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This case study presents a young woman who developed a severe obsessive-compulsive disorder after a routine medical procedure. It is suggested that this procedure brought back repressed guilt from three abortions and thus led to the onset of symptoms. The case is discussed in relationship to available research and theory.
The authors compared a group of 58 adolescent girls who had been pregnant once during a two-year period with an age-matched group of 58 girls who had become pregnant at least twice during the same period. They found that the girls' attitudes toward contraception did not predict contraceptive use. Regular use of contraception was associated with a positive relationship between the girls and their mothers and with the presence of the girls' fathers in the home. The authors suggest that parental support of contraception plays a more important role in preventing repeat pregnancies than does the adolescents' reported attitudes toward contraception.
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The length of delay in seeing a physician was related to perceived difficulty in access to services and to scepticism and doubt about the effectiveness of medical care. Attention is called to the importance of the doctor-patient relationship in fostering prompt patient action.
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A process of change was initiated in a Nicaraguan regional hospital in order to achieve a sustainable reduction of early neonatal mortality. A series of organizational, educational and hygienic measures was introduced, involving all staff in antenatal care, delivery care and neonatal care. Neonatal mortality decreased from 56/1000 live births in 1985 to 11/1000 in 1993. A commission of maternal and child health, a weekly perinatal audit, the active involvement of all staff and dedicated work of key individuals, as well as national policy decisions, are considered important determinants of the process. Keeping neonatal mortality in focus through continuous analysis of care routines, and through external exchange of ideas is important in order to sustain improvements and to decrease further the mortality.
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A three-dimensional dynamic simulation program for the prediction of leachate flows, their organic contamination and the gas generated in municipal waste landfills, (MODUELO) has been developed. It permits the simulation of canyon landfills in which the surface area changes throughout the landfill's history and of complex drainage systems. The "hydrologic module" calculates, based on the saturated flow equations, the water flow between cells and the overall moisture balance. Its results allow the "contamination module" to carry out the balance of organic material. This paper presents the development of the "hydrologic module". The contamination models are included in another paper. A preliminary application to the Meruelo Landfill (Spain) is also shown here. The fitting of a data series of leachate flows in Meruelo indicated the existence, in this particular landfill, of unconsidered phenomena. The final adjustment of the results makes it possible to obtain a reliable simulation of the degradation processes.
"A random sample of Mexican American women and a sample of family planning health care professionals, both from two major southwestern cities in the United States, were compared in terms of their reports of birth control methods used, problems in obtaining family planning services, and values involved in making fertility-related decisions, within the Mexican American population.... While there were points of agreement between the two samples, discrepancies were found in reports of problems in obtaining family planning services, fertility-related values, and in the acceptability of female sterilization as a birth control method. It was concluded that family planning professionals in these service areas tend to stereotype Mexican American women, and may not yet realize that the family planning attitudes and behavior of these women are probably changing in significant ways." (SUMMARY IN SPA)
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BACKGROUND: Recently, Almeida and Vinga offered a new approach for the representation of arbitrary discrete sequences, referred to as Universal Sequence Maps (USM), and discussed its applicability to genomic sequence analysis. Their work generalizes and extends Chaos Game Representation (CGR) of DNA for arbitrary discrete sequences. RESULTS: We have considered issues associated with the practical implementation of USMs and offer a variation on the algorithm that: 1) eliminates the overestimation of similar segment lengths, 2) permits the identification of arbitrarily long similar segments in the context of finite word length coordinate representations, 3) uses more computationally efficient operations, and 4) provides a simple conversion for recovering the USM coordinates. Computational performance comparisons and examples are provided. CONCLUSIONS: We have shown that the desirable properties of the USM encoding of nucleotide sequences can be retained in a practical implementation of the algorithm. In addition, the proposed implementation enables determination of local sequence identity at increased speed.
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Adolescents are extremely vulnerable to unwanted pregnancy. Counseling around the decision making process requires expertise in the areas of adolescent development, teenage motherhood and abortion. Teenagers usually need more intensive counseling than adult women in coping with an abortion because of their developmental status. If the abortion issue is not adequately resolved, adolescents may present later life problems around sexuality and parenting. Although teenagers who choose abortion have good potential to benefit from crisis intervention, there are very few services available to them.
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The infant mortality rate has been considered a summary of the quality of life and level of development of a given population. However, this indicator is very sensitive to such simple measures as oral rehydration therapy, vaccination, and continuation of breast-feeding. Given that such health activities have become more widespread, an infant mortality rate may no longer reflect a particular development model. With the aim of broadening the discussion regarding infant mortality, this study analyzed the 153 neighborhoods of the city of Rio de Janeiro, Brazil. Our objective was to identify areas with more risk, and the priority groups for interventions to decrease infant mortality. We analyzed neonatal and postneonatal mortality in each neighborhood. We also identified the children's home neighborhood and the location of their deaths and related these results to the socioeconomic classification of the corresponding neighborhoods. In relation to the average infant mortality rate for the city, we could not make statistically significant comparisons for some neighborhoods due to their small number of births. One-third of the infant deaths could have been prevented with early diagnosis and treatment. Only 15% of the deaths were considered unavoidable. Both neonatal mortality and postneonatal mortality were geographically dispersed, with no direct association with the socioeconomic profile of the neighborhoods. An analysis of the children's place of residence and the location of their deaths showed flows of patients from poor areas to more affluent city areas with better health services. This pattern highlights the effect of access to quality medical care on infant mortality.