ABSTRACT
Few studies have addressed the impact of parental attitudes on vaccinal coverage in early childhood. The purpose of this descriptive-analytical transverse study was to assess this problem in a cohort of parents with a 12- to 23-month-old child randomly identified by cluster analysis in five communities in the Oueme department. Data were collected using a questionnaire and tabulation sheet. Statistical analysis was performed by logistic regression using the stepwise digression method. Most of the 438 parents in the study cohort (74.2%) were between 21 and 35 years of age. More than half had not attended school and less than 20% were unemployed. The proportion refusing vaccination for their children was 35% among parents who had to walk more than 30 minutes back and forth to the health care facility and 38% among parents who had poor knowledge about vaccination. The refusal rate was 1.4 times higher for parents with no education than for parents who had attended school (P=0.005). Poor parental knowledge about vaccination was significantly correlated with refusal of vaccination (p<0.001). This study suggests that communication strategies aimed at enhancing parental knowledge and understanding about vaccination should be promoted at health care facilities as well as through other channels, e.g., news media and public events such as social and religious gatherings.
Subject(s)
Health Knowledge, Attitudes, Practice , Parents/psychology , Vaccination/psychology , Adolescent , Adult , Benin , Educational Status , Female , Health Education , Humans , Infant , Male , Middle Aged , Religion , Surveys and QuestionnairesABSTRACT
Les obstacles a la couverture vaccinale de la premiere enfance lies aux comportements des parents ont ete peu etudies. Nous les avons recherches au Benin grace a une etude transversale descriptive analytique des personnes ayant a charge un enfant de 12 a 23 mois revolus et choisies aleatoirement par la technique de grappes dans cinq communes du departement de l'Oueme. Les informations ont ete recueillies a l'aide d'un questionnaire et d'une fiche de depouillement. Une regression logistique a ete realisee selon la methode degressive pas a pas. Parmi 438 parents; 74;2etaient ages de 21 a 35 ans; plus de la moitie n'avait pas ete scolarisee et moins de 20etaient sans emploi. Les proportions de parents n'adherant pas a la vaccination etaient de 35quand la distance a pied par rapport a la formation sanitaire etait de plus de 30 minutes de marche (aller-retour); et de 38lorsque le niveau de connaissance etait faible. La proportion de parents non adherents a la vaccination etait 1;4 fois plus elevee chez ceux n'ayant pas ete scolarises que chez ceux ayant ete scolarises (p=0;05). Le faible niveau de connaissance des parents sur la vaccination etait significativement associe a la non adhesion des parents a la vaccination (p0;001). Cette etude suggere qu'il faudrait privilegier les strategies visant a elever le niveau d'information et de connaissances des parents et des communautes sur le theme de la vaccination; au sein du service de sante; et dans tous les autres secteurs de la communication : medias et organisations sociales et religieuses
Subject(s)
Coronary Artery Bypass , Coronary Disease/pathology , Postoperative Complications , Saphenous Vein/transplantation , Adolescent , Adult , Aged , Coronary Vessels/pathology , Female , Humans , Male , Middle Aged , Postoperative Complications/pathology , Saphenous Vein/pathology , Thrombosis/pathology , Transplantation, AutologousSubject(s)
Heart Valve Prosthesis/adverse effects , Heart Ventricles/injuries , Mitral Valve/surgery , Aged , Autopsy , Female , Humans , Middle AgedABSTRACT
PIP: Population education research will now be conducted at the regional, division, and local levels. It is expected that this decentralization will solve problems faced by population education teachers and supervisors in the field and help to formulate curricula suitable to local needs. It will also mean changes in the implementation of the research activities of the Department of Education and Culture-Population Education Program. Since its creation in 1972 the Population Education Program of the Research Unit has been conducting research studies on a centralized basis, seeking out research leads, conducting studies to determine the content and methodology of program curriculum, and assessing the effectiveness of training programs. During the past 3 years the Research Unit has also made significant progress in monitoring the program's activities - determining problems and needs, making recommendations on the basis of findings, and initiating action on such recommendations. 1 recommendation is to establish regional centers for research activities. If approved by the Commission on Population, the proposal will bring about major changes in the research program, the most significant of which will be the establishment of research centers in 12 teacher-training institutions all over the country. Additionally, these institutions will offer consultative services to researchers in the field. The reorganization of the research program, as well as the eventual restructuring of the Training and Curriculum Units, anticipates the withdrawal of foreign financial assistance by 1977. In the decentralized setup, basic results gathered by regional research centers can be immediately consumed by the training or curriculum staff based in these institutions. With decentralization and the related activities, the Population Education Program shows itself capable of responding to emerging research needs.^ieng
Subject(s)
Community Health Workers , Education , Organization and Administration , Sex Education , Asia , Asia, Southeastern , Developing Countries , Family Planning Services , Health Planning , PhilippinesABSTRACT
A post-mortem study of 10 patients who died soon after an aorto-coronary by-pass procedure (16 grafts) showed that 5 grafts were blocked by recent thrombus (31%) in 5 patients, 3 of whom had infarcts as a result. It seems that the two main causative factors of early thrombosis were: -the wider calibre of the saphenous graft; the ratio of the circumference of the graft to the circumference of the coronary artery at the site of anastomosis is greater when there is a graft thrombosis (5.6/1 +/- 2.2) than when the graft is permeable (2.3/1 +/- 1.1) (p less than 0.01); -stenosing atherosclerosis of the artieal tree beyond the anastamosis. Changes in the endothelium of the vein, especially those caused by suturing, could equally well play a part in thrombus formation. Certain other factors, such as an insufficiently large graft ostium into the aorta, and poor outflow in the distal arterial bed, or an insufficiently large territory of supply belonging to the artery which has been bypassed, may also influence the degree of myocardial revascularisation brought about by the operation. A by-pass procedure requires a vein graft with a reasonably small diameter which matches, if at all possible, that of the coronary artery, and a good flow in the distal arterial bed, which must be confirmed at operation.
Subject(s)
Coronary Artery Bypass/mortality , Coronary Disease/pathology , Postoperative Complications/pathology , Adult , Aged , Arteries/pathology , Coronary Disease/mortality , Female , Humans , Male , Middle Aged , Permeability , Postoperative Complications/mortality , Saphenous Vein/transplantation , Transplantation, AutologousABSTRACT
PIP: The Population Education Program (PEP) of the Department of Education and Culture in the Philippines takes pride in a built-in evaluation system which assesses accomplishments primarily in light of objectives laid out and gathers feedback useful in improving future training programs. Its evaluation theoretically serves to measure 3 training dimensions -- before, during, and after each training course. Evaluation of both the 5- and 1-week training programs follows the same pattern. Pretraining evaluation is done by administering a pretest at the beginning of each course, which quantitatively measures trainees' baseline knowledge and attitudes. It is intended for the use of trainers in determining how the course should proceed. Assessment made while training is in progress (formative evaluation) is done through a steering committee meeting held at the end of a week or a day for the 5- and 1-week courses, respectively. The meetings focus on identifying weaknesses requiring immediate or future course revisions. At the end of the course, a posttest is given to measure positive or negative changes in the trainees' knowledge and attitudes. These changes are assumed to have been caused by training. Additional qualitative information is collected through an evaluation sheet containing open-ended questions on different aspects of the course. Problems of "who" should evaluate and "how to" evaluate are among current problems evident in practice, and a revised training scheme has been implemented to deal with these problems.^ieng
Subject(s)
Decision Making , Evaluation Studies as Topic , Program Evaluation , Research , Sex Education , Asia , Asia, Southeastern , Behavior , Developing Countries , Education , Organization and Administration , PhilippinesABSTRACT
PIP: The functions of training evaluation in population education programs is the subject of this article. The author states that 1) decisions regarding training can be made more rational through a systematic analysis and collection of information; 2) positive attitudes towards evaluation depend on the trainees' and trainers' understanding of the purpose and importance of the evaluation process; 3) an evaluation system must be strongly based on a body of theories and propositions from which a conceptual framework for evaluating teacher training programs in population education can be developed; 4) evaluation must be directed toward providing information useful to decision-makers; 5) pre- and post-tests are measures of change that provide information on the trainees' pre- and post-instruction level of competence; 6) evaluation can exert its strongest influence during training by providing a system in which weaknesses or failures may be identified and corrected; 7) evaluation in principle and practice should initiate change; 8) a feedback mechanism provides continuous control and refinement of training procedures; and 9) the effectiveness of follow-up work depends on the establishment of clear-cut and validated criteria for assessing teacher competence and effectiveness of teacher-trainees on the job. In all of these areas, however, problems exist in the program reviewed by the author.^ieng
Subject(s)
Data Collection , Sex Education , Education , Population Control , Research , Sampling StudiesABSTRACT
The coronary angiograms of 32 patients were compared with the anatomical lesions found during the postmortem examinations which were done early after the X-ray examination. The angiographic and anatomical data coincided in 81.6 per cent of all the coronary artery segments studied. The best coincidence was observed for the right coronary artery and the less accurate for the left coronary trunk (nevertheless, with 77 per cent good correlations). On the whole, the observer tends to underestimate the severity of the stenoses involving the large trunks (left coronary trunk and anterior descending artery) and to overestimate the involvement of the distal segments, especially if their size is small. Habitually, the errors noted are insufficient to modify the therapeutic attitude. Rarely, on the anterior descending artery, they have led to the performance of an uneccessary aorta-to-coronary by-pass (1 case) or to an unjustified conservative attitude (2 cases). Equally, over-estimation of a distal bed to a left circumflex artery was responsible for an abusive contra-indication (1 case). Thus, if on the whole coronary angiography is a fiable examination, it is necessary to resort to new incidences to improve its results.
