Complex family planning and pediatric hematology oncology integrated clinic for young people with blood disorders and heavy or abnormal menstrual bleeding

Abstract Background The Eastern Zone of the Tigray (Ethiopia) is inhabited by 900,000 people, 34% of whom are adolescents and young people between 10-24 years of age, who are easily influenced by the social and family context and are exposed to significant health risks associated with the earliness of their approach to sexual life. Nonetheless, even if a complete health service is available, the quality is often undermined by the lack of the so-called Youth-Friendly Corners (high confidentiality spaces reserved for young people), promoted internationally by WHO. The aim of the study is to evaluate the effectiveness of the program established in this zone by the Medical Collaboration Committee regarding the creation of friendly health services for adolescent and youth people (AYFHS), especially built for sex education, family planning, abortion, and sexual transmitted infection (STI) prevention. Methods The program “#Youths at the centre!” was implemented in 20 rural health centers in the North-East Tigray on April 2018. Data from these AYFHS were collected monthly in aggregated indicators, separated for gender and age class. Use of AYFHS during 2018 and 2019 was assessed using percentage and 95% confidence interval and the period of implementation of the project and centers' characteristics were analyzed to investigate differences in AYFHS utilization. Results A monthly mean of 6.04% (6.01% - 6.08%) of adolescents and young people utilized an AYHFS for any of its service; 0.03% accessed for counseling, diagnosis, and treatment of STI, 1.31% for family planning, 1.09% for delivery, and 0.05% for legal abortion. Lower level of utilization was observed in more remote health centers, despite a general increase across the study period. Conclusions This project shows the importance of providing friendly facilities dedicated to adolescents and youth in low-income countries, in order to increment the utilization of health services from this population, especially in rural contexts. Key messages In rural areas of Africa the risks associated with poor health information of young people and the earliness of the beginning of sexual life remain a Public Health problem. In low income countries the presence of high confidentially spaces for young people in the Health Services could increase their utilization, especially for sex education and family planning.

Download Full-text

Burden of bloodstream infections among ambulatory pediatric hematology/oncology patients with a central line.

Journal of Clinical Oncology ◽

10.1200/jco.2016.34.7_suppl.262 ◽

2016 ◽

Vol 34 (7_suppl) ◽

pp. 262-262

Author(s):

Constance Barysauskas ◽

David G. Bundy ◽

Aditya H. Gaur ◽

Jeffrey D. Hord ◽

Marlene R. Miller ◽

...

Keyword(s):

Quality Improvement ◽

Bloodstream Infections ◽

Central Line ◽

Ambulatory Setting ◽

Blood Disorders ◽

Central Lines ◽

Pediatric Hematology ◽

Reduction Strategies ◽

Single Positive ◽

One Year

262 Background: Pediatric hematology/oncology (PHO) patients are at high risk of bloodstream infections (BSI). The burden of BSI in PHO patients in the ambulatory setting has not been well documented. Methods: The Children’s Hospital Association leads the Childhood Cancer and Blood Disorders Network, a multicenter United States quality improvement collaborative, working to reduce the incidence of inpatient and ambulatory Central Line-Associated BSI (CLABSI) among PHO patients. Positive blood culture events (+BCE) were adjudicated as CLABSI, single positive blood cultures (SPBC) with potential commensals, or secondary BSI (attributed to source other than the central line) following standardized National Healthcare Safety Network definitions. Our study investigated the prevalence of +BCE among all centers with 90% complete monthly reporting of both +BCE and central line days (CLD) for at least one year (n=25) between January 2012 and September 2014. Ambulatory and inpatient BSI rates and 95% confidence intervals (CI) were calculated as the number of +BCE per 1,000 CLD per month. Results: A total of 1,747 +BCE and 4,883,413 CLD were reported among our target ambulatory population, whereas 1,095 +BCE and 353,259 CLD were reported among our corresponding inpatient population [Table]. While the CLABSI and SPBC rates were significantly lower in the ambulatory setting compared to inpatient (p<0.001), the total number of ambulatory CLABSI and SPBC events was 2.0 and 1.6 times higher than inpatient events, respectively. Conclusions: Our findings from a large multicenter collaborative demonstrate the burden of BSI among ambulatory PHO patients and identify benchmarks for future quality improvement work.Further investigation is necessary to develop effective infection reduction strategies for ambulatory PHO patients with central lines. [Table: see text]

Download Full-text

Psychologic Adjustment of Siblings of Children With Chronic Illness

PEDIATRICS ◽

10.1542/peds.63.4.616 ◽

1979 ◽

Vol 63 (4) ◽

pp. 616-627 ◽

Cited By ~ 1

Author(s):

John V. Lavigne ◽

Michael Ryan

Keyword(s):

Plastic Surgery ◽

Behavioral Problems ◽

Social Withdrawal ◽

Emotional And Behavioral Problems ◽

Group Differences ◽

Blood Disorders ◽

Significant Group ◽

Pediatric Hematology ◽

Comparison Groups ◽

Patient Groups

Although numerous references are made to the stressful, deleterious effects of chronic or terminal illnesses and handicaps on the siblings of pediatric patients, very few studies have been conducted using comparison groups. The present study compares the adjustment of 3-to 13-year-old siblings of pediatric hematology (N = 62), cardiology (N = 57), and plastic surgery patients (N = 37) with healthy siblings (N = 46). The adjusttuent measure was an objective, paper-and-pencil measure of children's emotional and behavioral problems, the Louisville Behavior Checklist. On analyses of covariance, the patient groups were more likely to show symptoms of irritability and social withdrawal, and the differences between illness groups approached significance on measures of fear and inhibition. Among the younger children, ages 3 to 6, there were significant group differences, with the siblings of patients undergoing plastic surgery showing the highest level of general psychopathology. Among children ages 7 to 13, male siblings of patients with blood disorders were more likely to show signs of emotional disturbance than female siblings. No group differences were noted on measures of aggression or learning problems. Significant interactions between sex and age relationship to the child were noted on scales of social withdrawal, inhibition, immaturity, and irritability.

Download Full-text

Contraceptive behavior in women in the Republic of Kalmykia

Pediatrician (St Petersburg) ◽

10.17816/ped7279-84 ◽

2016 ◽

Vol 7 (2) ◽

pp. 79-84

Author(s):

Vadim K Iur’ev ◽

Anatolij G Serdjukov ◽

Ceren M Tebleev ◽

Viktor G Puzyrev

Keyword(s):

Family Planning ◽

Young People ◽

Healthcare Workers ◽

Intrauterine Device ◽

The Self ◽

Sexual Life ◽

Sexually Active ◽

Barrier Methods ◽

The Republic

Contraception is the important component of family planning. It plays the important role in fighting with abortion and preserving the reproductive health of women. The specially designed anonymous survey was performed in 375 women living in the Republic of Kalmykia in the age from 16 till 45 years old. The average age of beginning of sexual life was estimated as 18,6 ± 0,1 years at the examined group. The average age decreased from 19,3 ± 0,3 to 17,0 ± 0,2 during the last 10 years. Almost the half of respondent (45,9 %) started the sexual life before the marriage. Kalmyk women started the sexual life later than Russian and entered the premarital relationship rarely. 70,2 % of sexually active women protected from pregnancy: 74,2 % used barrier methods of contraception, 13,5 % - intrauterine device, 12,9 % - oral hormone contraception, 11,1% - rejected sexual intercourse. Women below 30 and Kalmyk women used the barrier methods of contraception most often. Women older than 30 years used intrauterine device most often, oral hormone contraception was in use among cities inhabitants and among Russian women. The self-appraisal of knowledge on contraception questions showed that women estimate their erudition as 3,98 ± 0,04 on average. One quarter (23,2 %) of women consider themselves insufficiently or poorly informed dealing with this question. Women in the age below 20 and inhabitants of countryside are less informed. The information was received from the formal source by 32,5 % of women (at school - 27,7 %, from healthcare workers - 4,8 %). The majority of women (50,8 %) received the information from the informal source: 17,9 % - mother and other relatives, 12,8 % - mass media, 4,3 % - printed matter. The role of school in the informing young people dealing with this question decreased during the last few years. The role of healthcare workers in the informing young people is very low.

Download Full-text

Introduction to leaving state care in China

Young People Leaving State Care in China ◽

10.1332/policypress/9781447336693.003.0001 ◽

2017 ◽

Author(s):

Xiaoyuan Shang ◽

Karen R. Fisher

Keyword(s):

Family Planning ◽

Young People ◽

Social Services ◽

Living Environment ◽

The Other ◽

Children And Young People ◽

The Family ◽

The Government ◽

To Receive

This introductory chapter talks about how the rapid social, economic, and demographic changes in China have affected all aspects of the living environment of children and young people, particularly children in state care. Positive developments are the growth of the mixed welfare state and the relaxation of the family planning requirements, so that all families can now choose to have more than one child and they are more likely to receive free social services. These trends imply that fewer children will be left in state care in the future. On the other hand, whereas the government once arranged jobs for young people leaving care or other young people with disabilities, it now relies on the developing labour market to fulfil this function.

Download Full-text

A statement endorsed by the family planning association and the royal college of nursing family planning forum regarding the continuing education article ‘promoting health in young people’ (art&science may 27)

Nursing Standard ◽

10.7748/ns.12.39.11.s23 ◽

1998 ◽

Vol 12 (39) ◽

pp. 11-11

Keyword(s):

Family Planning ◽

Young People ◽

Continuing Education ◽

Royal College ◽

The Family ◽

College Of Nursing

Download Full-text

A randomised controlled trial of an intervention delivered by app instant messaging to increase the acceptability of effective contraception among young people in Tajikistan: study protocol

BMJ Open ◽

10.1136/bmjopen-2017-017606 ◽

2017 ◽

Vol 7 (9) ◽

pp. e017606 ◽

Cited By ~ 4

Author(s):

Ona McCarthy ◽

Baptiste Leurent ◽

Phil Edwards ◽

Ravshan Tokhirov ◽

Caroline Free

Keyword(s):

Family Planning ◽

Randomised Controlled Trial ◽

Young People ◽

Mobile Phone ◽

Controlled Trial ◽

Tropical Medicine ◽

Trial Registration ◽

London School ◽

Effective Contraception ◽

Randomised Controlled

IntroductionWomen in lower income countries experience unintended pregnancies at a higher rate compared with women in higher income countries. Unintended pregnancy is associated with numerous poorer health outcomes for both women and their children. In Tajikistan, an estimated 26% of married individuals aged 15–24 years have an unmet need for contraception. The strong cultural value placed on childbearing and oppositional attitudes towards contraception are major barriers to contraceptive uptake in the country.Mobile phone ownership is widespread in Tajikistan. The option of receiving reproductive health support on your personal phone may be an appealing alternative to attending a clinic, particularly for young people. The London School of Hygiene & Tropical Medicine and the Tajik Family Planning Association have partnered to develop and evaluate a contraceptive behavioural intervention delivered by mobile phone. The intervention was developed in 2015–2016 guided by behavioural science. It consists of short instant messages sent through an app over 4 months, contains information about contraception and behaviour change methods.Methods and analysisThis randomised controlled trial is designed to evaluate the effect of the intervention on self-reported acceptability of effective contraception at 4 months. 570 men and women aged 16–24 years will be allocated with a ratio of 1:1 to receive the intervention messages or the control messages about trial participation. The messages will be sent through the Tajik Family Planning Association’s ‘healthy lifestyles’ app, which contains basic information about contraception.Ethics and disseminationThe trial was granted ethical approval by the London School of Hygiene & Tropical Medicine Interventions Research Ethics Committee on 16 May 2016 and by the Tajik National Scientific and Research Centre on Paediatrics and Child Surgery on 15 April 2016. The results of the trial will be submitted for publication in peer-reviewed academic journals and disseminated to study stakeholders.Trial registration numberClinicaltrial.govNCT02905513.Date of registration14 September 2016.WHO trial registration datasethttp://apps.who.int/trialsearch/Trial2.aspx?TrialID=NCT02905513

Download Full-text