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Vanguard family planning acceptors in Senegal.

This study examines contraceptive use among clients at the three clinics providing family planning services in Dakar, Senegal in early 1983. Most clients first became interested in family planning following the birth of a child, and most are interested in spacing future pregnancies, although one-third state that they want no more children. The clinic itself was found to be an important determinant of the type of contraceptive used, with only the government-operated clinic providing a balance between IUDs, oral contraceptives, and barrier methods. Nearly half of the clients interviewed said that a lack of knowledge about contraception is the reason for the low contraceptive prevalence rates among Senegalese women; another frequently cited reason was the opposition of the husband. Most clients reported the broadcast media to be the best means of providing family planning information to potential acceptors.

Contraceptive Devices, Male

The professional portfolio: documentation of prior learning.

Many questions about the use of the professional portfolio remain. Is the underlying assumption that registered nurses have prior learning that should be credited by baccalaureate programs acceptable to all faculty and all institutions of higher learning? Will the academic quality of the learning experiences of the registered nurse be enhanced or threatened by the portfolio process? Is the portfolio method appropriate for all nurse students or is it best suited to the experienced professional who is articulate and has clear educational and professional goals? How can questions of reliability and validity be addressed? Will faculty maintain the commitment to an individualized method of assessment in times of decreasing resources and expanding responsibilities?

Credentialing

Participative style of management in a family planning program.

In 1973, a small-scale project to involve family planning staff in program management was introduced in the Sangam primary health center in Andhra Pradesh by the Adminstrative Staff College of India, Hyderabad. Through group meetings, involving all levels of health center personnel, problem areas were identified and analysed and solutions sought. On the basis of recommendations made by the groups, a work plan was drawn up. Monthly review meetings were held to discuss progress in implementing the plan. The project was found to have a positive effect on staff morale and commitment, and program acceptance levels increased. In light of the success of the project at Sangam, a proposal has been submitted to the government to expand the project to other primary health centers in the district.

Attitude of Health Personnel

Long-term care of obese individuals in a community-based primary health care program.

A four-year treatment program for severe obesity containing behavioural modification, exercise and nutrition advice was developed at the obesity unit at the Karolinska Hospital. The program made it possible to achieve a sustained weight loss. As far as we know such long-term treatment result has not been reported for this group of patients before. As a consequence of the positive outcome the hospital treatment program was transformed to an out-patient program that could be used in a primary health care setting. The transformation process is emphasized in this presentation but also preliminary results of the weight reduction and the attrition rate in the primary health care setting of the weight reduction program are presented. The evaluation indicates that instructors and participants in the program overall have accepted the program. The mean weight reduction after ten weeks was 6.3 kg. The attrition rate during that time was 2%.

Adult

Swine influenza vaccine program in the community: acceptability, reactions and responses.

The operation of the national swine influenza immunization program was observed in the community of Tecumseh, Michigan. The purpose was to determine acceptability of a parenteral vaccine intended for the general population. Participation of the residents was excellent. More than 64 per cent of eligibles were vaccinated; this figure resembled that of the rest of the local area, but not the national figures nor a suburban area of Michigan where a similar study was carried out. Sore arm after vaccination was reported most frequently in younger female participants; however, sore arm was accepted as part of the process of vaccination and not considered a reaction by most. Such perceived reactions were not as commonly reported as in the large suburban area. Antibody response to the vaccine was excellent, not only in terms of antibodies to the swine virus itself but also in terms of cross reactive antibodies to the emergent H1N1 (Russian) influenza strain. As a result of the program, many vaccine recipients in the 25 to 49 year age groups are protected against this new epidemic virus.

Adolescent

Health care provider and contraceptive care setting: the relationship to contraceptive behavior.

This study examines contraceptive delivery characteristics and their association with contraceptive behavior. Data were collected in telephone interviews from a national sample of 1057 women who were using female contraceptives. The overwhelming majority of the sample obtained contraceptive services from gynecologists and other physician specialists and were seen in private facilities. Whereas nearly half of the providers recommended use of specific methods, only one-fourth discouraged use of particular methods. The pill was both the most frequently recommended and most commonly discouraged method. With regards to the provision of contraceptive information, practitioners were most likely to discuss the effectiveness of a method. In three of the four categories examined, a higher percentage of non-MDs than MDs gave information to their patients. Although the majority of women reported they were satisfied with the quality of care, mean satisfaction ratings were higher for female providers compared to male providers.

Adolescent

Evolution of a processing system in a large biomedical library.

The processing system used in the UCLA Biomedical Library is modest in size and still under development. Its origins date back to a batch mode serials control system begun in the mid-1960s. This was converted to an on-line system which currently has modules for check-in, updating and retrieval, claims, bindery preparation, and invoice information. Titles can be retrieved at the terminal by search of any word in the title, by subject heading, language, country of publication, and type of publication. The system is adaptable to network use and at present is shared with one other library. To the serials system has been added a computer-assisted cataloging and card production system. The latter utilizes serials nucleus software as well as design for data input and data storage. In-house listings and coding procedures overlap in a general way. Work is under way on further integration of the two processing subsystems and a feasibility study has been completed for addition of a subsystem for acquisitions which will combine and adapt features of the other two; for example, information retrieval characteristics from both, catalog coding and programs for acceptance of data, serials programs for claims, and other output programs. Cost benefits of the subsystems are described and discussed.

Cataloging

Modern health services and health care behavior: a survey in Kathmandu, Nepal.

The most important problem regarding health service utilization in Third World countries is that established indigenous forms of health care are readily available and compete with modern health care. Thus, in addition to understanding the components of the decision to seek medical help, we must understand the conditions that affect the choice of a specific health care system. This study examines the impact of medical pluralism on the use of modern forms of health care in Nepal. The findings show that the presence of medical pluralism is a significant factor which delays use of modern health services. Policy implications are discussed, and the need for more research in this area is stressed.

Attitude to Health

Intuitive user interfaces (IUI): a CASE starting point for design and programming.

The acceptance of a software product depends to a considerable extent on the user interface. The class of graphic-oriented user interfaces that are called Intuitive User Interfaces (IUI) is described. These interfaces allow the user to learn to operate software programs quickly. In the following the graphical layout put to use in an IUI is elaborated. All images the layout consists of are created with the aid of a paint program. Using these images, a procedure for creating, programming and linking an IUI to software applications is discussed and recommendations are made concerning software and hardware demands for easily creating IUIs. Practical experience of the authors with this procedure, mainly in the medical area, is described.

Computer Graphics

Nonfinancial barriers to prenatal care.

This article focused on nonfinancial barriers to prenatal care and pointed out that these barriers cannot be ignored if access to care is to be improved. The strategies suggested by the Consensus Conferences for reducing these barriers provide abundant opportunities for all professionals, and the implications for health policy formulated by the Conferences provide direction for eventually eliminating the barriers. It will take a combination of professional, political and public will to make this happen.

Adolescent