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At least 991 records · Page 55Linked to original sources
PubMedDate not supplied

Initiating a vasectomy training clinic in a family practice residency.

The development of and initial experience with a vasectomy training clinic in a family practice residency program are presented. A literature review and faculty consensus resulted in the acceptance of a standardized technique in which the ends of the vas are cauterized and not tied. An appropriate time block per patient to allow for counseling and for teaching of the technique was 90 minutes. Patients were recruited by instituting reduced charges and advertising through the local Planned Parenthood office and county health service. A partial prepayment was required to reduce broken appointments. Review of the first 50 cases indicates a good resident experience, an appropriately low complication rate, and no failures.

Family Practice↗
PubMed1995

[Fertility decline in China and family planning programs].

"The article looks in detail at the population development in China since the 1950s, highlighting some dramatic changes. In the late 1950s the country was hit by widespread famine, which resulted in increased mortality and decreased fertility. Infant mortality climbed to almost 300/1,000. During the 1960s fertility began to increase again and mortality declined. From the beginning of the 1970s fertility started to decline, dropping from about six to just over two children per woman in the late 1980s. Today, fertility is thought to be below replacement level. The main reason for this fertility decline lies in the highly efficient family planning programmes implemented in China since the 1950s and particularly since the 1970s. The decline in infant mortality and the favourable socio-economic development have also been important factors in the decline in fertility. Although fertility in China is currently at a low level, the country's population is still set to grow." (SUMMARY IN ENG)

Asia↗
PubMed1988

[A qualitative study on the reasons why the rural people in Nan province use contraceptive].

The purpose of this study is to investigate the reasons that rural people in Nan Province choose particular contraceptive methods, and places of services. The study utilizes the data from the study on the Impact and Efficiency of the Family Planning Program in Thailand: Phase II, which applied in-depth interview and small group discussion techniques. Findings indicate that wanting to limit the number of children to 2, wanting to space pregnancy, the limit of land, the conflict with working situation, and economic hardship are the reasons for using family planning. The major sources of contraception are health center, community health office, village health volunteer, village health practitioner, the border patrol police unit, and the military unit including other government agencies in the areas. As for the reasons for choosing a particular contraceptive method, convenience in practice and on obtaining services, desire for more children and concern over side effects are important.

Asia↗
PubMed1997

The Michigan equine monitoring system. I. Design, implementation and population estimates.

The Michigan equine monitoring system (MEMS) was designed and implemented in the State of Michigan, starting in 1991. The program was designed systematically to track the State's equine population, its health, and its economic implications to the equine industry. The MEMS was designed as a two-phase program. Phase I (the population and economic survey; the subject of this paper) was designed to provide new and statistically valid information describing the size, composition, location and economic characteristics of the Michigan equine industry. A standardized questionnaire was used to collect data via mail, telephone and personal interviews. Of the 3000 randomly selected list-frame samples, 2800 (93%) participated. However, 650 of these had no equids. There were 129,932 equids reported compared with 160,000 in 1984. The American Quarter Horse, Standardbred and Arabian breeds were the most numerous. Detailed results, including the size of equine operations/herds, uses, geographical distribution and the financial structure of the industry, are presented. A detailed account of the strategies used in designing and implementing the system is provided.

Animal Husbandry↗
PubMed1998

Exploratory analysis of factors associated with teens' repeated childbearing.

This study was designed to explore the factors regarding unique determinants of repeat childbearing among teens. The influence that key people have on subsequent teen childbearing is examined. Data for this research were gathered in focus groups with teen mothers and parents of teen mothers who access the Supplemental Nutrition Program for Women, Infants, and Children (WIC) in Georgia. Based on the results, repeated childbearing appears to occur within the context of poor parent-child relations, conflicting support for the roles teen mothers are expected to assume, limited social pressures for effective fathering, and limited access to social services for all family members. Pregnancy prevention efforts by agencies for teen mothers should coordinate services for the teen mother, her parent, and her partner.

Adolescent↗
PubMed1986

Services and educational approaches to adolescent pregnancy.

A historical review of adolescent pregnancy might be helpful if it could be studied for a particular country or in our own country for a particular state or city. Early information would for the most part be unreliable and where available, highly prejudicial. By providing contraceptives, family planning, counseling and abortion it was believed that teenage pregnancy could be prevented. It cannot be said that these techniques have failed. Maturing and self-discipline, however, are required to use the services properly that have been provided. Yet, neither maturity nor self-discipline is a major component of the adolescent life style. As more knowledge and understanding of adolescent pregnancy has become available, it has become apparent that this information has to be integrated into a comprehensive health care program. The Bronx Committee for the Community's Health, an incorporated group of eleven community health centers, is a unique model in the formation of a comprehensive, coordinated and accessible health care delivery system. A sixteen-week curriculum for 10-13 year olds, the Very Important Person (V.I.P.) program, teaches youngsters about developmental changes during puberty, and about reproductive physiology. There is an effort to promote health education for parents and children and to involve the parents in as many activities as possible in the schools, and in the community. There must be continued education for the nation's black leaders to enable them to relate specifically to the expressed needs and desires of black teens and their families. Continued efforts must be expended for political and legislative support to follow through on these initiatives until results can be evaluated and normal, healthy development of black teenagers can be assured.

Adolescent↗
PubMed1991

[Methods for the evaluation of a health intervention in developing countries: the case in the Arsi region, Ethiopia].

Since 1989 an evaluation study of the impact of a Primary Health Care (PHC) program is being carried out in Arsi region, Ethiopia. The principal aim of the study is to estimate the mortality rates in those villages mainly involved in PHC activities. A sample of 80 villages will be recruited to allow significant differences in mortality of 20 per thousand between less treated and best treated villages. Considering the absence of routine demographic data, a population census and demographic surveillance of the recruited villages have been carried out. All the activities related to the study are considered together with the principal logistic and methodologic problems.

Adult↗
PubMedDate not supplied

Non-governmental organizations in international health: past successes, future challenges.

Non-governmental organizations, or NGOs, are increasingly instrumental to the implementation of international health programs. Following an overview of current conditions in global health and the problems that could be targeted by NGOs, this article describes the activities and philosophies of several representative approaches in this sector. The attributes of NGOs that increase their potential effectiveness are discussed, including ability to reach areas of severe need, promotion of local involvement, low cost of operations, adaptiveness and innovation, independence, and sustainability. A summary is provided of major future challenges in international health that may be addressed by NGOs, with particular emphasis on tobacco-related disease, communicable diseases and the AIDS epidemic, maternal mortality and women's health, injury prevention and control, and the need to secure durable financial support.

Acquired Immunodeficiency Syndrome↗
PubMed1997

Cancer incidence and mortality: the priority of screening frequency and population coverage.

In addition to the usual measures of screening-test performance, it is important to consider testing frequency when evaluating a screening program. Data on which to base recommendations for the timing of screening tests are urgently needed. For example, in the cases of cervical and colon cancer, when the target is a precursor lesion, research indicates that less frequent screening may be appropriate. This finding may not apply, however, to screening for breast cancer by mammography, which requires currently recommended intervals for the early detection of malignancies. Resources now allocated to breast cancer might more effectively be applied to the construction of tests that would permit longer intervals between screenings. To achieve the National Cancer Institute's goal of reducing cancer mortality in the United States by the year 2000, it will be important to review the balance between population coverage and individual screening for each cancer and to emphasize prevention strategies that maximize population coverage while minimizing expenditures.

Adult↗
PubMedDate not supplied

Why did maternal mortality decline in Matlab?

In 1991, an article on the Maternity Care Program in Matlab, Bangladesh, reported a substantial decline in direct obstetric deaths in the intervention area, but not in the control area. The decline was attributed primarily to the posting of midwives at the village level. In this article, data are presented from the same period and area on a variety of intermediate events. They indicate that the decline in deaths was probably due to the combined efforts of community midwives and the physicians at the Matlab maternity clinic. Their ability to refer patients to higher levels of care was important. The data further indicate that the decline in deaths depended upon the functioning of the government hospital in Chandpur, where cesarean sections and blood transfusions were available. Midwives might also have made a special contribution by providing early termination of pregnancy, which is legal in Bangladesh.

Abortion, Induced↗
PubMed2003

Multicriteria optimization of biochemical systems by linear programming: application to production of ethanol by Saccharomyces cerevisiae.

In this study we present a method for simultaneous optimization of several metabolic responses of biochemical pathways. The method, based on the use of the power law formalism to obtain a linear system in logarithmic coordinates, is applied to ethanol production by Saccharomyces cerevisiae. Starting from an experimentally based kinetic model, we translated it to its power law equivalent. With this new model representation, we then applied the multiobjective optimization method. Our intent was to maximize ethanol production and minimize each of the internal metabolite concentrations. To ensure cell viability, all optimizations were carried out under imposed constraints. The different solutions obtained, which correspond to alternative patterns of enzyme overexpression, were implemented in the original model. We discovered few discrepancies between the S-system-optimized steady state and the corresponding optimized state in the original kinetic model, thus demonstrating the suitability of the S-system representation as the basis for the optimization procedure. In all optimized solutions, the ATP level reached its maximum and any increase in its activity positively affected the optimization process. This work illustrates that in any optimization study no single criteria is of general application being the multiobjective and constrained task the proper way to address it. It is concluded that the proposed multiobjective method can serve to carry out, in a single study, the general pattern of behavior of a given metabolic system with regard to its control and optimization.

Algorithms↗
PubMed1997

Adolescent sexuality: an educational and counseling challenge.

A review of family-planning literature reveals that researchers adopt narrow definitions of sexual behavior and focus almost exclusively on risks of pregnancy and diseases. Little concern is shown in these articles about promoting the idea of more communicative, pleasurable, and egalitarian sexual relations among teenagers, because the focus is on avoiding behaviors that are defined as "high risk." In the United States, there is little evidence that these contraceptive-based sex education programs have resulted in reduced sexual activity, diminished teenage-pregnancy rates, or increased effective contraceptive use. In Canada the clinical evidence is that existing prevention strategies are not working. In Sweden the increasing rates of STDs and teenage pregnancies in the late 1980s worried authorities. The figures were brought down in the 1990s by extensive efforts both in schools and at publicly funded adolescent health clinics and family-planning units. It has been shown that girls with good self-esteem and a sense of responsibility avoided pregnancies and STDs in follow-up studies. Girls with a high degree of risk-prone behavior or attitudes and girls with a problematic life situation and without adequate family support were those who became unintentionally pregnant and/or acquired an STD. Countries where sex education has been accepted, combined with widely spread family-planning services and abortion on demand, have the lowest pregnancy and abortion rates in the world. But even they could do better by putting sex education in its proper place in society and by using both old and new methods.

Adolescent↗
PubMed1996

Contraceptive methods: do Hispanic adolescents and their family planning care providers think about contraceptive methods the same way?

This article describes how a family planning clinic-based program to prevent repeat pregnancy among Hispanic adolescents in Los Angeles used qualitative research to understand client contraceptive behavior. Background information on Hispanic adolescent reproductive patterns and an overview of paths to motherhood among teen clients are provided to contextualize the results. Participants sorted contraceptive methods on perceived similarities and ranked them on effectiveness, safety, and use-preference. Multidimensional scaling was used to identify and compare conceptual models. Both providers and teens grouped methods by effectiveness and mode of action, but acceptability and ease of method use were also important for teens. Providers found participation a worthwhile educational experience that facilitated self-reflection about their own biases and better understanding of their clients' needs. This method could be applied in many clinical settings where education and counseling are important in treatment and where patients and providers are likely to have different conceptual models regarding therapy.

Adolescent↗
PubMed1998

Polydrug-using adolescent mothers and their infants receiving early intervention.

This study investigated the effects of an intervention for polydrug-using adolescent mothers. The program included educational, vocational, and parenting classes; social and drug rehab; and day care for their infants while they attended school half-day. The drug-exposed infants were similar to the nonexposed infants on traditional birth measures, although they had inferior Brazelton Neonatal Behavioral Assessment Scale scores, including habituation, orientation, abnormal reflexes, general irritability, and regulatory capacity. The drug-exposed infants also spent less time in quiet sleep and more time crying and showing stress behaviors. Both the mothers and the infants in the drug groups demonstrated inferior interactions, and their dopamine and serotonin levels were significantly higher. As early as 3 months (following 3 months of intervention), the drug rehab mothers and their infants looked more like the nondrug group in their interactions; by 6 months, they looked similar on virtually every measure. At 12 months, the infants of drug rehab mothers (versus the drug control group) had superior Early Social Communication Scale scores and Bayley Mental scale scores, as well as significantly greater head circumference and fewer pediatric complications. The drug rehab mothers also improved on several lifestyle variables. They demonstrated a lower incidence of continued drug use and repeat pregnancy, and a greater number continued school, received a high school or general equivalency diploma, or were placed in a job. Thus, a relatively cost-effective high school based intervention had positive effects on both adolescent mothers who had used drugs and their infants.

Adolescent↗
PubMedDate not supplied

Long-term outcomes of an abstinence-based, small-group pregnancy prevention program in New York City schools.

CONTEXT: Despite drops in U.S. teenage birthrates, questions continue to arise about how best to reduce the country's adolescent birthrate. School-based programs continue to be considered one of the best ways to reach adolescents at risk of early sexual activity. METHODS: A total of 312 students completed a pretest, a posttest and a follow-up one year after the posttest: 125 who had participated in a 3-4-month-long abstinence-based small-group intervention led by trained social workers, and 187 in a comparison group that received no special services. RESULTS: There were few significant differences between the intervention and comparison groups at posttest. At the one-year follow-up, however, intervention students had significantly better scores on locus of control, their relationship with their parents and (among males only) their attitudes about the appropriateness of teenage sex. Measures of depression, self-esteem, intentions to have sex, attitudes toward teenage pregnancy and various behaviors did not differ significantly between groups. By the time of the one-year follow-up, there was no difference between study groups among females in the initiation of sexual intercourse. Among the males, initiation of sexual intercourse appeared to be higher in the intervention group than in the comparison group, but the difference was not statistically significant. Positive outcomes were especially limited among students who were already sexually active at the start of the study, a finding that emphasizes the difficulties of reaching adolescents who are already at high risk for pregnancy CONCLUSIONS: A small-group abstinence-based intervention focusing on mental health can have some impact on adolescents' attitudes and relationships (particularly with their parents). Long-term evaluations are important for determining the effects of an intervention, as it is difficult to change adolescent risk behavior.

Adolescent↗
PubMed2001

Conceptual design of monitoring and evaluation plans for fish and wildlife in the Columbia River ecosystem.

A logical sequence of seven steps is proposed as a generic template to design plans for monitoring and evaluating fish and wildlife in the Columbia River ecosystem. Management programs for these resources fail to include coordinated monitoring and evaluation plans. This short-coming is indicative of pervasive management conflicts detected from regional to local geographic scales. In the absence of a cohesive ecological management framework, monitoring and evaluation activities proceed without a clear understanding of what uncertainty they are intended to address, nor is there a clear description of the process to utilize the information gained. As a result, the accountability for the investment of public funds for fish and wildlife restoration is poor, information collected from the environment is not included in decision-making, and the ability to gain knowledge while taking management actions is compromised. The sequence of steps discussed here does not identify or describe distinct monitoring activities or methodologies at any particular location or listed under any specific monitoring plan. Instead, it concentrates on the generic elements necessary for the design and implementation of coordinated fish and wildlife monitoring plans. It is proposed that at least four major issues demand considerable attention in order to improve regional monitoring and evaluation capabilities: The first is adoption of an ecological framework for the management of fish and wildlife at relevant geographic scales within the ecosystem. Such a framework must include an explicit identification of goals, objectives, and actions to steer coordinated decisions across the boundaries of technical disciplines, management jurisdictions, and institutional responsibilities. The second is that the identification of these management goals for the geographic location of interest must precede the design of monitoring and evaluation plans from the top down. Third, the evaluation component must be considered early on in the planning process, so that it blends smoothly with monitoring at the time of implementation. Fourth, decision-makers and scientists engaged in the planning of fish and wildlife monitoring and evaluation efforts in the region must have a close collaborative relationship. Monitoring and evaluation plans designed under these premises may enhance our collective observational capabilities, promote cost-effectiveness and adequate evaluation, and provide a useful tool to adjust our management practices to the challenges of complex ecosystems.

Animals↗
PubMedDate not supplied

The integrated health professions education program seminar.

Powerful dynamics of change require practitioners from all disciplines to be prepared to work in interdisciplinary teams, competently access health and information technologies, and understand the multiple functions required for adequate healthcare provision. The University of Iowa's Integrated Health Professions Program is a state-funded effort designed to provide students with a common educational experience to enable them to work collaboratively in underserved or rural settings. Students take part in a series of team-building seminars including technology-based instruction and activities in conjunction with visits to community clinical sites. The authors discuss the experiential, collaborative, and cooperative forms of learning that take place during the seminar series.

Community Health Services↗
PubMed1997

Prospects for the direct electron crystallographic determination of zeolite structures.

Recently two successful zeolite structures based on experimental electron crystallographic data have been published. Diffraction and image data based on the silicate portion of the zeolite, mordenite, which are perturbed by dynamical (as well as secondary) scattering, have been simulated by a multiple-beam dynamical scattering program. Structure analyses with these data show that the above claims are not unreasonable, given a high enough accelerating voltage for the electron beam. If, for example, 2.9 A resolution micrographs are taken from a 120 A thick crystal in a 200 or 400 kV electron microscope, the crystallographic phases found by image analysis (Fourier filtration) are accurate enough to be extended by the Sayre equation to the (atomic) resolution limit of the electron diffraction pattern (for example from a 105 A thick crystal illuminated by a 1,200 kV electron source). The resultant potential map can be interpreted to find most of the atomic positions and the remaining ones will appear during the progress of a Fourier refinement.

Aluminum Silicates↗