Public Health Commons^™

An Ambulatory Approach To Self-Care Of Diabetes, Fred W. Whitehouse, Iris J. Whitehouse, Mary Sue Cox, Dorothy M. Kahkonen

Henry Ford Hospital Medical Journal

Managing the insulin-requiring diabetic patient in an ambulatory selling includes metabolic regulation of the diabetes and education in its self-care. Means of achieving these goals include structured group or one-on-one individualized sessions. Third party policies relating to ambulatory care are challenged and their need for fiscal support emphasized. During the coming decade, diabetic patients should 1) have access to ambulatory care programs for metabolic regulation and education in self-care. 2) expect third party support of these programs, and 3) heighten their own priorities on diabetes care to ensure quality management of their diabetes.

Vertebral Compression Fractures At The Onset Of Acute Lymphoblastic Leukemia In A Child, M. Beatriz Oliveri, Carlos A. Mautalen, Carlos A. Rodriguez Fuchs, M. Del Carmen Romanelli

Henry Ford Hospital Medical Journal

A child with acute lymphoblastic leukemia, spinal osteoporosis with vertebral compression fractures, and hypercalcemia appearing early in the course of the hematologic disease was followed for two and a half years. Bone mineral density (BMD). measured by single photon absorptiometry at the radial shaft. was within normal limits for age and sex. However, x-rays of vertebrae and vertebral BMD. measured by dual photon absorptiometiy, showed marked demineralization. Despite leukemic remission, the spinal osteoporosis became worse and the patient required aggressive treatment for eight months. Treatment included 50 units of calcitonin subcutaneously every other day. 1.000 mg/day of oral calcium, and …

Primary Hyperparathyroidism And Monoclonal Gammopathy, D. Sudhaker Rao, Rosella Antonelli, Kevin R. Kane, John E. Kuhn, Celina Hetnal

Henry Ford Hospital Medical Journal

Coexistent primary hyperparathyroidism and monoclonal gammopathy, although rare, has been reported previously by a number of investigators. We report four patients with such an occurrence who were seen between 1976 and 1988. Another patient with primary hyperparathyroidism also had multiple myeloma and was in remission for 12 years. These patients represent approximately 1% of the 386 patients with primary hyperparathyroidism seen during the same 12-year period. Although several mechanisms have been proposed to explain this concurrence, we believe it is the result of a chance occurrence. A review of the literature, an estimate of the chance occurrence of coincidental monoclonal …

The Right To Die: An Old Woman's Formula, Mary Guinan

School of Public Health Faculty Research

On December 26, 1990, Nancy Cruzan died, 12 days after her feeding tube was removed. She had been in an irreversible coma for seven years and her parents had sued for the right to remove the feeding tube that was keeping her alive. The pain and suffering of her family in coming to this decision was certainly compounded by those who disagreed with them and tried to prevent the extubation. Whether one agrees with this particular decision or not, most of us will not be faced with such clear alternatives, ie, leave the tube in or take it out in …

Suicide In Micronesia: The 1920s And 1930s, David C. Purcell Jr.

Pacific Studies

No abstract provided.

Maine Aids Alliance Newsletter (February 1991), Maine Aids Allaince

Newsletter / Maine AIDS Alliance (1990-1991)

No abstract provided.

Chloramphenicol Therapy Of Typhoid Fever, Z A. Bhutta, S H. Naqvi, S Durrani, A Suria

Department of Paediatrics and Child Health

In a prospective study we compared two different dosage regimens of IV chloramphenicol succinate (100 mg/kg/day and 75 mg/kg/day) in children with culture proven typhoid. Trough and peak blood samples, obtained at 48 hrs, were analysed for free chloramphenicol by high pressure liquid chromatography (HPLC). Although the mean trough (8.8 +/- 7.7 versus 5.4 +/- 2.6 mcg/ml) and peak (19.9 +/- 12.2 versus 15.4 +/- 6.1 mcg/ml) chloramphenicol concentrations were comparable in both groups, a significantly wider range was found in the group receiving 100 mg/kg/day. Potentially toxic levels (greater than 30 mcg/ml) developed in two patients with liver dysfunction. …

Using Joint Fact-Finding To Resolve Disputes Over Cleanup Of Hazardous Waste Sites, R. Steven Konkel

Environmental Health Science Faculty and Staff Research

This research demonstrates how and why joint fact-finding works to break impasses in negotiations and overcome obstacles to the cleanup of hazardous waste sites. Superfund cleanup negotiations often involve multiple-party, multi-issue disputes. Disputes often arise over identification of the responsible parties, allocation of cost and liability, definition and interpretation of cleanup standards, and development of a viable settlement structure. In 1988, Marks and Susskind identified disagreements over the accuracy and validity of data as critical barriers to cleanup of Superfund and other hazardous waste sites. Disputes over data have led to delays, costly supplemental studies, and site fragmentation into multiple …

Review Of John V. Schappi, Improving Job Attendance (Bna Books), W. J. Hankins

RISK: Health, Safety & Environment (1990-2002)

Review of JOHN V. SCHAPPI, IMPROVING JOB ATTENDANCE. (BNA Books 1988.) [187 pp.] Appendices, bibliography, index. LC 87-27638; ISBN 0-87179-535-3

Evaluation Of Particulate Air Filters For Indoor Air Cleaning, Murray R. Clark, Kevin Tennal, Thomas Rimmer, Malay K. Mazumder

Journal of the Arkansas Academy of Science

No abstract provided.

Molecular Epidemiologic Techniques In Analysis Of Epidemic And Endemic Shigella Dysenteriae Type 1 Strains, Nancy A. Strockbine, Julie Parsonnet, Katherine Greene, Julia A. Kiehlbauch, I. Kaye Wachsmuth

United States Public Health Resources

During 1988 the number of Shigella dysenteriae type 1 infections reported in the United States increased fivefold. To determine if recent isolates from Mexico were related to those that caused epidemics of dysentery worldwide, Southern hybridization analysis was done with Shiga toxin and ribosomal RNA gene probes. Western hemisphere and Eastern Hemisphere strains differed by the size of a single EcoRI fragment carrying the Shiga toxin genes. Three ribosomal DNA (rDNA) patterns were observed, which correlated with the strain;s continental origin for 81 of 83 isolates tested. Together the Shiga toxin and rDNA probe results indicated that recent Mexican …

The Use Of Health Service Areas For Measuring Provider Availability, Diane M. Makuc, Bengt Haglund, Deborah D. Ingram, Joel C. Kleinman, Jacob J. Feldman

United States Public Health Resources

Measurement of the availability of health care providers in a geographic area is a useful component in assessing access to health care. One of the problems associated with the county provider-to-population ratio as a measure of availability is that patients frequently travel outside their counties of residence for health care, especially those residing in non-metropolitan counties. Thus, in measuring the number of providers per capita, it is important that the geographic unit of analysis be a health service area. We have defined health care service areas for the coterminous United States, based on 1988 Medicare data on travel patterns between …

Manual Para El Diseño De Investigación Operativa En Planificación Familiar, Andrew A. Fisher, John E. Laing, John E. Stoeckel, John Townsend

Reproductive Health

El Manual para el diseño de investigación operativa en planificación familiar, publicado por primera vez en inglés por el Population Council en 1983, se basó en las experiencias de los autores en investigaciones operativas en Asia. Esta segunda edición contiene secciones revisadas y aumentadas. En su caso, se han agregado ejemplos de América Latina y África. En la Introducción se hace una revisión completa y actualizada del desarrollo de la investigación operativa (IO) en salud y planificación familiar. Se han agregado nuevos capítulos sobre la selección de la intervención a ser probada en un investigación operativa sobre la descripción de …

A Comparison Between Physiological And Perceived Exertion During Maximal And Submaximal Treadmill Exercise At Three Menstrual Cycle Phases, Kathleen M. Mccune

Masters Theses

The purpose of this study was to investigate the differences in physiological and subjective perceived exertion levels at maximal and submaximal treadmill exercise between three phases of the menstrual cycle in eumennorheic women.

Nine females of varying fitness levels were subjects in the study. None of the subjects were using oral contraception or hormone altering medications at the time of the study.

The subjects performed three separate maximal graded exercise tests (GXT) using the Balke protocol. During each GXT, oxygen uptake (VO₂), heart rate (HR), blood pressure (BP), respiratory quotient (RQ), rate of perceived exertion, and total time …

An Investigation Into Physiological Responses And Ratings Of Perceived Exertion To Submaximal Cycle Ergometry When Using Aerodynamic And Drop Handlebars, Haydn Jarrett

Masters Theses

No abstract provided.

The Selection And Implementation Of A Drug And Alcohol Intervention Program/Model For Grand Coulee Dam Junior High School, Grand Coulee, Washington, Scott L. Ramsey

All Graduate Projects

The purpose of this study was to plan and implement an intervention program to combat adolescent substance abuse at Grand Coulee Dam Junior High School, Grand Coulee, Washington. This study presented a review of the research and literature related to drug and alcohol intervention models and has documented the steps and procedures taken by the Grand Coulee Dam Junior High School Core Team to implement the intervention model selected.

Prevention Of Morbidity And Mortality From Induced And Unsafe Abortion In Nigeria, Friday E. Okonofua, Toun Ilumoka

Reproductive Health

These proceedings are from a seminar organized by the Department of Obstetrics, Gynaecology, and Perinatology, Obafemi Awolowo University, Ile-Ife (Nigeria) in collaboration with the Population Council. The primary purpose of the multidisciplinary seminar was to identify the determinants of the high rate of mortality and morbidity from unsafe abortion in Nigeria. The specific objectives were: 1) to identify measures that could be undertaken on a short- and long-term basis to reduce the rate of abortion-related mortality, and 2) to set an agenda for research into abortion in Nigeria. The seminar consisted of oral presentations on related topics by researchers and …

Man/Hombre/Homme: Respuestas A Las Necesidades De La Salud Reproductiva Masculina En América Latina, Debbie Rogow, Judith Bruce, Ann Leonard

Poverty, Gender, and Youth

Esta edición de Quality/Calidad/Qualité responde a la siguiente pregunta: ¿cómo pueden los programas de planificación familiar entender y atender mejor a los intereses de los hombres? Las propuestas del artículo se derivan de la experiencia de PRO-PATER, en São Paulo, Brasil, y brevemente, de las actividades de la Clínica para el Hombre de Profamilia en Colombia. Las experiencias de tanto PRO-PATER como Profamilia sugieren que, aunque las necesidades de salud reproductiva de los hombres pueden ser distintas a las que expresan las mujeres, de todas maneras ellos están muy interesados. Queda claro que existe una abundante demanda para servicios de …

The Effect Of Psychosocial Factors On The Immune Response Of Hiv Infected Individuals As Measured By The Extent Of Relationship With Cd-4 T Cell Count And Physical Symptoms, Richard R. Taylor

Theses

The effect of psychosocial factors on the immune response of HIV infected human subjects was assessed by measuring the degree of relationship to CD-4 T cell count and physical symptoms.

Twenty six participants (22 white and 2 black males) all who had been diagnosed as HIV positive completed a battery of 11 psychological tests and a social and medical history questionnaire. Fifty four psychosocial factors were selected as having the potential to have a significant effect on immune response.

Correlational analyses yielded no strong relationships between the psychosocial factors and CD-4 T cell count or physical symptoms. Moderate associations were …

The Bangladesh Women's Health Coalition, Bonnie J. Kay, Adrienne Germain, Maggie Bangser

Poverty, Gender, and Youth

The Bangladesh Women's Health Coalition (BWHC) represents an important initiative in the movement toward more responsive modes of family planning delivery. In the context of a society where there are strict limits on the social role and physical mobility of most girls and women, BWHC has set itself the ambitious goal of enabling women—no matter what their income or education—to learn how to manage their own reproductive health and the health of their children in a way that enhances their sense of strength and competence. One of the real strengths of BWHC has been its willingness to learn from experience …

Child Care: Meeting The Needs Of Working Mothers And Their Children, Caroline Arnold, Jorge Mejia, Aster Haregot, Ann Leonard, Cassie Landers

Poverty, Gender, and Youth

This issue of SEEDS, developed in cooperation with the Consultative Group on Early Childhood Care and Development, with support from UNICEF, seeks to bring together the critical elements of women's work and child care, reviewing the issues from three different perspectives: child care as a means of enabling women to work, as a source of employment for women, and as a way of meeting the developmental needs of young children. The report examines three different UNICEF-supported approaches to child care on three different continents—Asia (Nepal), Africa (Ethiopia), and South America (Ecuador)—that have been developed with the needs of working women …

El Papel De Las Mujeres En La Conservación De Los Bosques Del Nepal, Augusta Molnar

Poverty, Gender, and Youth

Este número de SEEDS pone de relieve las formas en que se ha hecho participar a las mujeres en un programa gubernamental de conservación y restauración de bosques en Nepal. Como en muchos proyectos de gran escala e impacto generalizado, las mujeres no tenían un papel específico en el diseño original del proyecto. Pero una vez que comenzaron las actividades, tanto el personal nepales como sus colegas extranjeros tuvieron que reconocer que para que la estrategía participative pudiera funcionar, era esencial contar con las mujeres. De ahí que durante los primeros cinco anos del proyecto (1980–85) se probaron varias maneras …

Handbook For Family Planning Operations Research Design, Andrew A. Fisher, John E. Laing, John E. Stoeckel, John Townsend

Reproductive Health

The Handbook for Family Planning Operations Research Design, first published in English by the Population Council in 1983, was based on field research studies in Asia. This second edition contains revised and expanded sections. Where appropriate, examples from Latin America and Africa have been added. The introductory section contains a current statement on the process of health and family planning operations research (OR). New chapters have been included on selecting an appropriate intervention to test in an OR study, and on describing the main elements of the study intervention. The chapter on information dissemination has been expanded and a new …

Handbook For Family Planning Operations Research Design [Arabic], Andrew A. Fisher, John E. Laing, John E. Stoeckel, John Townsend

Reproductive Health

"The Handbook for Family Planning Operations Research Design," first published in English by the Population Council in 1983, was based on field research studies in Asia. This second edition contains revised and expanded sections. Where appropriate, examples from Latin America and Africa have been added. The introductory section contains a current statement on the process of health and family planning operations research (OR). New chapters have been included on selecting an appropriate intervention to test in an OR study, and on describing the main elements of the study intervention. The chapter on information dissemination has been expanded and a new …

Maternal Risk, Beverly Winikoff

Reproductive Health

This presentation to the 1991 Berzelius Symposium, Stockholm, Sweden, explores the issue of maternal risk—the probability or chance of dying or being seriously injured in pregnancy—as it is used in maternal health care. This concept of risk has been a useful tool for research and medical and epidemiological education, but its use as a tool for service delivery design has been more problematic. In order to construct a risk system, one has to have reliable data on the relationships between individual characteristics and the outcome being studied—something that is difficult to develop with regard to maternal health. Furthermore the system …

Limitations Of Maternal Care To Improve Maternal Health, Beverly Winikoff

Reproductive Health

In a presentation at the 1991 Berzelius Symposium in Sweden, a Population Council researcher described the limitations of healthcare systems, specifically during pregnancy, in terms of their effect on maternal health status. These limitations stem from an inability to improve health because of social conditions—poverty and illiteracy, overwork, inequality in sexual relationships—that cannot be solved by medical interventions. Maternal ill health originates before pregnancy and endures beyond it, whereas the window of contact with women during pregnancy is small. Nevertheless, recent evaluations suggest that the impact of prenatal care is in the caring process more than any specific aspect of …

Predictive Probabilities In Employee Drug-Testing, John M. Gleason, Darold T. Barnum

RISK: Health, Safety & Environment (1990-2002)

Substance abuse in the U.S. has been estimated to cost $99 billion annually through lower productivity. Yet the authors urge caution in attempting to reduce these costs and health and safety Risks. In doing so, they cite commonly high frequencies of false negatives and false positives in employee drug tests - the latter having the potential to do great injustice to many drug-free employees.

An Alternative Public Health Vision For A National Drug Strategy: "Treatment Works", Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

This article returns to a war waged virtually throughout this century--a war between the theories of punishment and rehabilitation in curtailing the drug epidemic. Today, the terms of the war are recast as supply-side policies based upon law enforcement; destroying crops in source countries; interdiction and increased sentencing; and demand reduction based upon prevention, education, and treatment. The war on drugs has reached a feverish pitch. New policies and statutes have tightened the grip of supply-side policies, with images of battle and hate mongering which go beyond the vilified drug lords and governments which harbor them, to the middle men, …

Genetic Discrimination: The Use Of Genetically Based Diagnostic And Prognostic Tests By Employers And Insurers, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

This paper analyzes the law, ethics and public policy concerning "genetic discrimination," defined as the denial of rights, privileges or opportunities on the basis of information obtained from genetically based diagnostic and prognostic tests. The Human Genome Initiative will enhance the ability to gather and organize information that may predict a person's future potential and disabilities. Enormous human benefits may ensue from understanding the etiology and pathophysiology of genetic disorders, including disease prevention through genetic counseling, and treatment of the disorders through genetic manipulation. This information will help clinicians understand and eventually treat many of the more than 4,000 diseases …

The Interconnected Epidemics Of Drug Dependency And Aids, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

Drug dependence and human immunodeficiency virus (HIV) are America's two most pressing epidemics, interconnected by a cycle of urban poverty, physical dependence and a culture of sharing needles and syringes. Extant political strategies to curb these interconnected epidemics involve two traditional approaches. The first--law enforcement and interdiction--is designed to limit the supply of illicit drugs to the marketplace. This strategy is advanced by broad criminal sanctions against importing, selling, distributing, medically prescribing, or possessing illicit drugs or drug paraphernalia. The second strategy to combat the drug and HIV epidemics involves reducing the demand for illicit drugs. Education, counseling, and treatment …