Counseling of birth control patients.
Explore the source record for details and available documents.
Adolescent↗
Biomedical subjects
C Kendall
Publications and source records attributed to C Kendall.
Feces, flies, and fetor: findings from a Peruvian shantytown.
Sanitary disposal of feces is vital to combat childhood diarrhea, and its promotion is key to improving health in developing countries. Knowledge of prevailing feces disposal practices is a prerequisite to formulation of effective intervention strategies. Two studies were conducted in a shantytown area of Lima, Peru. First, information was gathered through in-depth interviews with mothers and structured observations (4 hours) of young children and their caretakers. Data on beliefs and practices related to feces disposal behaviors were obtained. Excreta were deposited by animals or humans in or near the house in 82% of households observed. Beliefs about feces depended on their source and were reflected in how likely the feces were to be cleared. While 22% of children aged > or = 18 months were observed to use a potty for defecation, 48% defecated on the ground where the stools often remained. Although almost all children were cleaned after defecation, 30% retained some fecal matter on their body or clothes. Handwashing after the child's defecation was extremely rare for both children (5%) and caretakers (20%). The hygienic disposal of feces poses problems in this type of community. Nevertheless existing practices were found that show promise for promotion on a wider scale, including greater use of potties.
Feces↗
The Yoruba farm market as a communication channel in guinea worm disease surveillance.
Disease eradication programmes are by definition time bound and require strategies that facilitate timely intervention. Surveillance, which undergirds eradication, also requires timely strategies. Finding such strategies is especially challenging when the target disease is endemic in remote areas, e.g. guinea worm disease, the focus of this study. A strategy of market based surveillance was pilot tested in Ifeloju Local Government Area (LGA) of Oyo State, Nigeria. The project goal was to design a surveillance system that both fit into the natural communication network of rural people, and also enlisted their active involvement. Ethnographic research methods were employed to learn about market location, structure, catchment area and attendance pattern. Four larger farm markets (serving 164 hamlets with 17,000 population) were chosen. Each hamlet was visited and a volunteer 'reporter' was recruited. Reporters were trained on case recognition and detection, first aid and prevention, with a sensitivity to distinguishing indigenous and clinical perceptions of guinea worm. The market cycle was based on the traditional four-day week. Field workers visited every second market 16 times between October 1990 and February 1991. The reporter was expected to identify correctly the first case of the season and thus label the village as endemic for the season. Reporters gave oral reports, and positive indications were followed up within 48 hr by field workers, who verified the case and administered first aid. All hamlets were visited once a month to verify negative reports. Reporter attendance was monitored. Those who had a formal role in the market, e.g. sales agents, had better attendance than ordinary farmers who came only to sell their own produce. Knowledge of market structure and attender roles offers a guide for adapting this surveillance approach to other cultural systems and health issues.
Adolescent↗
A targetted intervention research on traditional healer perspectives of sexually transmitted illnesses in urban Zambia. Current research.
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Acquired Immunodeficiency Syndrome↗
Testing strategies to increase use of chloroquine chemoprophylaxis during pregnancy in Malaŵi.
The widespread problem of low and non-compliance to antimalarial chemoprophylaxis during pregnancy demands that attention be focused on alternative approaches to programming, product acceptability and demand for preventive services. This study describes the testing of three interventions to determine their effect on use of chloroquine (currently the most widely used drug for chemoprophylaxis) during pregnancy. The strategies evolved from community-based formative research undertaken to learn about the local concept of malaria and issues surrounding malaria prevention and treatment during pregnancy. The resulting interventions were tested in four clinics, and included a change in the health education message given during antenatal sessions, distribution of a sugar-coated chloroquine tablet, and an intervention combining the two strategies. The results showed a 45% increase in chloroquine use when the health education message was changed, and a 64% increase when the product was changed. High use levels were maintained with the combined intervention; an additive effect was seen. The study shows that improving the product was the most important factor in increasing the use of the program, and that changing the health education message can also make an impact on use.
Chemistry, Pharmaceutical↗
The household production of health: integrating social science perspectives on micro-level health determinants.
Efforts to control disease and improve health in developing countries require increasing collaboration between social and medical scientists. This collaboration should extend from the early stages of technology development to the evaluation and improvement of population-wide interventions. This paper provides an integrating framework for social science research on health producing processes at the household level, drawing on recent work in economics, anthropology, and public health. Further development of theory and methods in this area would benefit from interdisciplinary research in categories as defined by social and behavioral science in addition to those related to specific diseases and intervention programs.
Breast Feeding↗
The relative effectiveness of three reminder letters. On making and keeping mammogram appointments.
One hundred fifty women who had previously had at least one mammogram were sent one of three prompt letters informing them that they were due for screening. The letters were either reassuring, anxiety provoking, or the standard hospital prompt. Based on a review of the literature, we hypothesized that the reassuring letter would be most effective in motivating women to schedule and keep appointments, the anxiety-provoking letter would produce an intermediate level fo compliance, and the standard hospital letter would be least effective. Our hypothesis was partially supported. Overall, 45% of the women in the study scheduled mammogram appointments. This included 54% of those who received the reassuring letter, 42% of those who received the anxiety provoking letter, and 38% of those who received the standard letter. Although the results were in the predicted direction, the results of a chi-square test indicated that differences among groups were not statistically significant. When the dependent measure was number of appointments kept, rather than scheduled, however, significantly more women who received the reassuring letter actually kept their appointments compared with those who received the standard hospital letter. Subsequent analyses suggested that having a family history of breast cancer, receiving a reassuring letter, and being older than 50 years were important factors in scheduling appointments.
Adult↗
The design of a community-based health education intervention for the control of Aedes aegypti.
This report describes the process used to develop locally appropriate educational materials and to implement the education component of a community-based Aedes aegypti control program in Merida, Yucatan, Mexico. The process is broken into five stages: formative research, developing recommendations for behavior change, development of educational messages, development and production of educational materials, and distribution of the materials. Appropriate terminology and taxonomies for dengue were obtained from open in-depth interviews; baseline data from a knowledge, beliefs, and practices questionnaire served to confirm this information. A larval survey of house lots was carried out to identify the Ae. aegypti larval production sites found on individual house lots. This enabled the program to target the most important larval habitats. Community groups were organized to work on the development of messages and production of the educational materials to be used. The education intervention was successful in stimulating changes in both knowledge and behavior, which were measured in the evaluations of the intervention. To be successful, community-based strategies must be flexible and adapted to the local setting because of ecologic, cultural, and social differences between localities.
Aedes↗
The relative effectiveness of three reminder letters on making and keeping mammogram appointments.
One hundred fifty women who had previously had at least one mammogram were sent one of three prompt letters informing them that they were due for screening. The letters were either reassuring, anxiety provoking, or the standard hospital prompt. Based on a review of the literature, we hypothesized that the reassuring letter would be most effective in motivating women to schedule and keep appointments, the anxiety-provoking letter would produce an intermediate level of compliance, and the standard hospital letter would be least effective. Our hypothesis was partially supported. Overall, 45% of the women in the study scheduled mammogram appointments. This included 54% of those who received the reassuring letter, 42% of those who received the anxiety-provoking letter, and 38% of those who received the standard letter. Although the results were in the predicted direction, the results of a chi-square test indicated that differences among groups were not statistically significant. When the dependent measure was number of appointments kept, rather than scheduled, however, significantly more women who received the reassuring letter actually kept their appointments compared with those who received the standard hospital letter. Subsequent analyses suggested that having a family history of breast cancer, receiving a reassuring letter, and being older than 50 years were important factors in scheduling appointments.
Aged↗
Anti-vimentin monoclonal antibody recognizes a cell with dendritic appearance in the chicken's bursa of Fabricius.
The bursa of Fabricius was studied by immunohistochemical method using anti-vimentin monoclonal antibody (clone 3B4). This monoclonal antibody identified a vimentin positive cell in the medulla of the bursal follicle. During the first 2 weeks of life the vimentin positive cells located along the corticomedullary border and later became prominent in the medulla with the exception of a narrow zone adjacent to the corticomedullary border. After hatching the accumulation of vimentin-type intermediate filaments on one side of the nucleus endowed the vimentin positive cells with a polarized appearance. This "cap-like" vimentin positive area of the cytoplasm determined the position of the major cell process. Within the medulla the Ia positive secretory dendritic cells contained secretory granules in one of the cell processes. The distribution, shape, and polarized appearance of the vimentin positive cells were identical with that of the secretory dendritic cells. Therefore, the anti-vimentin monoclonal antibody proved to be useful for identification of the bursal secretory dendritic cells. During rapid bursal growth the number of secretory dendritic cells increased, possibly, by proliferation of vimentin negative secretory dendritic cell precursors located along the corticomedullary border.
Animals↗
Differentiation of bursal secretory-dendritic cells studied with anti-vimentin monoclonal antibody.
Embryonic and posthatched differentiation of bursal secretory dendritic cells, which express vimentin intermediate filaments, were studied with anti-vimentin (clone 3B4) and anti-cytokeratin (clone Lu5) monoclonal antibodies. Anti-cytokeratin staining revealed that medullary reticular epithelial cells formed a continuous network at every age, whereas the vimentin positive cells were single and showed dendritic appearance. On the basis of location, number, shape, polarized appearance, and Ia staining, the vimentin-positive cells and secretory dendritic cells appeared to be the same cell. Secretory dendritic cell precursors entered the bursal epithelium between 11 and 13 days of embryogenesis. The first vimentin positive cell appeared in the bud of 14-day embryos. Bud formation preceded the appearance of vimentin-positive cells. These observations suggested that the secretory dendritic cell precursor did not express vimentin when it entered the epithelium. Between 15 days of embryogenesis and 2 weeks of posthatch development, the changes in vimentin staining pattern revealed a cytological differentiation of the vimentin-positive cell. During rapid bursal growth, the number of secretory dendritic cells (vimentin-positive cells) increased about 18 times possibly by proliferation of vimentin-negative precursors in the epithelial arches of the corticomedullary border.
Animals↗
Learning from local knowledge to improve disease surveillance: perceptions of the guinea worm illness experience.
Surveillance is an essential tool in any campaign to eradicate disease; guinea worm (dracunculiasis), which is targeted for eradication before the year 2000, is no exception. One criterion of an eradicable disease is that it be easy to recognize as the program advances. Few experts doubt that the experience of a meter-long subcutaneous worm protruding through a painful ulcer can be missed or confused with another disease, thus ensuring that guinea worm meets this criterion. Field experiences of anthropologists and health educators have shown that one should never assume that community perceptions of illness experience coincide fully with medical case definitions of disease. This paper describes efforts to learn how the Yoruba people of southwestern Nigeria perceive sobia, the local name for guinea worm. Qualitative methods including informal interview, village discussion and participant observation were used to discern a pattern of illness presentation and progression. Interestingly, local perceptions were found to include a variety of illness manifestations beyond the common clinical case definition of an emergent worm, thus creating the potential for a high level of false positive reports. Local knowledge was then used to design a pilot project that trained volunteers to become part of the surveillance network for the national eradication program. The volunteers, who were largely illiterate, were able to distinguish between cultural and clinical definitions, and submit quite accurate reports on the guinea worm status of their villages. Among the 164 volunteers, only two submitted false reports due to incorrect disease definition. In contrast local government health workers who were conducting village searches during the same period were significantly more likely to register false positive reports. The culturally sensitive training based on local knowledge received by the village volunteers is thought to have contributed to their superior performance.
Culture↗
Explaining differences between qualitative and quantitative data: a study of chemoprophylaxis during pregnancy.
Experts acknowledge that communication projects would benefit from the use of open-ended interviews, focus groups, surveys, trials of behaviors, observation, and other research techniques to identify community and individual knowledge, beliefs, preferences, actual behavior, as well as a host of sociodemographic and economic characteristics necessary for planning and implementation. Communication planners often rely exclusively on survey research for program planning, claiming ease of administration and reliability of results. Reliance on this single research method often results in less appropriate interventions than could be developed with multiple research methods. This article reports the use of multiple methods to examine the cultural and behavioral factors which influence the use of antimalarial chemoprophylaxis during pregnancy in Malawi, Central Africa. This article will demonstrate how quantitative techniques such as cross sectional interviews and chemical tests as well as qualitative ethnographic information were used in the study; demonstrate how diverse results from multiple research techniques may be integrated; discuss general sources of bias in this research; and show how the use of multiple research methods may be incorporated in formative research for health communication programs.
Antimalarials↗
Plasma cells expressing immunoglobulins M and A but not immunoglobulin G develop an intimate relationship with central canal epithelium in the harderian gland of the chicken.
In the Harderian gland of the chicken, the epithelial and plasma cell relationships were studied by light and electron microscopy and immunohistochemical methods. In the wall of the central canal a dark epithelial cell was identified that had long branching cell processes. An anticytokeratin monoclonal antibody demonstrated that the dark cells provided an extremely large contact area for the plasma cells. Although IgM-, IgG-, and IgA-producing plasma cells were present in the Harderian gland, only IgM- and IgA-positive cells were capable of a distinct relationship with dark epithelial cells. The surface of the primary branches contained scattered IgA deposits whereas the epithelial cells of the secondary branches possessed IgA along the lateral cell membrane but not on the surface. Anti-IgA and anti-cytokeratin antibodies produced a similar staining pattern in the acini and secondary branches. Taken together, these observations suggest that IgA secretion is a function of secondary branches and that intracellular transport is influenced by the cytoskeletal system.
Animals↗
Results of a community-based Aedes aegypti control program in Merida, Yucatan, Mexico.
This report describes the results of a community-based Aedes aegypti control program in Merida, Yucatan, Mexico. Baseline surveys concerning knowledge, beliefs, and practices of 577 women and a larval survey of 616 house lots were carried out in October 1989. Following development of a public health communication intervention from this data, the program was implemented in six communities. Evaluation used an untreated control group design with pretest and two post-tests, one at completion and one six months later. Significant changes in knowledge and behavior were seen in the treatment group in both post-tests. Women in the intervention group were able to identify the Ae. aegypti mosquito, the larval production sites of the mosquito, and appropriate control methods. A behavior change proxy was measured by examining changes in the Breteau (number of positive containers/100 houses surveyed) and container indices. The Breteau index remained the same in the intervention group while it increased significantly in the comparison group. Changes were also seen with respect to individual containers. This project demonstrated that a community-based communication program aimed at larval production site elimination or control can be effective in changing behavior and reducing larval production sites.
Adult↗
Endogenous peroxidase- and vimentin-positive cells accumulate at the corticomedullary border of the chicken thymus.
The granulopoietic activity of the thymus and bursa of Fabricius was analyzed using an anti-vimentin monoclonal antibody and endogenous peroxidase reaction to detect possible hemopoietic precursors and functionally mature cells, respectively. Endogenous peroxidase-positive cells (EPC) and vimentin-positive cells (V9) were located at the corticomedullary zone of the thymus. The cells were grouped, suggesting their clonal expansion. The first EPC appeared in the thymus on Day 15 of embryonic age, 2 and 3 days later than in the bursa of Fabricius and spleen, respectively. They were intermingled with thymocytes. Although the bursal EPC disappeared by Day 7 after hatching, the number of thymic EPC continued to increase. The thymic EPC and V9 cells persisted for more than 12 wk of age. The V9 cells were present either as single cells or grouped cells in the 15-day-old embryos. The V9 cells represented a distinct cell population of the corticomedullary border that may cooperate with the EPC.
Animals↗
Beliefs about the prevention of dengue and other febrile illnesses in Mérida, Mexico.
A series of open interviews and a survey were conducted in several neighbourhoods in the city of Mérida, Mexico to find out whether poor response to government dengue control programmes might be related to the explanatory models about dengue and its prevention held by community members. Dengue was grouped by informants with other mild febrile illnesses, all of which were thought to be inevitable and capable of converting into more serious illnesses. Although vector control personnel think of prevention in terms of eliminating the larval habitats of mosquito vectors, the form of prevention most commonly described involved looking after oneself once sick, so that mild fevers do not evolve into serious fevers. Due to the prevalence of this different model of prevention, it is argued that simple messages about dengue may be misinterpreted. Vector control programmes need to take into account local models of febrile illnesses and their prevention in order to be effective.
Adult↗