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Vaginal Birth After Cesarean Section: Provider Perspectives And Maternal Decision Making, Isabella Chan, Emily Bronson, Allison Cantor

Florida Public Health Review

Although evidence suggests vaginal birth after cesarean section (VBAC) leads to fewer complications in subsequent pregnancies, lower risk of maternal morbidity, and fewer cesarean sections overall, VBAC rates in Florida are at 5.5%, notably lower than the U.S. average of 8.0%. This exploratory study examines the factors contributing to these low VBAC rates through a qualitative investigation using grounded theory. Semi-structured interviews with women and maternity care providers were conducted to explore attitudes, motivations, and experiences regarding VBAC. Findings reveal a distinction between providers' and women's attitudes toward and experiences with VBAC and identify factors involved in decision-making. Three themes …

Sexual Risk, Substance Use And Undiagnosed Seropositivity Among Men Who Have Sex With Men And Women In Miami, Florida, David W. Forrest, Gabriel Cardenas, Lisa R. Metsch, Charlene S. Dodson, Marlene Lalota

Florida Public Health Review

This paper utilizes the National HIV Behavioral Surveillance data in Miami for the men who have sex with men cycle (NHBS-MSM2) in 2008. We analyzed sexual risk, substance use and undiagnosed seropositivity in a diverse sample of men who have sex with men and women (MSMW) and compared them with MSM. Of 152 MSMW, 15.1% tested HIV positive with 73.9% previously undiagnosed. Almost half (44.1%) of the MSMW reported unprotected sex with male and female partners in the past year. More MSMW than MSM had undiagnosed HIV infection, exchanged sex for money or drugs, used crack and cocaine, been high …

Evaluating Inpatient Asthma Management Practices In Florida Hospitals, Alexandra C.H. Nowakowski, Henry J. Carretta, Julie K. Dudley, Jamie R. Forrest, Abbey N. Folsom

Florida Public Health Review

We evaluated inpatient asthma management practices in 10 Florida hospitals. We wanted to learn about care protocols, instrumental resources, and use of evidence-based guidelines. We sought to recommend strategies for improving care based on gaps identified by this study. We developed a survey that included detailed questions on care strategies and resources. Guidelines from the National Heart, Lung, and Blood Institute (NHLBI) in the Expert Panel Report 3 (EPR-3) for the Diagnosis and Management of Asthma were a primary focus. Hospitals were given the option of completing their surveys by phone or email. Data were analyzed via content coding of …

Curriculum On Adolescent-Friendly Health Services And Health Voucher Mechanisms: Facilitator's Training Manual, Population Council

Poverty, Gender, and Youth

The Adolescent Girls Empowerment Program (AGEP) in rural and urban Zambia aims to build social, health, and economic assets of adolescent girls. A safe spaces component is at the core of AGEP. Girls groups, under the guidance of a female mentor from the same community, provide a safe and supportive learning environment. The meetings are critical in building social assets for vulnerable girls—including friendships, self-esteem, trusting relationships with adults, and social support. The training content over the course of the year varies from sexual and reproductive health and life skills to financial education and nutrition training. Girls in AGEP receive …

Understanding Factors Influencing Adverse Sex Ratios At Birth In Bangladesh, Md. Noorunnabi Talukder, Ubaidur Rob, Md. Irfan Hossain, Forhana Rahman Noor

Poverty, Gender, and Youth

Nationally, the sex ratio at birth has persisted at its natural level of 105 male per 100 female newborns for the past half century in Bangladesh. However, at the regional level, Bangladesh is characterized by an east-west divide in sex ratios at birth. While the western region shows normal sex ratios at birth, the eastern region displays distorted sex ratios. To understand the factors that contribute to regional variations, a household survey was conducted among married women aged 18–49 years who had at least two living children. Views of health-care providers on gender-biased sex selection and of program implementers on …

Education, Numeracy, And Literacy: Baseline Findings, Population Council

Poverty, Gender, and Youth

The Adolescent Girls Empowerment Program (AGEP) is a program for girls ages 10–19 in rural and urban Zambia that aims to find the best ways to improve their social, health, and economic resources. The program involves over 10,000 girls participating in weekly girls’ group meetings, receiving health vouchers, and opening savings accounts. Over 5,000 girls, unmarried at baseline, are enrolled in a randomized, controlled trial and are being followed over four years—including the two years of the program and two years after. This brief describes the characteristics of these girls at baseline. Of the girls who are currently in school, …

Addressing Gender-Biased Sex Selection In Haryana, India: Promising Approaches, Shireen J. Jejeebhoy, Rajib Acharya, Sharmistha Basu, A.J. Francis Zavier

Poverty, Gender, and Youth

Persistently adverse sex ratios remain a challenge in India despite the enforcement of the PCPNDT (Pre-Conception and Pre-Natal Diagnostic Techniques) Act in 1994. Nevertheless, over the decade 2001–2011, positive shifts from very adverse to less adverse levels have occurred in a few states. Two districts in Haryana state—Kurukshetra and Sonipat—whose sex ratios displayed some and no improvement, respectively, are compared in an attempt to find promising programme directions to counter gender-biased sex selection. Comparisons are drawn from the attitudes and experiences of surveyed women and interviews with service providers and programme implementers, about sex-selection technology. Also addressed are differences in …

Sexual Behaviors And Biomarkers: Baseline Findings, Population Council

Poverty, Gender, and Youth

The Adolescent Girls Empowerment Program (AGEP) is a program for girls ages 10–19 in rural and urban Zambia that aims to find the best ways to improve their social, health, and economic resources. More than 10,000 girls participated in weekly girls’ group meetings, received health vouchers, and opened savings accounts. More than 5,000 girls, unmarried at baseline, were enrolled in a randomized, controlled trial and followed over four years—two years in the program and two years after the program ended. This brief describes the characteristics of enrolled girls at baseline.

Use Of Health Services: Baseline Findings, Population Council

Poverty, Gender, and Youth

The Adolescent Girls Empowerment Program (AGEP) is a program for girls ages 10-19 in rural and urban Zambia that aims to find the best ways to improve their social, health, and economic resources. The program involves over 10,000 girls participating in weekly girls’ group meetings, receiving health vouchers, and opening savings accounts. Over 5,000 girls, unmarried at baseline, are enrolled in a randomized, controlled trial and are being followed over four years—including the two years of the program and two years after. This brief describes the use of health services by these girls at baseline.

Adolescent Girls Initiative-Kenya: Program Overview, Population Council

Poverty, Gender, and Youth

Many adolescent girls in Kenya face considerable risks and vulnerabilities that affect their education, health, and general well-being—including early marriage; teenage pregnancy; early, unprotected, and/or unwanted sexual activity; violence; social isolation; and HIV/STIs. For the most part, very young adolescent girls who live in risk-prone environments have not yet experienced these negative outcomes. It is critical, therefore, to intervene early and increase girls’ capacity to overcome these risks before the challenges result in outcomes that may be irreversible. Research has shown that single-sector interventions are not adequate to obtain the range of outcomes needed to help girls enter into adulthood …

Sexual And Gender-Based Violence: Baseline Findings, Population Council

Poverty, Gender, and Youth

The Adolescent Girls Empowerment Program (AGEP) is a program for girls ages 10-19 in rural and urban Zambia that aims to find the best ways to improve their social, health, and economic resources. Sexual and gender-based violence (SGBV) is a pervasive global health problem. Women and girls are most at risk, and consequences include physical injury, psychological trauma, unwanted pregnancy, and sexually transmitted infections, including HIV. The AGEP program involves over 10,000 girls participating in weekly girls’ group meetings, receiving health vouchers and opening savings accounts. Over 5,000 girls, unmarried at baseline, are enrolled in a randomized, controlled trial and …

Adolescent Girls Initiative-Kenya: Baseline Report, Karen Austrian, Eunice N. Muthengi, Taylor Riley, Joyce Mumah, Caroline W. Kabiru, Benta Abuya

Poverty, Gender, and Youth

Many adolescent girls in Kenya face considerable risks and vulnerabilities that affect their education status, health, and general well-being. The Adolescent Girls Initiative–Kenya (AGI-K) will deliver multisectoral interventions for over 5,000 girls aged 11–14 in two marginalized areas of Kenya: the Kibera slums in Nairobi, and Wajir County in Northeastern Kenya. Implemented by Plan International in Kibera and Save the Children in Wajir, these interventions will be implemented for two years and will comprise a combination of girl-level, household-level, and community-level interventions. A randomized controlled trial will be used to compare the impact of four different packages of interventions to …

Building Assets Toolkit: Developing Positive Benchmarks For Adolescent Girls—Asset Cards, Judith Bruce, Sarah Engebretsen, Kimberly Glazer

Poverty, Gender, and Youth

This document contains the Building Assets Toolkit’s Asset Cards (110), set of Age Cards (age 6 to 20), and Program Planning Worksheet (sample provided). The Age Cards are to be printed out and placed according to the instructions. The Asset Cards are to be printed out and cut in half. Blank Asset Cards are provided to create customized assets. The Building Assets Toolkit is an approach for developing programs for specific segments of girls that will prepare them to better face the challenges of growing up. It will help program managers understand the needs of the girls in their community, …

Urban Adolescents Needs Assessment Survey In Bangladesh, Sajeda Amin

Poverty, Gender, and Youth

This report presents data on multiple dimensions of adolescents’ lives in urban settlements in Dhaka and Gazipur districts, Bangladesh. The study provides evidence on the lives of young people in a manner that can inform programs and policies directed toward this underserved population. Data is presented on education; reproductive health; family planning; marriage and dowry; physical mobility and social context; gender equality; family life, relationships, and emotional well-being; substance abuse; and livelihoods. There is presently little information about what makes adolescent girls and boys vulnerable in urban settings. The analysis explores and highlights sex, age, education, and marital-status-related differentials among …

Panel Survey Of Young People In Egypt (Sype) 2014: Generating Evidence For Policy, Programs, And Research [Arabic], Rania Roushdy, Maia Sieverding

Poverty, Gender, and Youth

The Panel Survey of Young People in Egypt (SYPE), first conducted in 2009 among Egyptian youth aged 10–29, focuses on education, employment, health, family formation, migration, reproductive health, social issues, and civic/political participation. This second round, SYPE 2014, was conducted in the wake of two youth-led revolutions (2011 and 2013). SYPE 2014 attempts to understand changes that occurred among Egyptian youth over the period between the two rounds through targeting the same group of respondents of the 2009 survey in 2014 to accurately document changes and progress in the status of these young people. Preliminary findings indicated: a slight decrease …

Women And Hiv: Risk Of Hiv Infection And How To Prevent [Arabic], Population Council

Poverty, Gender, and Youth

No abstract provided.

Reproductive Health Needs Of Married Girls In Assuit And Sohag Governorates [Arabic], Population Council

Poverty, Gender, and Youth

No abstract provided.

Unveiling The Consensus: Putting People First In Pakistan's Development Agenda, Government Of Pakistan, Unfpa, Population Council

Poverty, Gender, and Youth

This document contains the consensus from the Population Summit held in Islamabad, Pakistan, November 5–6, 2015. To date, an enduring commitment to a sound and adequate population welfare program has eluded Pakistan, leaving millions of couples who want to wait before having their next child or who consider that they have enough children, without good access to family planning. However, in the wake of devolution, in part through efforts of donors and civil society for awareness building, advocacy, and dialogue, opinion among all major stakeholders is coalescing around the need to address Pakistan’s alarming maternal and child health indicators through …

Africa’S Slow Fertility Transition, John Bongaarts

Poverty, Gender, and Youth

No abstract provided.

Gender-Biased Sex Selection In India: A Review Of The Situation And Interventions To Counter The Practice, Shireen J. Jejeebhoy, Sharmistha Basu, Rajib Acharya, A.J. Francis Zavier

Poverty, Gender, and Youth

This report on gender-biased sex selection in India is divided into six chapters, including an introduction in Chapter 1. Chapter 2 describes the laws and policies adopted by India to address gender-biased sex selection, as well as those intended to support and empower women and girls. Chapter 3 analyzes the trends and geographic variation in the sex ratio at birth and in the child sex ratio. Chapter 4 briefly describes the socioeconomic differences and factors underlying distorted sex ratios and gender-biased sex selection in India, and the social consequences of these practices. Experiences in implementing the PCPNDT Act, initiatives intended …

Um Só Currículo: Directrizes Para Uma Educação Integrada Em Sexualidade, Género, Hiv E Direitos Humanos, International Sexuality And Hiv Curriculum Working Group, Nicole Haberland, Deborah Rogow

Poverty, Gender, and Youth

Education on sexuality and HIV can help adolescents develop the capacity for healthy, respectful relationships and protect themselves from unwanted and unsafe sex, unintended pregnancy, and sexually transmitted infections. A 2015 Population Council study found that sexuality and HIV education programs that address gender and power in intimate relationships are five times more likely to be effective than programs that do not. However, most curricula still do not address these issues. “It’s All One Curriculum” provides a rationale, content, and sample activities for placing gender and rights at the center of sexuality and HIV curricula—both as stand-alone modules and integrated …

The Adolescent Experience In-Depth: Using Data To Identify And Reach The Most Vulnerable Young People—Tanzania 2009–2012, Population Council, Tanzania Commission For Aids (Tacaids), Zanzibar Aids Commission (Zac), Unicef Tanzania

Poverty, Gender, and Youth

“The Adolescent Experience In-Depth: Using Data to Identify and Reach the Most Vulnerable Young People: Tanzania 2009–12” is part of a series of Population Council guides that draw principally on data from the Demographic and Health Surveys to provide decisionmakers at all levels—from governments, nongovernmental organizations, and advocacy groups—with evidence on the situation of adolescent girls and boys and young women aged 10–24 years. The data are presented in graphs, tables, and maps (wherever possible), providing multiple formats to make the information accessible to a range of audiences. Section I is the Foreword. Section II offers brief technical notes specific …

Should Educators Be ‘Wrapping School Playgrounds In Cotton Wool’ To Encourage Physical Activity? Exploring Primary And Secondary Students’ Voices From The School Playground, Brendon P. Hyndman, Amanda Telford

Australian Journal of Teacher Education

Physical activity in school playgrounds has changed considerably over recent decades to reflect a climate of ‘surplus safety’. A growing culture of surplus safety can be attributed to a desire of parents and teachers responsible for children to protect school students from danger. The aim of this research was to examine students’ perceptions of playground safety influences on physical activity during school breaks from the perspectives of the ‘users’ of school playgrounds. Data collection consisted of seven focus groups (4 primary school & 3 secondary school) conducted across four schools (2 primary & 2 secondary). During this study, the focus …

Curatorial Implications Of Ophyra Capensis (Order Diptera, Family Muscidae) Puparia Recovered From The Body Of The Blessed Antonio Patrizi, Monticiano, Italy (Middle Ages), Johnica J. Morrow, Diesel A. Baldwin, Leon G. Higley, Dario Piombino-Mascali, Karl J. Reinhard

Karl Reinhard Publications

The discovery of dipteran remains on mummified individuals can lead to either cause for curatorial concern or to a better understanding of the individual’s post-mortem environment. The present study analyzed insect remains associated with the body of a unique medieval mummy of religious significance, that of the Blessed Antonio Patrizi da Monticiano. A total of 79 puparia were examined and all were identified as Ophyra capensis (Diptera: Muscidae). Additionally, a desiccated moth (Lepidoptera: Tineidae) was encountered. Puparia of O. capensis would be associated with normal decomposition shortly after the death of the mummified individual, and not an infestation beginning during …

The Impact Of Disability: A Comparative Approach To Medical Resource Allocation In Public Health Emergencies, Katie Hanschke, Leslie E. Wolf, Wendy F. Hensel

Faculty Publications By Year

It is a matter of time before the next widespread pandemic or natural disaster hits the United States (U.S.). The international response to the 2009 H1N1 influenza stands as a cautionary tale about how prepared the world is for such an emergency. Although the pandemic fortunately proved to be less severe than initially anticipated, it nevertheless resulted in shortages of medical equipment, overburdened hospitals, and preventable patient deaths, particularly among young people.

A pandemic will inevitably lead to difficult decisions about the allocation of medical resources, such as who will have priority access to ventilators and critical care beds when …

Toward Coherent Federal Oversight Of Medicine, Patricia J. Zettler

Faculty Publications By Year

The conventional wisdom in U.S. health law and policy holds that states regulate medical practice – the activities of physicians and other health care professionals – while the federal government regulates medical products. But relying on states as the principal regulators of medical practice has, at times, driven law and policy in directions that are problematic from a public health perspective, as demonstrated by a deadly 2012 outbreak of fungal meningitis that was linked to a state-regulated practice known as drug compounding. This Article argues that the federalism concerns underlying the conventional wisdom are misplaced. It demonstrates that, contrary to …

Mental Illness, Poverty And Stigma In India: A Case–Control Study, Jean-Francois Trani, Parul Bakhshi, Jill Kuhlberg, Sreelatha S. Narayanan, Hemalatha Venkataraman, Nagendra N. Mishra, Nora E. Groce, Sushrut Jadhav, Smita Deshpande

Brown School Faculty Publications

Objective: To assess the effect of experienced stigma on depth of multidimensional poverty of persons with severe mental illness (PSMI) in Delhi, India, controlling for gender, age and caste.Design: Matching case (hospital)–control (population) study.Setting: University Hospital (cases) and National Capital Region (controls), India.Participants: A case–control study was conducted from November 2011 to June 2012. 647 cases diagnosed with schizophrenia or affective disorders were recruited and 647 individuals of same age, sex and location of residence were matched as controls at a ratio of 1:2:1. Individuals who refused consent or provided incomplete interview were excluded.Main outcome measures: Higher risk of poverty …

Predictors Of Readmission In Shelters And Other Services Among Homeless Adults In Detroit, Devin Michael Hanson

Wayne State University Theses

Admission to an emergency shelter reflects an important outcome in a person's life, and many admissions to an emergency shelter reflects a human and financial cost. This article discusses the evolution of the measurement and understanding of homelessness. It looks at characteristics of people who make use of shelter in a chronic fashion to better understand what might predict risk for future continued use. This includes an analysis of a large dataset of emergency shelter utilization in Detroit Michigan collected between 2008 and 2012. Analysis reveals that fundamental demographic information, individual's interactions with the shelter system (good or bad), and …

Gender Difference When Processing Death By Suicide: Attitudes Amongst Third Level Students Aged 18-25 Attending Cork Institute Of Technology And College Support Professionals, Sandra Conroy

Masters

Rationale behind research: Survivors of suicide/ suicide bereaved face unique challenges in their grief, resulting in a greater risk of conditions such as complicated grief, PTSD and suicidal ideation developing (Young, Iglewicz, Glorioso, Lanouette, Seay, llapakurti & Zisook, 2012). In dealing with or 'processing' the loss of a loved one by suicide, Wertheimer details that, "suicidal thoughts are not uncommon during the early months of bereavement" (1991: 178). The incidence of young men dying by suicide is notably higher than that of women in this country; a stubborn gender difference persists in Ireland with males representing on average 80% of …

Designing For Dissemination: Lessons In Message Design From "1-2-3 Pap", Elisia L. Cohen, Katharine J. Head, Margaret J. Mcgladrey, Anna G. Hoover, Robin C. Vanderpool, Colleen Bridger, Angela Carman, Richard A. Crosby, Elaine Darling, Mary Tucker-Mclaughlin, Nancy Winterbauer

Communication Faculty Publications

Despite a large number of evidence-based health communication interventions tested in private, public, and community health settings, there is a dearth of research on successful secondary dissemination of these interventions to other audiences. This article presents the case study of "1-2-3 Pap," a health communication intervention to improve human papillomavirus (HPV) vaccination uptake and Pap testing outcomes in Eastern Kentucky, and explores strategies used to disseminate this intervention to other populations in Kentucky, North Carolina, and West Virginia. Through this dissemination project, we identified several health communication intervention design considerations that facilitated our successful dissemination to these other audiences; these …