Biomedical subjects

A Merkle

Publications and source records attributed to A Merkle.

15 recordsLinked to original sources

PubMed2001

A conceptual model for leadership development.

Collaboration among schools of public health and national, state, and local health agencies has resulted in creation of comprehensive public health workforce education and training initiatives that offer integrated, sequential, and accessible professional development programs, including a nation-wide network of public health leadership institutes. A conceptual model for leadership development is presented. It contains seven elements considered critical for design of leadership programs in public health: capacity/competence needs; program target; area served; program content; training level; learning approach; and implementation methods. This model can be used to design leadership as well as public health workforce education and training programs.

Cooperative Behavior↗

PubMed2000

Competency development in public health leadership.

The professional development of public health leaders requires competency-based instruction to increase their ability to address complex and changing demands for critical services. This article reviews the development of the Leadership Competency Framework by the National Public Health Leadership Development Network and discusses its significance. After reviewing pertinent literature and existing practice-based competency frameworks, network members developed the framework through sequential use of workgroup assignments and nominal group process. The framework is being used by network members to develop and refine program competency lists and content; to compare programs; to develop needs assessments, baseline measures, and performance standards; and to evaluate educational outcomes. It is a working document, to be continually refined and evaluated to ensure its continued relevance to performance in practice. Understanding both the applications and the limits of competency frameworks is important in individual, program, and organizational assessment. Benefits of using defined competencies in designing leadership programs include the integrated and sustained development of leadership capacity and the use of technology for increased access and quality control.

Curriculum↗

PubMed2000

Malaria control through impregnated bednets--a pilot project in selected villages in Lao PDR.

In 7 villages on the foothills of the Houayxai district of the Bokeo Province in Lao PDR between midyear 1995 to midyear 1997 an attempt was made to test the acceptability and use of DDT impregnated bed nets as well as environmental and behavioral risk factors. About 380 women between 15 to 45 years old and their children in the age range of 1 to 14 years had been studied. A pre-tested questionnaire had been applied and blood from women and children was taken from the finger prick and a conventional thick and thin blood smear was performed, fixed Giemsa stained and examined for malaria parasites. DDT (dichlorodiphenyltrichloroethane) impregnated mosquito nets were distributed in the intervention villages. The availability of mosquito nets increased statistically significant from approximately 50% to 70% for all family members in the intervention area between 1995 and 1997 and statistically significant decreased in the control area from 79% to 45.1%. There was a statistically significant decrease in malaria attacks as claimed by the females for the intervention area but not for the control villages. The proportion of positive blood smears did decrease overall for women and children in between 1995 to 1997. Occupation, location of the house and use of mosquito nets had been determined as the most important risk factors.

Adolescent↗

PubMed2000

Community based intervention of iron deficiency anemia in females and iodine deficiency disorders in school children in Lao PDR.

Under the supervision of the central and local health authorities, a pilot project was conducted in four villages in the Luangprabang Province, Lao PDR. The objective of the project was to test different regimes to supplement females with oral iron preparations to reduce iron deficient anemia (IDA) and control iodine deficiency disorders (IDD) in school children. Compared with iron sulphate tablets, iron fumerate tablets were well accepted and good compliance results were achieved. Hemoglobin concentration improved only in the group of females taking iron fumerate tablets. The goiter rate decreased from approximately 90% to about 45% for school children, regardless of whether iodine salt were used by their families or whether iodine capsules were used to treat the children. The latter attempt was hampered by the fact that also in the control village iodine fortified salt was used. This was due to a governmental attempt to control IDD nation-wide. Therefore, also in the control village a significant decrease in the goiter rate was observed.

Adolescent↗

PubMed2000

Control of intestinal parasitic infection--a pilot project in Lao PDR.

Intestinal helminths are a very common but still rather unrecognized public health problem. An attempt was undertaken to control the three important parasites, ie Ascaris, Trichuris and hookworm. Two villages in Vientiane Province in Lao PDR were selected, one as an intervention and the other as control village. Intervention measures started by providing mass treatment against Ascaris, Trichuris, hookworm and other intestinal parasitic infections in both villages. Health education and other intervention measures were implemented in the intervention village, which significantly influenced the re-infection rates in this village. These achievements were not due to an improvement of the availability of toilets or personal hygiene alone but more to the villagers' improved understanding of the route of the parasitic infections. It was concluded that intervention methods should be directed more towards particular age groups. Particular attention should be paid to control parasitic infections among females.

Adolescent↗

PubMed2000

Promotion of the health of rural women towards safe motherhood--an intervention project in northeast Thailand.

An intervention project focusing on the health of women in the reproductive age was conducted in three districts of Khon Kaen Province, northeast Thailand between 1991 and 1996. Main emphasis was placed on improving reproductive health, the nutritional status including the iron deficiency anemia (IDA) as well as iodine deficiency disorders (IDD), and the parasitic diseases liver fluke (Opisthorchis viverrini) and hookworm. For implementation a community based Primary Health Care approach was used including the training of health officials in health matters, primary health care workers and villagers as well as enhancing health education and the dissemination of health information. The health delivery system was encouraged to take appropriate actions such as in the treatment of parasitic diseases and the control of IDA and IDD. Monitoring was done on a regular basis. The outcome of the project was assessed by comparing baseline data compiled from a random sample of the target population with the results of the final evaluation. An attempt to compare results obtained from villages within and outside of the project area failed most probably because of spill over effects. A number of important indicators on family planning and mother and child health care improved during the time the project was implemented; this included practising family planning, and participation in antenatal care. Also the proportion of females becoming pregnant for the first time when 20 years or older increased. Child-raising also improved in that almost all females gave colostrum to their babies by this time. Almost 75% of the women breast-fed their children. Improvements occurred in the nutritional status as far as the micronutrients iron and iodine were concerned, however the overall nutritional status of females did not change, but a rather high proportion of females were found to be overnourished. The project failed in reducing abortion and the proportion of females becoming pregnant when they are 18 years old or younger. It was also not possible to improve the usage of postnatal care. As anticipated, the results achieved so far are most suitable in serving as a training ground and providing a favorable example to improve family planning, mother- and child health care, and also the general health of females in the region, particularly in neighboring countries such as Lao PDR, Cambodia and Vietnam.

Adolescent↗

PubMed2000

Reproductive health in selected villages in Lao PDR.

The aim of the project was to improve the knowledge and attitude towards birth spacing by training the villagers in the selected villages of Vientiane Province in Lao PDR in family planning, providing them with the various family planning methods, and improving antenatal (ANC) and postnatal (PNC) care in the villages. Throughout the province, traditional birth attendants (TBA) were trained on several occasions during the project period. There were clear indications that reproductive health improved between 1995 and 1997. Considerable improvements were observed in the percentage of women making use of ANC and practising birth spacing by using some form of contraception or other. The most common methods used were contraceptive pills and injectables. In the case of child mortality a slight decrease was found in the percentage of women having their first pregnancy below the age of 18 years. A still unsolved problem is the high number of abortions.

Adolescent↗

PubMed2000

Nutritional status of pre-school children and women in selected villages in the Suvannakhet Province, Lao PDR--an intervention trial.

A project to promote the health and nutritional status of women and pre-school children was started from 1995 to 1997 in three villages in Suvannakhet Province, Lao PDR. One village served as control. In 1995, for the baseline survey, 456 females, and in 1997, for the final evaluation, 363 females from the four villages volunteered for further investigations. An attempt was made to involve all females in the reproductive age residing in the villages. At the same time also the nutritional status of 321 and about 540 randomly selected pre-school children respectively was also assessed through physical examination and anthropometric measurements. Intervention measures included introducing growth charts and taking regular anthropometric measurements of women in the reproductive age and of pre-school children. Training in nutritional aspects such as giving colostrum to new-borns, prepare proper weaning food and supplementary feeding, animal-raising and home gardening was also introduced and provided to health personnel, village leaders and in women clubs. Special attention was given to the control of acute infectious diseases. The conventional EPI program was enforced as well. Health education in matters of mother and child health care was also provided. The proportion of undernourished women was rather high at about 15%. For pre-school children, the proportion of wasting was around 5%, and of stunting 50% and above. Intervention did not improve the nutritional status either of the women or of the children. It was concluded that the time span of two years is too short for a decrease in the proportion of undernourishment to be observed. An improvement was achieved for some indicators of mother and child health care. This seems to indicate the population's willingness to follow suggestions to improve their health. Most probably, if attempts to improve the nutritional status were continued, an improvement in this aspect could also be observed, if the population can be encouraged to take actions and develop initiatives by themselves.

Adolescent↗

PubMed1998

Nutritional status and serum lipids of a rural population in Northeast Thailand--an example of health transition.

An investigation was undertaken in Northeast Thailand, a country undergoing rapid health transition, to find out whether there is a likelihood that the nutritional and lipid pattern of an adult population in Northeast Thailand is related to coronary heart disease in the same way as in western countries. In a cross-sectional study, the body mass index (BMI) and the waist-hip ratio as well as the important plasma lipids were determined. The nutritional status and the lipid profile of the predominantly middle-aged population is characterised by a generally favourable nutritional status and lipid concentrations, where the distribution, indicated by the medians, of the relevant variables over the total population is concerned. A rather high proportion of individuals was found to be overnourished and to have high triglyceride levels. Individuals with high triglyceride levels run a risk of developing coronary heart disease only when the LDL-HDL fraction is above 5. Only 3% of the total population investigated had a LDL-HDL ratio above that value. Since hypertriglyceridaemia is also linked to the insulin-resistant syndrome, it is concluded that, if the mortality of coronary heart disease increases in future, then this must be accounted probably more to the after-effects of the insulin-resistant syndrome than to the direct effect of an atherogenic lipid pattern. This view is supported by a high prevalence of impaired glucose tolerance (IGT) and non-insulin dependent diabetes mellitus (NIDDM) in the population under survey. Preventive measures in the area should concentrate among others on reducing overnutrition, especially among women, and increasing physical activity and screening for NIDDM.

Adult↗

PubMed1997

Prevalence of abnormal glucose tolerance in Khon Kaen Province and validity of urine stick and fasting blood sugar as screening tools.

Three hundred and fifty-five individuals, 152 males and 203 females, aged between 30 and 74 years, were randomly selected in a two stage selection process from rural communities in three districts of Khon Kaen Province, Northeast Thailand. The prevalence of impaired glucose tolerance (IGT) and non-insulin dependent diabetes mellitus (NIDDM) in the rural area of Northeast Thailand were measured. In addition, the validity of the urine stick and fasting blood sugar as screening tools against the two hours glucose loading test as golden standard were determined. The survey was conducted in July 1995. The glucose loading test was performed on 277 individuals. IGT and NIDDM were classified according to current World Health Organization suggestions. Prevalence rates for IGT were 18.1 per cent and for NIDDM 11.9 per cent. No difference was found between males and females, also when controlled for age. NIDDM prevalence increased with age but IGT rates already were high in the younger age groups. This finding suggests that IGT precedes NIDDM in Thailand. The validity of the urine stick as a screening tool in communities was insufficient, with a sensitivity of less than 20 per cent. When using fasting blood sugar as a screening test, the sensitivity was close to 44 per cent and the specificity 90 per cent. It is concluded that the urine stick is not a useful screening tool and the method of using blood sugar concentrations for screening have to be improved before it can be applied within communities.

Adult↗

PubMed1991

[Fever and non-specific general symptoms].

A 28-year-old man was admitted to the hospital because of fever, nocturnal dry cough and unspecific symptoms. Two years before admission he had worked as a sailor in South America, and one year ago he had been in Gran Canaria for a vacation. No serious illness occurred during these stays abroad. During the hospitalization the patient reported nausea and experienced upper right abdominal pain. Ultrasonography, computed tomography and serological tests revealed an amebic liver abscess. After administration of metronidazole the fever and symptoms subsided.

Adult↗

PubMed1991

Strategies to maintain health in the Third World.

International cooperation with Third World countries aims at reducing the high morbidity and mortality of the population to a tolerable level. The main health problems are caused by poverty. Thus, the range of diseases in tropical countries can be explained more readily by the socio-economic situation than solely by the climate. Health services, in Africa in particular, have had to reduce drastically their budgets in the last ten years and now have only approximately 1/1000th of the funds usually available in industrialised countries. High population growth reduces the resources available per head, increases infection potential and worsens living conditions. Control strategies must take account of these circumstances in order to achieve the required sustained effect within the framework of primary health care. The example of the control of several infectious diseases, such as schistosomiasis, pneumonia, malaria and AIDS, is used to show that control programmes can be effective but, in the current conditions, can hardly be maintained without outside support. In the future, diseases caused by environmental problems and new life styles as a result of industrialization, urbanization and slum growth will move dramatically into the foreground.

Acquired Immunodeficiency Syndrome↗

PubMed1991

[Effect of electrically powered dental devices on cardiac parameter function in humans].

Electrically powered devices represent a hazard for patients with cardiac pacemakers. The aim of the present investigation was an in vivo evaluation of possible interactions between electrically powered dental instruments and the function of artificial pacemakers in humans. In 26 patients with artificial pacemakers, different dental instruments were applied, including air scaler, ultrasonic curets, electric pulp tester and electrotome. These devices were applied at highest intensity. Immediately prior to, during, and immediately after applications of these instruments, the pulse rate and the electrocardiogram (EKG) were recorded. The EKG recordings were assessed for irregularities in the distances between the pacemaker peaks. The dental devices were assessed for magnetic fields or induction tension. The results showed that none of the dental devices caused an irregularity in the pacemaker function. The air scaler, Piezon ultrasonic curet and the electric pulp tester caused no measurable magnetic fields. The Sonus 2 ultrasonic curet and the electrotome magnetic fields were measured up to 60 and 50 cm, respectively. All dental devices caused induction tension. The highest value was produced by the electrotome. It seems that cardiac pacemaker function is not affected by electrically powered dental devices. However, there remains a risk in relation to older pacemakers or defective dental devices.

Adult↗

PubMed1986

Mouth protectors and oral trauma: a study of adolescent football players.

A total of 754 junior high school and high school football players from the Birmingham, AL, area were studied to determine the extent of sports-related oral trauma among players. More than half the oral injuries and more than a third of the concussions were reported in sports other than football. Basketball and baseball players had a high prevalence of hard tissue oral trauma with virtually none of the players wearing mouth protectors. The results of this study indicate that current mouth protector designs are helpful in preventing hard tissue trauma, yet additional soft tissue protection is indicated in football mouth protector design.

Adolescent↗

PubMedDate not supplied

Complete intrusion of a maxillary right primary central incisor.

This clinical article presents a rare presentation of complete intrusion of a maxillary right primary central incisor. Routine examination of a 29-month old female patient revealed an intrusion injury where the primary central incisor was displaced through the floor of the nasal cavity. The traumatic impaction was erroneously diagnosed as an avulsion injury by the attending emergency room physician and later discovered by the dental team during routine care. The injury was documented with radiographs. The intruded incisor was removed through the right naris utilizing general anesthesia to manage behavior and surgical access. This article emphasizes the importance of radiographs and demonstrates the need to involve the dental professional in initial assessment of dental trauma.

Child, Preschool↗