Medicine and Health Sciences Commons^™

Circumcision Denialism Unfounded And Unscientific, Joya Banerjee, Jeffrey Klausner, Daniel Halperin, Richard Wamai, Edgar Schoen, Stephen Moses, Brian Morris, Stefan Bailis, Francois Venter, Neil Martinson, Thomas Coates, Glenda Gray, Kasonde Bowa

Richard G. Wamai

No abstract provided.

Hiv And Women: Incongruent Policies, Criminal Consequences, Aziza Ahmed

Aziza Ahmed

The new agency UN WOMEN must play an active role in the standardization of laws and policies at the global and national level where their incongruence has negative and often criminal consequences for the health and lives of women and girls. This article focuses in on three such examples: opt-out testing for HIV, criminalization of vertical transmission, and the new World Health Organization guidelines on breastfeeding.

Iron Status, Inflammation And Anemia In Bangladeshi Women Exposed To Arsenic, Joycelyn M. Faraj

Masters Theses 1911 - February 2014

Iron depletion (ID) is the most common nutrient deficiency worldwide and is the leading cause of anemia. Chronic arsenic (As) exposure is a major public health problem in Bangladesh and triggers inflammatory responses that render iron status assessment challenging. We assessed the prevalence of ID and iron deficiency anemia (IDA) in 147 arsenic-exposed Bangladeshi women (75 skin lesion cases; 72 controls), ages 18-33 years, who were part of a skin lesion study. Hemoglobin (Hb) was measured in whole blood; ferritin and hs-c-reactive protein (CRP) were measured in serum. The prevalence of anemia (Hb<120g/L) was 18%. Although the prevalence of ID (ferritin≤12mcg/L) did not differ between cases and controls, anemia was more common among cases (25% vs. 10%; p=0.02). Of anemic women, 27% (N=7) also had ID (Hb<120g/L and ferritin≤12mcg/L), indicating IDA. Women with normal iron status had higher toenail arsenic compared to iron-depleted women (2.9 vs 1.4 µg As/g toenail; p=0.00), and their water arsenic concentration was higher than that of iron-depleted women (18.8 vs 6.2 µg As/L; p=0.03); every 1µg increase in toenail As was associated with a 45% lowered risk of ID (OR=0.55, 95%CI=0.33,0.94). Much of the anemia in this cohort appears unrelated to ID, but could be linked to other nutrients, such as folate and vitamin B12, which are involved in both hematopoiesis and arsenic metabolism. It is possible that arsenic exposure in this cohort compromised folate and vitamin B12 status.

Vitamin D Levels And Risk Of Dyslipidemia Among Us Children With Diabetes And Obesity, Elsina E. Hagan

Masters Theses 1911 - February 2014

Dyslipidemia is increasing among U.S. children, and the prevalence is highest among children with diabetes and obesity. Recently, vitamin D deficiency has been suggested as a possible dietary risk factor for dyslipidemia. Despite the high prevalence of vitamin D deficiency amongst children, virtually no studies have evaluated the association between vitamin D and dyslipidemia among children. We evaluated the vitamin D and dyslipidemia relationship among 240 children and adolescents aged 2 through 21 years who were outpatients of a pediatric endocrinology unit at a large tertiary care facility in Western Massachusetts from April 2008 to April 2010. Eligible children were …

Prevalence Of Sexually Transmitted Infections Among Men Who Have Sex With Men And Injecting Drug Users And Validation Of Audio Computer-Assisted Self Interview (Acasi) Technique In Abuja, Lagos, And Ibadan, Nigeria: Report Fact Sheet, Enhancing Nigeria's Hiv/Aids Response (Enr) Programme

HIV and AIDS

Most-at-risk populations (MARPS), including men who have sex with men (MSM) and injecting drug users (IDUs), represent only 1 percent of Nigeria’s population yet account for 38 percent of new HIV infections. Despite their elevated risk, MSM and IDUs are less likely than the general population to access HIV prevention and sexual health services because of stigmatization. There is a dearth of data on prevalence of HIV and sexually transmitted infections (STIs) among MSM and IDUs because their behaviors make them difficult to be reached programmatically and engaged in research. While the need for HIV and STI prevalence data is …

Focus On Male Youths In Addressing Alcohol And Drug Abuse Risk In The Context Of Hiv Prevention Among Young People, Population Council

Reproductive Health

Research evidence shows that people who abuse alcohol are more likely to engage in behavior that puts them at risk of HIV infection, including having unprotected sex. In 2010, the Population Council’s APHIA II Operations Research Project collaborated with the Support for Addictions Prevention and Treatment in Africa Centre in Kenya on research to identify factors associated with alcohol and drug use among out-of-school youth in Kibera, to identify specific factors contributing to HIV risk, and to assess the impact of an intervention to link youths with an alcohol and drug abuse problem to counseling and rehabilitation services. A key …

Scaling Up The Integration Of Tuberculosis Screening Into Reproductive Health Services, Aphia Ii Or Project In Kenya

Reproductive Health

The Population Council’s APHIA II Operations Research and Kenya’s Ministry of Health implemented a pilot project in five facilities across Nairobi Province in 2010 with the aim of improving access to care and treatment for tuberculosis (TB) for women during postnatal care (PNC) services. As tuberculosis persists in Kenya, integration of screening and referrals within postnatal care services will increase case detection and treatment for those infected. Integration of TB screening is likely to be scaled up throughout PNC and maternal and child health services in Kenya. Strong linkages between health services, training, and supervision, and simple provider tools will …

The Supply Of Physicians And Care For Breast Cancer In Ontario And California, 1998 To 2006, Kevin M. Gorey, Isaac N. Luginaah, Caroline Hamm, Madhan K. Balagurusamy, Eric J. Holowaty

Social Work Publications

INTRODUCTION: We examined the differential effects of the supply of physicians on care for breast cancer in Ontario and California. We then used criteria for optimum care for breast cancer to estimate the regional needs for the supply of physicians.

METHODS: Ontario and California registries provided 951 and 984 instances of breast cancer diagnosed between 1998 and 2000 and followed until 2006. These cohorts were joined with the supply of county-level primary care physicians (PCPs) and specialists in cancer care and compared on care for breast cancer.

RESULTS: Significant protective PCP thresholds (7.75 to = 8.25 PCPs per 10 000 …

Libraries And Publishers Respond To Disaster With Groundbreaking Collaboration, Mary Moore Phd, Suzetta Burrows Mls, Maria Collins, Nancy Roderer

Faculty Research, Publications, and Presentations

The earthquake in Haiti prompted significant response from both health care workers and health sciences libraries. Individual libraries in the U.S. and elsewhere struggled to determine the best ways to support relief workers with health information resources and services. This column describes the Haiti earthquake and the response of health care workers, one organization’s experience in delivering services on the frontlines, the response of one library and its struggles to make information resources available, and the Emergency Access Initiative (EAI), an effective solution to offering information resources in times of disaster developed and implemented by the National Library of Medicine …

Integrating Alcohol Risk Reduction Into Htc Services, Population Council

Reproductive Health

This brief describes how screening for alcohol abuse and hosting long-term support groups through HIV testing and counseling centers (HTC) is one way to decrease high-risk sexual and alcohol behaviors among people who have tested for HIV. Findings from program activities funded by Population Council, Liverpool VCT and Support for Addiction Prevention and Treatment in Africa Center (SAPTA) found that screening HTC clients for alcohol abuse and referral to active support and counseling services is feasible. Follow up using SMS is also recommended. However, the lack of a control group in this study may hinder drawing direct causality between the …

Increasing Access To Family Planning (Fp) And Reproductive Health (Rh) Services Through Task-Sharing Between Community Health Workers (Chws) And Community Mid-Level Professionals In Large-Scale Public-Sector Programs: A Literature Review To Help Guide Case Studies, James R. Foreit, Sarah Raifman

Reproductive Health

This literature review covers case studies related to community-based distribution of family planning programs, and community health worker (CHW) programs that included family planning and other reproductive health services. It offers essential processes and implications for additional operations research which look at constraints and factors critical to introducing new program procedures or strengthening existing ones.

Increasing Access To Safe Abortion In Rural Maharashtra: Outcomes Of A Comprehensive Abortion Care Model, Shireen J. Jejeebhoy, A.J. Francis Zavier, Rajib Acharya, Shveta Kalyanwala

Reproductive Health

This assessment of a Comprehensive Abortion Care (CAC) model was conducted by the Population Council on behalf of the Consortium for Safe Abortions in India. The goal of the Consortium is to increase access to legal, safe, and comprehensive abortion services, including post-abortion family planning, in the public health system, and especially among the rural poor. This report describes the CAC model implemented in Aurangabad district, Maharashtra, and examines the extent to which the model improved (a) the availability and quality of abortion services in public sector facilities, and (b) women’s awareness and experiences with regard to abortion services. It …

Shaping Demand And Practices To Improve Family Health Outcomes In Northern India: A Framework For Behavior Change Communication, Population Council

Reproductive Health

An initiative from the Population Council could help in developing a comprehensive communication strategy to improve reproductive, maternal, newborn, and child health, and nutrition outcomes in Uttar Pradesh and other northern states of India. The identification of key barriers to and facilitating factors for selected target behaviors that have a direct bearing on maternal and child health could go a long way in packaging specific messages for different stakeholders, such as women, husbands, elder family members, opinion makers in the community, and frontline health workers. One of the key deliverables of this publication is to fill an important knowledge gap …

Survey Of Domestic And Work Life Experience And Reproductive Health Of Women Workers Of Selected Industrial Compounds In Ha Noi, Nguyen Thi Van Anh, Nguyen Hong Phuong

Reproductive Health

The Population Council Viet Nam and local stakeholders undertook a collaborative project in Ha Noi entitled “Improving the health care response to gender-based violence.” The study’s objectives were: 1) to assess the knowledge and experience of female workers about gender-based violence; 2) to assess knowledge and practice of women workers on reproductive health focusing on abortion; and 3) to make recommendation for the Ha Noi Health Service to improve the women workers’ knowledge on gender-based violence, choice of contraceptive method, reproductive health care, and abortion. The women factory workers, who have higher levels of education than their peers in the …

Female Genital Mutilation Practices In Kenya: The Role Of Alternative Rites Of Passage. A Case Study Of Kisii And Kuria Districts, Habil Oloo, Monica Wanjiru, Katy Newell-Jones

Reproductive Health

This research was undertaken by the Population Council to better understand female genital mutilation (FGM) as currently practiced by the Kuria and Kisii communities in Kenya. The study investigated current attitudes and practices in relation to FGM, awareness and attitudes toward the alternative rite of passage (ARP), and factors which encourage individuals to make decisions to abandon FGM. The findings show that FGM is still a celebrated public event among the Kuria, whereas in Kisii, it is a private family affair. The study suggests that the success of ARP as an approach to abandoning FGM is strongly dependent on the …

Comprehensive Responses To Sexual Violence In East And Southern Africa: Lessons Learned From Implementation, Jill Keesbury, Ian Askew, Monica Wanjiru, Grace Chiyaba, Kate Wilson, Felly Nkweto Simmonds

Reproductive Health

The Population Council has provided technical assistance and conducted research to strengthen the evidence base on sexual and gender-based violence (SGBV) programming in sub-Saharan Africa, where countries have begun to recognize the importance of both preventing violence and responding to the needs of SGBV survivors. These activities have created an active network of partners from across sub-Saharan Africa, who are developing, implementing, and evaluating core elements of a comprehensive, multisectoral response model. This brief reports how network partners have significantly increased the evidence base on program responses: a range of successful approaches have been demonstrated for improving comprehensive services within …

Community Health Workers Can Effectively Provide Information And Referrals To People Living With Hiv In Their Communities, Population Council

Reproductive Health

A number of studies reported high levels of sexually transmitted infections among people living with HIV (PLHIV). Unfortunately, prevention interventions targeting PLHIV in the community are not common in Kenya, and most PLHIV who are not on ART have limited access to prevention information and risk-reduction counseling. The Population Council’s APHIA II Operations Research Project conducted a research project to address these gaps. This study was conducted in 2010 in collaboration with the International Center for Reproductive Health and the National AIDS and STI Control Programme. The findings show that the intervention had a number of positive outcomes and concludes …

Levels, Trends And Determinants Of Contraceptive Use Among Adolescent Girls In Kenya, Francis Obare, Harriet Birungi, Chi-Chi Undie, Monica Wanjiru, Wilson Liambila, Ian Askew

Reproductive Health

In Kenya, recent trends in contraceptive use among currently married women aged 15–49 years show that after experiencing a stall between 1998 and 2003, the contraceptive prevalence rate (CPR) increased between 2003 and 2008–2009. Although the increase in CPR after 2003 is encouraging, there is limited understanding of how these changes affected adolescents, especially girls, given the unique sexual and reproductive health challenges that they face. This report is based on a secondary analysis of the Kenya Demographic and Health Surveys (KDHS) data to understand the trends, differentials, and determinants of contraceptive use among adolescent girls aged 15–19 years in …

Linking Hiv-Positive Family Planning Clients To Treatment And Care Services In Kenya, Wilson Liambila, Francis Obare, Harriet Birungi, Ruth Wayua Muia, Joyce Wanderi Maina, Mary N. Maina, Christine Awuor, Ibrahim Mohammed

Reproductive Health

A project from the Population Council’s USAID-funded FRONTIERS program found that integrating HIV counseling and testing into family planning (FP) services was feasible and acceptable to clients and providers, and led to significant improvement in the quality of care provided. However, a major limitation was that FP clients who tested HIV-positive were not actively linked to care and treatment services, including antiretroviral treatment, and screening and management of sexually transmitted infections. A new initiative aimed to design and test a referral framework for linking HIV-positive FP clients to treatment and care in selected health facilities; assess the acceptability of the …

Strengthening The Delivery Of Comprehensive Reproductive Health Services At The Community Level In Kenya, Population Council

Reproductive Health

The Population Council APHIA II Operations Research Project collaborated with the Ministry of Public Health and Sanitation to improve the quality of services offered by community-based midwives in two districts in Western Kenya, to prepare them to offer more comprehensive maternal services through antenatal, obstetric, postpartum, and newborn care. The study found that community midwives can tremendously increase clients’ access to essential maternal health services and other reproductive health services. Therefore Ministry of Health and its partners should scale up community midwives’ activities to enable more women access these services. Furthermore, information campaigns are needed to promote the range of …

The Prevention And Management Of Hiv And Sexual And Gender-Based Violence: Responding To The Needs Of Survivors And Those-At-Risk, Sarah Raifman, Ian Askew, Sajeda Amin, Jill Keesbury, Saiqa Mullick, Judith A. Diers, Meiwita P. Budiharsana, Chi-Chi Undie, Mary Zama, Mantshi Menziwa, Sherry Hutchinson, Naomi Rutenberg

Reproductive Health

The Population Council seeks to understand the social, economic, political, and physical context of risks for sexual and gender-based violence and HIV. Among the top priorities of Council research are supporting and evaluating efforts to prevent violence and HIV, including creating safe spaces for adolescent girls, and working with men and boys to change gender norms within the community; and comprehensively responding to the needs of survivors (including those who are HIV-infected) by strengthening health systems and integrating services. The purpose of this guide is to provide practical guidance on the steps necessary to establish and strengthen sexual violence (SV) …

Strengthening Union Level Facility For Providing Normal Delivery And Newborn Care Services: Facility Assessment Report, Md. Noorunnabi Talukder, Ubaidur Rob, A.K.M. Zafar Ullah Khan, Amar Krishna Baidya, M. Mostafizur Rahman Khan, Nargis Sultana

Reproductive Health

In Bangladesh, first-level fixed-facility services—provided at the union level through Health and Family Welfare Centers (HFWCs)—are designed to improve maternal and child health by making services available in rural areas. However, most HFWCs do not have the capacity to provide normal delivery services. HFWCs could help women receive free normal delivery services within a convenient distance from their home, if they were strengthened with necessary human resources, infrastructure, and equipment. The Population Council, with financial assistance from the UK Department for International Development (DFID), carried out a policy and research systems study to strengthen union HFWC’s provision of normal delivery …

Calling Attention To Young Adolescents: Building The Evidence Base To Inform Policies And Programs, Martha Brady

Poverty, Gender, and Youth

Young adolescence is a critical life-cycle stage marked by a dynamic combination of opportunity and risk. During this time, children undergo tremendous physical, emotional, social, and cognitive changes as well as socialization into prevailing sexual and gender norms. For the majority, young adolescence is characterized by relatively good health and stable family circumstances, but it can also be a period of vulnerability due to a number of rapid transitions that force some young people into adult roles. Most young adolescents experience the onset of puberty (girls earlier than boys), which typically marks an abrupt life change. Some young adolescents will …

Addressing Sexual And Gender-Based Violence (Sgbv) Against Adolescent Girls, Sajeda Amin, Althea D. Anderson

Poverty, Gender, and Youth

The Population Council’s extensive work on adolescent safe spaces and livelihoods programs has demonstrated the pathways of empowering adolescent girls and the substantial benefits for society. Monitoring and evaluation data from these initiatives have produced empirical evidence about threats to girls’ health and well-being that relate to both longstanding and emergent social forces. In developing countries, where the risk of adverse sexual and reproductive health outcomes is high and young girls are at high risk, it is important to address issues related to sexual and gender-based violence (SGBV) and gender norms that relate to these risks. The Council’s work with …

Vaccine Liability In The Supreme Court: Forging A Social Compact, John D. Kraemer, Lawrence O. Gostin

John D Kraemer

In its decision in Bruesewitz v. Wyeth LLC, the Supreme Court ruled that state products liability suits that allege design defects in vaccines are preempted by the National Childhood Vaccine Injury Act. This decision, the third in a trilogy of Supreme Court preemption cases that deal with products liability suits for health commodities, preserves the Vaccine Injury Compensation Program and the delicate balance between ensuring the vaccine supply and compensating injuries that it enables. Failing to preempt state product liability suits would have exposed vaccine manufacturers to substantial litigation costs defending unfounded claims about autism.

Clinical Subjectivation: Anthropologies Of Contemporary Biomedical Training., Seth M. Holmes Phd, Md, Angela C. Jenks Phd, Scott Stonington Phd, Md

Seth M. Holmes PhD, MD

No abstract provided.

En-Case-Ing The Patient: Disciplining Uncertainty In Medical Student Patient Presentations., Seth M. Holmes Phd, Md, Maya Ponte Phd, Md

Seth M. Holmes PhD, MD

The problem-oriented medical record is the widespread, standardized format for presenting and recording information about patients, which is taught to future physicians early in their medical training. Based on our participant obser- vation of medical training, we analyze the ways in which the patient presentation operates in medical training as a disciplinary technology that manages uncertainty in the clinical decision-making process. We uncover various mechanisms at work including the construction of a coherent narrative structure in which chaotic experiences are re-organized and re-interpreted to fit neatly in a linear plot with a predictable ending, the atomization of the patient as …

Structural Vulnerability And Hierarchies Of Ethnicity And Citizenship On The Farm., Seth M. Holmes Phd, Md

Seth M. Holmes PhD, MD

Every year, the United States employs nearly two million seasonal farm laborers, approximately half of whom are migrants (Rothenberg 1998). This article utilizes one year of participant observation on a berry farm in Washington State to analyze hierarchies of ethnicity and citizenship, structural vulnerability, and health disparities in agriculture in the United States. The farm labor structure is organized along a segregated continuum from US citizen Anglo-American to US citizen Latino, undocumented mestizo Mexican to undocumented indigenous Mexican. The ethnography shows how this structure symbolically reinforces conflations of race with perceptions of civilized and modern subjects. These hierarchies produce what …

Diseño De Un Programa Centrado En Las Niñas: Un Juego De Herramientas Para Desarrollar, Fortalecer Y Expandir Programas Para Niñas Adolescentes, Karen Austrian, Dennitah Ghati

Poverty, Gender, and Youth

“Diseño de un Programa Centrado en las Niñas: Un juego de herramientas para desarrollar, fortalecer y expandir programas para niñas adolescentes” es un conjunto de herramientas y directrices para fortalecer los programas para las adolescentes en las zonas urbanas de Kenia. Sobre la base de los debates de una reunión de 2010 del Adolescent Girls’ Brain Trust de Kenia, organizada por el Centro Binti Pamoja y el Population Council este juego de herramientas está pensado para cualquier persona interesada en trabajar con niñas adolescentes de 10 a 24 años. Quien esté diseñando o conduciendo un programa, o quien esté escribiendo …

Community Health Workers And The Media Can Be Effective In Providing Health Information To Married Adolescent Girls In The Community, Population Council

Reproductive Health

Past research has found that married adolescent girls in Nyanza Province, Kenya, face higher risks of HIV infection than unmarried but sexually active girls their age in the province and other parts of the country. To address this challenge, the Population Council’s APHIA II Operations Research Project, in collaboration with Well Told Story and the Ministry of Public Health and Sanitation, developed a study to assess the effectiveness of an intervention designed to increase married adolescent girls’ access to comprehensive reproductive health and HIV information and services in Homa Bay and Rachuonyo districts. The study found that using interactive communication …