Medicine and Health Sciences Commons^™

Married Adolescents: An Overview, Nicole Haberland, Erica Chong, Hillary J. Bracken

Poverty, Gender, and Youth

The nascent work reviewed in this compendium indicates that married girls experience significant social isolation and limited autonomy. Across the studies examined, on indicators of mobility, exposure to media, and social networks, married girls are consistently disadvantaged compared to their unmarried peers. Similarly, across studies, on most of the domains explored here (mobility, decision-making, control over economic resources, and possibly gender-based violence), married girls tend to be less empowered and more isolated than slightly older married females. There may also be health issues associated with marriage during adolescence. Married girls are frequently at a disadvantage in terms of reproductive health …

Married Adolescents: A Review Of Programmes, Auralice Graft, Nicole Haberland, Rachel E. Goldberg

Poverty, Gender, and Youth

Historically, major adolescent and reproductive health initiatives have failed to explicitly consider the needs of married adolescents. This paper provides insight into what is being done—or not being done—to support married adolescent girls and boys, how these populations’ needs are being conceptualized, and the extent to which social context is factored into program design. Some early work with adolescent mothers (married and unmarried) is considered. The degree to which selected adolescent programs have been able to reach married girls with their activities is briefly examined. A few basic parameters of potential interventions for married adolescents are presented, including an inventory …

Sexual Coercion: Young Men's Experiences As Victims And Perpetrators, Deepika Ganju, William Finger, Shireen J. Jejeebhoy, Vijaya Nidadavolu, K.G. Santhya, Iqbal Shah, Shyam Thapa, Ina Warriner

Poverty, Gender, and Youth

Available evidence suggests that a considerable number of young people experience nonconsensual sex across the world, however research has mainly concentrated on the experiences of young girls and their perspectives of perpetrators of violence. Little is known about coercion among young males as victims or perpetrators. Case studies presented at an international consultative meeting in September 2003 in New Delhi, India, challenged the common assumption that only women are victims of violence, and shed light on the experiences of young males as victims of sexual coercion. These case studies also discussed the perspectives of young males as perpetrators of violence …

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 …

Too Young To Be A Mother: A Description Of The Lives Of Married Adolescent Girls In Egypt, Omaima El-Gibaly, Susan M. Lee

Poverty, Gender, and Youth

Improving the status and health of women is high on the agenda of the Ministry of Health and Population in Egypt. Investing in the lives of women who marry in their teens has long-term benefits for these girls and their children. Valid information is needed, however, to address these girls’ special needs. Adolescent health is currently one of the major concerns of the Ministry of Health and Population, as is delaying early marriage and addressing the reproductive and other health needs of married girls. The Ministry was a fieldwork partner with the Population Council, providing data collection from primary health …

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 …

Growing Up In Pakistan: The Separate Experiences Of Males And Females, Cynthia B. Lloyd, Monica J. Grant

Poverty, Gender, and Youth

This Population Council working paper examines gender differences in transitions to adulthood in Pakistan. The survey covers key aspects of adolescents’ lives, including the timing of several adult transitions and a detailed accounting of time use over the previous 24 hours. The results of the analysis confirm the fundamental importance of schooling to transitions to adulthood. Those without any schooling, which still includes 15 percent of young men and 46 percent of young women, assume the work burdens of adults prematurely and are deprived of the opportunity for learning in an institutional setting outside the family. Those who do attend …

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 …

Urban Poverty And Health In Developing Countries: Household And Neighborhood Effects [Arabic], Mark R. Montgomery, Paul C. Hewett

Poverty, Gender, and Youth

In the United States and other high-income countries, where most people live in cities, there is intense scholarly and program interest in the effects of household and neighborhood living standards on health. Yet very few studies of developing-country cities have examined these issues. This paper investigates whether in these cities the health of women and young children is influenced by both household and neighborhood standards of living. Using data from the urban samples of 85 Demographic and Health Surveys, and modeling living standards using factor-analytic MIMIC methods, we find, first, that the neighborhoods of poor households are more heterogeneous than …

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.

Healing Wounds, Instilling Hope: The Tanzanian Partnership Against Obstetric Fistula, Thoraya Ahmed Obaid, Erica Chong

Poverty, Gender, and Youth

This edition of Quality/Calidad/Qualité describes a partnership formed to combat obstetric fistula in Tanzania. The Bugando Medical Center, the Women’s Dignity Project, the Tanzania Midwives Association, and the government cooperated on an extensive program for surgical repair, prevention, and policy research and activities. Lessons learned: 1) Fistula programs need to address social as well as medical issues. 2) Most repairs are successful, making an enormous difference in women’s lives. 3) Relatively little funding is necessary to start up a fistula program. 4) Fistula programs are vehicles for broader conversations about gender and poverty.

Guérir Les Blessures, Faire Naître L’Espoir: Le Partenariat Tanzanien Contre La Fistule Obstétricale, Thoraya Ahmed Obaid, Erica Chong

Poverty, Gender, and Youth

This edition of Quality/Calidad/Qualité describes a partnership formed to combat obstetric fistula in Tanzania. The Bugando Medical Center, the Women’s Dignity Project, the Tanzania Midwives Association, and the government cooperated on an extensive program for surgical repair, prevention, and policy research and activities. Lessons learned: 1) Fistula programs need to address social as well as medical issues. 2) Most repairs are successful, making an enormous difference in women’s lives. 3) Relatively little funding is necessary to start up a fistula program. 4) Fistula programs are vehicles for broader conversations about gender and poverty.

Linking Reproductive Health To Social Power: Community Health Workers In Belize And Pakistan, Susana Galdos, Lucella Campbell, Patricia Mohammed, Debbie Rogow, Saumya Ramarao, Ali M. Mir, Nicole Haberland

Poverty, Gender, and Youth

This issue of Quality/Calidad/Qualité focuses on two traditional family planning programs that undertook projects to help women enlarge their zone of influence in both the private and public spheres. The first case study focuses on the Belize Family Life Association (BFLA), a nongovernmental organization in a small Caribbean country. The second case study recounts the experience of the Pakistani government, which has an enormous, but entrenched, target-oriented family planning program. Both programs began by recognizing that women’s lack of social power is a major obstacle to their being able to protect their own health. Both trained village workers to regard …

Adolescent Life In Low Income And Slum Areas Of Addis Ababa, Ethiopia, Annabel Erulkar, Tekle-Ab Mekbib, Negussie Simie, Tsehai Gulema

Poverty, Gender, and Youth

The Ethiopian Ministry of Youth, Sports and Culture has long considered attention to the lives of Ethiopian adolescents as a priority intervention area for research and programs in the country. This study conducted with the Population Council gives critical insight into the lives of adolescent girls and boys in the low income and slum areas of Addis Ababa. Research and programs for young people tend to homogenize the adolescent population into one genderless mass, with little regard to age or social context. Greater segmentation of the adolescent population is needed in the design and content of programs, as well as …

Popular Perceptions Of Emerging Influences On Mortality And Longevity In Bangladesh And West Bengal, Sajeda Amin, Alaka Malwade Basu

Poverty, Gender, and Youth

Although new environmental and pathological threats to human survival and longevity have been documented, relatively little is known about how these threats are perceived in the popular imagination. During fieldwork in rural Bangladesh and West Bengal, India, researching the changing costs of and motivations for reproduction, the authors included survey questions on respondents’ perceptions of changing mortality. Child-mortality levels were perceived to have fallen drastically in recent times, but for the middle-aged and the elderly, the past was seen as a better time in terms of health and survival. The decline in adult health is attributed to environmental deterioration and …

Gender Differences In Time Use Among Adolescents In Developing Countries: Implications Of Rising School Enrollment Rates, Amanda Ritchie, Cynthia B. Lloyd, Monica J. Grant

Poverty, Gender, and Youth

Researchers at the Population Council have been involved in the collection of data on time use from adolescents in India, Kenya, Pakistan, and South Africa. Three questions are addressed in this working paper: (1) How does time use change during the transition to adulthood? (2) Does gender role differentiation intensify during the transition? (3) Does school attendance attenuate gender differences? The data document differences in time use patterns between students and nonstudents. Although female adolescent students still work longer hours than male adolescent students, the gender division of labor that typically develops during adolescence is greatly attenuated among students when …

Long-Range Trends In Adult Mortality: Models And Projection Methods, John Bongaarts

Poverty, Gender, and Youth

This Population Council working paper has two objectives: (1) to test a new version of the logistic model for the pattern of change over time in age-specific adult mortality rates, and (2) to develop a new method for projecting future trends in adult mortality. A test of the goodness-of-fit of the logistic model for the force of mortality indicates that its slope parameter is nearly constant over time. This finding suggests a variant of the model that is called the shifting logistic model. A new projection method based on the shifting mortality model is proposed and compared with the widely …

The Effect Of A Livelihoods Intervention In An Urban Slum In India: Do Vocational Counseling And Training Alter The Attitudes And Behavior Of Adolescent Girls?, Barbara Mensch, Monica J. Grant, Mary Philip Sebastian, Paul C. Hewett, Dale Huntington

Poverty, Gender, and Youth

This Population Council working paper examines whether an experimental intervention for girls aged 14–19 that provided reproductive health information, vocational counseling and training, and assistance with opening savings accounts in slum areas of Allahabad in Uttar Pradesh, India had an effect on their attitudes and behaviors. Although the livelihoods program was acceptable to parents and feasible to implement, the project had only a minimal impact on the behavior and attitudes of adolescent girls in the experimental slums. The greatest changes between the baseline and the endline surveys were found in those outcomes that most closely reflected the content of the …

Role Of Estrogens In The Secondary Hormonal Manipulation Of Hormone Refractory Prostate Cancer, Khurram M. Siddiqui, Farhat Abbas, Syed Raziuddin Biyabani, Muhammad Hammad Ather, Jamsheer J. Talati

Section of Urology

Objective: To evaluate the role of Estrogens (Honvan) in the secondary hormonal manipulation of patients with hormone refractory prostate cancer (HRCP). Methods: Twelve patients diagnosed as hormone refractory prostate cancer received intravenous estrogens for six days (Fosfestrol, a synthetic phosphorylated estrogen derivative), followed by a maintenance oral dose of 120 mg thrice daily as second line hormonal treatment. During the treatment they were given deep venous thrombosis prophylaxis. Their stage at initial presentation, primary treatment, mode of androgen ablation, prostate specific antigen (PSA) level, duration of remission prior of HRPC status, PSA doubling time before and after estrogen treatment were …

Patterns Of Variations In Escherichia Coli Strains That Produce Cytolethal Distending Toxin, Carol L. Pickett, Robert B. Lee, Aysegul Eyigor, Ben Elitzur, Emily M. Fox, Nancy A. Strockbine

United States Public Health Resources

A collection of 20 Escherichia coli strains that produce cytolethal distending toxin (CDT) were analyzed for their virulence-associated genes. All of these strains were serotyped, and multiplex PCR analysis was used to ascertain the presence of genes encoding other virulence factors, including Shiga toxin, intimin, enterohemolysin, cytotoxic necrotizing factor type 1 (CNF1) and CNF2, heat-stable toxin, and heat-labile toxin. These CDT-producing strains possessed various combinations of known virulence genes, some of which have not been noted before. Partial cdtB sequences were obtained from 10 of these strains, and their predicted CdtB sequences were compared to known E. coli CdtB sequences; …

Bovine Tuberculosis (Mycobacterium Bovis) In Wildlife In Spain, Alicia Aranaz, Lucía De Juan, Natalia Montero, Celia Sanchez, Margarita Galka, Consuelo Delso, Julio Alvarez, Beatriz Romero, Javier Bezos, Ana I. Vela, Victor Briones, Ana Mateos, Lucas Domínguez

Michigan Bovine Tuberculosis Bibliography and Database

Mycobacterium bovis infection in wildlife and feral species is a potential source of infection for livestock and a threat to protected and endangered species. The aim of this study was to identify Spanish wild animal species infected with M. bovis through bacteriological culture and spacer oligonucleotide typing (spoligotyping) of isolates for epidemiological purposes. This study included samples from red deer (Cervus elaphus), fallow deer (Dama dama), wild boar (Sus scrofa), Iberian lynx (Lynx pardina), hare (Lepus europaeus), and cattle (Bos taurus). They were collected in several geographical areas …

Shared Feed As A Means Of Deer-To-Deer Transmission Of Mycobacterium Bovis, Mitchell V. Palmer, W. Ray Waters, Diana L. Whipple

Michigan Bovine Tuberculosis Bibliography and Database

To determine the ability of experimentally inoculated white-tailed deer (Odocoileus virginianus) to transmit Mycobacterium bovis to naive deer through the sharing of feed, four deer were intratonsillarly inoculated with 4x10⁵ colony-forming units of M. bovis. On a daily basis, feed not consumed by inoculated deer after approximately 8 hr was offered to four naıve deer maintained in a separate pen, where direct contact, aerosol transmission, or transmission through personnel were prevented. After 150 days, naıve deer were euthanized and examined. All naıve deer had lesions consistent with tuberculosis and M. bovis was isolated from various tissues. …

Evaluation Of An In Vitro Blood-Based Assay To Detect Production Of Interferon-Γ By Mycobacterium Bovis–Infected White-Tailed Deer (Odocoileus Virginianus), Mitchell V. Palmer, W. Ray Waters, Diana L. Whipple, Ralph E. Slaughter, Stephen L. Jones

Michigan Bovine Tuberculosis Bibliography and Database

Tuberculosis due to Mycobacterium bovis in captive Cervidae was identified as an important disease in the United States in 1990 and prompted the addition of captive Cervidae to the USDA Uniform Methods and Rules for eradication of bovine tuberculosis. As well, M. bovis infection was identified in free-ranging white-tailed deer in northeast Michigan in 1995. Tuberculosis in both captive and free-ranging Cervidae represents a serious challenge to the eradication of M. bovis infection from the United States. Currently, the only approved antemortem tests for tuberculosis in Cervidae are the intradermal tuberculin skin test and the blood tuberculosis test (BTB). At …

Yeast Genome-Wide Drug-Induced Haploinsufficiency Screen To Determine Drug Mode Of Action, Kristin Baetz, Lianne Mchardy, Ken Gable, Tamsin Tarling, Delphine Rebérioux, Jenny Bryan, Raymond J. Andersen, Teresa Dunn, Phil Hieter, Michel Roberge

Uniformed Services University of the Health Sciences

Published in PNAS (2004) 101(13): pp. 4525-4530; doi:10.1073/pnas.0307122101

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 …

Incremental Genetic K-Means Algorithm And Its Application In Gene Expression Data Analysis, Yi Lu, Shiyong Lu, Farshad Fotouhi, Youping Deng, Susan J. Brown

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

In recent years, clustering algorithms have been effectively applied in molecular biology for gene expression data analysis. With the help of clustering algorithms such as K-means, hierarchical clustering, SOM, etc, genes are partitioned into groups based on the similarity between their expression profiles. In this way, functionally related genes are identified. As the amount of laboratory data in molecular biology grows exponentially each year due to advanced technologies such as Microarray, new efficient and effective methods for clustering must be developed to process this growing amount of biological data.

Results

In this paper, we propose a new clustering …

Human Chorionic Gonadotropin Administration Is Associated With High Pregnancy Rates During Ovarian Stimulation And Timed Intercourse Or Intrauterine Insemination, Mohamed F. Mitwally, Sonya Abdel-Razeq, Robert F. Casper

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

There are different factors that influence treatment outcome after ovarian stimulation and timed-intercourse or intrauterine insemination (IUI). After patient age, it has been suggested that timing of insemination in relation to ovulation is probably the most important variable affecting the success of treatment. The objective of this study is to study the value of human chorionic gonadotropin (hCG) administration and occurrence of luteinizing hormone (LH) surge in timing insemination on the treatment outcome after follicular monitoring with timed-intercourse or intrauterine insemination, with or without ovarian stimulation.

Methods

Retrospective analysis of 2000 consecutive completed treatment cycles (637 timed-intercourse and …

Low Dose Intravenous Minocycline Is Neuroprotective After Middle Cerebral Artery Occlusion-Reperfusion In Rats, Lin Xu, Susan C. Fagan, Jennifer L. Waller, David Edwards, Cesar V. Borlongan, Jianqing Zheng, William D. Hill, Giora Feuerstein, David C. Hess

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

Minocycline, a semi-synthetic tetracycline antibiotic, is an effective neuroprotective agent in animal models of cerebral ischemia when given in high doses intraperitoneally. The aim of this study was to determine if minocycline was effective at reducing infarct size in a Temporary Middle Cerebral Artery Occlusion model (TMCAO) when given at lower intravenous (IV) doses that correspond to human clinical exposure regimens.

Methods

Rats underwent 90 minutes of TMCAO. Minocycline or saline placebo was administered IV starting at 4, 5, or 6 hours post TMCAO. Infarct volume and neurofunctional tests were carried out at 24 hr after TMCAO using …

Do Recent Data From The Seychelles Islands Alter The Conclusions Of The Nrc Report On The Toxicological Effects Of Methylmercury?, Alan H. Stern, Joseph L. Jacobson, Louise Ryan, Thomas A. Burke

Wayne State University Associated BioMed Central Scholarship

Abstract

In 2000, the National Research Council (NRC), an arm of the National Academy of Sciences, released a report entitled, "Toxicological Effects of Methylmercury." The overall conclusion of that report was that, at levels of exposure in some fish- and marine mammal-consuming communities (including those in the Faroe Islands and New Zealand), subtle but significant adverse effects on neuropsychological development were occurring as a result of in utero exposure. Since the release of that report, there has been continuing discussion of the public health relevance of current levels of exposure to Methylmercury. Much of this discussion has been linked to …

Effect Of Four-Day Psyllium Supplementation On Bowel Preparation For Colonoscopy:A Prospective Double Blind Randomized Trial [Isrctn76623768], Walter A. Salwen, Marc D. Basson

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

Patients with new onset constipation or presumed hemorrhoid bleeding frequently require the use of both fiber supplements and diagnostic colonoscopy. We sought to determine whether preliminary fiber supplementation would alter the tolerability or efficacy of a standard bowel preparation for colonoscopy

Methods

A prospective, double blind, randomized trial was designed to compare a short course of a psyllium-based supplement versus placebo prior to a colon lavage. Patients were given an unlabeled canister of powder, and instructed to take 1 tablespoon with 8 oz of water bid for 4 days before colonoscopy. A 4-liter polyethylene based glycol lavage was …