Medicine and Health Sciences Commons^™

Aging In Place At Harbor Point: Outreach Follow-Up Of Older Adults Living In Independent Mixed-Income Apartments, Judith M. Conahan, Nina M. Silverstein, Kelly Fitzgerald

Gerontology Institute Publications

Most older people, despite functional impairments, plan to stay in their homes and/or communities as long as possible. According to an AARP survey, 82% of adults 65+ reported that they believe that they are “very likely” or “somewhat likely” to stay in their current homes or apartments for the rest of their lives. With increasing age, housing and community characteristics and services gain importance in meeting the challenges of “aging in place.” Staying in their homes maximizes elder’s independence, sustains their social connections, and reaffirms their identity and value.

Bridges And Barriers To Housing For Chronically Homeless Street Dwellers: The Effects Of Medical And Substance Abuse Services On Housing Attainment, Tatjana Meschede

Center for Social Policy Publications

In the winter of 1998/99, after the deaths of 16 homeless people in the streets of Boston attracted wide attention by the media, the Commissioner of the Massachusetts Department of Public Health (MDPH), Dr. Howard Koh, convened a group of I stakeholders serving the homeless street population. The goal of this MDPH Homeless Taskforce was to reduce the number of homeless people dying on the streets as well as to improve service delivery to those homeless individuals most at risk of dying. A wide range of individuals serving or encountering the homeless street population, including homeless outreach teams, law enforcement …

Individual And Social Influences On Ethnic Identity Among Latino Young Adults, Lenna L. Ontai-Grzebik, Marcela Raffaelli

Department of Psychology: Faculty Publications

Building on prior Latino ethnic identity research, this study had three goals: describe age-related trends in ethnic identity among young adults, examine relations among ethnic identity and individual factors, and explore the impact of family and peer socialization on ethnic identity. The participants (two hundred 19-to 30-year-olds; mean age = 22.5) completed self-report surveys sent to Latino undergraduate and graduate students enrolled in four midwestern institutions of higher education. The findings suggest individual factors are strong predictors of ethnic identity during early adulthood; respondents who were younger, high on Latino orientation, spent more time in the United States, and whose …

Similar Promotion Of Abeta1-42 Fibrillogenesis By Native Apolipoprotein E Epsilon3 And Epsilon4 Isoforms, David Sweeney, Ralph Martins, Harry Levine, Jonathan D. Smith, Sam Gandy

Sanders-Brown Center on Aging Faculty Publications

The apolipoprotein E epsilon4 allele contributes to the genetic susceptibility underlying a large proportion (~40-60%) of typical, sporadic Alzheimer disease. Apolipoprotein E deficient mice made transgenic for human apolipoprotein E epsilon4 accumulate excess cerebral amyloid when compared to similarly prepared mice expressing human apolipoprotein E epsilon3. Therefore, it is important to search for relevant interactions(s) between apolipoprotein E epsilon4 and Abeta in order to clarify the biological role for apolipoprotein E epsilon4 in Alzheimer disease. Using a thioflavine T (ThT)-based assay, we have investigated the effects of native human apolipoprotein E isoforms on the kinetics of Abeta fibrillogenesis. No obvious …

Review Of Family Health Social Work Practice: A Macro Level Approach. John T. Pardeck (Ed.) Reviewed By Marsha Blachman, Marsha Blachman

The Journal of Sociology & Social Welfare

Book review of John T. Pardeck (Ed.), Family Health Social Work Practice: A Macro Level Approach. Westport, CT: Auburn House, 2002. $ 67.95 hardcover.

Sharing Power With The People: Family Group Conferencing As A Democratic Experiment, Lisa Merkel-Holguin

The Journal of Sociology & Social Welfare

Can family group conferencing be leveraged to promote the democratic ideals of voice, freedom, justice, fairness, equality, and respect, and provide the citizenry with the opportunity to build a more just and civil society? This article reviews family group conferencing, and various model adaptations, from a democratic context and through the lens of responsive regulation.

Consumer Perspectives On Quality In Adult Day Care, Amy Leventhal Stern, Francis G. Caro

Gerontology Institute Publications

Purpose: The purpose of this project was to gain insight into the quality of care and services provided through adult day care from the user’s perspective. Design and Methods: The project utilized 13 focus groups to explore aspects associated with user needs, preferences, and satisfaction with adult day care centers. Results: Focus group participants described aspects of adult day care that are important in delivering quality care, program features that are effective, and key areas in need of improvement. Ensuring the safety of clients; having caring, friendly, and compassionate staff available to provide one-on-one attention; engaging clients in stimulating activities; …

Back To The Future: The Future Of Long-Term Care In Massachusetts, Deborah H. Thomson, John J. Ford

Gerontology Institute Publications

The state of Massachusetts, like the rest of the United States, is facing an approaching crisis in long-term care. Over the next few decades the number of Massachusetts residents age 65 and older will soar. As these numbers increase, so will the need for long-term care.

Massachusetts is ill prepared to provide the services that will be needed. Our current system of health care benefits leaves many elders with gaps in coverage. Those individuals who need long-term services often impoverish themselves and their spouses before the state pays for their care. Others languish on waiting lists to receive services. Our …

Strengthening Sti Treatment And Hiv/Aids Prevention Services In Carletonville, South Africa, Lewis Ndhlovu, Catherine Searle, Johannes Van Dam

HIV and AIDS

Although knowledge about HIV/AIDS is widespread in South Africa, adult HIV prevalence is high, indicating high levels of risky sexual behavior. Understanding the gap between knowledge and behavior requires an examination of the social context in which the epidemic occurs. The Horizons Program conducted an intervention study in the Carletonville area to study the social determinants of the HIV epidemic and to assess the impact of a targeted program of HIV and STI prevention and service delivery. In 1998, the Mothusimpilo (“Working together for health”) Intervention Project (MIP) was launched to reduce community prevalence of HIV and other STIs and …

Promoting Young People's Sexual And Reproductive Health: Stigma, Discrimination And Human Rights, Kate Wood, Peter Aggleton

Reproductive Health

Sponsored jointly by the DFID-supported Safe Passages to Adulthood program, John Snow International, YouthNet/Family Health International, and the Population Council, the international knowledge synthesis meeting on Promoting Young People’s Sexual and Reproductive Health: Stigma, Discrimination and Human Rights took place in Brighton, England, June 5–7, 2003. Participants from a wide variety of countries were invited to describe their experiences of working to challenge stigma and discrimination and promote human rights as they relate to young people’s sexual and reproductive health. The meeting brought together program leaders from a variety of countries to discuss stigma, discrimination, and human rights in relation …

Formal And Informal Abortion Services In Rajasthan, India: Results Of A Situation Analysis, Sandhya Barge, Hillary J. Bracken, Batya Elul, Nayan Kumar, Wajahat U. Khan, Shalini Verma, Carol Camlin

Reproductive Health

As part of a Population Council program of research on unwanted pregnancy and induced abortion in Rajasthan, the Population Council and the Centre for Operations Research and Training conducted a situation analysis of abortion services in both the formal and informal sectors in six districts. This report offers insights into the availability and organization of abortion services in the sampled areas in Rajasthan. The report also documents a vast array of informal providers who offer services for delayed menstruation or unwanted pregnancy. Informal providers appear particularly accessible to women because they are far more prevalent in rural areas than formal …

Determining An Effective And Replicable Communication-Based Mechanisms For Improving Young Couples' Access To And Use Of Reproductive Health Information And Services In Nepal—An Operations Research Study, Center For Research On Environment Health And Population Activities (Crehpa)

Reproductive Health

This operations research study sought to determine an effective communication-based model for increasing the involvement of community-based groups in improving access to and use of reproductive health services and information by young married couples. The study employed a quasi-experimental design with two experimental and two nonequivalent control groups in the Udaypur district of Nepal. As stated in this report, this OR study clearly demonstrates the effectiveness of communication-based models such as the formation and reactivation of Youth Communication Action Groups and Mother’s groups, basic and refresher training, group interaction and mobilization, and social events in creating an enabling environment for …

A World Apart: The Disadvantage And Social Isolation Of Married Adolescent Girls, Nicole Haberland, Erica Chong, Hillary J. Bracken

Poverty, Gender, and Youth

This brief is based on a paper prepared for the WHO/UNFPA/Population Council Technical Consultation on Married Adolescents, held in Geneva, Switzerland, December 9–12, 2003. The consultation brought together experts from the United Nations, donors, and nongovernmental agencies to consider the evidence regarding married adolescent girls’ reproductive health, vulnerability to HIV infection, social and economic disadvantage, and rights. The relationships to major policy initiatives—including safe motherhood, HIV, adolescent sexual and reproductive health, and reproductive rights—were explored, and emerging findings from the still relatively rare programs that are directed at this population were discussed. Despite the program attention and funding that have …

Socioeconomic Disadvantage And Unsafe Sexual Behaviors Among Young Women And Men In South Africa, Kelly Hallman

Poverty, Gender, and Youth

This study investigates how relative socioeconomic status influences the sexual behaviors of young women and men aged 14–24 years in KwaZulu-Natal Province, South Africa—an environment characterized by high HIV prevalence and high rates of poverty and inequality. Relative economic disadvantage is found to significantly increase the likelihood of a variety of unsafe sexual behaviors and experiences. Poorer young people, especially females, also have significantly lower access to media sources for family planning information. Without sufficient attention in the design and placement of HIV prevention programs to the economic and social conditions in which individuals live, the potential effectiveness of the …

Bridging The Gap Between Evidence-Based Innovation And National Health-Sector Reform In Ghana, John Koku Awoonor-Williams, Ellie S. Feinglass, Rachel Tobey, Maya Vaughan-Smith, Frank K. Nyonator, Tanya C. Jones, James F. Phillips

Poverty, Gender, and Youth

Although experimental trials often identify optimal strategies for improving community health, transferring operational innovation from well-funded research programs to resource-constrained settings often languishes. Because research initiatives are based in institutions equipped with unique resources and staff capabilities, results are often dismissed by decisionmakers as irrelevant to large-scale operations and national health policy. This article describes an initiative undertaken in Nkwanta District, Ghana, focusing on this problem. The Nkwanta District initiative is a critical link between the experimental study conducted in Navrongo, Ghana, and a national effort to scale up the innovations developed in that study. A 2002 Nkwanta district-level survey …

Making Motherhood Safer In Egypt, Karima Khalil, Farzaneh Roudi-Fahimi

Reproductive Health

Fewer Egyptian women die of maternal causes today than they did 10 or 15 years ago, due in large part to the national safe motherhood program. Nevertheless, maternal mortality is still relatively high, and the country faces challenges in reducing it further. Many of these challenges involve addressing the delays women face when they need essential obstetric care. In Egypt and other countries, most maternal deaths could be avoided if women had timely access to high-quality emergency obstetric services. Although Egypt’s level of maternal mortality is relatively high by international standards, recent evidence suggests that a woman’s lifetime risk of …

Forced Sexual Relations Among Married Young Women In Developing Countries, Deepika Ganju, William Finger, Shireen J. Jejeebhoy, Vijaya Nidadavolu, K.G. Santhya, Iqbal Shah, Shyam Thapa, Ina Warriner

Poverty, Gender, and Youth

Recent research in developing countries suggests that a considerable number of young women may experience forced sex within marriage, but most women may be inhibited from reporting these experiences due to shame, fear of reprisal, or deep-rooted unequal gender norms. In September 2003, a global consultative meeting on nonconsensual sex among young people in developing countries was held in New Delhi, India. The meeting was organized by the Population Council in collaboration with World Health Organization/Department of Reproductive Health and Research, and Family Health International/YouthNet. Participants included researchers, legal analysts, representatives from community-based NGOs, policy-makers, and young people themselves. Papers …

The Experience Of Adolescence In Rural Amhara Region, Ethiopia, Annabel Erulkar, Tekle-Ab Mekbib, Negussie Simie, Tsehai Gulema

Poverty, Gender, and Youth

This study aims to broaden the understanding of young lives in rural Ethiopia, specifically, Amhara Region. It finds that over half of the adolescents in the sample had never been to school. The most common reason for boys and girls not attending school was poverty, followed by early marriage for girls, and too many work responsibilities for boys. It finds that over half of the adolescents interviewed were illiterate. The study offers suggestions to address the programmatic needs of rural youth as well as neglected subgroups of adolescents.

Does Dowry Improve Life For Brides? A Test Of The Bequest Theory Of Dowry In Rural Bangladesh, Luciana Suran, Sajeda Amin, Lopita Huq, Kobita Chowdury

Poverty, Gender, and Youth

In recent years, dowry levels in Bangladesh have risen to previously unforeseen levels—sometimes three or four times a family’s total assets. Some recent economic writings suggest that dowry functions as a bequest or pre-mortem inheritance, implying it persists because it is “good for the bride.” Using panel data from an adolescent study in rural Bangladesh, this Population Council working paper explores the association between dowry and the prevalence of domestic abuse to test the bequest theory of dowry. Contrary to the prediction of the bequest theory, married females who paid dowry at marriage have a higher likelihood of reporting domestic …

The Roles, Responsibilities, And Realities Of Married Adolescent Males And Adolescent Fathers: A Brief Literature Review, Gary Barker, Jorge Lyra, Benedito Medrado

Poverty, Gender, and Youth

From the perspective of developing countries, we know relatively little about married adolescent males and adolescent fathers, and much of what we know is inferred from research with young women or comes from a few specific regions in the world. However, there has been a growing interest in the issue on the part of researchers, policy-makers, and program staff. This interest has coincided with increasing attention in general to men, with gender studies, and with sexual and reproductive health initiatives. Early marriage and early childbearing are much more prevalent among young women than young men, and the negative consequences are …

Population Aging And The Rising Cost Of Public Pensions [Arabic], John Bongaarts

Poverty, Gender, and Youth

Rapid population aging is raising concerns about the sustainability of public pension systems in high-income countries. The first part of this study identifies the four factors that determine trends in public pension expenditures: population aging, pension benefit levels, the mean age at retirement, and the labor force participation rate. The second part presents projections to 2050 of the impact of demographic trends on public pension expenditures in the absence of changes in pension benefits, labor force participation, and age at retirement. These projections demonstrate that current trends are unsustainable, because without reforms population aging will produce an unprecedented and harmful …

Equitable Access To Hiv Counseling And Testing For Youth In Developing Countries: A Review Of Current Practice, Ann P. Mccauley

HIV and AIDS

While many people get HIV-related counseling and testing, only those who receive pre- and post-test counseling, and test voluntarily, are participating in voluntary counseling and testing (VCT). The high rates of HIV infection among youth make it crucial to find programs to prevent infection. Because there is evidence that many adults benefit from VCT, there is increasing interest in extending these services to young people. VCT counseling helps adolescents evaluate their own behavior and its consequences. A negative test result offers the opportunity to recognize vulnerabilities and develop risk-reduction plans to adopt safe behaviors. Young people who test HIV-positive can …

Willingness To Pay Surveys For Setting Prices For Reproductive Health Products And Services: A User's Manual, Karen G. Fleischman Foreit, James R. Foreit

Reproductive Health

Social programs need to balance volume (coverage) and revenue (sustainability). The law of demand says that we cannot get both coverage and sustainability at the same time—as prices go up, demand will come down. Client loss with increasing prices is inevitable, except in those cases where starting prices are so low or demand is so high that demand is insensitive to price changes. Willingness to pay surveys allow program managers to simulate price-related changes in demand without actually changing prices, giving them a way to make pricing decisions based on empirical information. In making pricing decisions, managers of social programs …

Integration Of Reproductive Health Services For Men In Health And Family Welfare Centers In Bangladesh, Ubaidur Rob, Sharif M.I. Hossain, M.E. Khan, Ahmed Al-Sabir, Mohammed Ahsanul Alam

Reproductive Health

Since the mid-1970s, the Bangladesh national family planning program primarily focused on motivating women to use modern contraceptive methods and encouraging them to seek services from clinics. In addition, female field workers were recruited to deliver contraceptive methods at homes. The program design facilitated women’s access to information and medical care through clinics and home visits. In the process, however, the medical needs of males were marginalized. Men generally seek services from pharmacies, private practitioners, and district hospitals, and often ignore preventive steps and postpone seeking medical care for chronic health conditions. In cases of acute illness, they often resort …

New Findings From Intervention Research: Youth Reproductive Health And Hiv Prevention, Family Health International

Reproductive Health

On September 9, 2003, FRONTIERS/Population Council, Horizons/Population Council, and YouthNet/Family Health International co-sponsored a technical meeting in Washington, DC, “New Findings from Intervention Research: Youth Reproductive Health and HIV Prevention.” Approximately 150 HIV/AIDS, reproductive health, and youth development experts from a diversity of organizations and backgrounds participated. The purpose of the meeting was to disseminate newly available research findings on how to change youth reproductive health/HIV knowledge, attitudes, and behaviors in developing countries. The meeting also sought to stimulate discussion on lessons learned, best practices, and recommendations for future youth programs and research. This meeting report summarizes the presentations and …

Community Involvement In Reproductive Health: Findings From Research In Karnataka, India, Foundation For Research In Health Systems

Reproductive Health

In 1996, the government of India decided to provide a package of reproductive and child health services through the existing family welfare program, adopting a community needs assessment approach (CNAA). To implement this approach, the government abolished its practice of setting contraceptive targets centrally and introduced a decentralized planning strategy whereby health workers assessed the reproductive health needs of women in their respective areas and prepared local plans to meet those needs. They also involved community leaders to promote community participation in the reproductive and child health program. Since 1998, several evaluation studies have assessed the impact of CNAA on …

Safe Motherhood Demonstration Project, Western Province: Final Report, Charlotte E. Warren, Wilson Liambila

Reproductive Health

Since March 2000, the Population Council and the University of Nairobi have been assisting the Kenya Ministry of Health to implement Safe Motherhood activities in Western Kenya. The purpose of this project was to increase utilization of quality maternal services in the selected districts and, in an effort to improve pregnancy outcomes, focused on improving quality of antenatal care, essential obstetric care, clean and safe delivery, postpartum care, postabortion care, and management issues at all levels. In addition, the project focused on strengthening referral practices and addressing factors responsible for delays by pregnant women in making decisions on when, where, …

Les Implications Du Mariage Précoce Pour Les Politiques De Vih/Sida, Judith Bruce, Shelley Clark

Poverty, Gender, and Youth

Ce dossier est basé sur un document contextuel préparé pour la Consultation Technique OMS/ FNUAP/Population Council sur les Adolescentes Mariées, tenue à Genève en Suisse du 09 au 12 Décembre 2003 (le document final intitulé "Inclure les adolescentes mariées dans les politiques de santé reproductive des adolescents et de VIH/SIDA"). La Consultation a réuni des experts provenant des Nations Unies, des bailleurs de fonds et des agences non gouvernementales pour examiner les faits concernant la santé reproductive des adolescentes mariées, leur vulnérabilité face à l’infection du VIH, leurs inégalités sociales et économiques ainsi que leurs droits. Les rapports avec des …

Including Married Adolescents In Adolescent Reproductive Health And Hiv/Aids Policy, Judith Bruce, Shelley Clark

Poverty, Gender, and Youth

The majority of sexually active girls aged 15–19 in developing countries are married, and married adolescent girls tend to have higher rates of HIV infection than their sexually active, unmarried peers. Married adolescent girls represent a sizable fraction of adolescents at risk and experience some of the highest rates of HIV prevalence of any group. Nonetheless, married adolescents have been marginal in adolescent HIV/AIDS policies and programs and have not been the central subjects for programs aimed at adult married women. This paper offers a partial explanation for why married adolescents have so often been overlooked, the reasons why marriage …

A Multi-Sectoral Approach To Providing Reproductive Health Information And Services To Young People In Western Kenya: The Kenya Adolescent Reproductive Health Project, Ian Askew, Jane Chege, Carolyne Njue, Samson Radeny

Reproductive Health

Informing adolescents about appropriate and acceptable behaviors, and ways to protect themselves against unwanted and unprotected sex, has proved problematic in Kenya. Education programs for in- and out-of-school adolescents are lacking, there is controversy about providing services to sexually active adolescents, and a pervasive concern that sexuality education and contraceptive services leads to promiscuity. Unbiased and accurate information and services are needed if adolescents are to delay becoming sexually active, to resist pressures to engage in nonconsensual sex, and to protect themselves against unwanted pregnancies and infections if they do have sex. Moreover, strategies for providing such information and services …