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PubMed1989

The recruitment and retention of minority and disadvantaged allied health students.

Student recruitment and retention has been given high priority over the last several years. The School of Allied Health Sciences at the University of Texas Medical Branch at Galveston has been involved in recruitment and retention programs that have produced minority student enrollment of over 20% over the past seven years. The programs are supported by federal grants that have provided seed money to design, develop, and implement three specific recruitment and retention programs. These programs have assisted in enrolling over 575 minority students with a retention rate above 90%. Graduation, licensure, and certification rates have been at or above the majority population. These programs are adaptable at other allied health professions schools and have been used as models for several programs across the United States.

Data Collection↗
PubMedDate not supplied

[Pilot program of immunization against viral hepatitis B, integrated in the extended immunization program in Abancay (peru)].

INTRODUCTION: Abancay is located at 2,395 m.a.s.l. in the Peruvian Andean Region. It is a hyperendemic area for Hepatitis B virus (HBV) and hepatitis delta virus (HDV) infection, where 7% of the deaths are caused by acute and chronic hepatitis infections. In 1991, a pilot immunization program against HBV infection was started to control the incidence of VHB-VHD, and as a strategy to improve the EPI coverage in general. METHODS: Vaccination population was programmed to include 1,301 children under 1 year old and 3,488 children between 1-4 years old. A total of 3 doses of DNA recombinant vaccine against HBV per child were administered. The vaccination schedule fit within the EPI immunization schedule. For children under one year old, the program includes: Newborn: BCG, Polio 1, HBV1; 2-month old: Polio 2, DPT1, HBV2; 3-month old: DPT2, Polio 3; 4-month old: polio 4, HBV 3 and; 9 month old: Measles. For children aged between 1 and 4 years old, the program includes: HBV1, HBV2 one month after HBV1, and HBV six months after HBV1. RESULTS: One year after the immunization program started, 1,262 (97.0%) children under one year old and 2,529 (72.5%) between 1-4 years old were immunized. No relevant adverse effects have been reported. There were 8 deaths due to acute respiratory infection and acute diarrhea diseases, which are the main causes of death in this area. One of the objectives achieved was an improvement in the EPI vaccination coverage for children younger than 1 year old, with a DPT coverage of 97.0% in 1991 compared to 63.0% in 1988, 26.9% in 1989, and 61.9% in 1990. CONCLUSION: The inclusion of HVB vaccination in the EPI for a HBV and HDV endemic area improves the total EPI coverage and it is safe an effective.

Child, Preschool↗
PubMed1978

Training physicians of developing nations in female surgical contraception.

The majority of developing nations in the Third World (including Thailand) face similar medicosocioeconomic situations arising from uncontrolled population growth which outstrips developmental planning. One of the most effective medical means of combating these problems is surgical contraception. This study describes how the Ramathibodi National Training Program was developed and implemented in Thailand to increase the availability of sterilization services by training local physicians to perform the necessary operations. The success of this program is measured by the increase in the number of service delivery stations (182) and in the number of sterilization procedures performed (24 436 in a 32-month period).

Developing Countries↗
PubMed1984

Effectiveness of a health education program in a lower socioeconomic population. Replication of an ipecac guidance study.

When teaching home safety, we selectively highlight those hazards most likely to injure children at various developmental stages. In one of the few studies evaluating this approach, we successfully taught a middle class population appropriate home use of ipecac syrup. The study reported herein replicated that study in a lower socioeconomic population. Although learning occurred, statistical significance was not quite achieved. While this study does not refute the "targeted" approach, it does demonstrate that characteristics of the population are likely to affect the educational outcome. Impressive statistical improvement may not be demonstrated. Individual realistic goals must be established prior to implementation and evaluation of a program.

Accidents, Home↗
PubMed1977

Nepal: NFP/MCH Project's prime target.

Sterilization as a means of permanent family planning will be the prime target of the Nepal Family Planning and Maternity and Child Health Project in the current fiscal year. Under the permanent sterilization scheme, the project plans to open 18 laparoscopic camps in addition to 34 vasectomy camps in different parts of the country. The 146 mobile teams of the project sent to different parts of the country performed vasectomies on over 9000 males in the previous fiscal year. According to project statistics, more than 38,000 males have undergone vasectomy so far in Nepal. The rate of population growth is estimated to continue to increase by 3% in the next 5 years. This estimate is much higher than the original estimate made during the formation of the current 5-year plan.

Asia↗
PubMed1980

Plasma high-density lipoprotein cholesterol comparisons in black and white populations. The Lipid Research Clinics Program Prevalence Study.

High-density lipoprotein (HDL) cholesterol distributions were compared among 191 black and 1341 white males and 233 black and 1088 white females, ages 5-44 years, examined in five of the Lipid Research Clinic (LRC) population-based surveys. Mean HDL cholesterol was higher in blacks than whites in each 5-year age group for males and in seven of the eight age groups for females. The black-white mean HDL cholesterol difference was greater for males than females at each age studied. Mean HDL cholesterol was 4.8 mg/dl higher in black than white males ages 5-19 years, after statistical adjustment for age, Quetelet index and plasma total cholesterol differences between blacks and whites (p < 0.001); mean HDL cholesterol was 9.5 mg/dl higher in black than white adult males ages 20-44 years. Adjustment for levels of plasma triglyceride, which were lower in blacks than whites, reduced but did not eliminate the magnitude of the statistical significance in black-white differences: The adjusted means were 2.9 mg/dl higher in black children and 7.9 mg/dl higher in black adults. The finding of higher levels of HDL cholesterol in black males persisted after additional adjustment for alcohol consumption, smoking and educational levels. Adult U.S. black males have lower and black females have higher coronary heart disease mortality rates than their white peers. The magnitude of the black-white difference in HDL cholesterol for males in the LRC studies was within the range associated with coronary heart disease incidence reported in other studies.

Adolescent↗
PubMed2005

Shifts of Bordetella pertussis variants in Sweden from 1970 to 2003, during three periods marked by different vaccination programs.

The Swedish population of Bordetella pertussis strains was characterized from 1,247 isolates covering a whole-cell vaccine program up to 1979, a 17-year period without vaccination (1979 to 1996), and a period after the introduction of general vaccination among newborns with acellular pertussis vaccines (1997 to 2003). Strains were characterized by serotyping and genotyping of pertactin and ptxA and by means of pulsed-field gel electrophoresis (PFGE). With emphasis on vaccine-related markers, the vast majority of circulating strains were of nonvaccine type. There were shifts of serotype connected with shifts of vaccination program. Serotype Fim3 was most frequent during the periods with general vaccination schedules, whereas serotype Fim2 was predominant during the 17-year vaccine-free period. Pertactin 1 was predominant during the pertussis whole-cell (Pw) vaccine period but was thereafter replaced by prn2 and has not reappeared after the introduction of acellular pertussis (Pa) vaccines. ptxA (1) was predominant over all three decades. There was a significant difference in the distribution of serotypes between vaccinated and unvaccinated individuals, but not for pertactin. A few PFGE profiles were predominant over the years: BpSR25 (serotype Fim3 prn1/7) and BpSR18 (serotype Fim3 prn2) during the Pw period, BpSR1 (serotype Fim2 prn2) during the 17 years without general vaccination, and BpSR11 (serotype Fim3 prn2) after the reintroduction of general vaccination in 1996. Despite differences between the pertactin and toxin types of Pa vaccines and circulating strains, there is no evidence that there is a threat, i.e., the vaccination program so far has been effective against whooping cough, and there seems to be no impact on the effectiveness of the vaccination program from the bacterial polymorphism.

Bacterial Outer Membrane Proteins↗
PubMed2000

The importance of local data in unintended pregnancy prevention programming.

OBJECTIVE: Lack of local data on pregnancy intendedness poses a serious problem for those responsible for regional program development and evaluation. This article demonstrates how the Boulder County Health Department addressed this problem by conducting its own assessment. The information gathered served as the basis for collaborative population-based programming and policy development aimed at decreasing unintended pregnancy in the county. METHODS: A random-digit-dial telephone survey of 300 men and 300 women was conducted to estimate the prevalence of unintended pregnancy and establish groups at highest risk. Qualitative data regarding the psychosocial and contextual factors associated with unintended pregnancy were gathered in six focus groups conducted with 46 males and females aged 18-28 who had experienced an unintended pregnancy. RESULTS: The prevention strategies identified by the focus group participants lead to the development of locally relevant interventions among specific high-risk populations identified in the telephone survey. Programmatic and policy initiatives included raising awareness among key service providers and the community at large, creative means of bringing information and resources to those at risk, strengthening the delivery of clinical services, and promoting school involvement in unintended pregnancy prevention. CONCLUSION: Maternal and child health authorities should encourage the collection and use of pregnancy intendedness data at the local level.

Adolescent↗
PubMed1994

The CHAD program for the control of cardiovascular risk factors in a Jerusalem community: a 24-year retrospect.

The CHAD program, a community health program for the control of cardiovascular risk factors, was planned in 1969 as an experiment in community-oriented primary care (COPC) with the aim of assessing feasibility and effectiveness. The program was instituted in a family practice in Jerusalem in 1970, and has provided a working demonstration of the integration of community health care with the care of individuals and families. Effectiveness was evaluated by comparing changes in risk factor status with those in a comparison population. The program was most effective with respect to the control of hypertension and cigarette smoking. The changes were larger and earlier than those in the comparison population. Positive changes were also observed in the comparison population, which was served by a primary care clinic that also undertook measures for the control of cardiovascular risk factors.

Adult↗
PubMed1995

Indonesia. Adolescent reproductive health forms part of 5th country programme cycle.

Indonesia is now entering the Fifth Country Program Cycle of Population. The reproductive health and family well-being of the youth forms part of the country program. In order to translate this component into concrete action program, a project document in its first draft was developed for UNFPA (UN Population Fund) funding by the government and with the assistance of UNFPA CST, Bangkok and UNFPA Field Office in Jakarta. The project aims to raise the level of commitment and degree of participation of families, particularly parents, for developing among their pre-adolescent and adolescent children a better understanding of the concepts/process of adolescent reproductive health and desirable attitudes and values dealing with family well-being. This is to be achieved through family-centered learning approaches that will contribute to the adoption of the small, happy, and prosperous family norm. To achieve this goal, the project will develop national capacity by creating management teams, developing sets of training and counseling materials, delivering key messages through the media, upgrading skills in adolescent counseling and developing better understanding of adolescent reproductive health and family well-being issues among the facilitators. The strategy to be used is to set up small groups of 20-30 families which will regularly meet to discuss adolescent problems and issues with the help of cadres. They will be supported by provincial reproductive health and family well-being counseling centers which will also be set up to handle serious cases difficult for parents to handle. These centers, to be run by NGOs, will provide counseling services to parents and youth, evolve innovative and culturally acceptable counseling techniques, and at the same time serve as material and information collection, development and dissemination centers. The project will be launched in collaboration with seven NGOs in seven selected provinces. It is currently under review by UNFPA and the Government.

Adolescent↗
PubMed1997

Tenure track in emergency medicine.

STUDY OBJECTIVE: Tenure was designed to guarantee academic freedom through lifelong job security. Productive research, especially in the basic sciences, is the main criterion for tenure at most institutions; therefore faculty in more clinically focused specialties may experience more difficulty obtaining tenure. We examined the relationship between academic emergency medicine and tenure. METHODS: We used a questionnaire to survey the directors of all 108 approved US emergency medicine residency programs. The surveyed population was asked whether the program was affiliated with a medical school, the number of full-time faculty, and how many faculty members were tenured or on the tenure track. Follow-up mailings were sent to nonresponders. We also conducted a search of the Association of American Medical Colleges (AAMC) database to compare the number of emergency medicine faculty involved in the tenure process in other specialties. RESULTS: One hundred surveys (93%) were returned. At programs in which faculty were eligible for tenure, 9% (95% confidence interval [CI], 4% to 16%) were tenured and 27% (95% CI, 19% to 37%) were on the tenure track. Therefore only 36% of all EM faculty (95% CI, 27% to 46%) were tenured or on the tenure track. Among the 53 residency programs that offered tenure, 45% (95% CI, 32% to 60%) had no tenured faculty. At programs with academic department status, 74% of chairs were tenured, in contrast to only 32% of chiefs at institutions without academic department status (95% CI for difference of 42%, 14% to 71%). The AAMC survey revealed that about one-third as many emergency medicine faculty members were tenured compared with the other specialties. The proportion of faculty on the tenure track, however, was similar between the specialties. CONCLUSION: Most eligible emergency medicine faculty members are not tenured or on track to become tenured, and fewer emergency medicine faculty are tenured compared with the more traditional specialties. Emergency medicine may be vulnerable to being considered less academic unless its faculty members gain access to the tenure process.

Academic Medical Centers↗
PubMed2005

Geriatrics in Brazil: a big country with big opportunities.

Brazil has approximately 180 million inhabitants, of whom 15.2 million are aged 60 and older and 1.9 million are aged 80 and older. By 2025, the Brazilian elderly population is expected to grow to more than 32 million. Brazil has many problems related to its geographic and population size. Great distances between major cities, marked cultural and racial heterogeneity between the various geographic regions, high poverty levels, and decreasing family size all combine to put pressure on the medical and social services that can be made available to the elder population. Less than 500 Brazilian physicians are certified as geriatricians, translating into one geriatrician for every 37,000 elderly Brazilians. Beside 15 geriatric medicine residencies a larger number of fellowship programs exist, and these programs are in high demand, with more than 20 candidates per position, indicating new opportunities for growth in elder care. In addition, geriatric initiatives such as the annual elder vaccination program and the elder statute, recently approved by the Brazilian Congress, indicate that geriatric care in Brazil is entering a new era of growth and development. Although the challenges remain great, there are opportunities for Brazilian geriatrics and gerontology.

Aged↗
PubMedDate not supplied

A method for the dynamic management of genetic variability in dairy cattle.

According to the general approach developed in this paper, dynamic management of genetic variability in selected populations of dairy cattle is carried out for three simultaneous purposes: procreation of young bulls to be further progeny-tested, use of service bulls already selected and approval of recently progeny-tested bulls for use. At each step, the objective is to minimize the average pairwise relationship coefficient in the future population born from programmed matings and the existing population. As a common constraint, the average estimated breeding value of the new population, for a selection goal including many important traits, is set to a desired value. For the procreation of young bulls, breeding costs are additionally constrained. Optimization is fully analytical and directly considers matings. Corresponding algorithms are presented in detail. The efficiency of these procedures was tested on the current Norman population. Comparisons between optimized and real matings, clearly showed that optimization would have saved substantial genetic variability without reducing short-term genetic gains.

Animals↗
PubMed2004

The HIV/AIDS/STI situation in Lao People's Democratic Republic.

Lao People's Democratic Republic (Lao PDR) is a landlocked country with a population of 5.5 million and a total land area of 236,800 square kilometers. It has a population density of 23.3. It borders Thailand, Myanmar, China, Vietnam, and Cambodia. Its population distribution is 54.9% below the age of 20 years, and 27.8% aged between 20 and 39 years (NSC, 2002). Women comprise 49.5% of the overall population. 1 National Statistics Center, Basic Statics, 2002; National Statics Center, Population Census.

Acquired Immunodeficiency Syndrome↗