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PubMed1993

Factors related to the utilization of prenatal care in Vietnam.

Data from the 1988 Vietnam Demographic and Health Survey and 1990 Vietnam Accessibility of Contraceptives Survey were used in this analysis of the influence of selected individual and community characteristics on the utilization of prenatal care in Vietnam. Specific analysis of the impact of availability of health services and other development characteristics of the community on utilization of prenatal care was done in a rural subsample. The woman's educational level and total number of living children were the most significant predictors of prenatal care utilization. Age independent of parity did not significantly affect the use of prenatal care. Rural women and women living in provinces with the highest infant mortality rates were significantly less likely to use prenatal services than their counterparts in the urban areas and provinces with low infant mortality rates. Non-physician health care providers were the main sources of prenatal care for women in both rural and urban areas.

Adolescent↗
PubMed1993

The ability of adolescents to predict future outcome. Part I: Assessing predictive abilities.

Because adolescents are generally viewed as "risk-takers," an assessment of planning and decision-making skills during the teenage years may reveal why this developmental group tends to engage in dangerous behaviors. One area in which these abilities have significant consequences for future outcome is pregnancy, a condition that requires a decision to either give birth or abort. Previewing, a process by which caregivers introduce infants to the physical sensations of imminent developmental change and the implications of such change on their relationship, may affect the adolescent's ability to predict upcoming change. This paper explores previewing skills during the adolescent years and how this capacity affects the teenager's orientation toward future outcomes.

Adolescent↗
PubMed1993

The ability of adolescents to predict future outcome. Part II: Therapeutic enhancement of predictive skills.

The assertion of autonomy, a developmental challenge of adolescence, helps predict the teenager's attitude toward pregnancy and parenthood. Significantly, the ability to predict the future relationship with the infant has direct implications for the achievement of an adaptive outcome. Indeed, the interpersonal outcome of the parent-infant relationship may be predicted by the adolescent's behaviors with her infant. A prospective orientation may offer an important vantage point for improving this relationship. For example, the ability to predict future outcome helps identify potential conflict, such as abuse. When applying a prospective approach during the prenatal period, the adolescent's past relationship with her own mother and her motivations for becoming a parent will be explored in order to predict the future dyadic relationship. For adolescents who are already parents, an assessment of the dyad's contemporaneous interaction may further predict future interpersonal exchange. Moreover, orienting the adolescent parent toward the future may identify areas of potential conflict, as well as foster more adaptive dyadic exchange.

Adolescent↗
PubMed1993

Adoption as an option for unmarried pregnant teens.

Adolescent parenthood reduces the opportunities and optimal outcomes for both mother and child, yet pregnant teenagers rarely consider adoption. This paper reports a qualitative study that explored the reasons this option is so rarely examined. Twenty-one unmarried pregnant adolescents and their significant others were interviewed twice to determine the meaning adoption has for them. Four phenomena were found to be pivotal to the their willingness to consider adoption: (1) societal sanctions, (2) low level of knowledge, (3) anticipated psychological discomfort, and (4) lack of support from helping professionals. Information generated should be useful at health and social policy levels as well as to professionals who work with pregnant teenagers.

Adolescent↗
PubMed1993

[Oral rehydration therapy: an analysis of its results and impact on the hospitalization and mortality of children with diarrhea].

We present results of four years in oral rehydration therapy (ORT) in the Hospital Infantil del Estado de Sonora. There was 10.2 consults by diarrhoea for day. Children lower of one year old received oral rehydration therapy in 86.8%, were included 11% of prolonged diarrhoea and 32.3% of children with malnutrition. During the procedure diarrhoea there was complicated in 3% with paralytic ileus sepsis and pneumonia. Effectivity of ORT was in 90.9%; 92.8% in light dehydration and 78.7% moderate. Failure in 8.6% was due to vomitus, no acceptation of the oral solution, abundant evacuations and other complication presented. Were observed reduction in hospitalization, rate of 19.2% in 1986 to 38.4% in 1989. The diarrheal mortality decreased in the Urgence Department in 42% and in the Infectology Department in 54%. We considered these results as satisfactory, but are susceptible to better when we diffuse more the oral rehydration therapy in own region.

Adolescent↗
PubMed1993

Family planning in the teen population.

As an increasing percentage of adolescents reach their sexual debut at younger ages, effective contraceptive methods, which will decrease the risks of unintended pregnancies and sexually transmitted diseases (STDs), become even more critical. Contraceptive methods which are less 'compliance-dependent', such as the implantable subdermal levonorgestrel and the injectable depot formulation of medroxyprogesterone acetate, are popular in adolescents but careful counseling before method selection and on-going counseling when side-effects are experienced are necessary and essential. The use of condoms to decrease the risks of STDs will continue to be important for adolescents, and it remains to be seen what impact the long-term methods will have on effective condom use. Adolescents' access to abortions when contraceptive methods fail, or when no method is used, is being challenged with state laws which mandate parental notification or permission. A greater knowledge about the option of emergency contraception could potentially lead to increased use of this method, particularly when the option of medications such as RU486 becomes available. The potential for a reduction in unintended pregnancies in adolescents, and a reduced need for abortions is a welcome prospect.

Abortion, Legal↗
PubMed1993

Risk factors for mortality in the Bangladesh cyclone of 1991.

Cyclones continue to pose a dangerous threat to the coastal populations of Bangladesh, despite improvements in disaster control procedures. After 138,000 persons died in the April 1991 cyclone, we carried out a rapid epidemiological assessment to determine factors associated with cyclone-related mortality and to identify prevention strategies. A nonrandom survey of 45 housing clusters comprising 1123 persons showed that mortality was greatest among under-10-year-olds (26%) and women older than 40 years (31%). Nearly 22% of persons who did not reach a concrete or brick structure died, whereas all persons who sought refuge in such structures survived. Future cyclone-associated mortality in Bangladesh could be prevented by more effective warnings leading to an earlier response, better access to designated cyclone shelters, and improved preparedness in high-risk communities. In particular, deaths among women and under-10-year-olds could be reduced by ensuring that they are given special attention by families, neighbours, local authorities, and especially those in charge of early warnings and emergency evacuation.

Adult↗
PubMed1996

Dynamic simulation using a graphical programming language.

A power oscillator, suitable for energizing an ultrasonic surgical cutter was simulated using a graphical programming language. The simulation included a model of the amplitude control system as well as the ultrasonic actuator. In addition, those elements which existed in a practical oscillator and were typically obscure to the design requirements were identified, simulated and discussed.

Computer Simulation↗
PubMedDate not supplied

Comparing the Peru service availability module and situation analysis.

This report reviews the experience of the World Fertility Surveys and the Demographic and Health Surveys (DHS) in collecting community-level data on family planning. It assesses the validity of the community data for Peru that were collected via a service availability module, much like that which is used for the DHS, through a comparison with data from the Situation Analysis. The analysis indicates that the knowledgeable informant, the main source of information about family planning in each community for the service availability module, may not be an accurate source of data. Information about the availability of family planning services is more reliable when it is obtained by means of visits to service sites. However, given cost considerations, sampling problems, and analysis issues, routine linkage of Situation Analyses to household surveys such as the DHS is not recommended at this time.

Contraception Behavior↗
PubMed1996

Haemophilia care in Zimbabwe.

OBJECTIVE: To review haemophilia care in Zimbabwe. DESIGN: Retrospective study. SETTING: Cases seen in both central hospitals and health centres in Harare. MAIN OUTCOME MEASURES: Home treatment hospital admission and HIV seroconversion. RESULTS: Of the expected 500 haemophilicacs in a Zimbabwean male population of five million, only 190 had been registered by mid 1993. Home treatment is effective. CONCLUSION: Haemophilia care in Zimbabwe has a good foundation. Home care is effective and needs to be expanded simultaneously with health education for the cases.

Adolescent↗
PubMed1996

Using community health workers for malaria control: experience in Zaire.

The potential for using community health workers (CHW) for administering timely and effective treatment for presumptive malaria attacks was evaluated in the Katana health zone in Zaire. In each of the 12 villages of an intervention area (area A) with 13000 inhabitants, a CHW was trained in the use of a simple fever management algorithm. The CHWs performed their services under the supervision of the nurse in charge of the area's health centre (HC). Malaria morbidity and mortality trends were monitored during 2 years in area A and in an ecologically comparable control area (area B), where malaria treatment continued to be available at the HC only. Health care behaviour changed dramatically in the intervention area, and by the end of the observation period 65% of malaria episodes were treated at the community level. Malaria morbidity declined 50% in area A but remained stable in the control area. Parasitological indices showed similar trends. Malaria-specific mortality rates remained, however, at essentially the same levels in both areas. The non-comprehensiveness of the CHWs' care and their ambiguous position in the health care system created problems that compromise the sustainability of the intervention.

Adolescent↗
PubMed1996

Late psychological sequelae of abortion: questions from a primary care perspective.

Research strongly supports the view that pregnancy termination is seldom associated with adverse psychological sequelae in the short to medium term, but experience shows that there is a small group of women who experience long and intense suffering. This is a report of the cases of two women who presented with psychological problems associated with a termination 19 and 5 years earlier.

Abortion, Induced↗
PubMedDate not supplied

Health promotion technology transfer: organizational perspectives.

This paper explores the relationship between organizational dynamics and program dissemination. Specifically, it is an analysis of factors affecting the directed diffusion of health promotion innovations which target schools and worksites as delivery channels. Technology transfer is the construct which is used to capture this notion of directed diffusion. The term is defined for the purposes of the paper as all strategically planned efforts to promote, influence, or accelerate the natural diffusion or dissemination processes. The paper has three main objectives: first to identify the theoretical perspectives which have influenced my thinking in the area of health promotion technology transfer; second, to describe an organizing framework for the study of health promotion technology transfer; and third, to recommend directions for health promotion planning efforts in the future and the role that research might play in that process.

Child↗
PubMedDate not supplied

The effects of economic conditions and access to reproductive health services on state abortion rates and birthrates.

The effects that such factors as wages, welfare policies and access to physicians, family planning clinics and abortion providers have on abortion rates and birthrates are examined in analyses based on 1978-1988 state-level data and longitudinal regression techniques. The incidence of abortion is found to be lower in states where access to providers is reduced and state policies are restrictive. Calculations indicate that decreased access may have accounted for about one-quarter of the 5% decline in abortion rates between 1988 and 1992. In addition, birthrates are elevated where the costs of contraception are higher because access to obstetrician-gynecologists and family planning services is reduced. Economic resources such as higher wages for men and women and generous welfare benefits are significantly and consistently related to increased birthrates; however, even a 10% cut in public assistance benefits would result in only one birth fewer for every 212 women on welfare. Economic factors showed no consistent relationship with abortion rates.

Abortion, Legal↗
PubMed1997

Emergency contraception: a second chance at preventing adolescent unintended pregnancy.

Adolescent pregnancy challenges the United States and Europe. For most sexually active adolescents, pregnancy is unintended. Emergency contraception, also called the "morning-after treatment" or postcoital contraception is a way to prevent pregnancy after unprotected intercourse. In February 1997, the Food and Drug Administration (FDA) approved the use of certain oral contraceptive pills for emergency contraception. There are currently six brands of pills marketed in the United States that can be prescribed to, conform to the FDA-approved regimen. When emergency contraceptive pills are initiated within 72 hours of unprotected intercourse, they reduce the risk of pregnancy by 75%. Contraindications are the same as those used for ongoing contraceptive pills. The most common side effects are nausea, vomiting, menstrual disturbances, breast tenderness, abdominal cramping, dizziness, headache, and mood changes. Routinely counseling all adolescents about emergency contraceptive pills and increasing access to them can give adolescents a second chance at preventing pregnancy.

Adolescent↗