to ongoing face-to-face contact with healthcare providers.

Methods: Following a 1-year behavior change program, 22 North Carolina health departments were randomly assigned to a follow-up intervention or control condition. Data were collected from 1999 to 2001 by telephone-administered surveys at preintervention and postintervention for 511 low-income, midlife adult women enrolled …

Review Of Field Experiences: Integration Of Family Planning And Pmtct Services, Naomi Rutenberg, Carolyn Baek

HIV and AIDS

The Population Council and its research partners have been addressing several key questions about prevention of mother-to-child HIV transmission (PMTCT) services and how well they function in field settings. The World Health Organization asked the Population Council to provide a review of field experiences regarding the integration of family planning and PMTCT services. This report provides conclusions and recommendations as input into a WHO/UNFPA-sponsored consultative meeting on "The linkages between reproductive health and HIV/AIDS: Family planning and prevention of mother-to-child transmission."

Succession Planning In Uganda: Early Outreach For Aids-Affected Children And Their Families, Horizons Program, Makerere University Department Of Sociology, Plan Uganda

HIV and AIDS

This publication reports on an intervention study that evaluated the effectiveness of a succession planning (SP) program in Uganda. Unlike most other programs for AIDS-affected children, succession planning reaches children and their families while their HIV-positive parents are still living and in a position to plan for their children’s long-term well-being. Research carried out by the Department of Sociology at Makerere University (Kampala) and the Population Council Horizons program suggests that succession planning is a promising approach: despite AIDS-related stigma and cultural resistance to acknowledging illness and death, qualitative research indicates that the approach met with a high degree of …

Awareness Of Heart Health Promotion And Heart Disease Prevention Programs Among African, African-American, And Caucasian American Women, Leenghoi Lower

All Graduate Theses, Dissertations, and Other Capstone Projects

The aim of this study was to assess awareness of African, African-American, and Caucasian American women regarding heart health promotion and heart disease prevention programs. A survey consisting of 10 questions was given to 150 women from the Minnesota cities of Mankato, Minneapolis, and Saint Paul. Data was collected from 60 women. Results from this study indicated that 32.45% of women were aware of heart health promotion and heart disease prevention programs while 67.55% were not aware. An investigation was also carried out to determine knowledge of women regarding heart disease as the leading cause of morbidity in women. Results …

Improving The Reproductive Health Of Youth In Mexico, Ricardo Vernon, Maricela Dura

Reproductive Health

This project assessed the impact of the Mexican Foundation for Family Planning’s Young People Program (YPP) on: a) the attitudes of community stakeholders toward informing youth about reproductive health issues and making reproductive health services available for sexually-active youth; b) the sexual and reproductive health knowledge, attitudes, and behaviors of adolescents; and c) the way that providers offer reproductive health services to adolescents. In addition, the project determined whether adding a school-based sex education component increased the impact of community interventions on the knowledge, attitudes, and behaviors of adolescents. Survey results showed that the reproductive health knowledge and attitudes of …

Socioeconomic Disadvantage And Unsafe Sexual Behaviors Among Young Women And Men In South Africa, Kelly Hallman

Poverty, Gender, and Youth

This study investigates how relative socioeconomic status influences the sexual behaviors of young women and men aged 14–24 years in KwaZulu-Natal Province, South Africa—an environment characterized by high HIV prevalence and high rates of poverty and inequality. Relative economic disadvantage is found to significantly increase the likelihood of a variety of unsafe sexual behaviors and experiences. Poorer young people, especially females, also have significantly lower access to media sources for family planning information. Without sufficient attention in the design and placement of HIV prevention programs to the economic and social conditions in which individuals live, the potential effectiveness of the …

Healing Wounds, Instilling Hope: The Tanzanian Partnership Against Obstetric Fistula, Thoraya Ahmed Obaid, Erica Chong

Poverty, Gender, and Youth

This edition of Quality/Calidad/Qualité describes a partnership formed to combat obstetric fistula in Tanzania. The Bugando Medical Center, the Women’s Dignity Project, the Tanzania Midwives Association, and the government cooperated on an extensive program for surgical repair, prevention, and policy research and activities. Lessons learned: 1) Fistula programs need to address social as well as medical issues. 2) Most repairs are successful, making an enormous difference in women’s lives. 3) Relatively little funding is necessary to start up a fistula program. 4) Fistula programs are vehicles for broader conversations about gender and poverty.

Guérir Les Blessures, Faire Naître L’Espoir: Le Partenariat Tanzanien Contre La Fistule Obstétricale, Thoraya Ahmed Obaid, Erica Chong

Poverty, Gender, and Youth

This edition of Quality/Calidad/Qualité describes a partnership formed to combat obstetric fistula in Tanzania. The Bugando Medical Center, the Women’s Dignity Project, the Tanzania Midwives Association, and the government cooperated on an extensive program for surgical repair, prevention, and policy research and activities. Lessons learned: 1) Fistula programs need to address social as well as medical issues. 2) Most repairs are successful, making an enormous difference in women’s lives. 3) Relatively little funding is necessary to start up a fistula program. 4) Fistula programs are vehicles for broader conversations about gender and poverty.

Linking Reproductive Health To Social Power: Community Health Workers In Belize And Pakistan, Susana Galdos, Lucella Campbell, Patricia Mohammed, Debbie Rogow, Saumya Ramarao, Ali M. Mir, Nicole Haberland

Poverty, Gender, and Youth

This issue of Quality/Calidad/Qualité focuses on two traditional family planning programs that undertook projects to help women enlarge their zone of influence in both the private and public spheres. The first case study focuses on the Belize Family Life Association (BFLA), a nongovernmental organization in a small Caribbean country. The second case study recounts the experience of the Pakistani government, which has an enormous, but entrenched, target-oriented family planning program. Both programs began by recognizing that women’s lack of social power is a major obstacle to their being able to protect their own health. Both trained village workers to regard …

Human Chorionic Gonadotropin Administration Is Associated With High Pregnancy Rates During Ovarian Stimulation And Timed Intercourse Or Intrauterine Insemination, Mohamed F. Mitwally, Sonya Abdel-Razeq, Robert F. Casper

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

There are different factors that influence treatment outcome after ovarian stimulation and timed-intercourse or intrauterine insemination (IUI). After patient age, it has been suggested that timing of insemination in relation to ovulation is probably the most important variable affecting the success of treatment. The objective of this study is to study the value of human chorionic gonadotropin (hCG) administration and occurrence of luteinizing hormone (LH) surge in timing insemination on the treatment outcome after follicular monitoring with timed-intercourse or intrauterine insemination, with or without ovarian stimulation.

Methods

Retrospective analysis of 2000 consecutive completed treatment cycles (637 timed-intercourse and …

Promotion Of Lactation Amenorrhea Method Intervention Trial, Kazakhstan, Shamil Tazhibayev, Toregeldy Sharmanov, Ayan Ergalieva, Oksana Dolmatova, Orynkul Mukasheva, Aina Seidakhmetova, Raikhan Kushenova

Reproductive Health

In order to expand the benefits of breastfeeding as a birth spacing option for women in the Republic of Kazakhstan, the Kazakh Academy of Nutrition at the Academy of Preventive Medicine in Almaty conducted an operations research study to test the effectiveness of lactational amenorrhea method (LAM) promotion among women in Kazakhstan, as part of the Population Council’s Frontiers in Reproductive Health Small Grants Program. Results show that the intervention programs implemented in experimental baby-friendly hospitals (BFHs) and ordinary hospitals (OHs) improved women’s knowledge, skills, and desire to breastfeed The report concludes that training activities should be strengthened and all …

Improving Health Care Providers' Knowledge, Attitudes, And Practices In Reproductive Health In Rural Romania, Elaine Claire Himelfarb

Reproductive Health

To support new health reform initiatives undertaken by the Romanian Ministry of Health and Family, and in support of the USAID Romania strategy for improving women’s reproductive health, Project Concern International/Romania (PCI/R) was awarded a two-year grant to implement a reproductive healthcare project, Healthy Parents-Healthy Children (HP-HC). This project trained family physicians and nurses in rural dispensaries in techniques to improve pre- and postnatal care, including training on modern contraception, cervical and breast cancer screening, treating menopause and its symptoms, and the encouragement of healthy lifestyles. The goal of this OR project was to test the efficacy of interventions to …

Involving Men In Maternity Care: South Africa, Busi Kunene, Mags Beksinska, Simphiwe Zondi, Nobuhle Mthembu, Saiqa Mullick, Emma Ottolenghi, Immo Kleinschmidt, Susan E. Adamchak, Barbara Janowitz, Carmen Cuthbertson

Reproductive Health

The Reproductive Health Research Unit University of the Witwatersrand, South Africa, in partnership with the FRONTIERS Program of the Population Council, and the KwaZulu-Natal Department of Health conducted a three-year operations research study titled “Men in Maternity” in the Ethekwini district. The intervention was clinic-based and included two broad strategies: improving antenatal care services by strengthening the existing antenatal package and service monitoring and supervision; and introducing couple counseling by providing training to health providers, inviting partners of antenatal women to attend counseling twice during pregnancy and once post delivery, and providing information to couples with a new antenatal booklet. …

Testing The Effectiveness Of Integrating Community-Based Approaches For Encouraging Abandonment Of Female Genital Cutting Into Care's Reproductive Health Programs In Ethiopia And Kenya, Jane Chege, Ian Askew, Susan Igras, Jacinta Muteshi-Strachan

Reproductive Health

CARE International, with technical support from the Frontiers in Reproductive Health Program completed a study in Ethiopia and Kenya designed to test the effectiveness of education activities using behavior change communication (BCC) approaches and advocacy activities by religious and other key leaders to abandon female genital cutting (FGC). In Ethiopia, the increased knowledge of harmful FGC effects and human rights issues translated to a positive attitude in support of FGC abandonment and an intention not to cut their daughters in the future. In Kenya, the analysis indicated mixed results in attitude and intended behavior change.