The aim of this study was to determine men’s perceptions about family planning and how they participate or wish to participate in family planning activities in Mpigi District, central Uganda. Four focus group discussions were conducted with married men and with family planning providers from both the government and private sector. In addition, seven key informants were interviewed using a semi-structured interview guide. The results indicate that men have limited knowledge about family planning, that family planning services do not adequately meet the needs of men, and that spousal communication about family planning issues is generally poor. However, almost all men approved of modern family planning and expressed great interest in participating. The positive change of the beliefs and attitudes of men towards family planning in the past years has not been recognized by family planning programme managers, since available services are not in line with current public attitudes. A more couple-oriented approach to family planning is needed. Measures could include, for example, recruiting males as family planning providers, offering more family planning counselling for couples, and promoting female-oriented methods with men and vice versa.
An inquiry into the relation between exposure to silica dust, the presence of silicosis, and progressive systemic sclerosis was conducted in white South African gold miners by means of a case-control study. Seventy nine cases of progressive systemic sclerosis were matched by year of birth with an equal number of control miners selected randomly but bearing in mind the administrative channel through which the case had come to be identified. Analysis showed no association between silicosis and PSS but did show that the cumulative life time silica exposure was significantly higher in the cases compared with controls. This difference was due to a difference in the intensity of exposure to silica during mining service rather than a difference in duration of service. The results are discussed in the context of current thought on the aetiology of progressive systemic sclerosis, particularly in relation to autoimmune and genetic factors.
To evaluate the effectiveness of a comprehensive asthma management education program for 7- to 12-year-old children with asthma, entitled Roaring Adventures of Puff (RAP), 18 elementary schools in Edmonton were randomized to intervention and control groups. Participating in the program were 76 students with asthma in the intervention schools and 86 in the control schools. Children in the intervention schools had statistically significant improvements in unscheduled doctor visits, missed school days, moderate-to-severe parent rating of severity, severity of shortness of breath, limitations in the kind of play, and correct use of medications. Unscheduled doctor visits and missed school days were the only significant improvements in the control group; however, improvements were about half that of the intervention group. The results showed that a comprehensive, school-based asthma education program is feasible and improves outcomes.
The relationship between rheumatoid arthritis and silicosis was studied by means of a case-control study in South African goldminers. One hundred and fifty seven miners with rheumatoid arthritis classified as "definite" (91) or "probable" (66) were individually matched by year of birth with miners who had no evidence of rheumatoid arthritis. Unmatched analysis of the case-control status for "probable" and "definite" cases yielded an odds ratio of 2-84 (p = 0-0001). Separate analyses yielded an odds ratio of 3 79 (p = 00006) for "definite" cases, a non-significant odds ratio for "probable" cases, and an odds ratio of 500 (p = 00003) for the presence of rheumatoid factor. These results could not be explained on the basis of cumulative dust exposure or intensity of exposure. The rate of progression of silicosis in both the "definite" and the "probable" groups was greater than for the control patients with silicosis, as was the probability of silicosis presenting at the start with larger nodules (type r).The radiological and histological features of silicosis are sometimes modified in a characteristic manner in miners with rheumatoid arthritis1-a phenomenon seen also in coalminers' pneumoconiosis.2 3 The question of whether silicosis occurs more readily in individuals with rheumatoid arthritis exposed to silica has not, however, been addressed.Silicosis occurs in South African gold miners, who may be exposed to dust containing high levels of free silica. The main objective of this study was to determine whether silicosis was present more often in miners with rheumatoid arthritis than in miners without, and to determine whether any differences found in the prevalence of silicosis could be explained by differences in the amount or intensity of exposure to silica dust. Miners with silicosis and rheumatoid arthritis were compared with those without rheumatoid arthritis to establish whether the rate of progression and other features of silicosis were different under conditions of equal exposure to silica dust. Index subjects with silicosis who were seropositive for rheumatoid factor were compared with the control subjects with silicosis to determine whether the presence of rheumatoid factor was relevant to the progression of silicosis.
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