Hierarchical Logic Models as a Tool to Evaluate Programmatic Initiatives: Practical Solutions to Identified Problems.

Program planners, evaluators and other stakeholders use logic models to clearly articulate the links between proposed program goals, resources, activities, outcomes, and impacts of their initiatives. This systemic approach to programplanning and evaluation provides a road map for the program and assistsprograms to define strategies that will lead to success. In building logic models, stakeholders must define a program theory to provide a rationale for how the activities will lead to outcomes. Involving stakeholders in the development of program logic models instills a shared understanding of the program theory. When working with a large, multi-component program, the integration of logic models can provide further clarification about the program, as a whole, as well as individual program components.

Logic models can provide a productive framework for effective planning and a depiction of the process of change of an intervention. Most often presented as sequenced diagrams or flow charts, logic models demonstrate relationships among the following components: Statement of a problem, various causal and mitigating factors related to that problem, available resources to address the problem, intervention goals and planned activities, and anticipated short and long-term outcomes. This traditional logic model framework may be augmented to include consideration of key factors that may hinder and/or enhance the well-being of the target population, or attainment of the goal set, and may affect the program at the individual, family, programmatic/ organizational or policy level.(Read more)

Assessment of Opinions of Nursing Students in Poland, Czech Republic and Slovakia on Legislation on Admissibility of Abortion.

Today in various countries around the world, there is a dispute on the acceptability and legality of abortion .InPoland in October 2016, contestations between the proponents of so-calledpro-choice and pro-life attitudes took the form of mass street protests. Understanding the causes of such violent reaction of women facilitates comprehension of the essence of the dispute. Data on these social changes can be helpful in analyzing and subduing similar controversies in other countries.

In our opinion, understanding the causes of the ongoing culture war requires at least a brief review of the historical development of views on the acceptability of abortion and a review of current legislation and social circumstances in different countries of the world. It is important to outline the historical development of legislation in Eastern Europe countries. It is necessary also to characterize the reasoning of proponents of pro-life and pro-choice attitudes as well as their main philosophical arguments. We present such considerations in another paper.(Read More)

Does Timing of Aerobic Walking Impact Blood Glucose Control and Personal Preference in Adults with Type 2 Diabetes?

Aerobic exercise has two primary benefits for people with type 2 diabetes (T2D): 1) It temporarily reduces insulin resistance up to 48 hours, and 2) It lowers blood glucose (BG) even in the absence of effective insulin action. Therefore, a dose of exercise shouldindirectly lower BG by reducing insulin resistance. Exercising after meals while BG is rising should directly lower postprandial glucose (PPG), a primary contributor to glycosylated hemoglobin and a risk factor for cardiovascular disease.The only exercise guidelines given in the ADA’s 2012 Position Statement on the management of T2D were, “As much physical activity as possible should be promoted, ideally aiming for at least 150 min/week of moderate activity including aerobic, resistance, and flexibility training”.

DiPietro demonstrated that 45 minutes of aerobic walking, whether done in three 15-minute bouts after meals or in a single dose, similarly and significantly lowered 24-hour BG among adults at risk for developing T2D. Aerobic walking performed after meals, however, led to significantly lower postprandial BG. Not only is the type and timing of exercise important, but compliance among individuals with T2D is also critical. It may be that doing several 15-minute bouts of postprandial exercise is preferable to a single 45-minute block.(Read more)

Prevalence of Dysmenorrhea and its Effects on School Performance: A Crosssectional Study.

Menstruation is a normal physiological process that occurs approximately once a month in women of reproductive age as a result of the breakdown of the endometrial tissue. But dysmenorrhearefers to the occurrence of painful menstrual cramps of uterine origin. It is the most common gynecologic complaints in adolescence and young women, occurring in 60% to 93% of school girls and young women.

Major symptoms, including pain, adversely affect daily life and school performance, causing recurrent short-term school absenteeism among female adolescents. Previous epidemiologic investigations have reported the magnitudes of dysmenorrhea ranged from 43% to 91% in school girls. There are a limited number of studies conducted on university female students with the problem of dysmenorrhea in Ethiopia. Likewise, as far as our knowledge is concerned such study is the first to deal with dysmenorrhea and academic performance in our study area. However, some studies reported different prevalence; for instance, at Bahir Dar University the prevalence of dysmenorrhea and premenstrual syndrome were 85.1% and 72.8%, respectively.(Read More)

Hope for Autism.

We all love nothing more than our children, and the thought of having an autistic child is frightening. Autism's behavioral, social, verbal and non-verbaldisturbances affect children in major ways. Autism is a mysterious disorder; there is little understanding of its cause. What causes Autism? A short time ago, the only sentence that we can say “we have no idea.” Fortunately, the researchers are recently starting to deliver the answers. We now understand that there isn't a single cause for autism, we also know that there are multiple types of autism. Recently, researchers have reported a scale of gene polymorphisms linked to autism. However, only some of these polymorphisms are capable of causing autism directly. Both of gene polymorphisms and environmental factors affecting brain growth appear to be the cause of major cases of autism.

If the genetic risk factor for autism is present, a number of nongenetic, or “environmental,” factors are also having a role in increasing a child’s chance for becoming autistic. The risk factors for autism include what happened before and through birth, for example old parental age at time of pregnancy - both mother and father, not just the mother; maternal diseases; and some complications during birth, especially fetus’ brain oxygen deprivation. It is very important note that autism risk factors do not cause autism by themselves. But, in addition to genetic factors, they can increase the risk. Recent growing research reports that a mother can decrease her risk of delivering an autistic baby by taking folic acid tablets and/or eating meals rich in folic acid (500 mcg per day) during the months before and after pregnancy.(Read more)

Experimental Results of Phoebe Framework: Optimal Formulas for Estimating Fetus Weight and Age

Fetal age and weight estimation is to predict the birth weight or birth age before delivery. It is very important for doctors to diagnose abnormal or diseased cases so that she/he can decide treatments on such cases. This research is relevant to apply regression model into the birthestimation. Fetal ultrasound measures such as bi-parietal diameter (bpd), head circumference (hc), abdominal circumference (ac), fetal length (fl), arm volume (arm_vol), and thigh volume (thigh_vol) are recorded and considered as input sample for regression analysis which results in a regression function.

This function is formula for estimating fetal age and weight according to these ultrasound measures. Note, some terminologies such as regression function, function, regression model, estimate function, estimate model and estimate formula have the same meaning.(Read more)

Patients’ Level of Satisfaction with the Health Care Services Received at Outpatient Departments in Kilimanjaro Region, Tanzania

Traditionally, quality of health care services has been measured by means of professional standards ignoring the importance of patient’s satisfaction. The level of patients’ satisfaction isimportant for improving the quality of care provided. Based on different studies, there is a high variation of patients’ level of satisfaction between countries and within country.

In developed countries, patients are highly satisfied (90-95%) with the basic services provided at outpatient departments (OPD, while in developing countries it has been shown that, the range of patients’ satisfaction vary between 95% to <50%. In Nigeria 84% are satisfied while in Ethiopia 77% are satisfied with the health services rendered at the OPD. In Tanzania, at Muhimbili National Hospital satisfaction level was found to be high (90%-95%) while in Morogoro (Kilosa District Hospital) satisfaction level was moderate (70%) but at Mwananyamala Referral Hospital, satisfaction level was found to be low (<50%).If patient’s level of satisfaction on quality of care does not meet their standards, patients may decide to seek treatment somewhere else out of the formal health system that may lead to poor health seeking behaviors resulting in poor initial uptake of services, poor adherence, poor retention of services and at the end this may contribute to high morbidity and mortality.(Read more)