Medicine and Health Sciences Commons^™

Kenya: Multisectoral Engagement Increases Support For Adolescent Reproductive Health, Frontiers In Reproductive Health

Reproductive Health

In 1999, FRONTIERS launched the Kenya Adolescent Reproductive Health Project (KARHP), testing a multisectoral approach to improving young people’s reproductive health knowledge and behavior at community, school, and health-facility levels in two pilot districts in the Western Province. The intervention involved three key government ministries—Education, Science and Technology, Health, and Gender, Sports, Culture, and Social Services—with input from community leaders, parents, and youth. Positive findings from the study convinced the three ministries and USAID to institutionalize and scale up selected elements from the pilot project. In 2003, FRONTIERS and PATH began providing technical assistance aimed at mainstreaming and expanding cost-effective …

The Substance Of Quality Treatment With Coexisting Problems (Book Review), Kristina M. Kays

Faculty Publications - Psychology Department

Reviews the book, "Clinical handbook of co-existing mental health and drug and alcohol problems" by Amanda Baker and Richard Velleman (see record 2007-01081-000). The text editors, Baker and Velleman, propose to present "practical descriptions of assessments and interventions for coexisting problems, with a view to enhancing motivation, confidence and competence to do so". Not only do the chapters succinctly address expert views on assessment, but they also thoughtfully explain intervention approaches with coexisting issues, specific populations, and further training and supervision needs in the treatment of coexisting disorders. The editors use European spelling and an approach that is a "symptom-focused …

Getting To The Heart Of It (Book Review), Kristina M. Kays

Faculty Publications - Psychology Department

Reviews the book, "Assessment of Client Core Issues" by Richard W. Halstead (see record 2006-21518-000). According to Kays, this book offers a conceptualization of clinical cases synthesizing elements from narrative, schema, and cognitive therapy traditions. The author's stated goal is "to present a model that might help counselors think past a symptom-based formulation for diagnosis and incorporate a structured process for analyzing the vast amount of information clients reveal about their struggles in life". Depending heavily on schema therapy concepts originally developed by J. E. Young, Halstead develops an assessment approach that addresses both the unremarkable and problematic client situations. …

Evaluation Of Berhane Hewan: A Pilot Program To Promote Education And Delay Marriage In Rural Ethiopia, Annabel Erulkar, Eunice N. Muthengi

Poverty, Gender, and Youth

The Berhane Hewan Program pilot-tested in rural Ethiopia from 2004–06 was developed to sensitize community members to the dangers of child marriage, prevent early marriage among unmarried adolescents, and provide support for girls who are already married. The program included social mobilization of girls aged 10–19 into groups led by female mentors; support to stay in school or convening of groups outside of school including nonformal education and livelihoods skills; and community-wide conversations on early marriage and reproductive health issues affecting girls. Economic incentives were provided to families who did not marry off their daughters during the project period. Population-based …

Adolescence In The Kibera Slums Of Nairobi, Kenya, Annabel Erulkar, James K. Matheka

Poverty, Gender, and Youth

Rates of urbanization in Kenya are among the highest in the world and young people form a large proportion of those moving from rural to urban areas of the country. For many young people, the first point of entry into urban areas are the slums. Adolescents and young people make up a significant proportion of the slum-dwelling population, yet little is known about their experiences growing up in these poor urban environments. This population-based study of adolescents took place in the Kibera slum in Nairobi, Kenya, in 2006. The study explores the adolescent experience in one of Africa’s largest slum …

The Experience Of Married Adolescent Girls In Northern Nigeria, Annabel Erulkar, Mairo Bello

Poverty, Gender, and Youth

Programs for young people in sub-Saharan Africa have been directed largely toward unmarried adolescents, neglecting the fact that a large proportion of adolescents—especially girls—are married in some settings. Early marriage is a common feature of girls’ adolescence in Northern Nigeria, yet few programs are in place to support this sizable and vulnerable group. To suggest directions for future programming, Adolescent Health and Information Projects (AHIP) and the Population Council examined the lives of married and unmarried girls in two geopolitical regions of Nigeria, North West and North East. The study, as described in this report, consisted of secondary analysis of …

Changing Transitions To Adulthood In Vietnam's Remote Northern Uplands: A Focus On Ethnic Minority Youth And Their Families [Vietnamese], Bussarawan Teerawichitchainan, Hac Van Vinh, Nguyen Thi Phuong Lan

Poverty, Gender, and Youth

Ethnic minorities, who tend to live in remote mountainous areas, account for 15 percent of Vietnam’s 84 million total population and, according to a recent estimate, 61 percent of them are poor. Evidence suggests that despite recent efforts by the Government of Vietnam to promote poverty reduction in remote areas, a majority of ethnic minorities have not yet experienced positive change, contrary to their Kinh (ethnic Vietnamese) neighbors who have enjoyed substantial improvement in living standards. To identify program interventions that promote healthy human development and, in turn, positively affect Vietnam’s economic growth, it is crucial to have a comprehensive …

Teacher Absence As A Factor In Gender Inequalities In Access To Primary Schooling In Rural Pakistan, Sharon Ghuman, Cynthia B. Lloyd

Poverty, Gender, and Youth

This paper examines the case of Pakistan, where primary school enrollment among girls in rural areas is substantially lower than among children in urban areas and boys in rural areas, owing to lack of access to government girls’ schools. The focus is on teacher absence as a further barrier to schooling for girls. Using data from a panel study of primary schooling in rural Punjab and NWFP in 1997 and 2004, the report examines trends in teacher absence, examine the factors correlated with teacher absence in the government and private sector, and assesses the implications of these absence levels for …

The Role Of Schools In Promoting Sexual And Reproductive Health Among Adolescents In Developing Countries, Cynthia B. Lloyd

Poverty, Gender, and Youth

This Population Council working paper reviews the state of knowledge about relationships between schooling and adolescent reproductive health. With the spread of mass schooling and the growing share of adolescents who attend school, the opportunities for synergies between health and education policies and programs are growing. Data on cross-country variations in health conditions on the one hand, and variations in attendance and attainment patterns and school systems on the other hand, provide a framework for assessing alternative approaches to the promotion of adolescent sexual and reproductive health in different contexts. Disappointing findings from recent school-based reproductive health interventions in poor …

Girls' Adolescence In Burkina Faso: A Pivot Point For Social Change, Martha Brady, Lydia Saloucou, Erica Chong

Poverty, Gender, and Youth

As closer attention is paid to the lives of adolescents in sub-Saharan Africa, girls are found to be clearly disadvantaged, compared with their male counterparts. Burkinabé girls are frequently married at a young age, and more than one-third of married girls find themselves in polygamous unions as second or third wives, married to much older men. Understanding and recognizing girls’ realities is an important first step in planning appropriate and meaningful interventions for them. Girls who are unmarried, “promised,” engaged, or married face different constraints and merit different program approaches. This report by the Population Council aims to fill gaps …

Providing New Opportunities To Adolescent Girls In Socially Conservative Settings: The Ishraq Program In Rural Upper Egypt—Full Report, Martha Brady, Ragui Assaad, Barbara L. Ibrahim, Abeer Salem, Rania Salem, Nadia Zibani

Poverty, Gender, and Youth

Adolescent girls in the poorest villages of Upper Egypt, who were kept from school by poverty and other obstacles, face a bleak future that will replicate the poverty and disadvantage of their own families. This stark picture of vulnerability encouraged four long-standing nongovernmental organizations working in Egypt—Caritas, CEDPA (Centre for Development and Population Activities), the Population Council, and Save the Children—to create a multidimensional program for 13–15-year-old out-of-school girls. The pilot intervention, known locally as Ishraq, sought to transform girls’ lives by changing gender norms and community perceptions about girls’ roles in society while bringing them safely and confidently into …

Empowering Young Mothers In India: Results Of The First-Time Parents Project, K.G. Santhya, Nicole Haberland

Poverty, Gender, and Youth

In India, sexual activity among girls and young women typically takes place within marriage. Nationally, as many as 30 percent of adolescent girls aged 15–19 are married, presumably sexually active, and under pressure to bear a first child early in the marriage. While sexual activity for the majority of adolescent Indian girls occurs within the socially sanctioned institution of marriage, marital sex is not inherently safe, voluntary, or pleasurable. Promoting Healthy, Safe, and Productive Transitions to Adulthood Brief No. 8 describes the Population Council’s efforts to support married adolescent girls. The Council, in partnership with the Child in Need Institute …

Assessing The Multiple Disadvantages Of Mayan Girls: The Effects Of Gender, Ethnicity, Poverty, And Residence On Education In Guatemala, Kelly Hallman, Sara Peracca, Jennifer Catino, Marta Julia Ruiz

Poverty, Gender, and Youth

Although access to primary education in Guatemala has increased in recent years, particularly in rural areas, rates of primary-school completion and literacy for young people remain among the lowest in Latin America, and problems such as late entry, grade repetition, and early dropout persist. Adult literacy is estimated to be 85 percent in Latin America as a whole, compared with 70 percent in Guatemala. Although indigenous peoples in Latin America generally have less schooling than nonindigenous peoples, ethnic differences are greatest in Guatemala, where indigenous (Mayan) adults have less than half the level of schooling of nonindigenous (Ladino) adults. Recent …

Influencing Girls’ Lives: Acceptability And Effectiveness Of A Livelihoods Skill Building Intervention In Gujarat, Shveta Kalyanwala

Poverty, Gender, and Youth

There are 66 million adolescent females aged 13–19 in India. Their lives are characterized by limited education, lack of economic and social opportunities, early marriage and childbearing, and limited influence on decisions affecting their lives. Although programs in India have aimed to empower adolescent girls, they have largely focused on enhancing life skills and awareness. Programs to address women’s social and economic disadvantages have focused exclusively on adult women. To respond to the absence of programs devoted specifically to the social and economic empowerment of adolescent girls and young women, the Population Council partnered with the Self-Employed Women’s Association (SEWA) …

Sexuality And Hiv Education: Time For A Paradigm Shift, Nicole Haberland, Deborah Rogow

Poverty, Gender, and Youth

For decades, curriculum-based sexuality education has been a cornerstone of school- and community-based efforts to improve young people’s sexual and reproductive health, and more recently to prevent HIV infection. Unfortunately, public discourse about sex education has been mired in polarizing debates that distract attention from determining how sex and HIV education programs might best achieve the shared goals of many different constituencies. A recent comprehensive review of the impact of school-based sexuality and HIV education programs in developed and developing countries found that two-thirds of the programs reduced the risk associated with one or more reported sexual behaviors. This finding …

Girls Left Behind: Redirecting Hiv Interventions Toward The Most Vulnerable, Judith Bruce

Poverty, Gender, and Youth

As we enter the third decade of the HIV pandemic in sub-Saharan Africa, young women—often adolescent girls—are the new face of the disease. In particular, HIV/AIDS is threatening those girls and young women with limited social and economic assets—those who are unable to avoid, manage, or leave unsafe sexual relationships inside and outside of marriage. Girls at risk of sexual exploitation are not a small minority; they are counted in the hundreds of millions. Promoting Healthy, Safe, and Productive Transitions to Adulthood Brief No. 23 explores: structural determinants of risk, failure to reach the most vulnerable, moving ahead with the …

Obtaining More Accurate And Reliable Information From Adolescents Regarding Sti/Hiv Risk Behaviors, Barbara Mensch, Paul C. Hewett

Poverty, Gender, and Youth

To investigate the quality of self-reported data on sexual behavior, Population Council researchers conducted a study in a rural district of Malawi. They implemented a randomized experiment to assess whether audio computer-assisted self-interviewing (ACASI) produces more valid data on sexual behavior than face-to-face interviews. The Malawi study builds on an experiment conducted as part of a household-based survey of Kenyan adolescents. In Kenya and Malawi, there is clear evidence that mode of interviewing and probing of various sexual partnerships affect the reporting of sexual activity. According to Promoting Healthy, Safe, and Productive Transitions to Adulthood Brief No. 25, ACASI is …

Evaluación De Las Múltiples Desventajas De Las Niñas Mayas: Efectos Del Género, El Origen Étnico, La Pobreza Y El Lugar De Residencia Sobre La Educación En Guatemala, Kelly Hallman, Sara Peracca, Jennifer Catino, Marta Julia Ruiz

Poverty, Gender, and Youth

Aunque el acceso a la educación primaria en Guatemala se incrementó en los últimos años, especialmente en las áreas rurales, los índices de finalización de escuela primaria y de alfabetismo corespondeientes a personas jóvenes continúan estando entre los más bajos de Latinoamérica, y persisten otros problemas como el ingreso tardío, la repetición de cursos y el abandono temprano. Se estima que el índice de alfabetismo entre adultos es del 85 por ciento en Latinoamérica en general, comparado con sólo un 70 por ciento en Guatemala. Aunque los pueblos indígenas en Latinoamérica por lo general tienen menos escolaridad que los no …

Les Filles Sont Oubliées : Rediriger Les Interventions En Matière De Vih Vers Les Plus Vulnérables, Judith Bruce

Poverty, Gender, and Youth

Alors que nous entrons dans la troisième décennie de la pandémie de VIH en Afrique subsaharienne, les jeunes femmes, le plus souvent les adolescentes, sont le nouveau visage de la maladie. Le VIH/SIDA menace en particulier les jeunes femmes et les adolescentes qui se trouvent dans des situations sociaux-économiques peu favorables, celles qui ne peuvent éviter, gérer ni échapper à des relations sexuelles à risque au sein même du mariage or hors mariage. Les filles présentant un risque d'être exploitées sexuellement ne représentent pas une petite minorité; on peut les compter par centaines de millions. Promouvoir des transitions vers l'âge …

Las Niñas Rezagadas: Dirigir Las Intervenciones De Vih Hacia Las Más Vulnerables, Judith Bruce

Poverty, Gender, and Youth

Al ingresar en la tercera década de la pandemia del VIH en el África subsahariana, las mujeres jóvenes—a menudo adolescentes—conforman el nuevo rostro de la enfermedad. En especial, el VIH/SIDA amenaza a aquellas niñas y mujeres jóvenes con limitados posibilidades sociales y económicas; quienes que no pueden evitar, controlar o abandonar las relaciones sexuales inseguras, dentro y fuera del matrimonio. Las niñas que están en riesgo de ser explotatas sexualmente no constituyen una pequeña minoría; se calculan en cientos de millones. Promoción de transiciones a la vida adulta: Sanas, seguras y productivas N° 23 explora: los determinantes estructurales de riesgo, …

Herpes Simplex Virus 1 And Chlamydophila (Chlamydia) Pneumoniae Promote Ab 1-42 Amyloid Processing In Murine Astrocytes Linking An Infectious Process To Alzheimer's Disease, Laura R. Triplett, Adam L. Dore, Kevin S. Kralik, Brian J. Balin, Susan T. Hingley, Denah M. Appelt

Scholarly Posters

Background: Several studies have suggested an infectious etiology for Alzheimer's disease (AD). Previously, our laboratory identified Chlamydia pneumoniae (Cpn) from autopsied sporadic AD brains, as well as developed a BALB/c mouse model that demonstrated infection-induced amyloid plaques similar to those found in AD. Hypothesis: We propose that an additional pathogen such as herpes simplex virus type 1 (HSV1), also may be a contributing factor in toin the pathology seen in AD. HSV1, in addition to Cpn, may be triggering the abnormal cleavage of the beta amyloid precursor protein (bAPP) into Ab1-42 , thereby contributing to amyloid plaque formation. Our current …

Digest Of The Philadelphia College Of Osteopathic Medicine (Winter 2007), Philadelphia College Of Osteopathic Medicine

Digest

The Winter 2007 issue of the Digest of the Philadelphia College of Osteopathic Medicine includes the following articles:

• Opening Remarks
• Remembering Harry Ginsburg, DO ’42
• PCOM Updates and Kudos
• Building Partnerships: Assessing the Value of Physician-Patient Communications
• Recognizing Leadership, Loyalty, Service: Founders’ Day 2007
• Places, Camera, Action . . . Learning Primary Care Skills
• Out of Africa: True Tales of a Medical Missionary
• Class Notes
• In Memoriam
• My Turn
• PCOM Events

Diabetes Self-Management In The Migrant Latino Population, Dawn Weiler, Janice D. Crist

Nursing Faculty Publications and Presentations

This article will present an in-depth exploration and synthesis of current literature that informs nursing knowledge of diabetes self-management for the migrant Latino population. Extensive research in diabetes care has been conducted, however, there is a significant knowledge gap related to the factors that influence the achievement of glycemic control and self-management practices of the Latino population. Based on well-documented disparities in complications and health outcomes among Latinos when compared with White Americans, there is sufficient evidence to question whether traditional White beliefs about self-management are successful or appropriate for the Latino population in general and migrants specifically. Traditional models …

Office Nurse Educators: Improving Diabetes Self-Management For The Latino Population In The Clinic Setting, Dawn Weiler, Laura Tirrell

Nursing Faculty Publications and Presentations

Diabetes patients who understand their disease and how to manage it can achieve a lower complication rate. The American Diabetes Association recommends that patients receive self-management education and that patients' skills and knowledge be reassessed annually. The Healthy People 2010 objectives include a goal of at least 60% of diabetes patients receiving diabetes education. However, to date overall, far fewer (20%–50%) obtain comprehensive diabetes education and skills development to effectively implement self-management techniques. Low-income Latino patients generally fare even worse. This article describes a successful method to address this problem: the development and evaluation of an in-house diabetes education program, …

Research Strategies To Reduce Bovine Tuberculosis Transmission From Wildlife To Cattle, Are R. Brentensen, Mike R. Dunbar, Robert G. Mclean

Michigan Bovine Tuberculosis Bibliography and Database

Bovine tuberculosis (bTB) is a zoonotic disease caused by Mycobaterium bovis, and is transmissible to humans, wildlife and domestic livestock. In the northern Lower Peninsula of Michigan, white-tailed deer ( Odocoileus virginianus) serve as a reservoir for the disease and pose a significant threat to domestic cattle and captive cervids. Scientists at USDA, APHIS, Wildlife Services, National Wildlife Research Center have designed a variety of laboratory and field studies aimed at reducing or eliminating bTB infection in cattle by interrupting the transmission of the disease from wildlife reservoirs. These strategies include reducing bTB in deer by delivery of …

Research Strategies Of The National Wildlife Research Center To Control Bovine Tuberculosis In Wildlife In Michigan, Usa, A. R. Berentsen, M. R. Dunbary, R. G. Mclean

Michigan Bovine Tuberculosis Bibliography and Database

Bovine tuberculosis (bTB) is a zoonotic disease caused by Mycobaterium bovis and is transmissible to humans, wildlife, and domestic livestock. In the United Kingdom, the suspected wildlife reservoir of bTB is the badger (Meles meles) (HUTCHINGS and HARRIS, 1997), and in New Zealand, the culprit is the brush-tailed possum (Trichosurus vulpecula) (MORRIS et al., 1994). In northern Michigan, USA, bovine tuberculosis is endemic in white-tailed deer (Odocoileus virginianus). In 1975 a hunter-killed white-tailed deer in Alpena County, Michigan, USA, was tested positive for bTB. Subsequent surveillance by the Michigan Department of Natural Resources (MDNR) …

Risk Factors Associated With The Prevalence Of Tuberculosis-Like Lesions In Fenced Wild Boar And Red Deer In South Central Spain, Joaquin Vicente, Ursula Hofle, Joseba M. Garrido, Isabel G. Fernandez-De-Mera, Pelayo Acevedo, Ramon Juste, Marta Barral, Christian Gortazar

Michigan Bovine Tuberculosis Bibliography and Database

In recent decades the management of large game mammals has become increasingly intensive in south central Spain (SCS), resulting in complex epidemiological scenarios for disease maintenance, and has probably impeded schemes to eradicate tuberculosis (TB) in domestic livestock. We conducted an analysis of risk factors which investigated associations between the pattern of tuberculosis-like lesions (TBL) in wild boar (Sus scrofa) and red deer (Cervus elaphus) across 19 hunting estates from SCS and an extensive set of variables related to game management, land use and habitat structure. The aggregation of wild boar at artificial watering sites was …

Vaccination Of White-Tailed Deer (Odocoileus Virginianus) With Mycobacterium Bovis Bacillus Calmette Guerin, M. V. Palmer, T. C. Thacker, W. R. Waters

Michigan Bovine Tuberculosis Bibliography and Database

Wildlife reservoirs of Mycobacterium bovis represent serious obstacles to the eradication of tuberculosis in domestic livestock. In Michigan, USA tuberculous white-tailed deer transmit M. bovis to cattle. One approach in dealing with this wildlife reservoir is to vaccinate deer in order to interrupt the cycle of deer to deer and deer to cattle transmission. Thirty-one white-tailed deer were assigned to one of three groups; 2 SC doses of 10⁷ CFU of M. bovis BCG (n = 11); 1 SC dose of 10⁷ CFU of M. bovis BCG (n = 10); or unvaccinated deer (n = 10). …

A High-Resolution Map Of Segmental Dna Copy Number Variation In The Mouse Genome, Timothy A. Graubert, Patrick Cahan, Deepa Edwin, Rebecca R. Selzer, Todd A. Richmond, Peggy S. Eis, William D. Shannon, Xia Li, Howard L. Mcleod, James M. Cheverud, Timothy J. Ley

Open Access Publications

No abstract provided.

Revisiting The Organohalogens Associated With 1979-Samples Of Brazilian Bees, Walter Vetter, Donald Roberts

Uniformed Services University of the Health Sciences

Brazilian bees of the species Eufriesea purpurata are known to tolerate very high concentrations of DDT. As reported in the literature, these bees have suffered no harm from as much as 2 mg/bee, which is in the per-cent range of the body weight. In 1979, individuals of E. purpurata were captured as they collected DDT from walls of remote, rural houses in Brazil. Reported herein are quantities and identities of DDT, DDT metabolites, and other organohalogen compounds in four samples of bees stored since 1979. The concentrations of DDT (sum of p,p′-DDT, -DDE, and -DDD) ranged from …