Medicine and Health Commons^™

The Implications Of Early Marriage For Hiv/Aids Policy, Judith Bruce, Shelley Clark

Poverty, Gender, and Youth

This brief is based on a background paper prepared for the WHO/UNFPA/Population Council Technical Consultation on Married Adolescents, held in Geneva, Switzerland, December 9–12, 2003. The final paper is entitled “Including married adolescents in adolescent reproductive health and HIV/AIDS policy.” The consultation brought together experts from the United Nations, donors, and nongovernmental agencies to consider the evidence regarding married adolescent girls’ reproductive health, vulnerability to HIV infection, social and economic disadvantage, and rights. The relationships to major policy initiatives—including safe motherhood, HIV, adolescent sexual and reproductive health, and reproductive rights—were explored, and emerging findings from the still relatively rare programs …

Including Married Adolescents In Adolescent Reproductive Health And Hiv/Aids Policy, Judith Bruce, Shelley Clark

Poverty, Gender, and Youth

The majority of sexually active girls aged 15–19 in developing countries are married, and married adolescent girls tend to have higher rates of HIV infection than their sexually active, unmarried peers. Married adolescent girls represent a sizable fraction of adolescents at risk and experience some of the highest rates of HIV prevalence of any group. Nonetheless, married adolescents have been marginal in adolescent HIV/AIDS policies and programs and have not been the central subjects for programs aimed at adult married women. This paper offers a partial explanation for why married adolescents have so often been overlooked, the reasons why marriage …

Les Implications Du Mariage Précoce Pour Les Politiques De Vih/Sida, Judith Bruce, Shelley Clark

Poverty, Gender, and Youth

Ce dossier est basé sur un document contextuel préparé pour la Consultation Technique OMS/ FNUAP/Population Council sur les Adolescentes Mariées, tenue à Genève en Suisse du 09 au 12 Décembre 2003 (le document final intitulé "Inclure les adolescentes mariées dans les politiques de santé reproductive des adolescents et de VIH/SIDA"). La Consultation a réuni des experts provenant des Nations Unies, des bailleurs de fonds et des agences non gouvernementales pour examiner les faits concernant la santé reproductive des adolescentes mariées, leur vulnérabilité face à l’infection du VIH, leurs inégalités sociales et économiques ainsi que leurs droits. Les rapports avec des …

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.

Satisfaction With Provider Communication Among Spanish-Speaking Medicaid Enrollees, David M. Mosen, Matthew J. Carlson, Leo S. Morales, Pamela P. Hanes

Sociology Faculty Publications and Presentations

OBJECTIVE: To determine if differences between English- and Spanish-speaking parents in ratings of their children's health care can be explained by need for interpretive services.

METHODS: Using the Consumer Assessment of Health Plans Survey-Child-Survey (CAHPS), reports about provider communication were compared among 3 groups of parents enrolled in a Medicaid managed care health plan: 1) English speakers, 2) Spanish speakers with no self-reported need for interpretive services, and 3) Spanish speakers with self-reported need for interpretive services. Parents were asked to report how well their providers 1) listened carefully to what was being said, 2) explained things in a way …

The Impact Of Program Changes On Health Care For The Ohp Standard Population: Early Results From A Prospective Cohort Study, Matthew J. Carlson, Bill J. Wright, Charles Gallia

Sociology Faculty Publications and Presentations

The purpose of this study is to assess the impact of benefit changes on the Oregon Health Plan (OHP) Standard Population across three domains: Enrollment; Access to care; Utilization

Tackling The Issue Of Access: Situating Place Within Immigrant Women's Experiences Of Health And Health Care (Ontario), Jillian C. Paul

Theses and Dissertations (Comprehensive)

Access to health care services is an essential element to immigrant women receiving the care that they need. However, there are barriers that women face as immigrants in a new community. Language, cultural awareness and household responsibilities are issues that a significant number of immigrant women encounter when accessing health care services. There are significant gaps within geographic literature pertaining specifically to marginalized populations and health care experiences. More recent work is beginning to emerge that examines the social and behavioural aspects of health and health care. This study intends to contribute to this growing body of literature aimed at …

Human Rights And Health, Paul Hunt

Human Rights & Human Welfare

Introduction to Topical Research Digest section.

Next-Of-Kin Perceptions Of Physician Responsiveness To Symptoms Of Hospitalized Patients Near Death, Joel C. Cantor, Jan Blustein, Matthew J. Carlson, David A. Gould

Sociology Faculty Publications and Presentations

Many different medical providers visit critically ill patients during a hospitalization, and patients and family members may not feel any physician is truly in charge of care. This study explores whether perceiving that a physician was clearly in charge is associated with reports by surviving next of kin about the responsiveness of physicians to symptoms in hospitalized patients near the end of life. We conducted telephone interviews with surviving next of kin of adult patients (n = 1107) who died in one of five New York City teaching hospitals between April 1998 and June 1999 after a minimum 3-day inpatient …

Providing Health Care For Older Persons In Singapore, Peggy Teo, Angelique Chan, Paulin Straughan

Research Collection School of Social Sciences

Health care social policy in Singapore has passed the burden of care to the individual and the family on the rationale that it would enable the state to contain the costs of long-term care by channelling some of its funds to community services and to providing essential health services to all Singaporeans and not just the older group. While a wide array of services has come into existence, there is a lack of integration between the available resources and needs of the individual/family and what has been availed at the community and state levels. Part of the problem lies in …

Introduction Of A Waterless Alcohol-Based Hand Rub In A Long-Term Care Facility, Lona Mody, Mcneil A. Shelly, Rongjun Sun, Bradley Suzanne, Carol A. Kauffman

Sociology & Criminology Faculty Publications

OBJECTIVE:

To examine the impact of introduction of an alcohol-based hand rub on hand hygiene knowledge and compliance and hand colonization of healthcare workers (HCWs) in a long-term-care facility (LTCF).

METHODS:

Two floors of an LTCF participated. Ward A used the hand rub as an adjunct to soap and water; ward B was the control. HCWs' hands were cultured using the bag-broth technique for Staphylococcus aureus, gram-negative bacilli (GNB), Candida, and vancomycin-resistant enterococci (VRE). HCWs completed a questionnaire at baseline and after an educational intervention and introduction of rub.

RESULTS:

Hand hygiene practices, knowledge, and opinions did not change after …

Onset Of Major Depressive Disorder Among Adolescents, John P. Hoffmann, Scott A. Baldwin, Felicia G. Cerbone

Faculty Publications

Objectives: To examine the association between parental affective disorders and psychoactive substance use disor- ders and the onset of major depressive disorder (MDD) among adolescents and young adults and to determine whether this association is affected by stressful life events, family cohesion, self-esteem, or gender. Method: Prospective cohort study of 804 adolescents, aged 11–17 years, and their parents who were followed for seven consecutive years. The sam- ple was drawn from the Minneapolis-St. Paul metropolitan area. Parental diagnoses were based on Structured Clinical Interview for DSM-III-R administered during study screening stage. Diagnoses of MDD and age of onset were based …

Might A Psychosocial Approach Improve Our Understanding Of Itching And Scratching?, Herbert M. Adler

Department of Psychiatry and Human Behavior Faculty Papers

No abstract provided.

From Fleck’S Denkstil To Kuhn’S Paradigm: Conceptual Schemes And Incommensurability, Babette Babich

Articles and Chapters in Academic Book Collections

This article argues that the limited influence of Ludwik Fleck’s ideas on philosophy of science is due not only to their indirect dissemination by way of Thomas Kuhn, but also to an incommensurability between the standard conceptual framework of history and philosophy of science and Fleck’s own more integratedly historico-social and praxis-oriented approach to understanding the evolution of scientific discovery. What Kuhn named “paradigm” offers a periphrastic rendering or oblique translation of Fleck’s Denkstil/Denkkollektiv, a derivation that may also account for the lability of the term “paradigm”. This was due not to Kuhn’s unwillingness to credit Fleck but rather to …

Expanding Self-Direction In Services For The Aged And People With Disabilities, Ruth A. Burgess

Theses, Dissertations and Capstones

Medicaid-funded long-term care services are traditionally delivered in nursing homes. States may apply for waivers which allow them to provide home and community based services with Medicaid funds. Because these services are by definition an alternative to nursing home care, waiver services are generally based upon a medical model which emphasizes medical deficits and tends to restrict consumers’ movements to inside the home. Recent developments such as the Olmstead Decision and federal New Freedom Initiatives have caused states to recognize that consumers desire and have a legal right to be part of a community rather than institutionalized or homebound. These …

Reproductive Health Services In Kwazulu Natal, South Africa: A Situation Analysis Study Focusing On Hiv/Aids Services, Lewis Ndhlovu, Catherine Searle, Robert A. Miller, Andrew A. Fisher, Ester Snyman, Nancy L. Sloan

HIV and AIDS

This Horizons report examines the readiness of reproductive health services in South Africa, which are primarily geared to women, to deliver HIV and AIDS treatment, care, and prevention services. The goal of the study was to obtain information from a representative sample of provincial health care facilities offering reproductive health services in KwaZulu Natal to meet the growing demand for HIV/AIDS-related services. Ninety-eight hospitals, community health centers, and clinics participated in the situation analysis that identified gaps in service delivery and determined priorities for service integration. Results of the study were presented to a large audience of Department of Health, …

Empowering Communities To Respond To Hiv/Aids: Ndola Demonstration Project On Maternal And Child Health: Operations Research Final Report, Hope Humana, Linkages, National Food And Nutrition Commission, Ndola District Health Management Team, Horizons Program, Zambia Integrated Health Project

HIV and AIDS

A pre–post intervention study conducted in Zambia by Horizons and local NGOs and governmental organizations demonstrated that HIV voluntary counseling and testing (VCT) and infant feeding counseling (IFC) to mothers attending maternal and child health (MCH) clinics are vital components of any mother-to-child transmission (MTCT) reduction strategy, whether or not antiretrovirals (ARVs) are available. These interventions enable mothers to make informed and healthy decisions. Data from the Ndola Demonstration Project yielded encouraging results from efforts to improve the capacity of mothers to make informed decisions about their own health and the health of their infant. The interventions succeeded in raising …

Microfinance And Households Coping With Hiv/Aids In Zimbabwe: An Exploratory Study, Carolyn Barnes, Erica Keogh, Nontokozo Nemarundwe, Loveness Nyikahadzoi, Ellen Weiss

HIV and AIDS

This study, conducted in Zimbabwe, sought to better understand the relationship between a microfinance program, Zambuko Trust, and how microentrepreneurs’ households cope with the impact of HIV/AIDS. The study examined how HIV/AIDS is affecting Zambuko’s operations and what microfinance institutions (MFIs) can do to lessen the impact of HIV/AIDS on their clients and operations. The findings indicate several small yet important ways that MFI programs help microentrepreneurs and their families respond to these impacts through access to credit and business management training. Participation in a microfinance program led to income smoothing and better financial management, which can help households mitigate …

Determination Of Seric Retinol Levels In Relation To Consumed Diet And The Prevalence Of Anemia In Preschool- And School-Aged Children In The Communities Of Cuambo And La Rinconada, Imbabura Province, Verónica Chávez

Theses and Dissertations

In this investigation the seric retinol levels were determined in order to relate them with consumed diets by preschool- and school-aged children and the prevalence of anemia in the communities of Cuambo and La Rinconada, Imbabura province, in order to later compare them with reference values. Blood samples were taken from 74 children from the two communities, 30 in La Rinconada and 44 in Cuambo, beneficiaries of the Benson Institute, to determine retinol, ferritin, hemoglobin, and hematocrit. Also, a 24-hour record with frequency of food consumption survey was given to the studied children's parents, making a sample of 56 families. …

Evaluating Operations Research Utilization: Guidelines For Assessing Process And Impact, M. Celeste Marin, Jane T. Bertrand

Reproductive Health

The Population Council has been providing technical assistance and conducting Operations Research (OR) studies in family planning and reproductive health for over two decades. These studies are designed to identify problems and test strategies to resolve those problems, providing program managers, administrators, and policymakers with the information they need to improve service-delivery systems. The ultimate goal is that strategies tested through OR will be adopted, leading to changes in policy or operational procedures at institutional, national, or international levels. These changes are what we refer to as impact. The purpose of the new approach to evaluation described in this Evaluation …

Access To Care Among Vulnerable Populations Enrolled In Commercial Hmos, Matthew J. Carlson, Jan Blustein

Sociology Faculty Publications and Presentations

Abstract: This cross-sectional study compares self-reported access to care among a representative sample of 13,952 HMO enrollees in New Jersey. Using multivariate logistic regression, this study found that compared with college graduates, those with less than a high school education reported more difficulty obtaining tests or treatment. Compared with whites, Hispanics were more likely to report difficulty seeing their primary care provider, and African Americans reported greater difficulty seeing a specialist and obtaining tests and treatment. Enrollees in poor health were more likely to report problems seeing a specialist and obtaining tests and treatment than enrollees in excellent health. Income …

A Comparison Of Human Energy Fields Among Children, Youth, Adults, & Dahn Masters, Geoffrey K. Leigh, Karen A. Polonko, Catherine D. Leigh

Sociology & Criminal Justice Faculty Publications

While concepts and investigations of human energy fields have been developed for centuries, there has been little systematic work comparing the fields of children, adolescents, and adults. In addition, general fields have had little comparison between average adults and those participating in an intense practice that may affect the field. Using the GDV machine, this research compared small groups of children, adolescents, average adults, and Dahn Hak Masters on measures of 20 basic aspects of the human energy fields, including the seven chakras. Differences were found in seven of the 13 field parameters as well as all seven measures of …

Health Education For Urban Refugees In Cairo : A Pilot Project With Young Men From Sierra Leone And Liberia, Elizabeth Coker, Alison Bichard, Andrea Nannipieri, James Wani

Faculty Journal Articles

This pilot project, conducted under the auspices of the Forced Migration and Refugees Studies Program (FMRS) at the American University in Cairo, arose as part of a continued commitment to outreach projects of direct benefit to the refugee community. Maintaining healthy behaviors and accessing adequate health care are particular challenges for refugees living in large urban areas such as Cairo. Young refugees are at risk for unplanned pregnancy, sexually transmitted diseases, and other health-related problems such as nutritional deficits and stress-related disorders. Education in their country of origin may have been disrupted, and in Cairo they may be separated from …

Red Series Reference Values In Healthy People From 15 To 60 Years Old Who Live Between 1700 And 1850 Meters Above Sea Level (Coroico - Nor Yungas - La Paz, 2001), Maria Eugenia Quispe Nina

Theses and Dissertations

This study occurred in the area of Coroico at 1700 meters above sea level and in the community of Carmen Pampa, situated at 1850 meters above sea level. Coroico is the capital of Nor Yungas province, department of La Paz. This study hopes to contribute information on reference values for erythrocyte numbers, hemoglobin values, and hematocrits for people between 15 and 60 years old that live between 1700 and 1850 meters above sea level, with the goal of facilitating precise diagnosing of anemia. The study used samples of healthy people, residents with more than two months in Coroico, of middle …

The Information Needs Of The Families Of Patients With Advanced Cancer In An Acute Hospital, Sue Davis

Theses: Doctorates and Masters

A diagnosis of cancer has a major impact on the family as well as the patient. The families of patients with advanced cancer have many needs. In particular, a number of researchers have identified family members' needs for information as a priority. Most of this research, however, has been undertaken in the context of Palliative Care settings. Few empirical studies have been undertaken to examine the information needs of these families in an acute hospital setting. The aim of this study is to modify an existing tool, The Family Inventory of Needs (FIN), to more precisely assess the information needs …

The Sociophysiology Of Caring In The Doctor-Patient Relationship, Herbert M. Adler

Department of Psychiatry and Human Behavior Faculty Papers

The emotional investment required to construct a caring doctor-patient relationship can be justified on humane grounds. Can it also be justified as a direct physiologic intervention? Two lines of evidence point in this direction. People in an empathic relationship exhibit a correlation of indicators of autonomic activity. This occurs between speakers and responsive listeners, members of a coherent group, and bonded pairs of higher social animals. Furthermore, the experience of feeling cared about in a relationship reduces the secretion of stress hormones and shifts the neuroendocrine system toward homeostasis. Because the social engagement of emotions is simultaneously the social engagement …

Update - September 2002, Loma Linda University Center For Christian Bioethics

Update

In this issue:

-- Just Put Me to Sleep . . . PLEASE!: Ethical Issues in Palliative and "Terminal" Sedation
-- Terminal Sedation: A Jewish Perspective
-- Terminal Sedation: A Catholic Perspective
-- Announcing the Center for Christian Bioethics Nation Conference in 2003: "Promise and Peril of the New Genetics"
-- Center news . . .

The Link Between Smoking And Body Weight Among Adolescents, Tracey Barnett

Dissertations

Trends in smoking rates among adolescents indicate that white females generally smoke more than their adolescent counterparts, the only substance in which this occurs. Another trend in which white females far outnumber any other adolescent group is eating disorders. This study was conducted to assess the relationship between cigarette smoking and perception of weight among adolescents. A logistic regression model was constructed to test the relationship using the Adolescent Health Public Dataset. For females, there was a link between cigarette smoking and perception of overweight which was not found among the males. Similarly, white females had a significantly higher rate …

Parental Substance Use Disorder And The Risk Of Adolescent Drug Abuse: An Event History Analysis, John P. Hoffmann, Felicia G. Cerbone

Faculty Publications

A common observation in the research literature is that children of drug-dependent parents are at significantly heightened risk of adolescent drug use, abuse, and dependence. Recent research indicates that several psychological and interpersonal factors may affect the association between parents’ psychoactive substance use disorder (PSUD) and drug use risks among adolescents, yet studies have failed to examine explicitly whether these factors moderate the association between PSUD and adolescent substance abuse. This paper explores these potential relationships using longitudinal data from a study that has followed three cohorts of adolescents and their families over a 7-year period. The cohorts are defined …

Community-Acquired Pneumonia In Older Veterans: Does The Pneumonia Prognosis Index Help?, Lona Mody, Rongjun Sun, Suzanne Bradley

Sociology & Criminology Faculty Publications

OBJECTIVES: Mortality rates from pneumonia increase steadily with age. Recently, a disease severity model (the Pneumonia Prognosis Index (PPI)) has been developed to predict mortality from community-acquired pneumonia (CAP). PPI ranks severity of pneumonia from 1 to 5, with 5 being most severe. This retrospective study utilizes the PPI to address the prognosis of CAP in older adults. DESIGN: Retrospective review of medical charts. SETTING: Department of Veterans Affairs Medical Center.

PARTICIPANTS: All adults aged 60 and older admitted to a Veterans Affairs Medical Center with CAP between January 1 and December 31, 1998.

MEASUREMENTS: PPI was calculated using subjects' …