Articles: health.
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This study was carried out to determine the predisposing, enabling, and reinforcing factors related to practice behaviors in the prevention of adolescent pregnancy and sexually transmitted diseases (STDs), and to assess physicians' "ideal" history taking and service provision versus their actual practice in this clinical area. ⋯ Analysis of predisposing factors found that, for seven of 10 areas related to knowledge of the epidemiology of adolescent pregnancy and STDs, fewer than 50% of male physicians were able to give correct responses. All physicians believed this to be an important area for prevention, and 89% that prevention is possible, but only 62% believed that their own prevention efforts are effective. Respondents were about equally likely to view schools and physicians as having responsibility for prevention of adolescent pregnancy and STDs. Significant enabling factors included high levels of perceived personal comfort and skill, but time factors and opportunities to interact with adolescents sufficiently frequently to carry out prevention were seen as barriers. Most physicians (68%) agreed that the physician fee schedule was a negative reinforcing factor. Male physicians and those in rural practice were significantly more likely to have larger gaps between those preventive practices they saw as desirable and those they actually performed.
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The introduction of new contraceptive technologies has great potential for expanding contraceptive choice, but in practice, benefits have not always materialized as new methods have been added to public-sector programs. In response to lessons from the past, the UNDP/UNFPA/WHO/World Bank Special Programme of Research, Development, and Research Training in Human Reproduction (HRP) has taken major steps to develop a new approach and to support governments interested in its implementation. ⋯ It also suggests that technology choice should be undertaken through a participatory process that begins with an assessment of the need for contraceptive introduction and is followed by research and policy and program development. Initial results from Bolivia, Brazil, Burkina Faso, Chile, Myanmar, South Africa, Vietnam, and Zambia confirm the value of the new approach.
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This paper examines the social origins of the rise in adult mortality in Russia and selected Eastern European countries. Three explanations for this trend are considered: (1) Soviet health policy, (2) social stress, and (3) health lifestyles. ⋯ Soviet-style health policy was ineffective in dealing with the crisis, and stress per se does not seem to be the primary cause of the rise in mortality. Although more research is needed, the suggestion is made that poor health lifestyles--reflected especially in heavy alcohol consumption, and also in smoking, lack of exercise, and high-fat diets--are the major social determinant of the upturn in deaths.
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Revista médica de Chile · Jun 1997
Comparative Study[Epidemiological transition in Latin America: a comparison of four countries].
In the last decade, Latin America has experienced important transformations in its health conditions, due to demographic changes and a rapid urbanization process. ⋯ An increment in non communicable diseases is expected for the next decades in Latin America. Analysis of demographic and epidemiological transition is crucial to define health policies and to adequate health systems to the new situations.
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We designed a study to assess the nutritional status of children under five years of age attending MCH clinics in Dar es Salaam. This was a cross-sectional anthropometric study involving children 6-24 months who from July to August 1993 were attending Magomeni MCH clinic and those aged 18 months to five years who were attending Lugalo and Mwananyamala MCH clinics for routine growth monitoring and for vaccination between May to August 1994. The data collected included age, birthweight, sex, weight, height, breastfeeding status and HIV-1 serostatus. ⋯ HIV seropositivity and low birthweight were both associated with stunting and wasting. We conclude that malnutrition is still a sizeable problem among children attending urban MCH clinics in Dar es Salaam especially among those aged less than three years, to whom special malnutrition control strategies should be targeted. There is also a need to identify factors responsible for the observed decline in MCH attendance with age and correct the situation.