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At least 1,495 records · Page 83Linked to original sources
PubMed1993

Contraception in Spain.

This report analyzes various aspects of contraception in Spain. One notable finding is the wide socioeconomic, cultural and health variation among regions. Since 1975 a significant drop in the birth rate has been observed overall. Twenty per cent of the women studied at risk of pregnancy are using oral contraceptives. The most widespread contraceptive method is still coitus interruptus, followed by oral contraception and the condom, as well as the rhythm method. The highest use of oral contraceptive and IUDs is seen in Catalonia (20% and 26% respectively) followed by Andalusia, Madrid and Valencia. Although contraception has only recently become legal in Spain, it is widely available either without charge or very inexpensively; all methods including abortion are available. At present, priority is given to special interest groups such as women in special circumstances, teenagers, etc. and to special programs like "Integrated Care for Women" which includes contraception, STD, pregnancy monitoring, early diagnosis of gynaecologic cancer and menopause.

Abortion, Induced↗
PubMed1994

Primary prevention of conduct disorder.

Conduct disorders represent one of the most troubling and persistent childhood psychiatric disorders. This serious condition has a poor long-term prognosis and entails a wide range of negative consequences over the life span. No single intervention strategy has been identified that successfully alters its negative course. This article reviews developmental findings and previous intervention efforts and provides a rationale for approaching the problem of Conduct Disorder through primary preventive intervention. A comprehensive, family-based prevention model and specific clinical strategies for intervention are described. A case example is used to illustrate the integration of program components.

Antisocial Personality Disorder↗
PubMed1993

[The integration of a computer learning program for x-ray cephalometric analysis into student training].

A computer program was written for teaching undergraduate students definitions and localizations of reference points on cephalometric X-rays. The efficacy of the program as a teaching method was tested by comparing two junior/sophomore groups. While one group attended a conventional lecture for an hour, the other worked with the computer program for the same length of time. Prior to and immediately after instruction by the two methods each group marked reference points on various cephalometric tracings, which were then compared for accuracy. The result was that the students who worked with the computer marked significantly more reference points correctly than their counterparts who attended the lecture. 80% of the students belonging to the group which used the computer judged the program to be a positive educational experience. Such computer training proved to be an efficient tool for teaching students simple facts which require memorization and, equally important, the use of such educational aids. At the same time frees the instructors to dedicate more of their time to teaching more complicated and complex subject matters. A further benefit of the training program described in this article is that it can also be used to train chairside orthodontic assistants in private orthodontic practices.

Cephalometry↗
PubMed2000

[Termination of inpatient treatment for anorexia nervosa].

BACKGROUND: Dropout is a neglected area of research; patients with anorexia nervosa are a group with high risk for dropout. RESEARCH QUESTIONS: 1. What are the frequency and type of dropout in disorder-specific, integrated treatment programs for anorexic patients? 2. What are the predictors for dropout? METHOD: Analysis of 80 prospectively documented, consecutive treatment episodes of anorexic inpatients, based on multimodal clinical and psychometric parameters. RESULTS: Twenty percent of patients terminated on their own initiative, often after reaching target weight; 10% were discharged by the treatment team. At least 43% of dropouts continued with some sort of psychotherapy within the 3 months after discharge. Previous dropout was a predictor for dropout in the present episodes. Patients with no comorbidity had a higher risk of dropout. Patients discharged by the team had personality disorders more often. Patients with comorbid depression stayed in treatment. CONCLUSIONS: The form of termination of treatment should be routinely assessed. Previous dropout and comorbidity are indicators of the risk of dropout.

Adolescent↗
PubMed2005

Intermittent and mobile surgical services: logistics and outcomes.

A program of intermittent surgical services utilized a mobile facility to support multiple primary care sites in Ecuador. The fiscal and clinical outcomes of the program were analyzed. From 1994 to 2003 the mobile program responded to requests from 15 of 22 provinces of Ecuador for surgical care. The sites served could not offer permanent surgical care. Criteria for inclusion and follow-up were set. Medical records were kept in accordance with standards of the Ministry of Health. Standards of care and critical care pathways were instituted. The program had a permanent staff supplemented by volunteers. Cases were recorded and outcomes noted with respect to complications. The cost of the surgical aspect of the program was entirely covered by a foundation through donations and public service contracts. Financial records of the foundation were reviewed and the costs analyzed. A total of 4545 operations were done largely in general surgery specialties. The program made 40 to 50 excursions each year and proved to be a stable element of medical care delivery. There were no deaths, four major complications, and three minor complications. The cost per operation was less than $100. Comparison to U.S. and international volunteer organizations are reported. This program of intermittent mobile surgical services in coordination with fixed primary care constitutes a sustainable, high quality clinical program fully integrated into existing care of a national health ministry. In-country resources may provide greatly enhanced services at low cost and should be considered as an alternative.

Delivery of Health Care↗
PubMed2006

Watershed nitrogen and mercury geochemical fluxes integrate landscape factors in long-term research watersheds at Acadia National Park, Maine, USA.

This paper is an overview of this special issue devoted to watershed research in Acadia National Park (Acadia NP). The papers address components of an integrated research program on two upland watersheds at Acadia NP, USA (44 degrees 20' N latitude; 68 degrees 15' E longitude). These watersheds were instrumented in 1998 to provide a long-term foundation for regional ecological and watershed research. The research was initiated as part of EPA/NPS PRIMENet (Park Research and Intensive Monitoring of Ecosystems Network), a system of UV-monitoring stations and long-term watershed research sites located in US national parks. The initial goals at Acadia NP were to address research questions about mercury, acid rain, and nitrogen saturation developed from prior research. The project design was based on natural differences in forests and soils induced by an intense wildfire in one watershed in 1947. There is no evidence of fire in the reference watershed for several hundred years. We are testing hypotheses about controls on surface water chemistry, and bioavailability of contaminants in the contrasting watersheds. The unburned 47-ha Hadlock Brook watershed is 70% spruce-fir mature conifer forest. In contrast, burned 32-ha Cadillac Brook watershed, 4 km northeast of the Hadlock watershed, is 20% regenerating mixed northern hardwoods and 60% shrub/rocky balds. Differences in atmospheric deposition are controlled primarily by forest stand composition and age. The watersheds are gauged and have water chemistry stations at 122 m (Cadillac) and 137 m (Hadlock); watershed maximum elevations are 468 and 380 m, respectively. The stream water chemistry patterns reflect, in part, the legacy of the intense fire, which, in turn, controls differences in forest vegetation and soil characteristics. These factors result in higher nitrogen and mercury flux from the unburned watershed, reflecting differences in atmospheric deposition, contrasting ecosystem pools of nitrogen and mercury, and inferred differences in internal cycling and bioavailabilty.

Acid Rain↗
PubMed1988

Spectrum of diseases for resident education in internal medicine.

We examined the spectrum of diseases to which medical residents were exposed in a fully integrated residency program comprised of a voluntary and a municipal acute-care hospital. Although circulatory disorders and diseases of the respiratory and nervous systems accounted for the majority of cases, a broad spectrum of diseases was present for residents' training at both institutions. These observations must be considered within the context of the changing nature of medical practice in the United States, with a marked shift from inpatient to outpatient and office medical care.

Cardiovascular Diseases↗
PubMed1990

Panic disorder: cognitive-behavioral treatment.

The effectiveness of an integrated treatment program utilizing cognitive-behavioral therapies for Panic Disorder was examined. Treatment was comprised of Cognitive Model of Panic-derived procedures, Cognitive Therapy and Applied Relaxation Training. Subjects meeting DSM-III-R criteria for Panic Disorder received thirteen 2.5-hr sessions of outpatient therapy in small groups, over a 12-week period. Subjects were given an extensive rationale of the etiology, development and maintenance of Panic Disorder, within the framework of the Cognitive Model of Panic, and controlled behavioral experiments in panic evocation to internal panicogenic cues, cognitive reappraisal of somatic and ideational cues, breathing retraining, Applied Relaxation Training and Cognitive Therapy to identify and remediate maladaptive beliefs and dysfunctional cognitive schemas. A comprehensive assessment battery was given at pre-mid-post-treatment which included measures of tripartite functioning, global severity, panic, fear, anxiety, depression and psychiatric symptomatology. Analyses indicated statistically significant improvements across all outcome domains. All subjects were free of spontaneous (uncued) panic attacks at post-treatment, and all met operationalized criteria for high endstate functioning. These findings are discussed, with recommendations for future research.

Adult↗
PubMed1992

Alternative model for low risk obstetric care in Third World rural and peri-urban areas.

The Program for Integrated Health Care (PROAIS) has devised ways and means of reaching the traditional birth attendant, here called empiric midwife and training her to offer adequate, hygienic care at delivery for her low-risk patients. She is taught to recognize the high-risk patient and to send her to the weekly prenatal clinics staffed by physicians and registered nurses. The empiric midwife can also be taught prenatal care, detection of cervical and breast cancer, family planning, and the importance of breastfeeding. These women are considered colleagues by their formal medical counterparts and are treated as such. More recently some of the more capable have been placed on County Health Department payrolls.

Brazil↗
PubMed1990

Nepal: integrating traditional and modern health services in the remote area of Bashkharka.

Within a framework of Primary Health Care (PHC) and Health Promotion (HP), the focus of this paper is on integrating traditional and modern health care in the remote area of Bashkharka, Nepal. The relevance to integrated health care of factors such as geography, ethnicity, religion, national infrastructure and international development agencies are discussed. Issues concerning the relationship between the theory and practice of PHC and HP are raised.

Health Policy↗
PubMedDate not supplied

Profile of traditional birth attendants in a rural area of north India.

Two hundred traditional birth attendants (TBAs) of a community development block of India were interviewed. The majority were age 45 years or above (81%), illiterate (85%), and of low caste (78%). Most (88%) had three or more children. Although 27% had inherited the profession from older female relatives, only 4% have daughters or daughters-in-law in the profession. Almost half (48%) had conducted 11 or more deliveries in last year. The TBAs charged more money to deliver a male infant than to deliver a female. The TBA workforce in India appears to be shrinking, possibly because of gradual reduction in family size. Backup support from state maternal health care services is lacking. Existing cadre of TBAs should be involved in primary health care to ensure the survival of the institution of dais (TBAs) and to ensure the availability of basic maternity services to rural women.

Age Factors↗
PubMed1993

Acute toxicity of vitamin A given with vaccines in infancy.

A double-blind, randomised, placebo-controlled trial was conducted to evaluate the safety and toxicity of vitamin A supplementation within the Expanded Programme on Immunisation (EPI) in rural Bangladesh. 191 infants received 3 doses of either 50,000 IU of vitamin A or placebo at about 1.5, 2.5, and 3.5 months and were examined on days 1, 2, 3, and 8 after supplementation. 11 infants (11.5%) supplemented with vitamin A had episodes of bulging of the fontanelle as opposed to 1 (1%) in the placebo group. 16 of the 17 events occurred in the vitamin A supplemented group. No other side effects were noted. There was a tendency towards a cumulative effect of toxicity with increasing doses.

Bangladesh↗
PubMed1995

A visual data flow environment for macromolecular crystallographic computing.

This article describes the integration of programs from the widely used CCP4 macromolecular crystallography package into a modern data flow visualization environment (application visualization system [AVS]), which provides a simple graphical user interface, a visual programming paradigm, and a variety of 1-, 2-, and 3-D data visualization tools for the display of graphical information and the results of crystallographic calculations, such as electron density and Patterson maps. The CCP4 suite comprises a number of separate Fortran 77 programs, which communicate via common file formats. Each program is encapsulated into an AVS macro module, and may be linked to others in a data flow network, reflecting the nature of many crystallographic calculations. Named pipes are used to pass input parameters from a graphical user interface to the program module, and also to intercept line printer output, which can be filtered to extract graphical information and significant numerical parameters. These may be passed to downstream modules, permitting calculations to be automated if no user interaction is required, or giving the user the opportunity to make selections in an interactive manner.

Base Sequence↗