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At least 127 records · Page 7Linked to original sources
PubMed1996

Developing culturally sensitive HIV/AIDS and substance abuse prevention curricula for Native American youth.

In 1990, researchers and health care professionals joined with members of several southwestern Native American communities to form an HIV/AIDS and substance abuse prevention partnership. Culturally sensitive approaches to theory-based interventions were developed into highly replicable, structured, school-based and community-based intervention programs. Process evaluations indicated high levels of program acceptance and fidelity. Outcome evaluations demonstrated significant positive preventive intervention effects among participants. This article reports how NAPPASA school prevention curricula were developed and discusses three critical processes in developing these successful curricula: 1) selection of integrative theory to address the multi-dimensional antecedents of HIV/AIDS and substance abuse among Native Americans, 2) use of ethnographic methodology to obtain intensive input from target groups and community members to ensure cultural and developmental sensitivity in the curriculum, and 3) use of process and outcome evaluations of pilot and field trials to develop an optimal curriculum.

Adolescent↗
PubMed2004

Changing physician prescribing patterns through problem-based learning: an interactive, teleconference case-based education program and review of problem-based learning.

BACKGROUND: Although asthma guidelines have recommended the use of anti-inflammatory controller medications since 1991, studies have consistently shown widespread failure to follow the guidelines. Major barriers include lack of knowledge and the inability to operationalize knowledge. Improved continuing medical education methods should result in more effective learning by physicians and other health care professionals, leading to better adherence to guidelines, resulting in better outcomes. OBJECTIVE: To evaluate the effectiveness of an interactive, case-based, educational intervention, also known as problem-based learning, using a series of interactive, case-based teleconferences. METHODS: A series of interactive, case-based teleconferences was completed with 20 primary care physicians. Each case involved a child aged 16 months to 12 years with asthma. A 12-month analysis of physician prescribing patterns was conducted. RESULTS: Program acceptance by the 20 physicians was uniformly positive. Significant improvement was noted, with an overall increase in controller use. Review of prescription data showed an increase in inhaled corticosteroid use from an average of 2.54 to 7.76 refills per month for the 6 months after the intervention (P < .001). CONCLUSIONS: After participating in a unique educational intervention-problem-based learning using interactive, case-based teleconferences-the prescribing patterns of physicians were altered significantly toward better adherence to asthma guidelines, as demonstrated by an increased use of anti-inflammatory controller medications (inhaled corticosteroids and leukotriene antagonists).

Anti-Asthmatic Agents↗
PubMed1989

FORTRAN source listing for simulating three-dimensional convergent beam patterns with absorption by the Bloch wave method.

The FORTRAN source code is given for a computer program that calculates the two-dimensional intensity distribution in convergent-beam transmission electron microdiffraction (CBED) patterns from perfect crystals. The program uses the eigenvalue or Bloch-wave method. It allows three-dimensional dynamical diffraction, and so includes all higher-order Laue zone effects without approximation. No symmetry reduction is included. The program accepts noncentrosymmetric or centrosymmetric crystal structures and allows absorption corrections to be included. It uses the "EISPACK" subroutines for the diagonalisation of a general complex matrix. Up to 100 CBED disks may be included. The code is also available via "Bitnet."

Electron Probe Microanalysis↗
PubMed1991

Experiences of a health team working in a new urban settlement area in Istanbul.

A project aiming at creating a model for comprehensive maternal and child health care for urban underdeveloped areas was started in a new settlement area of migrants in the vicinity of Istanbul. The project had an impact on health care status, particularly among infants and children, but the results indicated that more effort was needed to reach the mothers. It was noted that building space and the appearance of the work place influenced the prestige of the team. Absentee problems could be partly surmounted by repeated home visits. Based on this experience, it was concluded that health services in underdeveloped areas need to be supported by non medical personnel to act as home visitors and as mediators between the community and the health team. It was also concluded that an established recording system to include both clinical data and attendance is needed to define the cases who need special care.

Adult↗
PubMed1994

A PC-based computer program for quality assessment of INAA results of emission and air particulate samples.

A PC-based computer program for quality assessment (QAS) of results obtained by neutron activation analysis (NAA) is described. Program QAS is designed for the quality assurance system based on a routine use of certified reference materials (CRMs) with similar matrix composition as the samples analyzed together with each sample batch. The results obtained for CRMs samples are then compared with certified (true) values and with the results obtained for particular CRM in previous analysis runs. Five various tests are applied to check the quality of NAA results (for CRM and, consequently, for real samples) obtained for a particular analysis run. Control charts for elemental concentrations found in CRM and ranges of results for duplicate aliquots of CRM are displayed to visualize possible discrepancies. The program accepts files transported from gamma-ray spectrometric system ND 683 (based on a PDP 11 computer), extracts and stores reference material results, and prepares a work spreadsheet for each set of results to avoid typist and other kinds of errors.

Air Pollution↗
PubMed1992

A program to facilitate cytotoxicity assay data reduction.

A report of a program which performs the initial computational reduction of the raw data from a cytotoxicity assay and outputs the reduced data as an image of the arrangement of the assay(s) upon the microwell plate. The program accepts the raw data either as manual or diskette file input.

Algorithms↗
PubMed1994

A PC program for classification into one of several groups on the basis of longitudinal data.

A stand-alone, menu-driven PC program, ZCLASS, written in GAUSS386i, for classifying subjects into one of several distinct, existing groups on the basis of longitudinal data is described, illustrated, and made available to interested readers. The program accepts data from studies where common times of measurement are planned, but missing data are accommodated in that one or more measurement sequences may be incomplete.

Anthropometry↗
PubMed1989

Mortality in acute gynecology: a developing country perspective.

Over a 20-month period 109 deaths were recorded in the Acute Gynecology Ward, Kenyatta National Hospital, Nairobi; a rate of 5 deaths per month. Forty-one percent of the deaths were directly attributable to pregnancy and 46% were due to malignancy (mainly cervical carcinoma). Of the dead, 12.4% were teenagers and 63% below 35 years in age. They were generally of low parity. A tragic picture is presented of death of young women in their prime from almost entirely preventable causes. The need for improved maternal care, including family planning and cytological screening for cervical carcinoma is discussed and emphasized.

Abortion, Septic↗
PubMed1987

Effects of father-daughter contact on use of pregnancy services by Mexican, Mexican-American, and Anglo adolescents.

This study describes whether frequency and quality of father-daughter contact during adolescent pregnancy differ by ethnicity, whether this contact affects health behavior, and how ethnicity conditions the relationship between contact and behavior. Health behavior is defined as timing of pregnancy test and first prenatal visit. Data were gathered from a sample of 105 Anglo, Mexican-American, and Mexican adolescents interviewed at mid-pregnancy. Almost twice as many Mexicans (64%) as Mexican-Americans never saw their fathers (p less than 0.03). Girls living with their fathers obtained pregnancy tests significantly later (p less than 0.01) than those living independently. This relationship was maintained when ethnicity was held constant (p less than 0.01). When quality of contact was included, the relationship between residency with father and timing of pregnancy test became even stronger (p less than 0.003).

Adolescent↗
PubMed1987

Effects of social supports on attitudes and health behaviors of pregnant adolescents.

The influence of social support on maternal attitudes and behaviors was assessed in 57 third-trimester adolescent women attending an urban prenatal clinic. Sociodemographic characteristics, social support, self-esteem, and feelings about pregnancy were measured by questionnaire. The support and influence of the adolescent father was emphasized. Social support was measured as a multidimensional construct derived by a priori and empirical procedures. The outcomes measured were the amount of prenatal care, attendance at scheduled postpartum appointments, and pleasure with the pregnancy. Stepwise multiple-regression analyses were used to assess the contributions of the predictor to criterion variables. Pleasure with pregnancy was positively associated with the receipt of assistance from the adolescent's mother, favorable opinions of friends, and satisfaction with living arrangements. Attendance at postpartum visits was associated with high self-esteem. Notably absent as significant contributors were sociodemographic characteristics, receipt of emotional and tangible support from the adolescent father, and expectation of aid from social-assistance programs.

Adolescent↗
PubMed1988

Adolescents' willingness to use a school-based clinic in view of expressed health concerns.

A health needs assessment was developed to facilitate implementation of a comprehensive school-based adolescent clinic. Students were asked about their willingness to use a school-based clinic for certain health and emotional problems. Six hundred students in grades 9 through 12 completed anonymous self-administered questionnaires. Twenty-eight percent of respondents reported recently feeling depressed; 12% reported a prior suicide attempt. Twenty-five percent of students felt they were overweight. Of 56% who had experienced intercourse at least once, only one third had ever used birth control. Twenty-one percent smoked cigarettes and 27% marijuana, 24% used other drugs, and 38% used alcohol. Students who reported depression and past suicide attempts were significantly (p less than or equal to 0.001) more willing to use the clinic for counseling needs than students not so reporting. Those with perceived weight problems reported more willingness to use a school clinic for nutrition information than those who did not feel overweight. Currently sexually active students were also more willing (p less than or equal to 0.001) than nonsexually active students to use the clinic for sexuality information and sexually transmitted disease screens. Respondents who used drugs, alcohol, or cigarettes, however, were no more willing than nonsubstance-using peers to use clinic services for relevant health information.

Adolescent↗
PubMed1989

School-based clinic use and other factors affecting adolescent contraceptive behavior.

Adolescent risk taking, preventive behavior, and contraceptive use were investigated using a self-administered questionnaire in a sample of 260 inner-city high school students targeted by a school-based health clinic. Multivariate models consisting of individual and environmental variables significantly predicted sexual activity and contraceptive use. Older age at first intercourse, higher number of welfare benefits received by the household (including Medicaid, food stamps, and free or reduced price lunch), and use of the school-based clinic were significant positive predictors of more frequent contraceptive use by adolescents. Results of our study suggest that programs may be having some success in encouraging and enabling sexually active adolescents to use contraception and to use it more consistently. Rigorous program evaluations should help program planners and policy makers design and refine adolescent pregnancy-prevention efforts.

Adolescent↗
PubMed1990

Incentives and their influence on appointment compliance in a teenage family-planning clinic.

The purpose of this study was to ascertain whether or not the family-planning compliance patterns of indigent adolescents could be influenced by various types of incentives. From February 1988 through January 1989, 534 postpartum inner city teenagers, aged 12-19, who delivered at a large city-county public hospital, participated. Teens were randomly assigned to two treatment groups that either offered a coupon for milk for the infant or a gift for the teenage mother if they returned for their postpartum visit 4-6 weeks after delivery. A third group, which used no incentive for appointment keeping, acted as a control. Although overall compliance was low, a significant relationship was found between type of program incentive and compliance outcome. The program using milk coupons as an incentive had the best compliance rate. This incentive appeared to be most effective with black adolescents. Such incentive programs, although not without controversy, offer a potential way to enhance postpartum contraceptive appointment-keeping compliance in a high-risk population.

Adolescent↗
PubMed2005

An approach for delineating drinking water wellhead protection areas at the Nile Delta, Egypt.

In Egypt, production has a high priority. To this end protecting the quality of the groundwater, specifically when used for drinking water, and delineating protection areas around the drinking water wellheads for strict landuse restrictions is essential. The delineation methods are numerous; nonetheless, the uniqueness of the hydrogeological, institutional as well as social conditions in the Nile Delta region dictate a customized approach. The analysis of the hydrological conditions and land ownership at the Nile Delta indicates the need for an accurate methodology. On the other hand, attempting to calculate the wellhead protected areas around each of the drinking wells (more than 1500) requires data, human resources, and time that exceed the capabilities of the groundwater management agency. Accordingly, a combination of two methods (simplified variable shapes and numerical modeling) was adopted. Sensitivity analyses carried out using hypothetical modeling conditions have identified the pumping rate, clay thickness, hydraulic gradient, vertical conductivity of the clay, and the hydraulic conductivity as the most significant parameters in determining the dimensions of the wellhead protection areas (WHPAs). Tables of sets of WHPAs dimensions were calculated using synthetic modeling conditions representing the most common ranges of the significant parameters. Specific WHPA dimensions can be calculated by interpolation, utilizing the produced tables along with the operational and hydrogeological conditions for the well under consideration. In order to simplify the interpolation of the appropriate dimensions of the WHPAs from the calculated tables, an interactive computer program was written. The program accepts the real time data of the significant parameters as its input, and gives the appropriate WHPAs dimensions as its output.

Conservation of Natural Resources↗
PubMed2005

Subcutaneous administration of cefepime.

Management of symptomatic infections can aid in palliation. We investigated the pharmacokinetics and tolerability of cefepime given as a subcutaneous infusion. This novel route of administration is proposed as an alternative to intravenous and intramuscular administration for patients treated outside an institutional setting, such as home hospice. Ten healthy adult volunteers received a single dose of 1g cefepime infused subcutaneously over 30 minutes. Serial serum samples (0.5, 1, 1.5, 2, 4, 6, 9, and 12 hours) were obtained after the end of infusion, and cefepime concentrations were determined by high performance liquid chromatography (HPLC). All serum concentration profiles were modeled by a population pharmacokinetic analysis using the Non-Parametric Adaptive Grid (NPAG) program. Acceptability of administration was evaluated using subjective sensation grading, observation of the subcutaneous site, and a final global evaluation. The mean (median) Cmax, beta-t1/2, AUC0-oo and total clearance were found to be 36.1 (30.9) mg/L, 2.34 (2.56) hours, 134.8 (125.3) h*mg/L, and 7.42 (7.98) L/h, respectively. All infusions were completed without difficulty or discomfort. No drug side effects occurred. The global acceptability was "strongly agreeable" with all the subjects. Subcutaneous infusion of cefepime appeared to result in a pharmacokinetic profile similar to that of an intramuscular injection. Our evaluations showed excellent tolerability and acceptability. These favorable results warrant further clinical evaluation.

Adult↗
PubMed2006

'Rakter dosh'--corrupting blood: The challenges of preventing thalassemia in Bengal, India.

Thalassemia is an inherited blood disorder that has been receiving increasing attention in India. However, prevention of thalassemia in India continues to be difficult despite efforts of public health professionals and the government. Using West Bengal as a case study, this paper attempts to unravel some of the barriers to the prevention campaign and the consequent under utilization of the program. Lack of access, low awareness, low-risk perception and poverty are all important proximate constraints; however, one of the greatest barriers to the program is rooted in cultural notions of blood, marriage, identity, personhood and kinship in Bengali society. Blood is so deeply valued in the Bengali kinship system that this genetic mutation is perceived to be corrupting the blood (rakter dosh). Being a thalassemia carrier (i.e., having thalassemia minor) renders an individual unfit as a suitable marriage partner because of beliefs related to purity of blood, its association with the continuity of the lineage, and subsequent transmission of desirable traits to future generations. The risk of non-marriage affects women disproportionately, and parents are not inclined to test their daughters because of the possibility of not being able to marry them off to eligible suitors. The stigma associated with having thalassemia minor (TMI) is a deterrent to the disclosure of thalassemia status as well as to testing. Using anthropological theories and ethnographic methods, this paper focuses on the gendered process by which the diagnosis of a thalassemia carrier 'spoils' identities, thereby creating a disjuncture between the goals of the prevention program and people's need for social conformity, and ultimately between medical desirability and social desirability. The paper also suggests policies for enhancing the utilization of the program. Finally the conclusions from this study have potential applications for public health prevention programs that confront problems of stigma in program acceptability.

Blood↗