Breast-feeding trends and the breast-feeding promotion programme in the Philippines.
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Results for “Communication Programs”
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[Training in health education in child welfare nursing schools: a survey of teachers and students].
The emergence of new nurses' profile, stemming from study program of 1992, has urged nursery-nurse schools to think about their current training program. We have hold an inquiry in these schools to know how this new profile could be a factor to make easier the training in health education. We have also asked nursery-nurse teachers about the same problem in order to make suggestions just before reform of study's program of nursery-nurse certificate. This inquiry has shown that profile was polymorphic and there was some evolution in used tools of communication. Thenafter, suggestions regard the whole of training program but in priority about a procedure for a community health in order to satisfy needs of populations concerned by nursery nurse work.
Adolescent↗
An account of the usefulness of a pilot clinical ethics program at a community hospital.
This article describes the development and implementation of a six-month pilot clinical ethics program at Saint Thomas Hospital (Nashville, Tenn). To assess the impact of this program, baseline data were gathered from a self-selected sample of critical and special care unit nurses and physicians about the "most troublesome" ethical dilemmas in their practices. Nurses and physicians reported facing similar dilemmas in practice. Nurses believed that chaplains and peers were most "beneficial" in resolving their "most troublesome" cases; physicians did not deem one particular individual or service to be of any greater benefit than any other in dilemma resolution. Nurses and physicians indicated that in many cases patients and families did not appear involved in the process. In a posttest survey following the pilot program, nurses rated the beneficial role of chaplains somewhat lower and agreed that the clinical ethics service was beneficial. As with the pretest sample, the posttest nurses evaluated the role of the attending physician as "detrimental" to resolving their ethical conflicts. In the posttest, physicians ranked the role of the clinical ethicist as comparable to that of chaplains and social workers.
Attitude of Health Personnel↗
[Demography. Fewer children to live better].
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Africa↗
What makes for a compassionate patient-caregiver relationship?
BACKGROUND: During Summer 2005, the Kenneth B. Schwartz Center asked hospitals to hold rounds to discuss the topic, "What Makes for a Compassionate Patient-Caregiver Relationship?" Review of questionnaires and transcripts of the rounds held at 54 hospitals in 21 states yielded three major categories: communication, common ground, and respect for individuality. COMMUNICATION: Suggestions to improve compassionate care often focused on style and content. Rounds attendees felt that compassionate care also depends on imparting medical facts in a clear and useful manner to patients--often difficult for complex medical issues. COMMON GROUND: Compassionate care depends on showing empathy for a patient's illness experience no matter what his or her background. Rounds participants felt that caregivers could make a conscious choice to care deeply for patients. Sharing personal information with patients and admitting mistakes were key methods for identifying common ground. TREATING THE PATIENT AS AN INDIVIDUAL: Compassionate care requires striking an individualized balance between providing guidance and allowing autonomy to achieve shared consensus, especially with complex information. A PRESCRIPTION FOR CHANGE: Most interventions target students yet do not continually reinforce compassion. Advocates for compassionate care should instead treat lack of compassion not as an acute trauma but as a chronic condition requiring a lifetime of continuous support, regular guidance, repeated reinforcement, specific targeted outcomes, and more innovative care programs.
Communication↗
Modification of motor control of wrist extension by mesh-glove electrical afferent stimulation in stroke patients.
OBJECTIVE: To study the effect of mesh-glove afferent stimulation on motor control of voluntary wrist movement in stroke patients who have chronic neurological deficits. DESIGN: Case series. Motor control was evaluated by surface EMG of the arm muscles and kinematics of voluntary wrist movements on 3 occasions: before and immediately after the initial session of mesh-glove stimulation, and then after a daily mesh-glove stimulation program conducted over several months. SETTING: Tertiary care center. PATIENTS: The inclusion criteria were: a history of stroke lasting longer than 6 months; completion of a rehabilitation program during early recovery; and preserved cognitive and communicative ability. Fourteen referred patients (age 63 +/- 9yr; time since stroke 31 +/- 22mo) fulfilled the criteria and completed the daily stimulation program. INTERVENTION: A single initial and then daily mesh-glove electrical afferent stimulation was applied to the hand of the involved upper limb for 20 to 30min. MAIN OUTCOME MEASURES: Surface EMGs from the affected biceps brachii and wrist extensor muscles and amplitudes of wrist movements were analyzed. RESULTS: The single, initial mesh-glove application had no effect on outcome measures. Following a daily mesh-glove stimulation program, however, both the amplitude of wrist extension movement and wrist extensor integrated EMG were significantly increased while coactivation of biceps brachii decreased. These findings were most prominent in subjects with partially preserved voluntary wrist movements. CONCLUSION: We conclude that daily mesh-glove stimulation can modify altered motor control and improve voluntary wrist extension movement in stroke subjects with chronic neurological deficits.
Afferent Pathways↗
Development and maintenance of guideline-based decision support for pharmacological treatment of hypertension.
The objective was to build a computer-based decision support system (DSS), which could apply the formal rules embedded in guidelines regarding pharmacological treatment of hypertension. The aim was also to test VISUAL BASIC as a development tool for DSS's in health care. From the Swedish guidelines for treatment of hypertension, the most widely accepted and scientifically best proved treatment strategies were chosen and implemented as rules. A DSS that is capable of applying the evidence-based rules extracted from guidelines regarding drug treatment of hypertension, to any patient's medical profile, was constructed. The output consists of a recommendation regarding preferred generic drug class and also a written report, reflecting decision steps provided by the rule-base and inference engine. We also provide methods for formalising an implementable language of guidelines. A mainstream programming language like VISUAL BASIC can be an alternative when building complicated decision support systems. A logic formal notation can facilitate communication between the expert and the programmer. The program is a stand-alone product independent of computerized medical records and thereby easy to install and maintain.
Antihypertensive Agents↗
Bridges crossed yesterday, peaks to be conquered tomorrow. AIDS and the condom.
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Acquired Immunodeficiency Syndrome↗
The urban community as the client in preterm birth prevention: evaluation of a program component.
Education of communities about preterm birth is essential because preterm birth is a major perinatal health problem, contributing 60-80% of the perinatal mortality in the United States. Preterm birth impacts on the health of the community through the increased morbidity and mortality of the affected children, which leads to higher health care costs and compromised future productivity. The role of early enrollment into prenatal care in the improvement of perinatal outcomes has been established by many investigators. A health education strategy using a communication in the form of a videotaped program was designed in order to increase community awareness about this serious health problem and about the importance of early prenatal care. The purpose of this investigation was to evaluate that strategy by: determining the validity of the communication; analyzing its impact on related behavioral intentions of Community Board members; and assessing the association between behavioral intentions and reported behaviors in those Community Board members. A panel of experts in the fields of prenatal care/preterm birth or health education/communication was used to evaluate the face validity of the communication, using the Communication Rating Scale, an instrument developed by James Malfetti, Ed. D. The Fishbein Linear Regression Model was utilized in ascertaining attitudes and social normative factors predictive of behavioral intentions. A nonequivalant control group design was used to measure the impact of the communication on the behavioral intentions of 10 Community Boards in the Bronx, New York. The findings included high ratings by the expert panel; a positive significant difference between behavioral intentions of Community Board members before and after viewing the communication; and significant correlation between behavioral intentions and reported behaviors.(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
Mucho camino: the experiences of two undocumented Mexican mothers participating in their child's early intervention program.
OBJECTIVE: This study describes the experiences of two mothers of Mexican origin who are immigrants living under undocumented status in the United States and who participated in their children's early intervention programs. METHOD: In-depth interviews, archival data, and participant observation conducted with two mothers of children with special needs provided data for this case study design research. A phenomenological analytical approach and qualitative data analysis software were employed to gain understandings particular to each family's experience. RESULTS: These families share similar experiences and interactions with many other families in the United States who live within the context of having a child with a disabling condition. Constraints on family functioning related to the families' status of undocumented immigration included: mothers as active participants in their children's early intervention programs, mothers' understanding of their children, mothers' communication with service providers, and life as an immigrant family of Mexican origin living under undocumented status. CONCLUSIONS: The examination of how these mothers negotiated family life while participating in their child's early intervention program provides an appreciation for how these families view the long road--"mucho camino"--involved in achieving their family's well-being.
Adult↗
An evaluation of the effectiveness of targeted social marketing to promote adolescent and young adult reproductive health in Cameroon.
This study examines the effectiveness of the PSI/PMSC Horizon Jeunes youth-targeted social marketing program for improving adolescent reproductive health in urban Cameroon. The program targeted adolescents through peer education, youth clubs, mass media promotion, and behavior change communications. After about 13 months of intervention, knowledge of the program was nearly universal, and the majority of youths had direct contact with the program. Program effectiveness is examined using a quasi-experimental research design with a preintervention and postintervention survey in an intervention and comparison site. The intervention had a significant effect on several determinants of preventive behavior, including awareness of sexual risks, knowledge of birth control methods, and discussion of sexuality and contraceptives. The intervention increased the proportion of female youths who reported using oral contraceptives and condoms for birth control. However, condom use is not yet consistent. Although the proportion of young men who reported using condoms for birth control also increased, this change could not be attributed to the intervention. Although this short intervention successfully increased the reported use of various birth control methods, including condoms, there is no evidence that the intervention increased use of condoms for STD prevention of sexually transmitted diseases.
Adolescent↗
Telemedicine: Strabismus e-consultation.
BACKGROUND: Volunteer ophthalmologists can achieve success with teaching and service programs working with high intensity over a short term. Continuation of initially successful programs may be limited by lack of timely, effective communication and follow-up. In an attempt to overcome these limitations, a total of 6 telemedicine programs were established after a successful trial program at the Ramon Pando Ferrer Hospital in Havana, Cuba. METHODS: Two pediatric ophthalmology-strabismus clinics, one in Cuba and one in Romania, were provided a digital camera and a computer in order to obtain and then transmit by e-mail patient images obtained according to a prescribed format. Ophthalmologists in both of these programs were instructed personally during an orientation period in their clinics. Training included use of a digital camera and computer, patient examination, and surgical technique in the operating room. Four additional programs referred patients via digital images after receiving only written and oral instruction. RESULTS: The diagnosis and treatment plan determined by one of us (E.M.H.) for each of the first 15 Cuban patients after study of digital images sent by e-mail was the same as the diagnosis and treatment plan determined by the same observer after in-person examination of the patients. On the basis of the level of confidence attained in these patients, 35 additional patients from a total of 6 clinics were seen by digital consultation only. CONCLUSION: A store-and-forward telemedicine consultation technique that uses digital images and e-mail holds promise to be an effective means for carrying out consultation for patients with strabismus.
Child↗
[Maternal syphilis and congenital syphilis in Latin America: big problem, simple solution].
From the data submitted to the Pan American Health Organization (PAHO) by nationwide programs against sexually transmitted diseases (STD), HIV infection, and AIDS (2002), one can estimate the overall prevalence of syphilis among pregnant women to be 3.1% and to range from 1.00% in Peru to 6.21% in Paraguay. According to these data, the incidence of congenital syphilis ranges from 1.4 per 1000 live births in El Salvador to 12.0 per 1000 live births in Honduras. Among men who engage in sex with other men, who often classify themselves as heterosexual, as well as in female sex workers, the prevalence of syphilis ranged from 5% to 15%. Factors that determine the persistence of congenital syphilis as public health problem include a lack of awareness of the seriousness of the problem among politicians, health officials, and health care providers, difficult access to prenatal care, and screening services, a low demand for the test among users, and the stigma and discrimination that surround sexually transmitted diseases (STD). This paper seeks to focus the attention of health professionals on maternal and congenital syphilis so they will undertake actions, using an interprogrammatic approach, to eliminate congenital syphilis from Latin America and the Caribbean. Eliminating congenital syphilis will only become possible if interventions targeting vulnerable groups are also implemented. PAHO's role in eliminating congenital syphilis includes determining the baseline situation in the Region as a whole and in each country, developing communication and procurement strategies, supporting nationwide programs, promoting operational research, and facilitating interprogrammatic coordination.
Adult↗
The impact of mass media advertising on a voluntary sterilization program in Brazil.
The effect of magazine advertising on vasectomy acceptance was tested in São Paulo, Brazil. Four advertisements ran for ten weeks in eight magazines. Clinic performance doubled during the campaign and stabilized at 54 percent higher than baseline. The advertisements selectively attracted the target audience without bringing in large numbers of ineligible candidates, completely avoided negative reactions, and recruited men previously unexposed to vasectomy. The cost of the advertising campaign was offset by additional revenue generated by the increase in vasectomies performed. The results suggest that while interpersonal communications can maintain performance in voluntary sterilization programs, mass media promotion may be necessary for program growth.
Advertising↗
Pharmacy services in a 240-bed Gordon Friesen-design hospital.
This article describes a typical Gordon Friesen-design institution in which the facility design and systems design complement one another to make an efficiently run hospital. The basic concepts of the hospital are to keep the nurse with the patient and to maintain a steady supply flow by centralizing responsibility for materials. Problems that occur in pharmacies of facilities designed by Friesen usually are related to logistics. The design of the institution make delivery of medication and communication with staff nurses more difficult. Pharmacy programs such as unit dose and intravenous admixtures, excellent examples of products in "patient-ready units," complement the other supply delivery systems that are typical of a Friesen-design institution. Good written and verbal communications between nursing staff and pharmacy can bring about a smoothly flowing pharmacy service that blends with the overall concept.
Hospital Administration↗
Secured medical imaging over the Internet.
The Internet has established itself as an affordable, extremely viable and ubiquitous communications network that can be easily accessed from virtually any point in the world. This makes it ideally suited for medical image communications. Issues regarding security and confidentiality of information on the Internet, however, need to be addressed for both occasional, individual users and consistent enterprise-wide users. In addition, the limited bandwidth of most Internet connections must be factored into the development of a realistic usermodel and resulting protocol. Open architecture issues must also be considered so that images can be communicated to recipients who do not have similar programs. Further, application-specific software is required to integrate image acquisition, encryption and transmission into a single, streamlined process. Using Photomailer software provided by PhysiTel Inc., the authors investigated the use of sending secured still images over the Internet. The scope of their investigation covered the use of the Internet for communicating images for consultation, referral, mentoring and education. Photomailer software was used at several local and remote sites. The program was used for both sending and receiving images. It was also used for sending images to recipients who did not have Photomailer, but instead relied on conventional email programs. The results of the investigation demonstrated that using products such as Photomailer, images could be quickly and easily communicated from one location to another via the Internet. In addition, the investigators were able to retrieve images off of their existing email accounts, thereby providing greater flexibility and convenience than other systems which require scheduled transmission of information on dedicated systems. We conclude that Photomailer and similar products may provide a significant benefit and improve communications among colleagues, providing an inexpensive means of sending secured images on the Internet.
Computer Communication Networks↗
Triplet code-independent programming of living systems organisation by DNA: the link with intelligence and memory.
Previous suggestions from this laboratory (3), (a) that within its molecular electronic structure, DNA houses a computer-analog program of immense complexity, operating independently of, but complementary to, triplet coding and (b) that, inter alia, this program is the driving force for organising and executing the construction of species individuals in three dimensions, are extended in the present communication. It is now concluded that the DNA program also embodies an 'intelligence' component, which extends its organising ability both qualitatively and quantitatively beyond any of the heavily circumscribed 'self-organising' attributes claimed to be associated with naturally occurring inanimate systems. Further, that as part of the developmental process, a program component organises the fabrication of mammalian central nervous systems, including that of human beings with the associated attributes of intelligence, creativity and constructional skills. It is further suggested that the sophisticated random access memory system associated with human beings in particular may be explicable in terms of an extension of the DNA programming system: basically this involves the latter operating as computer-type 'hardware' for the storage of long-term memory and interacting with, primarily, glial cell RNA, acting as 'software' and storing short term traces. Finally, it is suggested that such an interrelationship between DNA/RNA molecular electronic structures can provide the necessary memory storage capacity and flexibility and also facilitates random access to the long-term DNA memory store.
Animals↗
Women's fears and men's anxieties: the impact of family planning on gender relations in northern Ghana.
The Navrongo experiment, a family planning and health project in northern Ghana, has demonstrated that an appropriately designed, community-based family planning program can produce a change in contraceptive practice that had been considered unattainable in such a setting. Simultaneously, however, evidence suggests that newly introduced family planning services and contraceptive availability can activate tension in gender relations. In this society, where payment of bridewealth signifies a woman's requirement to bear children, there are deeply ingrained expectations about women's reproductive obligations. Physical abuse and reprisals from the extended family pose substantial threats to women; men are anxious that women who practice contraception might be unfaithful. Data from focus-group discussions with men and women are examined in this report and highlight the strains on gender relations resulting from contraceptive use. The measures taken to address this problem and methods of minimizing the risk of adverse social consequences are discussed.
Adult↗