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Biomedical subjects

J F Phillips

Publications and source records attributed to J F Phillips.

At least 91 records · Page 5Linked to original sources
PubMedDate not supplied

Chronic ethanol ingestion during puberty alters the transient increase in testicular 5 alpha-reductase in the Swiss-Webster mouse.

Previous experiments with inbred mice showed that chronic ethanol treatment delays male pubertal development. An initial event in sexual maturation in the rat is a transient increase in 5 alpha-reductase. The present study was conducted to determine whether similar ethanol effects occur in outbred mice (Swiss-Webster), to determine the ontological profile of testicular 5 alpha-reductase in the mouse, and to evaluate the effect of ethanol treatment on this enzyme. After 29 days of treatment with a liquid diet (beginning at age 20 days), reductions in the ethanol-treated mice as compared with the controls were noted in testicular weight (55.0 +/- 2.0 vs. 63.0 +/- 2.4 mg; P less than 0.01), epididymal sperm content (6.8 X 10(5) vs. 14.4 X 10(5); P less than 0.05), and sperm motility (45% vs. 57%; P less than 0.05). After 43 days, differences no longer existed. In chow-fed mice, a substantial rise in 5 alpha-reductase (1 unit = 1 pmole DHT formed/45 min/mg testis) began at age 24 days. Activity peaked at approximately 65 units at 25 to 30 days and gradually declined to 6.4 +/- 0.8 units at 63 days. After 29 days treatment, 5 alpha-reductase of the pair-fed control group was 26.8 +/- 4.9 units, which decreased to a baseline value of 7.0 +/- 2.1 units after 43 days treatment. In contrast, 5 alpha-reductase of the ethanol-treated group remained at baseline levels after 29 days (7.7 +/- 2.3 units) and 43 days of treatment (7.6 +/- 2.3 units).(ABSTRACT TRUNCATED AT 250 WORDS)

3-Oxo-5-alpha-Steroid 4-Dehydrogenase↗
PubMedDate not supplied

Analysis of motivation to contraceptive use applying the weighting procedure.

This paper presents a technique for scaling contraceptive use motivation for the sample population of the Family Planning Health Services Project in Matlab. The project, which began in 1977, is conducted by the International Centre for Diarrhoeal Disease Research, Bangladesh. The hypothesis of the research is that through the use of a scaling algorithm the power of demographic characteristics, attitudes, and intentions for predicting contraceptive use can be enhanced. The analysis shows that two factors explain use motivation. Scale 1 is weighted for demographic variables and desire for additional children, while Scale 2 is comprised of education and intentions of contraceptive use. Both scales have a pronounced independent predictive power. We conclude that scaling has improved upon the predictive power of indicators of reproductive motivations.

Bangladesh↗
PubMedDate not supplied

Contraceptive use in Matlab, Bangladesh: the role of gender preference.

Research in several Asian societies has suggested that sons are generally preferred over daughters. The implications of gender preferences for actual fertility behavior have not been adequately investigated, however. This analysis examines the effect of the sex composition of surviving children on the acceptance and discontinuation of contraception in a sample of 3,145 women in Matlab, Bangladesh, who were observed for 60 months. Hazards regression analyses are employed in the analysis. Strong and highly significant effects of gender preference on contraceptive use are observed. The preference is not monotonically son-biased but is moderated toward a balanced composition, because parents desire to have several sons and at least one daughter. These findings suggest that gender preferences, particularly a preference for sons, represent a significant barrier to fertility regulation in rural Bangladesh.

Bangladesh↗
PubMedDate not supplied

The demographic impact of family planning programs.

In response to concerns about the adverse consequences of rapid population growth, family planning programs have been implemented in many developing countries. The aim of the present study is to assess the impact of this programmatic approach on long-range population growth. The result of a new and hypothetical population projection indicates that in the absence of family planning programs the population of the developing world could be expected to reach 14.6 billion in the year 2100 instead of the 10 billion that is currently projected by the World Bank. Despite the apparent success of existing interventions, fertility control is far from complete, as many women continue to bear unwanted births. To assess the impact of this unintended childbearing a second hypothetical projection is made. With perfect implementation of reproductive preferences, the population size of the developing world in 2100 would be reduced by an estimated 2.2 billion below the current projection. Further strengthening of family planning programs and improvements in birth control technology are therefore likely to provide important demographic benefits.

Contraception Behavior↗
PubMedDate not supplied

Cigarette smoking and risk of clinical relapse in patients with Crohn's disease.

Risk of clinical relapse among cigarette smokers and nonsmokers was examined in a cohort of 74 adult Crohn's disease (CD) patients who were identified and followed at monthly intervals for six months. We measured clinical activity by a weighted symptom index used previously. Relapse at any point during the study was defined by the index score exceeding 150. Approximately 50% of nonsmokers experienced clinical relapse during the study period. Current smokers experienced a relapse risk 1.6 times that of nonsmokers (P less than .01). The risk estimates correspond to mean overall clinical activity scores of 142 +/- 34 for smokers compared to 119 +/- 26 for nonsmokers. Adjustment for confounding effects did not substantially alter the association shown between cigarette use and clinical relapse. We observed no increase in the likelihood of relapse among former smokers. The statistically significant finding that current smoking increases the risk of relapse for CD patients is of clinical importance, given the high prevalence of smoking (42%) among CD patients in this sample.

Adult↗
PubMedDate not supplied

Determinants of reproductive change in a traditional society: evidence from Matlab, Bangladesh.

A decade has elapsed since a project was launched in Matlab, Bangladesh to test the hypothesis that contraceptive services can induce and sustain fertility decline in a rural traditional population. The demographic impact of this project has been pronounced, lending support to the view that supply-side policies can succeed even where institutional supports for demand are weak. This paper reviews the relationship between the Bangladesh climate of demand and the Matlab system of supply with the aim of explaining how such effects arise. A sociologically appropriate system of supply can induce fertility change in a society where such change would not spontaneously arise. The study of programs and the "sociology of the supply side" thus deserve the same degree of rigor accorded to research on the "sociology of demand."

Bangladesh↗
PubMedDate not supplied

Beyond supply: the importance of female family planning workers in rural Bangladesh.

Using participant observation data on worker-client exchanges from Bangladesh, this article examines the interface between a government family planning program and the rural women it serves. Case material focuses first on the program function typically identified in the literature: meeting unmet demand for contraception by providing convenient supply. Functions that have been less recognized are then illustrated: (1) the worker's role in reducing fear of contraceptive technology; (2) her effort to address religious barriers, child mortality risks, and high fertility preferences; and (3) her role in mobilizing male support. The range of functions performed by the female family planning worker in the cases discussed here demonstrates that her role transcends the boundaries of what is conventionally implied by the concept of supply. She acts as an agent of change whose presence helps to shift reproductive decision-making away from passivity, exposing women long secluded by the tradition of purdah to the modern notion of deliberate choice.

Bangladesh↗
PubMedDate not supplied

Trends in family size preferences and contraceptive use in Matlab, Bangladesh.

In the nearly ten years of its existence, the Matlab Family Planning and Health Services Project has been characterized by a remarkable rise in contraceptive use and a corresponding decline in fertility. This study examines available evidence on trends in family size preferences in the Matlab area from 1977 to 1984 and their relationship to contraceptive use. Within the Matlab treatment area, the most significant factor behind the increase in contraceptive use has been a sharp rise in the practice of contraception for spacing births. There also appears to have been a more modest increase in the proportion of women wanting no additional children. Family size preferences in the treatment and comparison areas were roughly comparable, suggesting--to the extent that such preferences have changed over time--change may have occurred throughout the Matlab study area. The findings are evaluated in terms of their implications for the current debate on the contribution of family planning programs to fertility decline in developing countries.

Adult↗
PubMedDate not supplied

Integrating health services into an MCH-FP program in Matlab, Bangladesh: an analytical update.

This is a follow-up to a 1984 study that analyzed the relationship between areal variation in the contraceptive prevalence time series and in the intensity of maternal and child health (MCH) services of the Matlab Family Planning Health Services Project. Results based on 69 months of observation suggested that the addition of MCH components to a program with basic MCH and comprehensive family planning services had no incremental impact on family planning efficacy. However, basic MCH services, involving clinical back-up to family planning and child care since the beginning of the program in Matlab, may have contributed to clients' faith in the clinic staff and the overall efficacy of the Matlab program. In the 18 months that followed the cut-off date for this analysis, contraceptive prevalence increased markedly in the study areas. The present analysis repeats the earlier one for the extended time series to determine if the intensification of health services in Matlab contributed to this secondary increase in prevalence, and to ascertain whether the MCH service regimes have long-run differential impacts. Results for the 87-month time series are similar to those of the previous analysis, suggesting that the introduction of additional MCH inputs in the Matlab service area over the 1982-83 period had no incremental impact on the contraceptive prevalence rate time trend.

Bangladesh↗
PubMedDate not supplied

Client relations in South Asia: programmatic and societal determinants.

Client relations constitute a neglected area of research in family planning. Findings from studies in northern India and Bangladesh reveal considerable variation in both the quantity and quality of contacts in programs that function under roughly comparable socioeconomic conditions. Client relations are determined by a complex set of forces in which both programmatic factors and conditions pertaining to the societal environment play a key role. Worker-client exchanges have a net, incremental effect on contraceptive use.

Bangladesh↗
PubMedDate not supplied

Integrating health services into an MCH-FP program: lessons from Matlab, Bangladesh.

Since 1977 the International Centre for Diarrhoeal Disease Research, Bangladesh, has conducted a field experiment in family planning and MCH in its Matlab research station. The project began with an emphasis on family planning and MCH services were added in stages. This paper uses time series regression methods to address the question of whether the addition of health services contributed to family planning efficacy in Matlab in a program launched with minimal MCH services. The results show that some MCH interventions increased contraceptive prevalence, some decreased it, and others had no effect. The broader significance of these findings for implementing integrated programs is discussed.

Bangladesh↗
PubMedDate not supplied

Strengthening government health and family planning programs: findings from an action research project in rural Bangladesh.

An ongoing study at the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B) is based on the premise that public sector health and family planning programs can be improved through an assessment of the dysfunctional aspects of their operations, the development of problem-solving capabilities, and the transfer of strategies successfully tested in a small-scale pilot project. This paper reports findings from a field trial implemented in a subunit of the project area at an early stage of the project. Operational barriers to public sector program implementation are discussed with regard to the quantity of work, the quality of work, supplies and facilities, integration of health and family planning, and leadership, supervision, and decision making. Initial results of the ICDDR,B intervention on these managerial processes are also indicated.

Bangladesh↗
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Transferring health and family planning service innovations to the public sector: an experiment in organization development in Bangladesh.

The International Centre for Diarrhoeal Disease Research, Bangladesh, has launched a field experiment in two rural thanas of Bangladesh to test the transferability of its successful health and family planning experiment in Matlab to the Ministry of Health and Population Control service system. This paper reviews the Matlab experiment with particular attention to its organization and identifies elements for transfer. The intervention strategy and operations research design of the new experiment are discussed. The proposed design follows an organization development strategy in which collaborative diagnostic research is used to foster institutional change.

Bangladesh↗
PubMedDate not supplied

The Navrongo Community Health and Family Planning Project.

In 1994, an experiment was launched by the Navrongo Health Research Centre that will test the demographic impact of community health and family planning services in a rural, traditional area of northern Ghana. While exhaustive social research has been directed to clarifying societal constraints to reproductive change, relatively little is known about how African cultural characteristics can be a resource to family planning programs. This study will clarify ways in which cultural resources of a traditional African society can be used in efforts to foster reproductive change. This article reviews characteristics of the study population, the design of the Navrongo experiment, and the research plan. The Navrongo Project will be the first African experimental trial of the demographic impact of family planning.

Adult↗
PubMedDate not supplied

Worker-client exchanges and contraceptive use in rural Bangladesh.

In this article, longitudinal data from rural Bangladesh are used to assess the impact of household visits from family planning workers on contraceptive use. A panel of women was interviewed in a demographic survey and reinterviewed every 90 days for six successive rounds. Regression methods are used to estimate the effect of these encounters on the odds that a woman will use contraceptives. Statistical controls adjust for the potentially confounding effects of underlying demand for contraception. Findings suggest that both male and female worker-initiated exchanges have an effect, although the impact of outreach is more pronounced if the worker is female. Estimated effects are consistent with the hypothesis that the predominant impact of outreach is to crystallize existing latent demand for contraception. Results also suggest, however, that female worker outreach generates new demand by fostering ideational change.

Adult↗
PubMedDate not supplied

The impact of outreach on the continuity of contraceptive use in rural Bangladesh.

In 1978, the Bangladesh family planning program launched a national program of outreach services that continues to the present. Young married women were hired and trained to visit women in their homes, offer contraceptive services, provide information, and support sustained use over time. This report uses data from two rural districts to assess the effect of the household visitation program on the continuity of contraceptive use. Results of a multivariate analysis show that household outreach has had a pronounced net effect on the continuity of contraceptive use throughout the study period and that the magnitude of this effect has increased with time. This finding suggests that sustained contraceptive use continues to benefit from home-based outreach even after a decade of service encounters. Policy implications of this finding are discussed.

Adolescent↗
PubMedDate not supplied

Developing a culturally appropriate family planning program for the Navrongo experiment.

This article describes the first six months of the strategic planning process to develop a culturally appropriate community health and family planning program for a traditional community in a district of northern Ghana, served by the Navrongo Health Research Centre. To explain the context within which fertility decisions are made, this article describes the district's severe ecological, social, economic, and health constraints to family planning. It discusses related programmatic obstacles and presents the strategies developed to respond to them. A system of care has been developed that is closely coordinated with traditional leaders and communication networks. Management systems support outreach workers by emphasizing the importance of peer leadership, supervisory support, and community liaison in the implementation of village-based services. A large-scale experiment will be fielded to test the demographic impact of this approach.

Community Participation↗