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PubMed2006

The choice of a health care provider in Eritrea.

The purpose of the study was to assess the factors that affect patients' choice of health care service providers and to analyse the effect of each factor, and to examine the policy implications for future health care provision in Eritrea. The data for this study was collected in a 10-month period from January to October 2003. A total of 1657 households were included in the study. Our findings reveals that education, perceived quality, distance, user fees, severity of illness, socio-economic status and place of residence are statistically significant in the choice of a health care provider. Our study further shows that illness recognition is much lower for poor and less educated individuals. When an illness is recognized by the individual or household, a typical observation is that health care is less likely to be sought when the individual or household is poor and lives far from the facilities, and then only in case of a serious illness. Information on the choice of health care service providers is crucial for planning, organizing and evaluation of health services. The people's perception of disease/illness, their concept of health and the basis for their choice in health care has to be considered in order to respond with appropriate services and information, education and communication programs.

Adult↗

PubMed2005

Human health research and policy development: experience in the Great Lakes region.

As a direct outgrowth of industrial and agricultural activities, the quality of the Great Lakes ecosystem has declined significantly because of toxic substances in the water, eutrophication, overfishing, and invasive species that have been introduced into the waterways. Although measures have been adopted to restore the health of the ecosystem, contamination of Great Lakes sport fish continues arising from conditions that still prevail, but on a more limited scale. As a consequence, the Great Lakes states have issued guidelines for the public in the form of health advisories for fish consumption to encourage practices that will minimize exposure to contaminants found in Great Lakes sport fish. Scientific research has strongly influenced many policy decisions, including the development of laws, rules, and guidelines applicable to public health not only in regard to fish advisories but also other issues impacting human health. This paper proposes to outline how policy has been influenced by scientific findings and the far-reaching effect that these decisions have had on the health status of the public in the Great Lakes area and its potential for influencing the nation as a whole and our global neighbors. Within the Great Lakes basin, polychlorinated biphenyls (PCB) and mercury are the subject of the greatest number of fish advisories. Great Lakes-based researchers have studied populations residing in the Great Lakes basin to determine their level of awareness concerning fish consumption health advisories. They found that almost 50% of the residents who consumed Great Lakes sport fish were aware of sport fish consumption advisories. Of those with awareness, almost 60% were males and only about 40% were females. The researchers attributed the greater awareness among males to the health advisory materials that males receive with their fishing licenses and to their contact with fishing-related groups. The lower level of awareness among women regarding fish consumption advisories subsequently prompted the researchers to recommend targeting risk communication programs for female consumers of Great Lakes sport fish, particularly women of reproductive age. The Wisconsin Department of Health and Family Services subsequently followed the recommendation and developed uniform outreach materials for women, minorities, and the general public to be used by the Great Lakes states. The policy change directing educational materials to at-risk groups (e.g., women of reproductive age and minorities) is a direct outgrowth of the finding of low awareness about fish advisories among women who were interviewed.

Adult↗

PubMed1998

Parallel implementations of individual-based models in biology: bulletin- and non-bulletin-board approaches.

Particle-based models are simulations in which the discrete representation of physical phenomenon involves interacting particles. This paper studies the efficiency of two different methods of implementing these models on a network of UNIX workstations. Two data parallel methods of modeling particles are tested: bulletin-board and non-bulletin-board. In the former method, the programs communicate through a logically shared, associative memory called a bulletin-board. The simulated particles are distributed among the workstations dynamically as the processing load on the processors changes. In the latter method, the particles are divided amongst the networked workstations statically at load time. The simulated system is a collection of ants moving and foraging in a two-dimensional space. This paper analyzes and compares the execution times of both implementations for different combinations of particles and number of workstation, using speed-up, tuple granularity and communication cost as measures. Analysis shows that the bulletin-board method is better for particle-based simulations when the correct granularity is chosen.

Animals↗

PubMed1996

viwish: a visualization server for protein modelling and docking.

A visualization tool viwish for proteins based on the Tcl command language has been developed. The system is completely menu driven and can display arbitrary many proteins in arbitrary many windows. It isinstantly t o use, even for non computer experts and provides possibilities to modify menus, configurations, and windows. It may be used as a stand-alone molecular graphics package or as a graphics server for external programs. Communications with these client applications is established even across different machines (through the send command to Tk, an extension of Tcl). In addition, a wide rage of chemical data like molecular surfaces and 3D gridded samplings of chemical features can be displayed. Therefore the systmen is especially useful for the development of algorithms that need visual distributed freely, including the source code.

Binding Sites↗

PubMed2006

Introduction of community-based skin-to-skin care in rural Uttar Pradesh, India.

OBJECTIVE: Two-thirds of women globally give birth at home, yet little data are available on use of skin-to-skin care (STSC) in the community. We describe the acceptability of STSC in rural Uttar Pradesh, India, and measured maternal, newborn, and ambient temperature in the home in order to inform strategies for introduction of STSC in the community. STUDY DESIGN: Community-based workers in intervention clusters implemented a community mobilization and behavior change communication program that promoted birth preparedness and essential newborn care, including adoption of STSC, with pregnant mothers, their families, and key influential community members. Acceptance of STSC was assessed through in-depth interviews and focus groups, and temperature was measured during home visits on day of life 0 or 1. RESULTS: Incidence of hypothermia (<36.5 degrees C) was high in both low birth weight (LBW) and normal birth weight (NBW) infants (49.2%, (361/733) and 43% (418/971), respectively). Mean body temperature of newborns was lower (P<0.01) in ambient temperatures <20 degrees C (35.9+/-1.4 degrees C, n=225) compared to > or =20 degrees C (36.5+/-0.9 degrees C, n=1450). Among hypothermic newborns, 42% (331/787) of their mothers had a lower temperature (range -6.7 to 0.1 degrees C, mean difference 0.4+/-1.2 degrees C). Acceptance of STSC was nearly universal. No adverse events from STSC were reported. STSC was perceived to prevent newborn hypothermia, enhance mother's capability to protect her baby from evil spirits, and make the baby more content. CONCLUSION: STSC was highly acceptable in rural India when introduced through appropriate cultural paradigms. STSC may be of benefit for all newborns and for many mothers as well. New approaches are needed for introduction of STSC in the community compared to the hospital.

Body Temperature Regulation↗

PubMed1977

Impact of external influences on food packaging.

Since the food supply is dependent upon an effective packaging system, threats to packaging represent implied threats to food processing and distribution. Enacted and potential legislation and regulation are retarding technological and commercial progress in food packaging and have already restricted some food packaging/processins systems. The results of these external influences is not simply the sum of the individual acts, but is a cascading self-imposed arresting of food packaging/processing advancement. The technological bases for the enacted and proposed legislation and regulation are presented in the enumeration of the external influences on food packaging. Economic and sociological arguments and facts surrounding the issues are also presented. Among the external influences on food packaging detailed are indirect additives, nutritional labeling, benefit:risk, solid waste and litter, environmental pollution, universal product code, and food industry productivity. The magnitude of the total impact of these external influences upon the food supply is so large that assertive action must be taken to channel these influences into more productive awareness. An objective and comprehensive public communications program supported by the technological community appears mandatory.

Advertising↗

PubMed2005

The application of youth substance use media campaigns to problem gambling: a critical evaluation.

Despite the negative impact that problem gambling poses on individuals and society there have been few gambling prevention campaigns specifically targeting youth. The authors review the literature on past and current drug, alcohol, and tobacco use prevention media campaigns, examining the similarities across 25 health communication programs with the aim of viewing their applicability for the prevention of youth problem gambling. Critical features of effective campaigns are identified and assessed in terms of their applicability for youth problem gambling. Recommendations for the design, implementation, and evaluation of a youth gambling media campaign are discussed.

Adolescent↗

PubMed1984

Vapor pressure and solvent vapor hazards.

This paper discusses applications of vapor pressure to industrial hygiene. Vapor pressure is the quantitative term characterizing solvent volatility; it is also equivalent to the concentration of solvent vapor at the liquid surface. The ratio between this concentration at the source and the acceptable concentration at the breathing zone is an intrinsic property of each chemical but varies over 6 orders-of-magnitude among common organic chemicals. The name Vapor Hazard Ratio (VHR) is introduced quantifying this ratio; and its logarithm is termed the Vapor Hazard Index (VHI). Thus, while vapor pressure is directly relatable to the economic effects of solvent evaporation and to airborne concentrations, the VHI has the added component of occupational toxicity. To be used safely and/or acceptably within the workplace, vapors must be diluted from concentrations at the source by a ratio equal to or greater than the Vapor Hazard Ratio, either by general or local exhaust ventilation. It is argued that the VHI can be used currently to predict the relative hazards of vapor concentrations of proposed substitute solvents to be used in similar settings and in hazard communication programs, and in the future with vapor dilution profiles to anticipate achieving quantitative compliance levels with new processes, work practices or ventilation controls. A review of the pertinent vapor pressure literature is also provided.

Air Pollutants, Occupational↗

PubMed2000

Are tailored health education materials always more effective than non-tailored materials?

While promising, the evidence in support of tailored health communication has not been overwhelming. One explanation is that tailored materials may be far superior to non-tailored materials in some cases, but only slightly better, no different or less effective in others. In this study, 198 overweight adults were randomly assigned to receive either tailored or non-tailored weight loss materials. Participants' cognitive, affective and behavioral responses to the materials were measured at an immediate and 1 month follow-up. Analyses compared those who received tailored materials to those who received non-tailored materials that were--by chance alone--either a good fit, moderate fit or poor fit, based on the match between behavioral characteristics of the participant and content of the non-tailored materials. Findings showed that good-fitting non-tailored materials performed as well or better than tailored materials for several cognitive, affective and behavioral outcomes. However, moderate- and poor-fitting non-tailored materials were consistently inferior to both approaches. The art and science of creating tailored health communication programs is still evolving. Data from this study suggest present approaches to tailoring are more effective than non-tailored materials in most, but not all cases. Specific recommendations are made describing ways to refine tailoring methods to maximize the effectiveness of this approach.

Adult↗

PubMed1993

Manage nurse stress and increase potential at the bedside.

The nursing profession must continue to cement recognition as a powerful and innovative force in health care by first "caring for themselves" at the bedside for the goal of patient continuity of care. The negative effects of stress, both internal and external, major, minor, and adaptive, are rooted in the nurses occupational stress level, and how that level influences the continuity of care. Stress assessments and unit specific stress management sessions need to become ingrained within the health care environment by instituting "comprehensive" stress management programs. Communicative "healing" needs to flow from the bedside to the CEO and back down again.

Adaptation, Psychological↗

PubMed1997

Environmental ecology of Cryptosporidium and public health implications.

Cryptosporidium has become the most important contaminant found in drinking water and is associated with a high risk of waterborne disease particularly for the immunocompromised. There have been 12 documented waterborne outbreaks in North America since 1985; in two of these (Milwaukee and Las Vegas) mortality rates in the immunocompromised ranged from 52% to 68%. The immunofluorescence antibody assay (IFA) using epifluorescence microscopy has been used to examine the occurrence of Cryptosporidium in sewage (1 to 120 oocysts/liter), filtered secondary treated wastewater (0.01 to 0.13 oocysts/liter), surface waters (0.001 to 107 oocysts/liter), groundwater (0.004 to 0.922 oocysts/liter) and treated drinking water (0.001 to 0.72 oocysts/liter). New rules are being developed (Information Collection Rule and Enhanced Surface Water Treatment Rule) to obtain more occurrence data for drinking water systems for use with new risk assessment models. Public health officials should consider a communication program to physicians treating the immunocompromised, nursing homes, develop a plan to evaluate cases of cryptosporidiosis in the community, and contribute to the development of public policies that limit contamination of source waters, improve water treatment, and protect public health.

Animals↗

PubMed1993

[Influence of mass media on mental health].

The author summarizes different research findings which have evaluated the influence of the media on the mental health of children, adolescents and adults. After this review of the literature, strategies are proposed to improve the promotion of mental health in the media. Also the importance of collaboration between health professionals and broadcasters in this process is highlighted. Concrete examples are reported such as the communication programs which have been developed by the Quebec Mental Illness Foundation and the Quebec Psychiatrists' Association.

Adolescent↗

PubMed1989

Aided auditory thresholds in children with postmeningitic deafness.

Postmeningitic hearing loss is often bilateral, profound, and rapid in onset. Children with postmeningitic hearing loss may be identified as potential candidates for cochlear implantation. The length of time required for a definitive trial with conventional amplification, which must precede a final decision regarding cochlear implant surgery, has been the subject of debate. Twenty-five children with bilateral severe-to-profound postmeningitic sensorineural hearing loss were fitted with appropriate amplification and results of serial-aided tests were analyzed to determine the degree of benefit and changes in aided thresholds over time. Twelve children gave aided responses that clearly indicated the presence of residual hearing and good aided benefit. Ten youngsters have responded consistently in the vibrotactile range when aided, thus receiving limited benefit from conventional amplification. Of particular interest are three children who initially exhibited limited or no auditory responses but who, after a period of 16 to 25 months, showed excellent benefit with binaural hearing aids. These children are all in total communication programs and have received good auditory training. Caution should be exercised when concluding that such a child does not benefit from amplification.

Audiometry, Evoked Response↗

PubMed1997

Health advisories for consumers of Great Lakes sport fish: is the message being received?

Nationwide, 45 states issue health advisories for sport fish consumers. Chemical contaminants in some Great Lakes (GL) sport fish include compounds suspected of causing adverse reproductive and developmental effects. Although advisories to reduce consumption of contaminated fish, especially by women, have been issued by GL states (i.e., Illinois, Indiana, Michigan, Minnesota, New York, Ohio, Pennsylvania, and Wisconsin) since the mid-1970s, little is known about advisory awareness and GL sport fish consumption in the general population. To estimate the prevalence of GL sport fish consumption and health advisory awareness, we conducted a population-based telephone survey of 8,306 adult residents of the eight GL states. We gathered information concerning respondents' demographic characteristics, fish consumption during the preceding year, and sport fish consumption advisory awareness. The survey response rate was 69%. GL sport fish were eaten during the preceding year by 8.4% -95% confidence interval (CI), 7.6-9.2- of adults in the GL states, approximately 4.7 million persons. Women accounted for 43.9% (CI,39. 4-48.4) of consumers. Although 49.9% of GL sport fish consumers were aware of a health advisory, awareness varied significantly by sex: 58.2% (CI, 51.7-64.7) of males and 39.1% (CI, 32.6-45.6) of females were aware. Using logistic regression, we found awareness associated with male sex -odds ratio (OR) = 2.3; CI, 1.5-3.5), white race (OR = 4.2; CI, 1.9-9.1), college degree (OR = 3.1; CI, 1.3-7.6), and consuming >=24 GL sport fish meals/year (OR = 2.4; CI, 1.4-4.3). Only half of GL sport fish consumers reported awareness of a health advisory concerning eating GL sport fish. Awareness was especially low among women, suggesting the need of targeted risk communication programs for female consumers.

Adolescent↗

PubMed2002

Patterns of spelling in young deaf and hard of hearing students.

The study examined the invented spelling abilities demonstrated by kindergarten and first-grade deaf and hard of hearing students. The study included two parts: In Part 1, the researcher compared three groups (deaf, hard of hearing, and hearing) using posttesting only on the Early Reading Screening Inventory, or ERSI (Morris, 1998), and in part 2 collected and analyzed samples of the spelling of deaf students in a Total Communication program. Analysis showed that the deaf group performed significantly differently in three areas: concept of word, word recognition, and phoneme awareness ("invented spelling"; Read, 1971). The deaf group outperformed the hearing and hard of hearing groups in concept of word and word recognition. But in phoneme awareness, the deaf group performed significantly less well than the hearing group. Therefore, the deaf group's spelling was followed for 1 year. Deaf students' spelling patterns were not the same as those of hearing and hard of hearing students. Deaf students' spelling miscues were directly related to the cueing systems of lipreading, signing, and fingerspelling.

Achievement↗

PubMed2002

[Unwanted pregnancy: impact on health and society in Latin America and the Caribbean].

Engaging in sexuality and reproduction should always be something that is wanted and planned. Unfortunately, when that is not the case, one result can be unwanted pregnancy. Unwanted pregnancies have consequences for women, their families, and their countries. This document reviews the causes and results of unwanted pregnancy, emphasizing the impact that this problem has on Latin America and the Caribbean (LAC). Four reasons why unwanted pregnancy is a continuing problem in LAC are: 1) people's growing desire to have smaller families, 2) the unmet need for family planning, 3) the fact that contraceptive methods are not 100% effective, and 4) unwanted sexual relations. Unwanted pregnancies especially affect adolescent women, single women, and women over 40 years of age. Given their desperate situation with an unwanted pregnancy, some women opt for an unsafe abortion, which can lead to their death. Other women can go so far as to commit suicide, or be murdered by a family member or other person who is unhappy that the pregnancy has occurred. It has been found that women who decide to continue with the pregnancy have higher risks of suffering an illness, and the same is true for the child. Reducing unwanted pregnancies and treating post-abortion complications are key to lowering maternal mortality and morbidity. This necessitates developing mass communication programs that address gender issues, education programs for girls, and sex education programs. It is also vital to make available to all persons reproductive health services that include family planning methods. In the countries of LAC with laws that specify grounds for legally ending a pregnancy, it is necessary that health care be organized to actually provide this service, and that health care programs obtain the safest, most effective technologies now available for ending a pregnancy.

Abortion, Induced↗

PubMed1980

Is the dream of a voluntary society still possible? The 1980 Harvey Cushing oration.

The United States Ambassador to the Court of St. James reviews the historic search for a society which is as voluntary as possible for the greatest number of citizens. Under the rule of law, there must continue to exist freedom of choice, freshness of start and opportunity, and the promise of mobility. The citizenry should not become dependent upon public administrators or political masters. Growth and expansion should not be constrained beyond reasonable limits, and openness of opportunity must be given high priority. The variety of State and private educational resources should be tapped for the design of educational communication programs.

Democracy↗

PubMedDate not supplied

Coping with closure. Consideration of legal issues in hospital closing can save precious time and considerable money.

From the legal perspective, closing a hospital can be as difficult as opening one. Whether a hospital is closing or downsizing, it should become familiar with the relevant legal issues before the process begins and develop a strategy for addressing them. Hospitals planning to discontinue services often must give advance notice to federal, state, and local governmental agencies, as well as to nongovernmental organizations such as the Joint Commission on Accreditation of Healthcare Organizations and to contractors. Failure to notify the applicable state licensing agency may violate the hospital licensing act and subject the hospital and its officers and directors to statutory sanctions. A hospital must carefully consider the closure's effect on its medical staff. If the medical staff brings legal action, the law in many states and the hospital's own corporate and medical staff bylaws may provide some defenses. A major consideration in any closure is the procedures for dealing with employee issues such as termination rights and benefits, access to personnel files, unemployment compensation benefits, severance pay and notice, transfer privileges, posttermination obligations, bargaining unit issues, preferential hiring, and communications. A hospital closure will also trigger issues concerning Medicare and Medicaid reimbursement, debt instruments, Hill-Burton grants, bankruptcy, and Joint Commission accreditation. A good community communications program is essential to a smooth closure or downsizing. If the hospital does not explain why it must take the action, the community may misinterpret its motives and react with hostility, which can influence government agencies. The hospital might retain a professional public relations consultant, especially if the community is complex or has been hostile to the hospital in the past.

Catholicism↗