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PubMed1990

Characteristics of condom use and associated problems: experience in Bangladesh.

Data from the 1983 Bangladesh Condom User Survey (BCUS) are analyzed for patterns of condom use and various problems directly influencing their effectiveness. The survey was undertaken to explain an apparent gap between reports of the number of condoms distributed in certain areas compared with prevalence of users as reported in contraceptive prevalence surveys. These data are analyzed from behavioral and management perspectives to identify various factors influencing utilization, with potential implications for understanding and improving family planning and AIDS/STD prevention service systems. Patterns of use are related to differences in source of supply through public, free or private-priced systems, differences in urban or semi-rural place of residence, and differences in perceptions of men or women. The problem with condom use most often identified by the respondents was breakage.

Adult↗
PubMed2006

Life satisfaction among older people (65+) with reduced self-care capacity: the relationship to social, health and financial aspects.

AIMS AND OBJECTIVES: This study aimed at investigating life satisfaction and its relation to living conditions, overall health, self-care capacity, feeling lonely, physical activities and financial resources among people (65+) with reduced self-care capacity. BACKGROUND: Knowledge about factors related to low life satisfaction among older people with reduced self-care capacity is sparse, although this is important in health care and nursing so that the care is adapted to their needs and perspective. Previous research has mainly focused on isolated aspects such as pain in relation to life satisfaction among older people in general and less among so those with reduced self-care capacity in general. DESIGN AND METHOD: A subsample of 522 persons was selected from a randomly selected cross-sectional survey using a modified form of the Older Americans' Resources Schedule and Life Satisfaction Index Z. RESULTS: The mean age in the total sample was 77.9; women (79.5) were significantly older than men (77.0). Low life satisfaction was found among women, as well as those living in special accommodations. Life Satisfaction Index Z was 15.3 (SD 5.6) in the total sample. Gender and living conditions did not explain life satisfaction whilst poor overall self-reported health and poor financial resources in relation to needs had the strongest explanatory value. Also of significant importance were loneliness, the degree of reduced self-care capacity and feeling worried. CONCLUSION: Life satisfaction in older people with reduced self-care capacity is determined by several factors, with social, physical, mental and financial aspects probably interacting with each other; especially feeling lonely, degree of self-care capacity, poor overall health, feeling worried and poor financial resources in relation to needs. These factors need to be considered in the care of these people to preserve or improve their life satisfaction. RELEVANCE TO CLINICAL PRACTICE: Nursing interventions in terms of preventive home visits, rehabilitation, health education directed towards physical, psychological, social and economic aspects of importance may help to preserve or improve life satisfaction for those with reduced self-care capacity.

Activities of Daily Living↗
PubMed2006

Giving and receiving of gifts between pharmaceutical companies and medical specialists in Australia.

BACKGROUND: This study investigated the 'gift-relationship' between pharmaceutical companies and doctors. METHODS: The study was based on a survey questionnaire of 823 medical specialists from across Australia. The aim of this study was to investigate gifts offered to medical specialists in Australia by pharmaceutical companies, financial support actively sought by medical specialists for activities other than research and to consider what is ethically appropriate. RESULTS: A high percentage of specialists received offers of food (96%), items for the office (94%), personal gifts (51%) and journals or textbooks (50%). Most specialists were invited to product launches, symposia or educational events (75-84%) and 52% received offers of travel to conferences. A high proportion of offers were accepted (66-79%) except invitations to product launches (49%), sponsored symposia (53%) and offers of travel that included partners (27%). Fifteen per cent of specialists requested financial support from pharmaceutical companies for activities and items, including conferences, travel, educational activities, salaries and donations to specific funds. The study outlined guidelines on gifts from pharmaceutical companies and differing standards applying to gifts and grants for travel. We found that, although most gifts and requests for support complied with professional and pharmaceutical industry guidelines, some--including personal gifts, tickets to sporting events, entertainment and travel expenses for specialists' partners--did not. CONCLUSION: To ensure that physicians' judgements are free from real or perceived influence from industry and to maintain public trust, we support a shift towards more conservative standards on gifts and support for travel evident in recent guidelines.

Adult↗
PubMed1999

The Community Integration Questionnaire revisited: an assessment of factor structure and validity.

OBJECTIVE: To investigate the factor structure and concurrent validity of the Community Integration Questionnaire (CIQ), using a large sample of persons with traumatic brain injury (TBI). DESIGN: Principal components analysis with varimax rotation was performed on CIQ items completed through interview with patients at 1 year after injury. Correlational analyses compared CIQ scores to scores on other widely used outcome measures. SETTING: Outpatient clinics affiliated with four TBI Model System rehabilitation centers funded by the National Institute on Disability and Rehabilitation Research. PARTICIPANTS: Three hundred twelve patients with medically documented TBI who were enrolled in the TBI Model Systems Project. The majority of patients were Caucasian males with severe TBI. MAIN OUTCOME MEASURES: CIQ; Functional Independence Measure (FIM); Functional Assessment Measure (FAM); Disability Rating Scale (DRS). RESULTS: Three factors emerged: Home Competency, Social Integration, and Productive Activity. The financial management item was moved from Social Integration to Home Competency, and the travel item was moved from Productive Activity to Social Integration. Each CIQ scale score showed significant correlations in the expected direction with the FIM+FAM and DRS items. CONCLUSIONS: The results provide further evidence for the validity of the CIQ and improve the scoring system. The factor structure is clinically and theoretically meaningful. The subscale and total scores show significant relationships with other widely used measures of outcome. Future research should focus on increasing the range of questions, accounting for changes from preinjury functioning, and obtaining normative data on the new factors.

Activities of Daily Living↗
PubMedDate not supplied

Legislation on contraception and abortion for adolescents.

The serious health and social consequences of adolescent pregnancy call for the examination of the laws that affect adolescents' access to contraception and abortion. The general law of any country relating to the availability, sale, or distribution and financing of contraceptives affects adolescents. Similarly, a country's general law on abortion applies to adolescents faced with unwanted pregnancy and affects them accordingly. In addition, special legislation relating to adolescents, particularly legislation or court decisions concerning parental consent for contraception or abortion for a minor, has an important influence on the access that sexually active young people have to services.

Abortion, Legal↗
PubMed1994

Primary health care trading companies for sustainable development.

A programme of comprehensive primary health care in Zambia has been accompanied by the emergence of autonomous, non-profit trading and production companies that sell health-related goods to communities and health institutions and find markets for locally produced good.

Commerce↗
PubMed1994

Mega metropolitan areas in Australia 1970-1990.

The author reviews trends in metropolitan-area development in Australia. "Overall the very big metropolitan regions continue to dominate the location of investment around the country.... Concentration of people and economic activity in mega-metropolitan regions persists."

Australia↗
PubMed2000

Use of business planning methods to monitor global health budgets in Turkmenistan.

After undergoing many changes, the financing of health care in countries of the former Soviet Union is now showing signs of maturing. Soon after the political transition in these countries, the development of insurance systems and fee-for-service payment systems dominated the discussions on health reform. At present there is increasing emphasis on case mix adjusted payments in larger hospitals and on global budgets in smaller district hospitals. The problem is that such systems are often mistrusted for not providing sufficient financial control. At the same time, unless further planned restructuring is introduced, payment systems cannot on their own induce the fundamental change required in the health care system. As described in this article, in Tejen etrap (district), Turkmenistan, prospective business plans, which link planned objectives and activities with financial allocations, provide a framework for setting and monitoring budget expenditure. Plans can be linked to the overall objectives of the restructuring system and can be used to ensure sound financial management. The process of business planning, which calls for a major change in the way health facilities examine their activities, can be used as a vehicle to increase awareness of management issues. It also provides a way of satisfying the requirement for a rigorous, bottom-up planning of financial resources.

Budgets↗
PubMed1994

Women's impetus in community and health development.

Women in Indonesia are playing an increasingly large part in economic activity and community development. Moreover, they are making a significant beneficial impact on the nation's health, most notably, perhaps, by helping to secure financial resources. The present article describes some of the ways in which women are working to improve the well-being of the Indonesian people.

Community Health Services↗
PubMed1997

Should governments subsidize the use of insecticide-impregnated mosquito nets in Africa? Implications of a cost-effectiveness analysis.

Recent large-scale field trials show that mosquito nets impregnated with insecticide can substantially reduce all-cause mortality in children in malaria-endemic areas in Africa. This paper considers the cost-effectiveness of impregnated nets, initially from the perspective of a government programme which would distribute nets free of charge and organize and fund re-impregnation on an annual basis. The calculations show that with the reductions in all-cause mortality observed in the trials, complete government subsidy of nets through a vertical programme would represent an efficient use of scarce resources for most combinations of assumptions. However, alternative ways of financing and organizing the use of impregnated nets are also possible and may be more cost-effective than vertical delivery. Distribution of nets and insecticide might be less costly than required for a vertical programme by integrating delivery with other types of government health programmes, with private sector delivery systems for other types of products, or with government systems developed for other sectors such as agriculture. Further, not all the costs need to be met by governments, as costs could be shared with donors, NGOs and the beneficiaries. The major conclusion is that impregnated nets would save a large number of lives in malaria endemic areas, they are an efficient use of scare resources, and ways of encouraging their use need to be developed and tested.

Africa↗
PubMedDate not supplied

Freestanding abortion clinics: services, structure, fees.

In 1981, The Alan Guttmacher Institute (AGI), in collaboration with the National Abortion Federation (NAF), conducted a survey of 240 abortion clinics to update information about clinic structure and the relationship of structural characteristics to services, policies and fees. The clinics surveyed were a stratified random sample of all non-hospital abortion facilities that provided 400 or more abortions in the United States in 1980. Among the findings are the following: Thirty-one percent of the clinics reported that they are nonprofit or tax-exempt corporations. The nonprofit clinics are not significantly different from for-profit clinics in either the number of patients they serve or the region of the country in which they are located. Twenty percent of facilities, although regarded as clinics by the AGI for research purposes, define themselves as physicians' offices. These offices are more often located in the West and have smaller caseloads than other clinics. They are also disproportionately located in states with high abortion rates, which suggests that private physicians in these states are more willing than doctors in other states to provide relatively large numbers of abortions in their offices. Two-thirds of the clinics are licensed, most of them by states, but some by cities and counties. Licensed clinics have larger caseloads than nonlicensed facilities, but they are no different in terms of the other characteristics measured in the study, including services offered and fee structure. Fifty-four percent of clinics provide abortions after 12 weeks since the last menstrual period (LMP), and 24 percent, past 14 weeks.(ABSTRACT TRUNCATED AT 250 WORDS)

Abortion, Legal↗