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Bennett W.L.,Reproductive Health | Bennett W.L.,Johns Hopkins University | Cooper L.A.,Johns Hopkins University | Cooper L.A.,Johns Hopkins Medical Institutions | And 2 more authors.
American Journal of Preventive Medicine | Year: 2015

Background Despite emphasis of recent guidelines on multidisciplinary teams for collaborative weight management, little is known about non-physician health professionals' perspectives on obesity, their weight management training, and self-efficacy for obesity care. Purpose To evaluate differences in health professionals' perspectives on (1) the causes of obesity; (2) training in weight management; and (3) self-efficacy for providing obesity care. Methods Data were obtained from a cross-sectional Internet-based survey of 500 U.S. Health professionals from nutrition, nursing, behavioral/mental health, exercise, and pharmacy (collected from January 20 through February 5, 2014). Inferences were derived using logistic regression adjusting for age and education (analyzed in 2014). Results Nearly all non-physician health professionals, regardless of specialty, cited individual-level factors, such as overconsumption of food (97%), as important causes of obesity. Nutrition professionals were significantly more likely to report high-quality training in weight management (78%) than the other professionals (nursing, 53%; behavioral/mental health, 32%; exercise, 50%; pharmacy, 47%; p<0.05). Nutrition professionals were significantly more likely to report high confidence in helping obese patients achieve clinically significant weight loss (88%) than the other professionals (nursing, 61%; behavioral/mental health, 51%; exercise, 52%; pharmacy, 61%; p<0.05), and more likely to perceive success in helping patients with obesity achieve clinically significant weight loss (nutrition, 81%; nursing, behavioral/mental health, exercise, and pharmacy, all <50%; p<0.05). Conclusions Nursing, behavioral/mental health, exercise, and pharmacy professionals may need additional training in weight management and obesity care to effectively participate in collaborative weight management models. © 2015 American Journal of Preventive Medicine. Source

Marcell A.V.,University of Maryland, Baltimore | Allan E.,University of Maryland, Baltimore | Clay E.A.,Historic East Baltimore Community Action Coalition | Watson C.,Reproductive Health | Sonenstein F.L.,Center for Adolescent Health both
Perspectives on Sexual and Reproductive Health | Year: 2013

Context: Out-of-school black males aged 15-24 have higher levels of sexual risk-taking than in-school black males of the same age. However, few sexual risk reduction curricula are focused on out-of-school male youth. Methods: A sexual and reproductive health intervention conducted at a Baltimore youth employment and training program in 2008-2010 was evaluated in a study involving 197 youth aged 16-24 from a predominantly black population. Ninety-eight participants received three one-hour curriculum sessions on consecutive days; 99 served as controls. At baseline and three months later, participants completed a survey assessing demographic characteristics and various knowledge, attitude and behavior measures. Regression analysis with random effects was used to assess differences between intervention participants and controls in changes in outcomes over time. Results: In analyses adjusting for baseline characteristics, intervention participants showed greater improvements in outcomes between baseline and follow-up than did controls. Specifically, a male who received the intervention was more likely than a control male to report increases in knowledge of STDs and health care use (odds ratio, 1.6 for each), frequency of condom use (1.8), use of lubricant with condoms (23.6), communication with a provider about STDs (12.3) and STD testing (16.6). Conclusion: These findings suggest the potential benefits of integrating safer-sex and health care information into a sexual and reproductive health curriculum for out-of-school male youth. © 2013 by the Guttmacher Institute. Source

Mohammed A.A.,Kassala University | Elnour M.H.,Kassala State Ministry of Health | Mohammed E.E.,Kassala University | Ahmed S.A.,Reproductive Health | Abdelfattah A.I.,Kassala University
BMC Pregnancy and Childbirth | Year: 2011

Background: The maternal mortality ratio in Sudan was estimated at 750/100,000 live births. Sudan was one of eleven countries that are responsible for 65% of global maternal deaths according to a recent World Health Organization (WHO) estimate. Maternal mortality in Kassala State was high in national demographic surveys. This study was conducted to investigate the causes and contributing factors of maternal deaths and to identify any discrepancies in rates and causes between different areas.Methods: A reproductive age mortality survey (RAMOS) was conducted to study maternal mortality in Kassala State. Deaths of women of reproductive age (WRA) in four purposively selected areas were identified by interviewing key informants in each village followed by verbal autopsy.Results: Over a three-year period, 168 maternal deaths were identified among 26,066 WRA. Verbal autopsies were conducted in 148 (88.1%) of these cases. Of these, 64 (43.2%) were due to pregnancy and childbirth complications. Maternal mortality rates and ratios were 80.6 per 100,000 WRA and 713.6 per 100,000 live births (LB), respectively. There was a wide discrepancy between urban and rural maternal mortality ratios (369 and 872\100,000 LB, respectively). Direct obstetric causes were responsible for 58.4% of deaths. Severe anemia (20.3%) and acute febrile illness (9.4%) were the major indirect causes of maternal death whereas obstetric hemorrhage (15.6%), obstructed labor (14.1%) and puerperal sepsis (10.9%) were the major obstetric causes.Of the contributing factors, we found delay of referral in 73.4% of cases in spite of a high problem recognition rate (75%). 67.2% of deaths occurred at home, indicating under utilization of health facilities, and transportation problems were found in 54.7% of deaths.There was a high illiteracy rate among the deceased and their husbands (62.5% and 48.4%, respectively).Conclusions: Maternal mortality rates and ratios were found to be high, with a wide variation between urban and rural populations. Direct causes of maternal death were similar to those in developing countries. To reduce this high maternal mortality rate we recommend improving provision of emergency obstetric care (Emoc) in all health facilities, expanding midwifery training and coverage especially in rural areas. © 2011 Mohammed et al; licensee BioMed Central Ltd. Source

Shah I.H.,Harvard University | Ahman E.,World Health Organization | Ortayli N.,Reproductive Health
Contraception | Year: 2014

Background The 1994 International Conference on Population and Development (ICPD) viewed access to safe abortion as imperative for public health. Progress since ICPD Globally, the number of induced abortions (safe and unsafe) per 1000 women aged 15-44 years declined from 35 in 1995 to 28 in 2008. The number of deaths due to unsafe abortion declined from 69,000 in 1990 to 47,000 in 2008, as safe and effective methods of abortion, including manual vacuum aspiration and medical abortion, became more widely available. During the same period, there was a slight increase in the number of countries where abortion is permitted on request, and 70 countries made grounds for abortion more liberal. Challenges Since ICPD, the decline in unsafe abortion was slower than that in safe abortion, and unsafe-abortion-related mortality continued to be a problem. Nearly all unsafe abortions and mortality occur in developing countries. Recommendations While more must be done to ensure universal access to safe, acceptable and affordable contraception to reduce the need for abortion, this need will always exist. Information on grounds for safe abortion should be made widely available for women to access services to which they are legally entitled to. As recommended by ICPD, quality postabortion care including contraception counseling and provision should be available to all women, regardless of the legal grounds for abortion. The paper provides the evidence on unsafe abortion, a reproductive health issue that is entirely preventable but has been largely neglected or tarnished by emotional and contentious debates. © 2014 Elsevier Inc. © 2014 Elsevier Inc. All rights reserved. Source

Akbari S.A.A.,Shahid Beheshti University of Medical Sciences | Montazeri S.,Reproductive Health | Torabi F.,Shahid Beheshti University of Medical Sciences | Amiri S.,Shahid Beheshti University of Medical Sciences | And 2 more authors.
International Journal of General Medicine | Year: 2012

Background: Advances in medical knowledge and treatment modalities have resulted in an increased survival rate for high-risk infants. This increased number of survivors enables study of the future development of these children. Other than infection and trauma, developmental and behavioral problems are the most common medical problems among such children. This study sought correlations between anthropometric indices at birth and developmental delay in children aged 4-60 months who visited health service centers affiliated with the Isfahan University of Medical Sciences in 2010. Methods: In this descriptive, correlational study, 401 children aged 4-60 months and visiting health service centers were selected using a multistage method. Anthropometric indices at birth were collected from their health care records, and developmental status was measured using the Ages and Stages Questionnaire, the validity (0.84) and reliability (0.94) of which were obtained from a previous study. Results: The mean age of the children in the normal group was 17.33 ± 13.18 months and that in the developmental delay group was 29.92 ± 19.19 months. Most children in the normal group were female (56%) and in the developmental delay group were male (55.2%). No correlation was found between height and head circumference at birth and developmental delay. However, the birth weight of children with developmental delay was four times lower than that of children with normal development (P = 0.004, odds ratio 4). Conclusion: Birth weight and male gender were factors that strongly correlated with developmental delay in this study. © 2012 Amir Ali Akbari et al, publisher and licensee Dove Medical Press Ltd. Source

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