Impact of technology on women: strategies for non-formal education.
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Conservation of Natural Resources↗
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Knowledge of AIDS and HIV risk-related sexual behavior among Nigerian naval personnel.
BACKGROUND: The epidemic of HIV continues to grow in Nigeria. Personnel in the military are at increased risk of HIV infection. Although HIV-risk related sexual behavior of Nigerian police officers has been studied, little is known about the sexual behavior of their counterparts in the Navy. This study describes knowledge of AIDS, and HIV-risk sexual behavior of naval personnel in Lagos Nigeria. METHODS: Four hundred and eighty personnel of the Nigerian Navy completed a 70-item questionnaire in 2002. Group discussion and in-depth interviews of four key informants were also conducted to gain insights into the context of risky sexual behaviors and suggestions for feasible HIV primary prevention interventions. RESULTS: The mean age of the respondents was 34 years. Although the overall mean AIDS knowledge score was 7.1 of 10 points, 52.1% of respondents believed that a cure for AIDS was available in Nigeria and that one can get HIV by sharing personal items with an infected person (25.3%). The majority (88.1%) had had lifetime multiple partners ranging from 1-40 with a mean of 5.1; 32.5% of male respondents had had sexual contact with a female sex worker, 19.9% did so during the six months preceding the survey. Forty-one percent of those with sexual contact with a female sex worker did not use a condom during the most recent sexual encounter with these women. Naval personnel who have been transferred abroad reported significantly more risky sexual behaviors than others. Group discussants and key informants believed that sex with multiple partners is a tradition that has persisted in the navy even in the era of AIDS because of the belief that AIDS affects only foreigners, that use of traditional medicine provides protection against HIV infection, and influence of alcohol. CONCLUSION: Many naval personnel report participating in high-risk sexual behavior which may increase their risk of acquiring and spreading HIV. Naval personnel live and interact freely with civilian population and are potential bridging group for disseminating HIV into the larger population. Interventions including sustained educational program, promotion of condoms, changes in transfer policies are recommended to address this problem.
Acquired Immunodeficiency Syndrome↗
Sustaining the Wait Time Strategy.
Significant early positive cultural changes have been made in the Ontario healthcare system to address the province's Wait Time Strategy. Improving efficiency in parallel with the introduction of accountability agreements will provide early successes. However, there are fundamental system weaknesses that must be addressed in the long term to sustain the program. These include a wait list information system that addresses all patients waiting for care, additional healthcare providers with wider scopes of practice, improving hospital capacity, accountability agreements with agreed-upon performance indicators, new payment systems for physicians and a fundamental change in referral and care processes. Innovative approaches such as gain-sharing should be considered. Though resources are scarce, there is a need for significant early additional investments to achieve long-term success.
Health Care Costs↗
Encouraging faculty to use writing as a tool to foster learning in the disciplines through writing across the curriculum.
Writing Across the Curriculum (WAC), the national movement to infuse writing activities into the academic disciplines, promises eventually to enhance student writing competence, although its immediate goal is to foster mastery of course learning objectives. Those faculty who use WAC solely to improve writing skills assume the role of an English instructor and obligate themselves to take on an enormous amount of additional work perhaps without advancing their primary instructional missions. A limited return on this investment of effort will have the likely effect of prompting a faculty member to discard WAC. Over the long run, doing so will diminish opportunities for students to engage in productive writing experiences. Presented in this article are five strategies used in a faculty- development seminar that are designed to encourage the use of writing as an instructional tool. Individual teachers may use these strategies as justification for initiating WAC; just as important, program supervisors may use them to sustain a WAC program once it has begun.
Curriculum↗
Sustained effects of an educational program to reduce sales of cigarettes to minors.
We report 1-year follow-up data from a sample of stores participating in a 6-month community-wide educational effort to reduce cigarette sales to minors in Santa Clara County, California. The proportion of over-the-counter sales to minors at the 1-year follow-up illustrated that although statistically significant reductions were maintained 6 months after the intervention ended, recidivism occurred. Suggestions for achieving long-term reductions in sales to minors are offered.
Adolescent↗
Communitywide smoking prevention: long-term outcomes of the Minnesota Heart Health Program and the Class of 1989 Study.
OBJECTIVES: The Class of 1989 Study is part of the Minnesota Heart Health Program (MHHP), a populationwide research and demonstration project designed to reduce cardiovascular disease in three educated communities from 1980 to 1993. This paper describes an intensive, school-based behavioral intervention on cigarette smoking, comparing long-term outcomes in one of the intervention communities with those in a matched reference community. METHODS: Beginning in sixth grade (1983), seven annual waves of cohort and cross-sectional behavioral measurements were taken from one MHHP intervention community and its matched pair. All students in each community were eligible to participate (baseline n = 2401). Self-reported data collected at each period described prevalence and intensity of cigarette smoking. RESULTS: There were no differences at baseline for either weekly smoking prevalence or intensity of smoking. Throughout the follow-up period, however, smoking rates as determined by these measures were significantly lower in the intervention community: 14.6% of students were weekly smokers at the end of high school compared with 24.1% in the reference community. CONCLUSIONS: These results suggest that multiple intervention components such as behavioral education in schools, booster programs to sustain training, and complementary communitywide strategies may all be needed for lasting reductions in adolescent tobacco use.
Adolescent↗
Cleaner production and methodological proposal of eco-efficiency measurement in a Mexican petrochemical complex.
Abstract In the frame of the Petróleos Mexicanos Institutional Program for Sustainable Development, processes were evaluated in the manufacture operation of the petrochemical industry, with the purpose of reducing their ecological fingerprint. Thirteen cleaner production opportunities were registered in six process plants: ethylene oxide and glycols, acetaldehyde, ethylene, high density polyethylene, polypropylene switch and acrylonitrile, and 45 recommendations in the waste water treatment plant. Morelos is the second most important petrochemical complex in the Mexican and Latin American petrochemical industry. A tool was developed to obtain eco-efficiency indicators in operation processes, and as a result, potential savings were obtained based on best performance, as well as the integrated distribution of Sankey diagrams. Likewise, a mechanism of calculation to obtain economic savings based on the reduction of residues during the whole productive process is proposed. These improvement opportunities and recommendations will result in economic and environmental benefits minimising the use of water, efficient use of energy, raw materials and reducing residues from source, generating less environmental impacts during the process.
Acetaldehyde↗
Controlled modulation of inflammatory, stress and apoptotic responses in macrophages.
An outstanding question of current immunology is to define the mechanisms by which microbial products influence the immunopathologic host response elements in the early stages of infection. Macrophages are now well recognized to have a critical role in both innate and acquired immunity. In order to adjust promptly to continuous changes in microenvironment and maintain the immunologic balance, macrophages adequately respond by activating one of the numerous immunologic programs. However, sustained macrophage activation and excessive production of inflammatory mediators can perpetuate the numerous pathological processes and contribute to induction of stress response and even apoptosis. Therefore, selective modulation of macrophage activity represents an important strategy for prevention and treatment of inappropriate inflammatory responses in order to minimize the unwanted side-effects of the immunity. Macrophages can be selectively reprogrammed for a specific phenotype of immune response, e.g. cytokine or nitric oxide (NO), by relatively short-term exposure of the cells to substimulatory concentrations of different microbial components, including LPS. These LPS-dependent reprogramming effects are mediated by IFN-gamma-independent autocrine cytokine regulatory mechanisms that also controlled at the transcriptional level. Furthermore, LPS reprogrammed macrophages exhibit differential capacity to resist experimentally induced apoptosis and to produce heat shock proteins. Complete analysis of, and appreciation for, the immunoregulatory mechanisms implicated in LPS-dependent reprogramming of immune responses in macrophages can be expected to increase our understanding of the host innate response, as well as allow investigators to utilize emerging immunologic technologies in effective treatment of infections and chronic inflammatory diseases.
Animals↗
Impregnated bed nets for malaria control: biological success and social responsibility.
Malaria is a serious public health problem in numerous countries of the world. In Africa alone, it is estimated that more than a million children less than five years of age die each year from this disease. The problem has become more critical with the development of Plasmodium falciparum resistance to chloroquine, the high cost of replacement antimalarials, and vector resistance to the cheaper insecticides such as DDT. Emphasis now is on sustainable control programs that can be implemented by communities with assistance from primary health care providers. This has led to a re-examination of impregnated bed nets (IBNs) that serve as a physical barrier to break human-vector contact. Over the last decade, bed nets impregnated with cheap and long-lasting pyrethroids used in Africa and Asia have shown their utility in reducing human-vector contact, inoculation of humans with sporozoites, clinical episodes of fever, and high levels of parasitemia. One study in The Gambia demonstrated that mortality in young children was significantly reduced, and the results of that study have led to the initiation of large-scale mortality studies in different epidemiologic areas in Africa. This paper reviews current bed net materials, recommended insecticides, an impregnation technique, costs, and the importance of community participation. As a malaria control option IBNs appear to be very promising, but further entomologic and epidemiologic assessments, including mortality studies, are needed. Future use of IBNs should be considered as part of a larger program that includes other vector control measures, proper case management, appropriate use of antimalarials for prevention in specific target groups, surveillance, and program monitoring with attention to changing epidemiologic situations and developing technology.
Animals↗
The changing epidemiology of human hookworm infection in Australia.
OBJECTIVE: To document the distribution of human hookworm infection in Australia. DESIGN: A retrospective study of published data and accessible archival records. METHODS: The core data were derived from the report of the Australian Hookworm Campaign, annual reports of various State health departments and the Queensland Institute of Medical Research, and unpublished files of the former Queensland Aboriginal Health Programme. FINDINGS: Today, hookworm infection is endemic only among Aboriginal communities of northern Western Australia and the Northern Territory, where Ancylostoma duodenale may be the sole species. Early this century, infection was also established in Queensland and northern New South Wales, in both Aboriginal and white communities, and Necator americanus predominated. The origin of these parasites is obscure. Sustained control programs seem to have eradicated hookworms from Queensland. CONCLUSIONS: Improved sanitation, hygiene and chemotherapy have eliminated hookworms from white populations of Australia. Continued anthelminthic campaigns will also clear the parasites from Aboriginal communities, but unless living conditions improve significantly infection will recur.
Ancylostomiasis↗
Error reduction in surgical pathology.
CONTEXT: Because of its complex nature, surgical pathology practice is inherently error prone. Currently, there is pressure to reduce errors in medicine, including pathology. OBJECTIVE: To review factors that contribute to errors and to discuss error-reduction strategies. DESIGN: Literature review. RESULTS: Multiple factors contribute to errors in medicine, including variable input, complexity, inconsistency, tight coupling, human intervention, time constraints, and a hierarchical culture. Strategies that may reduce errors include reducing reliance on memory, improving information access, error-proofing processes, decreasing reliance on vigilance, standardizing tasks and language, reducing the number of handoffs, simplifying processes, adjusting work schedules and environment, providing adequate training, and placing the correct people in the correct jobs. CONCLUSIONS: Surgical pathology is a complex system with ample opportunity for error. Significant error reduction is unlikely to occur without a sustained comprehensive program of quality control and quality assurance. Incremental adoption of information technology and automation along with improved training in patient safety and quality management can help reduce errors.
Diagnostic Errors↗
Can Medicare survive its saviors?
It is now an open question whether Medicare will provide adequate health coverage to the baby-boom generation as it begins turning 65 just over a decade from now. The source of uncertainty is not whether America has the resources to sustain the program; we do. The real challenge comes instead from proposals to save Medicare. Far from preserving its benefits, the major restructuring proposals under discussion would radically alter the principles on which Medicare rests and erode the protection it affords.
Aged↗
[Use of the CD-ROM "Tox-Didact" for teaching of toxicology and pharmacology].
Tox-Didact is a multimedia teaching software package for initial training, continuing training and self-learning of toxicology and pharmacology. This software covers a large part of toxicology in its acute and chronic pathology using several approaches: drugs (salicylics, paracetamol, lithium ...); toxins (lead, methanol, carbon monoxide ...); drug addiction and doping (cocaine, heroin, LSD, amphetamines ...); systemic targets (kidneys, skin, liver ...). Tox-Didact is currently composed of 39 modules in validation, each tackling the diagnosis, biological surveillance, treatment, prevention and documentation of a real clinical case. Each module is organized around four types of questions, requiring a choice either (drug, symptom, formula ...) or an open response. Each validated answer is analysed by software which then comments on or corrects it. The essential points which characterize this software are: its multidisciplinarity (toxicology, pharmacology, semiology ...), its reliability (validated by experts), its simplicity of use. It is modular and offers an interactive teaching approach. The objective is to create a portable multimedia tool operational with all computer systems (IBM PC, Macintosh). This program is sustained by the Région des Pays de la Loire and by the Multimedia Resource Office of the French Ministry of National Education.
CD-ROM↗
HIV and AIDS--United States, 1981-2000.
The acquired immunodeficiency syndrome (AIDS) epidemic has had a substantial impact on the health and economy of many nations. Since the first AIDS cases were reported in the United States in June 1981, the number of cases and deaths among persons with AIDS increased rapidly during the 1980s followed by substantial declines in new cases and deaths in the late 1990s. This report describes the changes in the characteristics of persons with AIDS since 1981. The greatest impact of the epidemic is among men who have sex with men (MSM) and among racial/ethnic minorities, with increases in the number of cases among women and of cases attributed to heterosexual transmission. The number of persons living with AIDS has increased as deaths have declined. Controlling the epidemic requires sustained prevention programs in all of these affected communities, particularly programs targeting MSM, women, and injection drug users.
Acquired Immunodeficiency Syndrome↗
Creating healthy futures. 2000 NOVA Award winners.
Winners of this year's NOVA awards, sponsored by the American Hospital Association and H&HN magazine, all share a broad definition of health. These five stars of community benefit also understand that a community and a health care organization share responsibility for what creates health, and that collaborative efforts are the only way to sustain innovative programs.
Awards and Prizes↗
Orem's self-care deficit nursing theory: its philosophic foundation and the state of the science.
There is a preponderance of descriptive studies, ranging from those using a simple descriptive correlational approach to multivariate approaches. Only one study is clearly identified as an experimental study (Moore, 1987) and two clearly identified as replication studies (Lenatsch, 1999; Schott-Baer, Fisher, & Gregory, 1995). Fewer than half make clear links between the variables being examined and situations of nursing practice; that is, they examine elements of the theory of self-care without making the link to nursing practice an explicit part of the study. While this work is increasing our knowledge about self-care (Stage II), further work needs to be done to put the results of these in the context of nursing practice as in Stages III, IV, or V. Most of the studies reviewed are Stage II and provide an enhanced or broader description of an element or component of the theory, empirically describing the relationships between or among age, gender, self-care actions, disease, and so forth. These studies add to our understanding of existing and known or proposed relationships within the extant theory. The majority of studies examine self-care and/or self-care deficits. There are many studies but little evidence that sustained research programs are developing and expanding the theory. The bricks are piling up around the framework, but only a few scholars are working on building the walls. These programs of research are occurring in universities where a critical mass of interested scholars and students can be found. The use of theoretical language is sometimes imprecise and at other times inaccurate. Valid new terms are introduced but the relationship to existing theoretical constructs is not always explicit. There is little critical review of research in the literature. Ongoing dialog among scholars is minimal. There is a need for nurse scholars to come together and to engage in such a dialogue to enhance the work. Given the relatively short history of nursing research and, more importantly, the conduct of nursing theory-based research, the number and quality of the work being conducted is quite remarkable. There has been a substantial amount of work produced and the quality of it has improved over time. Orem has provided nurse researchers with a theoretical system comprising an ontological structure, related epistemology, and numerous models that give direction to scholarly efforts. Scholars using this theoretical system would be well-advised to use these in conceptualizing and interpreting their work.
Humans↗
Choices and responsibilities: finding the balance.
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Conservation of Natural Resources↗
Calakmul Model Forest. Reports from the field -- Latin America.
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Americas↗