Medicine and Health Commons^™

Development Of An Instrument To Identify The Virtues Of Expert Nursing Practice: ‘Byrd’S Nurses Ethical Sensitivity Test’ (Byrd’S Nest), Lisa Marie Byrd

Dissertations

The purpose of this research was to develop and analyze the psychometric properties of Byrd’s Nurse’s Ethical Sensitivity Test (Byrd’s NEST). An instrument to evaluate nurses’ ethical sensitivity in practice by examining choices of action in ethical dilemmas based on nursing virtues: compassion, fidelity to trust, moral courage, justice, self-confidence, resilience, practical reasoning, and integrity (Benner, Tanner, & Chelsa, 1996; Volbrecht, 2002). Benner’s theory of skill acquisition-novice to expert was the theoretical framework for this research which surveyed for correlations between a nurse’s ethical sensitivity and educational level, years of experience, certification, and work setting. Until now, there have been …

Day Of Dialogue On Public Sector Pricing Of Pharmaceutical Products, Population Council

Formulation/Product Development

For decades, patients, doctors, ethicists, and other interested parties have debated the economics of the pharmaceutical industry. What is the best way to get medications and related products to the people who need them, regardless of their ability to pay? Can prices be lowered without jeopardizing basic research for new drugs? Are pharmaceutical company pricing practices monopolistic? What are the legal and ethical obligations related to drugs developed—partially or fully—with public funds? The Population Council convened a daylong meeting of academics, scientists, representatives from the nonprofit sector, the pharmaceutical industry, foundations, and government donor agencies, and practicing lawyers and doctors. …

Indigenous Suicide In New Zealand, Annette L. Beautrais, David M. Fergusson

Aboriginal Policy Research Consortium International (APRCi)

This article describes patterns of suicide and attempted suicide among the indigenous (Ma ̄ori) population of New Zealand using official data from the New Zealand Health Information Service (NZHIS). The majority of Ma ̄ori suicides (75%) occurr in young people aged <35 years. Rates of suicide are higher among Ma ̄ori males and females aged <25 than in their non-Ma ̄ori peers. Rates of hospitalization for attempted suicides are higher amongst Ma ̄ori males aged 15–24, compared to non-Ma ̄ori. In contrast, suicide is virtually unknown amongst older Ma ̄ori (60 years). This article reviews explanations for the observed rates of suicide in Ma ̄ori, and examines approaches to effective intervention to reduce rates of suicide in young Ma ̄ori.

Hydroxyurea And Sickle Cell Anemia: Effect On Quality Of Life, Samir K. Ballas, Franca B. Barton, Myron A. Waclawiw, Paul Swerdlow, James R. Eckman, Charles H. Pegelow, Mabel Koshy, Bruce A. Barton, Duane R. Bonds

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

The Multicenter Study of Hydroxyurea (HU) in Sickle Cell Anemia (MSH) previously showed that daily oral HU reduces painful sickle cell (SS) crises by 50% in patients with moderate to severe disease. The morbidity associated with this disease is known to have serious negative impact on the overall quality of life(QOL) of affected individuals.

Methods

The data in this report were collected from the 299 patients enrolled in the MSH. Health quality of llife (HQOL) measures were assessed in the MSH as a secondary endpoint to determine if the clinical benefit of HU could translate into a measurable …

Reducing Aids-Related Stigma And Discrimination In Indian Hospitals, Vaishali Sharma Mahendra, Laelia Gilborn, Bitra George, Luke Samson, Rupa Mudoi, Sarita Jadav, Indrani Gupta, Shalini Bharat, Celine Daly

HIV and AIDS

People living with HIV/AIDS in India, as elsewhere, face stigma and discrimination in a variety of contexts. Research in India has shown that stigma and discrimination against HIV-positive people and those perceived to be infected are common in hospitals and act as barriers to seeking and receiving critical treatment and care services. Recognizing the need to move beyond documentation of the problem, three New Delhi hospitals; SHARAN, an Indian NGO; and the Horizons program, with support from the National AIDS Control Organisation (NACO), carried out an operations research project to develop and test responses to hospital-based stigma and discrimination against …

Promoting More Gender-Equitable Norms And Behaviors Among Young Men As An Hiv/Aids Prevention Strategy, Julie Pulerwitz, Gary Barker, Marcio Segundo, Marcos Nascimento

HIV and AIDS

The Population Council and the Promundo Institute studied the effectiveness of interventions in Brazil designed to change the attitudes of young men in relation to gender norms and reducing the risk of contracting HIV/STIs. One conclusion of the study was the recognition of the importance of engaging young people (men and women) in the issue of gender relations and the risks of HIV contamination. The results of the study indicate that addressing inequitable gender norms, particularly those that define masculinity, can be an important element of HIV prevention strategies. These findings suggest that group education interventions can successfully influence young …

Abc Messages For Hiv Prevention In Kenya: Clarity And Confusion, Barriers And Facilitators, Julie Pulerwitz, Tiffany Lillie, Louis Apicella, Ann P. Mccauley, Tobey C. Nelson, Simon Ochieng, Peter Mwarogo, Karusa Kiragu, Edward Kunyanga

HIV and AIDS

The Horizons Program and FHI/IMPACT developed a collaborative research study to explore how adults and youth in Kenya define and perceive the ABC (abstinence/being faithful/consistent condom use) terms and behaviors. Additional objectives of the study were to identify attitudes and norms around the ABC behaviors that influence perceptions of them, and the role of important actors in transmitting messages about them. Findings highlight potential challenges in promoting each of the ABC behaviors, as well as some positive elements that can be built upon when developing programs. HIV prevention programs that incorporate ABC messages—both in Kenya and elsewhere—should consider a number …

Examining Adherence And Sexual Behavior Among Patients On Antiretroviral Therapy In India, Avina Sarna, Indrani Gupta, Sanjay Pujari, A.K. Sengar, Rajiv Garg, Ellen Weiss

HIV and AIDS

With increased availability of ART, HIV-positive individuals are living healthier lives and continuing or resuming sexual activity. However, optimism related to ART’s success in slowing disease progression, reducing viral load, and improving health status may lead to more risky sexual practices and a possible increase in transmission of infections. To determining the sexual behavior of HIV-positive persons on ART, the Horizons program, in collaboration with research partners in Delhi and Pune, conducted a study to assess current levels of adherence to ART among a sample of people living with HIV/AIDS, identify the factors that influence their adherence to treatment, and …

Orphans And Vulnerable Youth In Bulawayo, Zimbabwe: An Exploratory Study Of Psychosocial Well-Being And Psychosocial Support, Laelia Gilborn, Louis Apicella, Jonathan Brakarsh, Linda Dube, Kyle Jemison, Mark Kluckow, Tricia Smith, Leslie M. Snider

HIV and AIDS

This Population Council Horizons report presents findings from an exploratory study by the Regional Psychosocial Support Initiative and Catholic Relief Services’ Support to Replicable, Innovative Village/Community-level Efforts Program of vulnerable youth living in and around Bulawayo, Zimbabwe. It describes their demographic characteristics, exposure to stress and trauma, and psychosocial well-being. The report also highlights the relationships between psychosocial well-being outcomes and exposure to stress and trauma, and the differences in psychosocial well-being between males and females, orphaned and nonorphaned youth, and younger and older adolescents. The report concludes with program and research implications.

Exploring Current Practices In Pediatric Arv Rollout And Integration With Early Childhood Programs In South Africa: A Rapid Situation Analysis, Desiree Michaels, Brian Eley, Lewis Ndhlovu, Naomi Rutenberg

HIV and AIDS

This Horizons program report describes the status of pediatric HIV treatment in selected sites in South Africa, identifies gaps in service delivery, and proposes recommendations for strengthening services and expanding children’s access to treatment. The study provides much needed information on critical issues of pediatric HIV care, especially regarding health service and contextual issues surrounding the expansion of access to treatment for HIV-infected children, and key factors that facilitate sustainability of treatment by young children. The aims of the study were to identify successful program strategies in pediatric HIV treatment in South Africa and to determine priority knowledge gaps to …

Role Identity Formation Of Occupational Therapy Students, Denise A. Rotert

Electronic Theses and Dissertations

This study is an examination of the professional socialization process of occupational therapy students from a role identity theoretical perspective. First-year students, second-year students, fieldwork students, and faculty at an occupational therapy educational program at a Midwestern institution volunteered to participate in the study. Data were collected through focus group interviews and surveys. The focus of the study was to determine factors associated with occupational therapy students’ identity salience, commitment, and role-person merger. Interviews and surveys were used to determine what factors, over and above didactic education, influence the socialization of students into the profession of occupational therapy and what …

Suicide Trends And Prevention In Nevada, Matt Wray

Social Health of Nevada Reports

Suicide has been around for as long as human society and it continues to challenge our collective wisdom. Consider this data provided by the National Institute of Medicine:

• Each year about one million people commit suicide worldwide.
• Every year some 30,000 Americans end their lives by suicide, and approximately 650,000 people receive emergency treatment after attempting suicide.
• Every 41 seconds someone in the U.S. attempts suicide; every 16.7 minutes, someone completes suicide; and every day over 85 people die by suicide.
• Suicide is the eighth leading cause of death in the U.S. and the third leading cause of death among …

Problem Gambling And Treatment In Nevada, Bo Bernhard

Social Health of Nevada Reports

For many years, it was moral experts, rather than medical and academic ones, who told us who gambled “too much.” Speaking from pulpits rather than podiums, church leaders informed us that gambling was uniquely subversive of the American way of life, for its something-for-nothing promise threatened to undermine the popular ethic of honest toil and gradual accumulation of goods. Samuel Hopkins, in an 1835 sermon on “The Evils of Gambling,” captured this sensibility: “Let the gambler know that he is watched, and marked; and that . . . he is loathed. Let the man who dares to furnish a resort …

Diseases Prevalence And Behavioral Choices In Nevada, Mary Guinan, Chad L. Cross, Lawrence Sands

Social Health of Nevada Reports

Determining the health of a state population is a complex task. It involves knowing at least the prevalence of various diseases and conditions as well as the leading causes of death and disability compared to a national mean or median. The World Health Organization defines health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” Since health is affected by numerous social, economic, environmental, and cultural factors, these factors must also be considered when examining the health status of a population. All attempts to rank states in health are limited …

Health Care Access And Insurance Availability In Nevada, Charles B. Moseley, Michelle Sotero

Social Health of Nevada Reports

According to the Institute of Medicine (IOM),

• Approximately 18,000 Americans die prematurely every year, solely because they lack health insurance coverage (Institute of Medicine, 2004).
• The IOM estimates that the aggregate cost of increased morbidity and mortality due to un-insurance in the U.S. is between $65 billion and $130 billion per year.
• Costs to the health care system can be measured conservatively in terms of the value of uncompensated care provided to the uninsured, estimated at almost $35 billion in 2001, of which $24 billion was provided by hospitals.

Access to medical care is not a constitutional right in the …

Female Genital Mutilation In Kenya: Evidence Links Health Workers To Fgm, Population Council, Gtz

Reproductive Health

Female genital mutilation (FGM) is a traditional practice that affects women and girls in several African countries. It is practiced in a variety of ways, classified by WHO into four broad types all found in Kenya. In some communities it is associated with passage into maturity; in others, it is considered a symbol of ethnic identity, a religious obligation, or a necessary prerequisite for marriage, either through symbolizing attainment of womanhood or as a means of preserving and demonstrating virginity. FGM is considered a harmful traditional practice because it may be associated with a variety of short- and long-term health …

Safe Motherhood Applied Research And Training (Smart) Report 1: Project Overview, Gul Rashida, Peter C. Miller

Reproductive Health

Maternal mortality in Pakistan is believed to be quite high, at about 350–500 maternal deaths per 100,000 live births. Reducing maternal mortality is one of the major objectives of the Government of Pakistan. Interventions required to address maternal mortality include safe motherhood, which means a woman’s ability to have a safe and healthy pregnancy and delivery. The Safe Motherhood Applied Research and Training (SMART) project was an operations research project designed to develop and test interventions to reduce maternal and neonatal mortality in a predominantly rural district of Pakistan. The vast majority of maternal deaths are attributed to delays in …

The Impact Of Immunization On The Association Between Poverty And Child Survival: Evidence From Kassena-Nankana District Of Northern Ghana, Ayaga A. Bawah, James F. Phillips, Martin Adjuik, Maya Vaughan-Smith, Bruce Macleod, Fred N. Binka

Poverty, Gender, and Youth

Research conducted in Africa has demonstrated consistently that parental poverty and low educational attainment adversely affect child survival. Relative poverty has a pronounced effect on the survival of children, even in a setting where nearly all families are poor. Results from the research presented in the working paper lend strong support to the United Nations’ goal of reducing excess childhood mortality among the poor by directing a particular focus on immunization. Findings in this working paper show that the adverse effects of poverty disappear and that the effects of educational attainment are reduced in survival models that control for immunization …

Urban Versus Rural Mortality Among Older Adults In China, Zachary Zimmer, Toshiko Kaneda, Laura Spess

Poverty, Gender, and Youth

For some time, Chinese government policies have treated rural and urban areas very differently, and a by-product of China’s rapid development seems to be an even greater differentiation between urban and rural social and economic life. Over the next several decades, in part because of rapid fertility declines and in part as a result of mortality declines at older ages, China and other developing countries will experience enormous increases in the proportion of older adults and the proportion of the “oldest-old.” It is reasonable to expect that these age structure changes will alter the provision of health care, making an …

Poverty, Wealth Inequality, And Health Among Older Adults In Rural Cambodia, Zachary Zimmer

Poverty, Gender, and Youth

This working paper examines the distribution of household wealth and tests whether associations exist between wealth inequality and health outcomes among older adults living in one of the world’s poorest regions, rural Cambodia. Results confirm difficult economic conditions among most elderly in rural Cambodia. This study suggests there is some validity to generalizing the relationship between wealth inequality and health to extremely poor populations and that a very small difference in wealth makes a relatively large difference in regard to the association with health among those living in impoverished surroundings.

Egypt: Are Egyptian Couples Willing To Stop At Two Children? Results Of The Slow Fertility Transition Survey [Arabic], Population Council

Reproductive Health

No abstract provided.

Building Capacity To Utilize Operations Research: Strategies And Lessons Learned, James R. Foreit

Reproductive Health

The effectiveness of development assistance depends on good decision-making. Many donors and international health agencies such as USAID, DFID, and WHO are placing more emphasis on the utilization of research results for policy and program development. Yet, while there is a long tradition of training researchers to produce research, there are few lessons on how to teach managers to request and use research results for making program decisions. Addressing this gap has been a major strategy of the Population Council’s Frontiers in Reproductive Health Program (FRONTIERS). Since its inception in 1998, FRONTIERS has complemented its support for operations research (OR) …

Tuko Pamoja: Adolescent Reproductive Health And Life Skills Curriculum, Path, Population Council

Reproductive Health

As they move through adolescence, young people begin to have different kinds of relationships with their peers, family members, and adults; good communication and other skills can help ensure that these relationships are satisfying and mutually respectful. Young people need to learn to manage new feelings about sexuality to make responsible decisions about their health, reproduction, and parenthood. This manual, the second edition of the Kenya Adolescent Reproductive Health Curriculum, is for teachers; community, religious, and youth group leaders; health care professionals; and anyone working with young people. The curriculum is designed to delay sexual debut and promote sexual and …

Systematic Screening: A Strategy For Determining And Meeting Clients' Reproductive Health Needs, James R. Foreit

Reproductive Health

Systematic screening is a strategy to integrate reproductive health services at the provider level. Integration is the proactive provision of multiple reproductive health services in the same facility at the same time. Systematic screening is a simple intervention to increase the number of services received at a single client visit. In this strategy, providers use a checklist or questionnaire to identify each client’s needs and desires for reproductive health services. They then provide these services during the same visit, through an appointment at the same clinic, or through referral to another facility. The Population Council’s Frontiers in Reproductive Health Program …

Cómo Identificar Y Satisfacer La Necesidad De Servicios Adicionales: Manual Para Gerentes, Ricardo Vernon, James R. Foreit, Emma Ottolenghi

Reproductive Health

Este manual está diseñado para ayudar a los encargados de tomar decisiones, los administradores, los supervisores y los proveedores de programas a introducir la detección sistemática en sus servicios de salud. La detección sistemática puede mejorar la salud de la mujer al abordar múltiples necesidades no satisfechas de servicios de salud reproductiva y otros. Este manual proporciona: actividades necesarias para implementar una detección sistemática; cómo seleccionar las instalaciones, los servicios que se examinarán y quién lo hará; desarrollo, adaptación y pruebas preliminares de listas de verificación de detección sistemática; asesoramiento para capacitar a los evaluadores/proveedores y supervisores; y un esquema …

Make Better Use Of Provider Time In Public Health Clinics, Barbara Janowitz

Reproductive Health

Funding for reproductive health services is stagnant or declining globally, yet population projections, particularly in Africa, indicate that demand for services will increase in the near term. Between 2002 and 2025, for example, the population of women of childbearing age (15–49) is expected to increase by 2 percent annually in sub-Saharan Africa. With this growth will come increased demand for contraception, and other reproductive health services such as antenatal care, safe birthing services, and postpartum care for mothers and children. Concern about increasing demand for services has led program managers to examine the productivity and costs of existing programs. While …

Safe Motherhood Applied Research And Training (Smart) Report 2: The Interventions, Abdul Wajid, Zakir Hussain Shah, Ashfa Hashmi, Zeba Tasneem, Lubna Shireen

Reproductive Health

The Safe Motherhood Applied Research and Training (SMART) project, an operations research project designed to develop and test interventions to reduce maternal, perinatal, and neonatal mortality and morbidity in predominantly rural districts of Pakistan, was a three-year project (2003 to 2006) funded by the European Union. The study area was in the district of Dera Ghazi Khan; the control area was in the district of Layyah. The project focused on three areas to accomplish its goals: empowering women to seek appropriate and timely general, maternal, and newborn care; supporting methods that encourage men to play a positive and active role …

Safe Motherhood Applied Research And Training (Smart) Report 3: Changes In Knowledge And Behavior Of Women And Families, Muhammad Shafique Arif, Peter C. Miller, Nayyer Munir, Irfan Masood

Reproductive Health

The Safe Motherhood Applied Research and Training (SMART) project was conceived as an operations research project designed to test the effectiveness of two different strategies for improving maternal and neonatal health in Pakistan. To evaluate the results of this test, several types of evaluative research were conducted, including qualitative studies of various types, health systems assessments, evaluations of specific components, and household surveys. The household surveys are the subject of this report, which is Report 3 (Changes in knowledge and behavior of women and families) in a series of six. The surveys are two types: a large-scale, before-after household survey …

Safe Motherhood Applied Research And Training (Smart) Report 4: Knowledge And Behaviour Of Service Providers, Zakir Hussain Shah, Saima Pervaiz

Reproductive Health

The Safe Motherhood Applied Research and Training (SMART) project was an operations research project designed to develop and test interventions to reduce maternal, perinatal, and neonatal mortality and morbidity in predominantly rural districts of Pakistan. The study area was in the district of Dera Ghazi Khan; the control area was in the district of Layyah. The project focused on three areas: empowering women to seek appropriate and timely general, maternal, and newborn care; supporting methods that encourage men to play a positive and active role in decision-making and seeking care for their families in matters relating to maternal and newborn …

Workplace Organization, Labor Process Control And Occupational Health. Ph. D. Dissertation, Linda Treiber

Faculty Articles

The purpose of this research is to understand the complex relationships between working conditions and occupational health. The research draws from labor process theory that generally views worker control over the labor process as essential to non-alienated labor and from epidemiologic models of host, agent/exposure, and environment. Using General Social Survey 2002 cross sectional data, I investigate the effects of standard epidemiologic factors and worker labor process control factors in multivariate models to predict the dependent variables of workplace injury, persistent pain, exhaustion, and general health status. I suggest that labor process autonomy, social cohesion and skill utilization generally have …