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Interviews with Mexican midwives.

Mexican society contains a variety of indigenous cultures as well as European influences. Most babies in rural areas are delivered by midwives. Traditional midwives, government-trained and empirical midwives, nurse-midwives, and foreign-trained midwives all practice in Mexico. Nurse-midwives in one project are demonstrating their ability to meet the needs of urban childbearing women. A midwifery organization is developing under the leadership of midwives influenced by the contemporary midwifery movement in the United States. In this article, some traditional Mexican midwifery practices are discussed and interviews with several different Mexican midwives from a variety of backgrounds are presented.

Cultural Characteristics↗

Women in child development: themes from the SRCD Oral History Project.

Research in child development has emerged as a major intellectual discipline and a topic of great interest and importance to society. The Society for Research in Child Development (SRCD) has been the leading scholarly society concerned with the advancement of this research. As part of its focus on a history of the field, the SRCD has undertaken an oral history project in which prominent members are interviewed. Of the 102 completed interviews, 47 are women's accounts, which document important contributions women have made to child development. The experiences reported by individual participants reflect themes in the general history of women in psychology and child development during the early and mid-1900s. Women encountered obstacles to their efforts, even as they were supported by others and struggled to achieve prominence amid the sometimes ambiguous or conflicting circumstances that characterized women's entry into child development.

Child↗

Who forgets? An analysis of memory effects in a retrospective survey on migration history.

"This study, focused on modelling memory effects in migration history data, is [based on] a survey conducted in 1988 by the National Institute for Demographic Studies (I.N.E.D.), in collaboration with the Catholic University of Louvain-la-Neuve (U.C.L., Belgium). This data allows insight into the reliability of responses obtained from an autobiographical retrospective survey, and highlights the demographic characteristics that may interact with memory effects in recall of migration history. In addition, the data obtained from this survey allows response reliability comparisons between gender, and also between joint interviewing of spouses and singular interviewing of spouses." 500 couples living in Wallonie, Belgium, and aged between 41 and 54 years were surveyed. (SUMMARY IN FRE)

Belgium↗

Factors influencing private health providers' technical quality of care for acute respiratory infections among under-five children in rural West Bengal, India.

In many developing countries, private health practitioners provide a significant portion of curative care for diseases which are of public health importance. Currently, health sector reform efforts in these countries are fostering increased participation of private providers in the delivery of health services, including those of public health importance. Guaranteeing good technical quality of care is critical to the process. However, little is known about private providers' technical quality of care (disease management practices) and the factors influencing these services. The purpose of this study was to contribute information on this topic. The study was conducted among private providers in rural West Bengal, India and focused on providers' disease management practices for acute respiratory infections (ARI) among under-five children. World Health Organization (WHO) guidelines for ARI case management were used as the expected standard of care. Observations of patient-provider encounters and interviews with the providers and mothers were the main sources of data. The study found that private health providers in rural West Bengal have inadequate technical quality of care. The problem was related both to low levels of performance (limited potential) and inconsistency in performance (within-provider variation). Limited potential for good technical quality for ARI among the providers was related to lack of knowledge (technical incompetence). One of the important factors influencing within-provider variation was patient load. Since rural private providers operate on a fee-for-service payment system, there are incentives related to seeing many patients. The study concluded that to bring about sustainable improvements in private providers' ARI disease management practices, training programs and interventions that improved compliance were necessary.

Acute Disease↗

A comparison of driver- and passenger-based estimates of alcohol-impaired driving.

INTRODUCTION: Persons who drive after drinking or ride with drinking drivers are at increased risk of motor vehicle crash. Although alcohol is involved in 40% of fatal motor vehicle crashes yearly, there exist few systems to monitor alcohol-impaired driving. In this study we compare driver- and passenger-based estimates of the prevalence of alcohol-impaired driving. DESIGN: A random-digit-dialing telephone survey of the United States. Participants were adults aged 18 or older who were English- or Spanish-speaking from 5238 households (response rate = 56.1%). RESULTS: From the 4603 respondents who reported driving in the preceding 30 days, we estimate that there were 126 million drinking-driving episodes in the United States in 1994. From the 4380 passengers in the preceding 30 days, we estimate 191 million episodes. Three percent of respondents self-reported as drinking drivers (4.8% of males and 1.3% of females) and 4.9% as passengers of drinking drivers. Drinking drivers were more likely to be passengers of drinking drivers (44% versus 4% of nondrinking drivers). Drinking drivers were also more than twice as likely to report drinking daily, and only one half as likely to report always wearing their safety belts. CONCLUSION: Passengers who report riding with a drinking driver may provide an important estimate of the prevalence of drinking driving. Passengers of drinking drivers represent a high-risk group that is not considered in most prevention efforts. Because being a passenger of a drinking driver is not illegal, it may be an easier topic for clinicians to broach than drinking and driving.

Accidents, Traffic↗

Application of computer-assisted interviews to sexual behavior research.

Collection of sensitive data with the use of video-enhanced, computer-assisted, self-administered interviews (V-CASI) has the potential to reduce interview bias and improve the validity of the study. The purpose of this study was to compare responses to sensitive questions elicited by V-CASI and by face-to-face interview (FTFI) methods. Women attending a New Orleans, Louisiana, public family planning or sexually transmitted disease clinic from July 1995 to July 1996, diagnosed with a Chlamydia trachomatis infection responded to eight close-ended behavioral questions (four socially undesirable, two socially desirable, and two neutral behaviors) using both FTFI and V-CASI techniques in a randomized crossover design. Of the 280 women included, the mean age was 23 years, 95 percent were African American, and 71 percent felt comfortable using computers. While kappa scores indicated good-to-excellent agreement between interview techniques, women tended to admit to socially undesirable behaviors more often on V-CASI compared with FTFI. Thirty percent of the women gave a discrepant response between V-CASI and FTFI toward social desirability. Women who reported a socially undesirable behavior in V-CASI (i.e., more than two sex partners and infrequent condom usage) were more likely to have a discrepant response. Utilization of the same logistic regression model to predict condom use yielded different results when data from V-CASI were used compared with data from FTFI. The V-CASI technique can reduce social desirability bias and improve validity in research requiring information on sensitive sexual behaviors.

Adolescent↗

Rapid rural appraisal: its role in health planning in developing countries.

There is an urgent need for a quick inexpensive and reliable method for identifying groups and individuals most in need of primary health care. The Rapid Rural Appraisal (RRA) is the most appropriate approach. It is a method by which resources can be quickly deployed to alleviate the problems of the poor. If properly used it can play a major role in identifying community health needs thereby aiding the health planning process and improving the health of the people. Nevertheless, RRA techniques should not be regarded as separate and apart from other research methodologies but complementary to them.

Developing Countries↗

Daily morbidity records: recall and reliability.

Methodological issues concerning the collection and analysis of daily morbidity data in community studies in developing countries are discussed. The effects of recall period and inter-observer variation on symptom prevalence are considered in the context of a longitudinal study in The Gambia, in which prevalence fell by about half over 1-week's recall. In the same study, many infant-days were recorded separately on two occasions, allowing an assessment of reliability in this type of morbidity diary data. The implications of these findings both in terms of data quality and cost-effectiveness are discussed, with the conclusion that weekly interviews examining the previous week's morbidity on a day-by-day basis are operationally optimal.

Adverse Drug Reaction Reporting Systems↗

Practical fieldwork.

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Acquired Immunodeficiency Syndrome↗