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Cultural Competence In Epidemiological Field Work With Cultures In Flux: Romania, Diane Depken, Catherine Zeman

International Journal of Global Health

This article is a case study of conducting field -based epidemiological work in a former communist country. A brief background of Romanian history and culture is followed by discussion of the challenges of doing epidemiological science in a culture experiencing socio-political flux. In this former communist country where a common understanding of specific methods of epidemiological science and research ethics is not necessarily shared by both visiting and indigenous scientists, successful fieldwork depends on a high degree of understanding, sensitivity, and patience. The United States Department of Health and Human Services' Office of Minority Health, OMH provides guidelines for culturally …

Hiv Voluntary Counseling And Testing Among Youth Ages 14 To 21: Results From An Exploratory Study In Nairobi, Kenya, And Kampala And Masaka, Uganda, Horizons Program, Kenya Project Partners, Uganda Project Partners

HIV and AIDS

HIV voluntary counseling and testing (VCT) programs increase safe sexual behavior and use of care and support services among adults. By helping clients learn their HIV serostatus and creating a personalized HIV risk-reduction plan, VCT can provide the information and support necessary to change risky behaviors that could lead to HIV infection or transmission. Counseling and a risk-reduction plan are the key features distinguishing VCT from other HIV testing services. VCT has become a widely advocated HIV/AIDS prevention strategy among adults. Sixty percent of all new HIV infections in sub-Saharan Africa, however, occur among young people ages 10–24. Because few …

Community Involvement In The Prevention Of Mother-To-Child Transmission Of Hiv: Insights And Recommendations, Naomi Rutenberg, Mary Lyn Field-Nguer, Laura Nyblade

HIV and AIDS

Mother-to-child transmission is the primary route of HIV infection in children under 15 years of age. Since the beginning of the HIV epidemic, an estimated 5.1 million children worldwide have been infected with HIV. Clinical trials in several countries have shown that mother-to-child transmission of HIV can be greatly reduced through administering antiretroviral therapy to pregnant women. These trials culminated in a recommendation by UNAIDS and its partners in the Interagency Task Team for the Prevention of Mother-to-Child Transmission that prevention of perinatal transmission should be a part of the standard package of care for HIV-positive women and their children. …

Borrelia Lonestari Infection After A Bite By An Amblyomma Americanum Tick, Angela M. James, Dionysios Liveris, Gary P. Wormser, Ira Schwartz, Marisa A. Montecalvo, Barbara J. B. Johnson

United States Public Health Resources

Erythematous rashes that are suggestive of early Lyme disease have been associated with the bite of Amblyomma americanum ticks, particularly in the southern United States. However, Borrelia burgdorferi, the causative agent of Lyme disease, has not been cultured from skin biopsy specimens from these patients, and diagnostic serum antibodies usually have not been found. Borrelia lonestari sp nov, an uncultured spirochete, has been detected in A. americanum ticks by DNA amplification techniques, but its role in human illness is unknown. We observed erythema migrans in a patient with an attached A. americanum tick. DNA amplification of the flagellin gene …

The Unequal Cancer Burden: Efforts Of The Centers For Disease Control And Prevention To Bridge The Gap Through Public Health, Nancy C. Lee

United States Public Health Resources

Despite the broad advances made in cancer research and interventions in the last quarter of a century, inequality still persists as we confront challenges arising from the unequal burden of cancer among Americans. Some racial and ethnic minorities, people with low incomes, those in rural areas, and other medically underserved populations suffer disproportionately from cancer. We know, for example, that African Americans are about 34% more likely to die of cancer than whites and more than two times more likely to die of cancer than Asian/Pacific Islanders, American Indians, or Hispanics.

Disparities also exist among the major racial and ethnic …

Transitions To Adulthood In The Context Of Aids In South Africa: Report Of Wave I, Naomi Rutenberg, Cathrien Kehus-Alons, Lisanne Brown, Kate Macintyre, Anthea Dallimore, Carol E. Kaufman

HIV and AIDS

This is a prospective study of reproductive behavior and sexual health of adolescents in South Africa as well as their education and employment experiences, family and environmental conditions, and other factors in their lives that may influence their sexual behavior and choices. This report is designed to inform educators, policymakers, and the public in South Africa and beyond of the initial findings of the study, with the ultimate goal of helping to design and refine policies and programs that will improve opportunities and capacities of adolescents and may contribute to changing behaviors and choices. The report focuses on describing the …

Prevention Of Trafficking And The Care And Support Of Trafficked Persons In The Context Of An Emerging Hiv/Aids Epidemic In Nepal, Celine Daly

HIV and AIDS

This study is a collaborative effort between the Asia Foundation (Kathmandu) and the Horizons project of the Population Council (New Delhi) to document the current intervention models and community-based study of human trafficking in the context of an emerging HIV/AIDS epidemic in Nepal. To address the human rights component of trafficking, the three components of this study focus on the rights and needs of trafficked persons as well as those who are vulnerable to trafficking. An analysis and assessment of the effectiveness of laws, policies, and interventions in the apprehension, prosecution, and conviction of alleged traffickers is not included in …

Interventions To Reduce Hiv/Aids Stigma: What Have We Learned?, Lisanne Brown, Lea Trujillo, Kate Macintyre

HIV and AIDS

Stigma is a common human reaction to disease. Throughout history many diseases have carried considerable stigma, including leprosy, tuberculosis, cancer, mental illness, and many sexually transmitted diseases. HIV/AIDS is only the latest disease to be stigmatized. This paper reviews 21 interventions that have explicitly attempted to decrease AIDS stigma both in the developed and developing countries and 9 studies that aim to decrease stigma related with other diseases. The studies selected met stringent evaluation criteria in order to draw common lessons for future development of interventions to combat stigma. This paper assesses published and reported studies through comparison of audiences, …

Acceptability Of The Female Condom After A Social Marketing Campaign In Campinas, Brazil, Horizons Program

HIV and AIDS

The female condom is a relatively new product that is intended to serve the dual role of protecting against unwanted pregnancy and sexually transmitted infections (STIs). Recent research has found moderate to high levels of initial trial and acceptance of the female condom among women. However, information is lacking about its continued use, particularly among women at high risk of HIV and other STIs. The female condom was registered in Brazil in January 1997 and since then has been available commercially through DKT, a social marketing organization. In addition to socially marketed female condoms, the Brazilian Ministry of Health has …

A Question Of Scale? The Challenge Of Expanding The Impact Of Non-Governmental Organisations' Hiv/Aids Efforts In Developing Countries, Jocelyn Dejong

HIV and AIDS

There are currently more than 36 million people living with HIV/AIDS globally, and in 1999 5.3 million individuals were newly infected with the virus. AIDS activities initiated by nongovernmental organizations (NGOs) have been highly influential on thinking and strategies found within the HIV/AIDS sector. Yet NGOs often experience particular difficulties in increasing the scale of their activities to reach larger numbers of people, to have an impact at levels higher than the community, and to address the broader social determinants of HIV/AIDS. Perceiving the urgent need for NGOs to expand the scale of their activities in the face of an …

Hiv And Partner Violence: What Are The Implications For Voluntary Counseling And Testing?, Carolyn Knapp

HIV and AIDS

Millions of women around the world face two great threats to their health and well-being: HIV/AIDS and violence by an intimate partner. One of the strongest associations between the two is the role that violence and the threat of violence play in limiting a woman’s ability to negotiate safer sex with a partner. A similar fear of violence also discourages women who receive HIV voluntary counseling and testing (VCT) from telling partners about test results. This study explored the links between HIV infection, serostatus disclosure, and partner violence among women attending a VCT clinic in Dar es Salaam, Tanzania. Researchers …

Reducing Hiv Infection Among Youth: What Can Schools Do? Key Baseline Findings From Mexico, South Africa, And Thailand, Holley Stewart, Ann P. Mccauley, Simon Baker, Martha Givaudan, Shegs James, Iwin Leenen, Susan Pick, Priscilla Reddy, Usasinee Rewthong, Patchara Rumakom, Dilys Walker

HIV and AIDS

Although many program planners see schools as a convenient location for HIV-prevention programs, there is controversy about whether school programs can ever be strong enough to go beyond improving knowledge and attitudes to increasing the adoption of safe sexual behaviors. Evaluations of school programs in Mexico, South Africa, and Thailand focus on this question: Can school HIV programs change behavior? In each country, local organizations have worked with educators on teacher training and course design to ensure high-quality school interventions. Researchers surveyed students’ knowledge, attitudes, norms, and reported behavior before the intervention, immediately after the intervention, and again several months …

Hiv And Partner Violence: Implications For Hiv Voluntary Counseling And Testing Programs In Dar Es Salaam, Tanzania, Suzanne Maman, Jessie K. Mbwambo, Margaret Hogan, Gad P. Kilonzo, Michael D. Sweat, Ellen Weiss

HIV and AIDS

This study explored the links between HIV infection, serostatus disclosure, and partner violence among women attending a VCT clinic in Dar es Salaam, Tanzania. Men and women both perceive HIV testing as a way to plan for the future but are motivated to undergo testing by a number of different individual, relationship, and environmental factors. The women in our study described more barriers to HIV testing than did men, and women who have communicated with their partners about VCT before seeking services are significantly more likely to share their HIV test results than those who have not talked with their …

The Case For Microbicides: A Global Priority, Kathy Attawell

HIV and AIDS

The HIV/AIDS epidemic continues to spread, undermining development, reversing health gains, and exacerbating poverty. It will be some time before a vaccine is available and accessible, thus there is an urgent need to identify additional prevention options, in particular a method that women control, which could save millions of lives. This report from the Population Council and International Family Health presents the case for microbicides—products used vaginally to prevent infection from HIV and other STIs in women and their sexual partners—and discusses recent progress and developments, outstanding challenges, and the action required to ensure that products will be made available …

Making A Difference For Children Affected By Aids: Baseline Findings From Operations Research In Uganda, Laelia Gilborn, Rebecca Nyonyintono, Robert Kabumbuli, Gabriel Jagwe-Wadda

HIV and AIDS

Many organizations and programs have begun to provide services and support to AIDS-orphaned children in East and southern Africa. Typical program components include the provision of school fees and supplies, supplementary feeding, home-visiting programs in which community members visit and assist affected children, and vocational training. However, few of these programs have been formally evaluated for impact. This paper reports on baseline findings from a study of two programs for AIDS-affected children and their families implemented by PLAN International in the Luwero and Tororo districts of Uganda. One program, referred to as orphan support, provides educational, health, and nutritional assistance …

Increasing Coverage Of Reproductive Health Issues In The Indonesian Print Media, Wanda Firmansyah, Sahar Hegazi, Siti Rokhmawati Darwisyah, Lila Amaliah

Reproductive Health

With the reform movement in Indonesia, the FRONTIERS project recognized the new opportunities for influencing public debate and informing public opinion on reproductive health issues and undertook a project for disseminating the results of contemporary research on reproductive health. The project had three main objectives: 1) to increase print media coverage of critical reproductive health issues by enhancing journalists’ role as responsible communication agents; 2) to contribute to public debate on emerging reproductive health issues in order to influence policy development and guide program management; and 3) to increase public awareness of key health issues, with a particular focus on …

Women, Communities, And The Prevention Of Mother-To-Child Transmission Of Hiv: Issues And Findings From Community Research In Botswana And Zambia, Laura Nyblade, Mary Lyn Field-Nguer

HIV and AIDS

This paper discusses research in Botswana and Zambia that showed gaps in community knowledge about HIV transmission, particularly from mother to child, and yielded insights into community perspectives about the barriers to using voluntary counseling and testing services; the stigma and fear associated with HIV; traditional norms on breastfeeding; and the role of family and community members in women’s decisions to participate in programs to prevent mother-to-child transmission of HIV. A separate Population Council publication (“Community involvement in the prevention of mother-to-child transmission of HIV: Insights and recommendations”) offers recommendations for community involvement strategies that will encourage program planners to …

Comment Promouvoir L'Utilisation Des Résultats D'Une Analyse Situationnelle À L'Échelle Nationale: Expérience Du Sénégal, Adama Ndoye, Bineta M'Bow, Cheikh Bamba Diop, Mady Cisse, Macoumba Thiam, Diouratie Sanogo, Mbacke Niang

Reproductive Health

Avec cette dissémination des résultats de l’Analyse Situationnelle (AS) de 1998 le Ministère de la Santé réalise la troisième activité de ce genre. Au sortir de la dissémination, plusieurs enseignements sont tirés: Une bonne préparation de l’activité est nécessaire et, dans ce sens, la place de l’atelier de planification et l’établissement concerté d’un calendrier des activités par les niveaux national et régional sont prépondérants. L’organisation pratique des ateliers de dissémination doit compter avec l’utilisation des professionnels de la santé des régions et des médias locaux. Cette initiative a permis de crédibiliser les résultats ce qui a favorisé leur appropriation par …

Communication Skills Of Autistic Malaysian Children Undergoing The Aba Programme, Chithra K. M. Krishnan Adiyodi

Student Works (2000-2009)

The aim of this research was to diagnose the communication ability of a group of ten children with autism who were undergoing the Applied Behaviour Analysis programme at a NASOM Autistic Educational Centre in Klang. The research also set out to show that these children were able to use in their daily life the skills that they have learnt in the programme. The ability of these children to communicate before and after the intervention was noted by using a Behavioural Language Assessment Form. through interviews with teachers and in the observations of the researcher. It was found that some communication …

From Patna To Paris: Providing Safe And Humane Abortion, Carmen Barroso, Martha Brady, Batya Elul, Shelley Clark, Sneh Vishwanath, Sunanda Rabindranathan

Poverty, Gender, and Youth

With access to safe, legal abortion under severe constraint or debate in many parts of the world, less attention has been paid to the issue of quality of abortion care. This issue of Quality/Calidad/Qualité explores two programs that operate in very different settings but with a shared commitment to providing high-quality abortion care in a context of broader reproductive health services: the Clinique d’Orthogénie of Broussais Hospital in France and Parivar Seva Sanstha in India. In both programs, each woman or girl who arrives for abortion receives crucial basic care, including: appropriate medical treatment to ensure complete abortion and safe …

Influencing Reproductive Health Policy And Programs In The Philippines: Implementing An Advocacy Model For Utilization Of Operations Research, Saniata Masulit, Marilou P. Costello, Sahar Hegazi

Reproductive Health

This project tested a model of operations research (OR) dissemination and utilization targeting program managers in Mindanao, the second largest island of the Philippines. The model combines capacity-building with the use of innovative advocacy approaches to disseminate OR results, by creating a network of policy champions who will advocate the use of OR findings through a variety of strategies after they have been provided with information on the advocacy issue and their presentation skills enhanced. The project demonstrated that this type of network could lead to significant program changes, but also revealed that there is no single strategy or approach …

Indonesia: Train Journalists To Write About Reproductive Health, Frontiers In Reproductive Health

Reproductive Health

After government control over the media was liberalized in 1998, Indonesian journalists had a new mandate to explore new issues and foster public debate. Several studies had found evidence that women’s health worsened from 1997–99, yet media coverage of this topic was limited. To increase press coverage of reproductive health (RH) topics, the Population Council conducted an 18-month media project in collaboration with the State Ministry for Women’s Empowerment and other key agencies. The project focused on improving RH knowledge and reporting skills among 22 print journalists. Project staff monitored RH coverage in 22 major newspapers, magazines, and tabloids. After …

Obstacles To Contraceptive Use In Pakistan: A Study In Punjab, John B. Casterline, Zeba Sathar, Minhaj Ul Haque

Poverty, Gender, and Youth

The principal aim of this study is to assess the strength in Pakistan of a set of hypothesized obstacles to practicing contraception. Our concern is those factors that prevent women from translating a desire to avoid becoming pregnant into contraceptive practice, a common predicament in Pakistan in recent decades. We analyze survey data collected in Punjab province in 1996 that contain unusually detailed measurement of various perceived costs of practicing contraception, as well as focused measurement of fertility motivation. The framework guiding the research specifies six major obstacles to contraceptive use: the strength of motivation to avoid pregnancy, awareness and …

The Reporting Of Sensitive Behavior Among Adolescents: A Methodological Experiment In Kenya, Barbara Mensch, Paul C. Hewett, Annabel Erulkar

Poverty, Gender, and Youth

This paper assesses whether audio computer-assisted self-interviewing (audio-CASI), a technique designed in the United States to collect data on sensitive behaviors, is a feasible method of survey data collection in a developing-country setting and whether it produces more valid reporting of sexual activity and related behaviors than traditional survey methods. The analysis is based on interviews with nearly 4,400 unmarried adolescents aged 15-21 in Nyeri, a rural district of Kenya that was selected because previous research had indicated a wide discrepancy in the reporting of premarital sexual behavior between boys and girls. The study was based on a quasi-experimental design …

Social Networks And Contraceptive Dynamics In Southern Ghana, Mark R. Montgomery, Gebre-Egziabher Kiros, Dominic K. Agyeman, John B. Casterline, Peter Aglobitse, Paul C. Hewett

Poverty, Gender, and Youth

There is accumulating evidence that social diffusion processes affect the pace of the adoption of modern contraception in societies undergoing fertility transition. In settings where mortality has declined and many other social and economic changes are underway, decisions about contraception are fraught with uncertainty and risk. In such circumstances, couples may rely on other persons for information and guidance. In this paper, we examine the influence of informal social networks on the contraceptive behavior of reproductive-age women, using longitudinal data collected in six communities in southern Ghana. Our results confirm the hypothesis that adoption of modern contraception is strongly affected …

Poverty And Public Services In Developing-Country Cities, Paul C. Hewett, Mark R. Montgomery

Poverty, Gender, and Youth

This paper examines the availability of basic public services such as water supply and sanitation in the cities and towns of developing countries, using data drawn from the Demographic and Health Surveys. Inadequate provision of public services can compromise health, hinder economic growth, and stymie efforts to reduce poverty. We find that wide rural-urban gaps remain in service delivery, and that smaller cities-where about half of urban residents live-are notably under-served by comparison with larger cities.

Out Of Africa: Origins Of The Taenia Tapeworms In Humans, Eric P. Hoberg, Nancy L. Alkire, Alan De Queiroz, Arlene Jones

Harold W. Manter Laboratory of Parasitology: Faculty Publications

Phylogenetic and divergence date analyses indicate that the occurrence of Taenia tapeworms in humans pre-dates the development of agriculture, animal husbandry and domestication of cattle (Bos spp.) or swine (Sus scrofa) Taeniid tapeworms in Africa twice independently colonized hominids and the genus Homo prior to the origin of modern humans. Dietary and behavioural shifts, from herbivory to scavenging and carnivory, as early Homo entered the carnivore guild in the Pliocene/Pleistocene, were drivers for host switching by tapeworms to hominids from carnivores including hyaenids and felids. Parasitological data provide a unique means of elucidating the historical ecology, foraging behavior …

Impact De L'Entretien Sur La Résistance Au Glissement Des Planchers, André Massicotte, Sophie Boudrias, François Quirion

Rapports de recherche scientifique

Depuis 1997, QInc a réalisé plusieurs recherches expérimentales visant à optimiser l’entretien des planchers dans le but ultime de réduire le nombre de lésions professionnelles causées par les chutes sur les planchers glissants. La particularité de la présente étude est d’aborder la problématique de la glissance des planchers qui sont peu susceptibles d’être contaminés par la matière grasse, par exemple les corridors et les salles des centres hospitaliers et des écoles.

Dans les études antérieures, on évaluait l’efficacité d’un nettoyage à enlever la matière grasse. Dans cette étude, on évalue l’impact de 180 nettoyages sur la résistance au glissement ainsi …

Influence De L'Instabilité Statique Sur La Force De Serrage Des Outils À Main Mécaniques, Denis Rancourt

Rapports de recherche scientifique

L’utilisation d’outils à main mécaniques tels les perceuses, les riveteuses, les marteaux-piqueurs etc., constituent un danger potentiel pour les travailleurs en industrie. En effet, il semble reconnu que ces outils peuvent causer différentes atteintes du système neuro-musculo-squelettique tels le syndrome des vibrations ou le syndrome du canal carpien. Malgré plusieurs études, on ne connaît pas encore très bien l’étiologie de plusieurs maladies du système neuro-musculo-squelettique et les facteurs de risques identifiés sont souvent évalués empiriquement. Une avenue potentiellement intéressante pour mieux identifier l’origine de ces maladies est d’étudier des aspects fondamentaux du contrôle moteur humain lors de la manipulation d’outils …

Intégration De La Sécurité Dès La Conception Des Systèmes De Production Dans L'Industrie Papetière, Par Le Développement D'Un Programme De Formation Axé Sur Le Transfert Des Compétences, René Benoit

Rapports de recherche scientifique

Ce rapport fait la synthèse d’un important projet de recherche réalisé dans le secteur des papetières du Québec. Dans un premier temps, sont décrits le contexte et l’origine du projet de même que la problématique générale reliée aux problèmes de sécurité pour les travailleurs exposés aux risques associés aux machines dotées de systèmes de commandes modernes. Dans un deuxième temps, ce document présente la pré-étude ayant conduit à la réalisation du projet dont ce rapport fait état. Cette pré-étude a permis de confirmer d’une part, le rôle majeur de l’ingénierie dans la conception des systèmes de commandes pour l’amélioration de …