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Availability and use of services for maternal and child health care in rural Nigeria.

A personal in-home interview was conducted in four rural towns in Nigeria. The aims of the interview were to describe the content of Maternal and Child Health (MCH) care in these rural towns and to assess how patterns of prenatal, delivery and postnatal service use are related to a variety of demographic and socioeconomic variables in the population. Findings from data analysis indicate that services available are deficient in terms of the number of centers and content of care. Variables found to be statistically significant (P less than 0.01) for use of services are maternal education, occupation, distance and previous use of a physician. Husband's occupation was significant only for prenatal registration, but not for subsequent use of services. Recommendations include a reorganization of rural MCH services and an introduction of female literacy programs, especially at the rural level.

Adolescent↗

Media violence.

Research on the effects of media violence is not well understood by the general public. Despite this fact, there is an overwhelming consensus in the scientific literature about the unhealthy effects of media violence. Meta-analyses show that media-violence viewing consistently is associated with higher levels of antisocial behavior, ranging from the trivial (imitative violence directed against toys) to the serious (criminal violence), with many consequential outcomes in between (acceptance of violence as a solution to problems, increased feelings of hostility, and the apparent delivery of painful stimulation to another person). Desensitization is another well-documented effect of viewing violence, which is observable in reduced arousal and emotional disturbance while witnessing violence, the reduced tendency to intervene in a fight, and less sympathy for the victims of violence. Although there is evidence that youth who are already violent are more likely to seek out violent entertainment, there is strong evidence that the relationship between violence viewing and antisocial behavior is bidirectional. There is growing evidence that media violence also engenders intense fear in children which often lasts days, months, and even years. The media's potential role in solutions to these problems is only beginning to be explored, in investigations examining the uses and effects of movie ratings, television ratings, and the V-chip, and the effects of media literacy programs and public education efforts. Future research should explore important individual differences in responses to media violence and effective ways to intervene in the negative effects.

Adolescent↗

Evidence-based practice, response to intervention, and the prevention of reading difficulties.

PURPOSE: This article provides an evidence-based perspective on what school communities can do to lower the prevalence of reading difficulties among their pupils through preventive interventions. It also delineates the roles that speech-language pathologists (SLPs) might play in these interventions. METHOD: This article is organized to first provide a broad overview of current directions in research, practice, and policy in educational interventions, with an emphasis on how the three are increasingly integrated to respond to evidence showing that American school children are underperforming in reading. Next, the concept of response to intervention (RTI) is described. RTI is an educational policy and practice that is grounded in the accumulated literature that focuses on how schools might better organize themselves to deliver multitiered reading interventions to reduce children's risk for reading disability. Last, this article provides three organizational principles that school-based professionals, including SLPs, might follow to deliver RTI interventions. IMPLICATIONS: This article provides an important and timely description of key concepts in the prevention of reading difficulties through proactive multitiered interventions. SLPs can draw on the suggestions presented here to inform their local efforts in implementing preventive literacy programs that are consistent with an RTI paradigm.

Awareness↗

Empowering the public to be informed consumers of genetic technologies and services.

OBJECTIVE: The genetics community, together with lay advocacy organizations and the general public, should strategically plan a focused, culturally competent, community-based public genetic literacy program. METHODS: Inclusive of all stakeholders (consumers, professionals, disability communities, disenfranchised communities), society can advance this objective through a proactive, focused and coordinated outreach to build public awareness and understanding. RESULTS: Genetic Alliance programs support consumers with genetic disorders, raise health professional awareness of their concerns, educate the public about emerging genetic information and technologies, increase access to high quality information resources, and advocate for public policies that ensure the promises of genetics. CONCLUSION: The challenge before the genetics community is to be proactive, clear, and inclusive. The public should be empowered to make informed choices, allowing the potential benefits of genetic technologies and services to become manifest in improved healthcare and quality of life.

Biotechnology↗

Identifying and intervening with girls at risk for violence.

Youth violence has become a prominent national concern, largely focused on boys who have perpetrated highly publicized massacres. Less well-publicized is the rapid increase in arrests of girls for violent crimes and weapons violations. In just 2 decades, violent crime arrests for female juveniles increased by 108%. From research findings, a composite portrait of the violent girl can be drawn. This profile can be used to identify girls at risk for criminal behaviors. In this article, a three-pronged approach to girls' violent behavior is presented: (a) violence prevention and emotional literacy programs that can be implemented by school nurses, (b) parent education programs that can be conducted at Parent-Teacher Association meetings, churches, and community centers, and (c) counseling interventions that can be delivered to troubled girls by psychiatric nurses. Nurses can play vital roles in consultation to teachers and parents and in direct service provision to girls who are on a tragic trajectory of fighting, expulsion from school, and juvenile justice infractions.

Adolescent↗

Participatory workplace literacy training in a hospital setting.

This qualitative case study of a workplace literacy program in a hospital setting provides a description and analysis of a continuum of educational services. The specific purposes of the study were to identify the benefits of working through an advisory committee, to explain the program planning processes that create a context for participatory learning, and to give examples of the support needed by an advisory committee. Special attention was paid to the participation of employees as students in the program. Implications for developing a participatory approach are discussed.

Academic Medical Centers↗

Dissolving the burden of generalized anxiety disorder.

Generalized anxiety disorder (GAD) is a common disorder marked by excessive anxiety, worry, and somatic manifestations lasting over 6 months. GAD occurs relatively early in life in the majority of individuals; it is often chronic and comorbid with other anxiety disorders, affective disorders, and/ or medical conditions. GAD is as functionally debilitating as major depression even without comorbidity and, hence, is associated with considerable economic and societal burdens as well as health care utilization. Underrecognition of GAD and undertreatment of this disorder are major factors contributing to the individual and societal burden of GAD. Earlier long-term studies in GAD reported low remission rates despite treatment. More recent data support the potential for achieving remission in GAD with appropriate treatment. There is a critical need to enhance mental health literacy programs and translate the efficacy data into effectiveness schemes in clinical practice by improving disease management strategies. A conceptual basis for achieving these goals is provided by moving from a disorder model to a disease model in psychiatric practice. This move allows for staging of psychiatric illnesses, with GAD as a prototypical example. For the clinician, the critical paradigm shift is in modifying the treatment goal from the attenuation of symptoms, as in a "response," to the achievement of a state of "remission" (i.e., a virtually asymptomatic state). Remission of symptoms allows for improvement of psychosocial functioning and quality of life and potentially wellness. In this review, a synopsis of the epidemiology, natural history, economic and social cost, and clinical management issues is given as a road map to dissolving the burden of GAD.

Anxiety Disorders↗

Reach Out and Read: a pediatric clinic-based approach to early literacy promotion.

Approximately 90 million adults in the United States read at a level that limits their ability to function as full members of society or limits their ability to meet their basic needs. Reading success as an adult is related to early literacy experiences. Reading aloud by parents is the single most critical factor in a child's reading success later in life. Children in households where there is little exposure to reading are at risk for reading failure even before entering school. As primary health care providers, pediatric nurse practitioners are in a unique position to affect and encourage parental behaviors that foster early literacy development in children. Literacy should become incorporated as an integral component of health promotion for children. Reach Out and Read is a successful literacy program in the United States that can be easily adopted by pediatric nurse practitioners in primary care settings.

Child↗

USAID in Nepal.

Explore the source record for details and available documents.

Agriculture↗

Results of a community-based low-literacy nutrition education program.

A nutrition intervention focused on low-fat eating pattern changes was conducted among low-literacy participants in a Twin Cities Metropolitan area Expanded Food and Nutrition Education Program (EFNEP). A total of 134 EFNEP participants who participated in the intervention were compared to 70 comparison participants who received EFNEP nutrition education materials. Associations between changes in outcome variables specific to the intervention were evaluated using mixed-model regression analyses. The principal effects seen for this program were related to changes in eating pattern scales. More modest effects were seen in scales related to attitudes of low-fat eating, and although changes in dietary fat intake as measured by 24-hour dietary interviews suggested a positive intervention effect, this did not approach statistical significance.

Adult↗

Effects of a treatment adherence enhancement program on health literacy, patient-provider relationships, and adherence to HAART among low-income HIV-positive Spanish-speaking Latinos.

The impact of an adherence enhancement program for low income HIV-infected Spanish-speaking Latinos on health literacy, patient-provider relationships, and adherence to HAART was examined. Evaluations were conducted at baseline, 6 weeks, and 6 months for participants (n = 85) randomly assigned to either the intervention group or a comparison group; 69 (81%) remained in the study for the entire 6-month duration. The intervention group scored significantly better than the comparison group on 3 of 5 measures of HIV health literacy at 6 weeks and on 2 of 5 measures, at 6 months. While there was a weak trend for the intervention group to report an increase in self-efficacy of medication adherence management, baseline to 6 weeks, no other changes were significant. Perceptions of the quality of relationship and communications with their HIV-treating physicians improved both at 6 weeks (p = 0.04) and at 6 months (p < 0.001). The comparison group showed little change baseline to 6 weeks and baseline to 6 months. While there was a trend for the pilot group to report better medication adherence, these differences were not statistically significant. Further evaluation of the impact of this adherence enhancement program is needed.

Adult↗

Television literacy: comprehension of program content using closed captions for the deaf.

Recent legislation has made captioned television programs common technology; consequently, televised programs have become more accessible to a broader public. In the United States, television captions are generally in written English, yet the English-literacy rates among people who are deaf are low compared to hearing peers. This research tests the accessibility of television by assessing deaf and hearing students' comprehension of captions with and without visuals/video based on their ability to respond correctly to questions about the script and central details. Results indicate that reading grade level is highly correlated with caption comprehension test scores. Across caption conditions, comprehension test scores of students who are deaf were consistently below the scores of hearing students. The captioned video provided significantly better comprehension of the script for students who are deaf, suggesting that visual stimuli provide essential information for viewers who are deaf, which improves comprehension of televised script.

Journal Article↗