Effects of the Zanzibar School-Based Deworming Program on Iron Status of Children.

We evaluated the effects of the Zanzibar school-based deworming program on the iron status of primary school children. Parasitologic and nutritional assessments were carried out at baseline, 6 mo, and 12 mo in 4 nonprogram schools (n = 1002), 4 schools in which students received twice-yearly deworming (n = 952), and 4 schools in which students received thrice-yearly deworming (n = 970) with 500 mg generic mebendazole. Schools were randomly selected for evaluation and allocated to program groups. Relative to no treatment, thrice-yearly deworming caused significant decreases in protoporphyrin concentrations and both deworming regimens caused marginally significant increases in serum ferritin concentrations. The average annual changes in protoporphyrin concentrations were -5.9 and -23.5 micromol/mol heme in the control and thrice-yearly deworming groups, respectively (P < 0.001). The average changes in ferritin concentration were 2.8 and 4.5 microg/L, respectively (P = 0.07). Deworming had no effect on annual hemoglobin change or prevalence of anemia. However, the relative risk of severe anemia (hemoglobin < 70 g/L) was 0.77 (95% confidence limits: 0.39, 1.51) in the twice-yearly deworming group and 0.45 (0.19, 1.08) in the thrice-yearly deworming group. The effects on prevalence of high protoporphyrin values and incidence of moderate-to-severe anemia (hemoglobin < 90 g/L) were significantly greater in children with > 2000 hookworm eggs/g feces at baseline. We estimate that this deworming program prevented 1260 cases of moderate-to-severe anemia and 276 cases of severe anemia in a population of 30,000 schoolchildren in 1 y. Where hookworm is heavily endemic, deworming programs can improve iron status and prevent moderate and severe anemia, but deworming may be needed at least twice yearly

The Perspective of College Seniors in ROTC on Becoming a Commissioned Officer

While there is growing research into Military and Mental health issues, the focus of such research has primarily been restricted to those populations who are retired from Military or who step-down from Active Duty. Following a case study with Reservists, we became aware that mental health issues in the Military Population may potentially stem from concepts involved the initial training phases. With the hypothesis that ROTC Cadets are among the youngest persons engaging in Military training, we approached ROTC Air Force and ROTC Army Cadets who were Seniors by credit at Cedarville University. The Cadets were asked to participate in a face-to-face interview with a researcher, to share their experiences of ROTC and their perspectives on what life as a Commissioned Officer would be like. Participation in the interviews was voluntary, but the Air Force Commander and Army Commander had informed their Cadets that this study had been approved by them and participation was encouraged. Participants included both male and female Cadets from a broad range of academic majors. The interviews were analyzed and six themes emerged:- (a) Being associated with high caliber professionals (b) Balancing military persona with non-military persona (c) Skills and strategies for success in life (d) Personal values (e) Awareness of challenges (f) Impact of training on persona. Overall, the Cadets expressed excitement at the prospect of becoming Commissioned Officers, and pride in being among those who serve their country

Health Law: Cases, Materials and Problems

For more than two decades, Health Law: Cases, Materials and Problems has defined the field of health law, providing a balanced overview of law as it affects patients, professionals, institutions, and entities that deliver and finance U.S. health care. The 7th Edition of Health Law comprehensively reviews the provisions of the Affordable Care Act with topics such as the oversight of quality (including the latest developments in patient safety), cost control (including consumer-directed health care), guarantees of adequate access to services, exempt-organization tax issues, transactions and relationships among health care professionals and providers, the Employee Retirement Income Security Act (ERISA), and malpractice litigation. The Supreme Court decision in National Federation of Independent Business v. Sebelius is carefully edited to present all the issues in the case.Written without a policy bias to fairly reflect all viewpoints, the book considers legal and ethical issues involving death, human reproduction, medical treatment decision making, and medical research. It also explores the government\u27s efforts to control costs and expand access through Medicare and Medicaid and examines government attempts to police anticompetitive activities, fraud, and abuse. Using carefully edited primary materials and effective classroom-tested problems, the book exposes students to the core issues in health law using the most recent judicial and statutory materials.https://digitalrepository.unm.edu/law_facbookdisplay/1168/thumbnail.jp

Risk factors for presentation to hospital with severe anaemia in Tanzanian children: a case-control study.

In malaria endemic areas anaemia is a usually silent condition that nevertheless places a considerable burden on health services. Cases of severe anaemia often require hospitalization and blood transfusions. The objective of this study was to assess risk factors for admission with anaemia to facilitate the design of anaemia control programmes. We conducted a prospective case-control study of children aged 2-59 months admitted to a district hospital in southern Tanzania. There were 216 cases of severe anaemia [packed cell volume (PCV) < 25%] and 234 age-matched controls (PCV > or = 25%). Most cases [55.6% (n = 120)] were < 1 year of age. Anaemia was significantly associated with the educational level of parents, type of accommodation, health-seeking behaviour, the child's nutritional status and recent and current medical history. Of these, the single most important factor was Plasmodium falciparum parasitaemia [OR 4.3, 95% confidence interval (CI) 2.9-6.5, P < 0.001]. Multivariate analysis showed that increased recent health expenditure [OR 2.2 (95% CI 1.3-3.9), P = 0.005], malnutrition [OR 2.4 (95%CI 1.3-4.3), P < 0.001], living > 10 km from the hospital [OR 3.0 (95% CI 1.9-4.9), P < 0.001], a history of previous blood transfusion [OR 3.8 (95% CI 1.7-9.1), P < 0.001] and P. falciparum parasitaemia [OR 9.5 (95% CI 4.3-21.3), P < 0.001] were independently related to risk of being admitted with anaemia. These findings are considered in terms of the pathophysiological pathway leading to anaemia. The concentration of anaemia in infants and problems of access to health services and adequate case management underline the need for targeted preventive strategies for anaemia control

Liability and Quality Issues in Health Care

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Bioethics: Health Case Law and Ethics

This book provides a rich body of materials for courses in bioethics and law. Primary legal sources, including judicial opinions, statutes, regulations and institutional policies, will give students insight into the strategies used by courts, legislatures, agencies and health care providers in addressing bioethics issues. The book also draws from interdisciplinary research in medicine, ethics, and law to provide students diverse critiques of legal and public policy issues in bioethics. Materials in this text are tightly edited and designed to create high quality and focused classroom discussion, and, the text includes classroom tested problems that will engage students more deeply on each issue.Bioethics: Health Care Law and Ethics begins with accessible introductory material on how to do ethics analysis. It then provides separate chapters on Reproduction and Birth (including current issues relating to abortion and contraception and issues related to assisted reproductive technologies); Legal, Social, and Ethical Issues in Genetics; Life and Death Decision-making; Regulation of Research Involving Human Subjects; Distributive Justice and Organ Transplantation; and Current Controversies in Public Health (including issues related to immunization practice).https://digitalrepository.unm.edu/law_facbookdisplay/1009/thumbnail.jp

The Law of Health Care Organization and Finance

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