Gender Socialization during Adolescence in Low- and Middle-Income Countries : Conceptualization, influences and outcomes

Adolescence is a critical period in the development of gender attitudes and behaviours, which have potentially life-long effects.The rapid changes that take place during adolescence provide opportunities for the development and implementation of policies and programmes, which can influence the gender socialization process, in order to maximize positive outcomes.This paper set out to provide a conceptual understanding of the gender socialization process during adolescence, its influences and outcomes, and practical suggestions on how to use this knowledge in the design of policies and programmes to improve gender equality. First, theoretical contributions from psychology, sociology and biology were reviewed to situate the gender socialization process during adolescence in a broader context of multi-level influences. Second, a socio-ecological framework was introduced to bring together the main factors that influence the gender socialization process and its outcomes.Third, knowledge on how to influence the gender socialization process and its outcomes was summarized in order to provide practical recommendations for policies and programmes.This included: a) reviewing changes in demographics, the global media and gendered economic opportunities, to understand how the gender socialization process, gender norms and identities have been transformed at the macro level; and b) conducting a literature review of smallscale programmes designed to impact the gender socialization process.The literature review identified 31 programmes grouped around three broad strategies: 1) empowering young people (mainly girls) with information, skills, and social support to challenge norms; 2) fostering an enabling environment in which to challenge gender norms; and 3) working with men and boys, including directly with young individuals and with influential males to change attitudes and beliefs The paper concludes with recommendations for more holistic policy and programming efforts around gender socialization in adolescence

Assessing the carcinogenic potential of low-dose exposures to chemical mixtures in the environment: the challenge ahead.

Lifestyle factors are responsible for a considerable portion of cancer incidence worldwide, but credible estimates from the World Health Organization and the International Agency for Research on Cancer (IARC) suggest that the fraction of cancers attributable to toxic environmental exposures is between 7% and 19%. To explore the hypothesis that low-dose exposures to mixtures of chemicals in the environment may be combining to contribute to environmental carcinogenesis, we reviewed 11 hallmark phenotypes of cancer, multiple priority target sites for disruption in each area and prototypical chemical disruptors for all targets, this included dose-response characterizations, evidence of low-dose effects and cross-hallmark effects for all targets and chemicals. In total, 85 examples of chemicals were reviewed for actions on key pathways/mechanisms related to carcinogenesis. Only 15% (13/85) were found to have evidence of a dose-response threshold, whereas 59% (50/85) exerted low-dose effects. No dose-response information was found for the remaining 26% (22/85). Our analysis suggests that the cumulative effects of individual (non-carcinogenic) chemicals acting on different pathways, and a variety of related systems, organs, tissues and cells could plausibly conspire to produce carcinogenic synergies. Additional basic research on carcinogenesis and research focused on low-dose effects of chemical mixtures needs to be rigorously pursued before the merits of this hypothesis can be further advanced. However, the structure of the World Health Organization International Programme on Chemical Safety 'Mode of Action' framework should be revisited as it has inherent weaknesses that are not fully aligned with our current understanding of cancer biology

Disruptive chemicals, senescence and immortality

Cell death is a process of dying within biological cells that are ceasing to function. This process is essential in regulating organism development, tissue homeostasis, and to eliminate cells in the body that are irreparably damaged. In general, dysfunction in normal cellular death is tightly linked to cancer progression. Specifically, the up-regulation of prosurvival factors, including oncogenic factors and antiapoptotic signaling pathways, and the down-regulation of proapoptotic factors, including tumor suppressive factors, confers resistance to cell death in tumor cells, which supports the emergence of a fully immortalized cellular phenotype. This review considers the potential relevance of ubiquitous environmental chemical exposures that have been shown to disrupt key pathways and mechanisms associated with this sort of dysfunction. Specifically, bisphenol A, chlorothalonil, dibutyl phthalate, dichlorvos, lindane, linuron, methoxychlor and oxyfluorfen are discussed as prototypical chemical disruptors; as their effects relate to resistance to cell death, as constituents within environmental mixtures and as potential contributors to environmental carcinogenesis.The publisher and the author(s) have made this article open access. This is the publisher’s final pdf. The published article is copyrighted by the author(s) and published by Oxford University Press. The published article can be found at: http://carcin.oxfordjournals.org

Assessing the carcinogenic potential of low-dose exposures to chemical mixtures in the environment: the challenge ahead

Lifestyle factors are responsible for a considerable portion of cancer incidence worldwide, but credible estimates from the World Health Organization and the International Agency for Research on Cancer (IARC) suggest that the fraction of cancers attributable to toxic environmental exposures is between 7% and 19%. To explore the hypothesis that low-dose exposures to mixtures of chemicals in the environment may be combining to contribute to environmental carcinogenesis, we reviewed 11 hallmark phenotypes of cancer, multiple priority target sites for disruption in each area and prototypical chemical disruptors for all targets, this included dose-response characterizations, evidence of low-dose effects and cross-hallmark effects for all targets and chemicals. In total, 85 examples of chemicals were reviewed for actions on key pathways/mechanisms related to carcinogenesis. Only 15% (13/85) were found to have evidence of a dose-response threshold, whereas 59% (50/85) exerted low-dose effects. No dose-response information was found for the remaining 26% (22/85). Our analysis suggests that the cumulative effects of individual (non-carcinogenic) chemicals acting on different pathways, and a variety of related systems, organs, tissues and cells could plausibly conspire to produce carcinogenic synergies. Additional basic research on carcinogenesis and research focused on low-dose effects of chemical mixtures needs to be rigorously pursued before the merits of this hypothesis can be further advanced. However, the structure of the World Health Organization International Programme on Chemical Safety ‘Mode of Action’ framework should be revisited as it has inherent weaknesses that are not fully aligned with our current understanding of cancer biology

Assessing the carcinogenic potential of low-dose exposures to chemical mixtures in the environment: the challenge ahead

Lifestyle factors are responsible for a considerable portion of cancer incidence worldwide, but credible estimates from the World Health Organization and the International Agency for Research on Cancer (IARC) suggest that the fraction of cancers attributable to toxic environmental exposures is between 7% and 19%. To explore the hypothesis that low-dose exposures to mixtures of chemicals in the environment may be combining to contribute to environmental carcinogenesis, we reviewed 11 hallmark phenotypes of cancer, multiple priority target sites for disruption in each area and prototypical chemical disruptors for all targets, this included dose-response characterizations, evidence of low-dose effects and cross-hallmark effects for all targets and chemicals. In total, 85 examples of chemicals were reviewed for actions on key pathways/ mechanisms related to carcinogenesis. Only 15% (13/85) were found to have evidence of a dose-response threshold, whereas 59% (50/85) exerted low-dose effects. No dose-response information was found for the remaining 26% (22/85). Our analysis suggests that the cumulative effects of individual (non-carcinogenic) chemicals acting on different pathways, and a variety of related systems, organs, tissues and cells could plausibly conspire to produce carcinogenic synergies. Additional basic research on carcinogenesis and research focused on low-dose effects of chemical mixtures needs to be rigorously pursued before the merits of this hypothesis can be further advanced. However, the structure of the World Health Organization International Programme on Chemical Safety ‘Mode of Action’ framework should be revisited as it has inherent weaknesses that are not fully aligned with our current understanding of cancer biology

Couple Relationships and Contraceptive Use in Peri-Urban Ethiopia

Background A strong association has been found between intimate partner relationships and individual health outcomes. Public health research and programs, however, continue to place emphasis mainly on individual cognitive and behavioral change. Studies of contextual influences also omit examining mutual influences and interdependence across individuals and their social relationships. Dyadic contextual influences are especially pertinent for decisions about contraceptive practice because they usually require the cooperation of two individuals in an intimate relationship. Studying the measurement and interdependence of partners’ assessment of the quality of their marital relationships can also help establish any associations they may have with a range of contraceptive use outcomes, such as current practice, type of method, and continuity of use. Methods This research utilizes partners’ assessments of their marital relationship quality collected from a probability sample of couples resident in a peri-urban community in Ethiopia. The Family Health and Wealth Study (FHWS) is an ongoing cohort study being conducted in several sub-Saharan African settings. This dissertation carries out an in-depth exploration of the psychometric properties of four marital quality scales, validated in the West, for the female and male partner samples. The re-specifed scales are then utilized to examine interdependence in spousal relationships by assessing if a spouse’s current marital quality report is affected by his or her previous marital quality report using two rounds of FHWS data. The Actor Partner Interdependence Model, a statistical technique designed to model interdependence in dyads, was adopted to examine these relationships. The associations between female and male partners’ marital quality measures and contraceptive use outcomes were then estimated with multivariate logistic and multinomial regression analysis. Results This study’s analyses did not support the original four-factor structure of the marital quality scales and instead a three-factor measure emerged specific for each gender and comprised of domains of trust, commitment and conflict. The measures were internally consistent and demonstrated good convergent, discriminant and concurrent validity. Our study also found linkages between wives’ and husbands’ marital quality scores, indicating the presence of spousal interdependence in this peri-urban Ethiopian setting. Surprisingly, our results found that females exerted a stronger influence on husbands’ marital quality reports than vice versa. Several marital quality measures were found to be significantly associated with contraceptive use outcomes. Male partners’ scores had a positive and stronger association with their own reported contraceptive behaviors and with their female counterparts’ continuity of use. Conclusions Understanding couple-level marital dynamics can help to improve the health and contraceptive use outcomes of individual spouses

Reproductive Coercion and Contraceptive Use in Ethiopia

Context: While intimate partner violence (IPV) is recognized as a major contributor to poor reproductive health outcomes, the relationship between IPV and contraceptive use is unclear. Reproductive coercion (RC), a mechanism by which power is maintained over a partner through enforced reproductive behaviours, could be the missing link in understanding this relationship. However, there is limited understanding of RC and contraceptive use in sub-Saharan Africa.Data Source and Methods: We use large-scale population based survey data from Ethiopia and examine the relationship between reproductive coercion and contraceptive use and estimate the predictors of reproductive coercion using multivariate logistic regression models.Findings: Our findings suggest a strong negative association between RC and contraceptive use after adjusting for IPV and other factors, while emotional IPV was strongly predictive of RC.Conclusion: RC can be critical for understanding how controlling behaviours and violence manifest in the reproductive arena and impact family planning decision-making

Association of Maternal Height With Child Mortality, Anthropometric Failure, and Anemia in India

CONTEXT: Prior research on the determinants of child health has focused on contemporaneous risk factors such as maternal behaviors, dietary factors, and immediate environmental conditions. Research on intergenerational factors that might also predispose a child to increased health adversity remains limited. OBJECTIVE: To examine the association between maternal height and child mortality, anthropometric failure, and anemia. DESIGN, SETTING, AND POPULATION: We retrieved data from the 2005-2006 National Family Health Survey in India (released in 2008). The study population constitutes a nationally representative cross-sectional sample of singleton children aged 0 to 59 months and born after January 2000 or January 2001 (n = 50 750) to mothers aged 15 to 49 years from all 29 states of India. Information on children was obtained by a face-to-face interview with mothers, with a response rate of 94.5%. Height was measured with an adjustable measuring board calibrated in millimeters. Demographic and socioeconomic variables were considered as covariates. Modified Poisson regression models that account for multistage survey design and sampling weights were estimated. MAIN OUTCOME MEASURES: Mortality was the primary end point; underweight, stunting, wasting, and anemia were included as secondary outcomes. RESULTS: In adjusted models, a 1-cm increase in maternal height was associated with a decreased risk of child mortality (relative risk [RR], 0.978; 95% confidence interval [CI], 0.970-0.987; P < .001), underweight (RR, 0.971; 95% CI, 0.968-0.974; P < .001), stunting (RR, 0.971; 95% CI, 0.968-0.0973; P < .001), wasting (RR, 0.989; 95% CI, 0.984-0.994; P < .001), and anemia (RR, 0.998; 95% CI, 0.997-0.999; P = .02). Children born to mothers who were less than 145 cm in height were 1.71 times more likely to die (95% CI, 1.37-2.13) (absolute probability, 0.09; 95% CI, 0.07-0.12) compared with mothers who were at least 160 cm in height (absolute probability, 0.05; 95% CI, 0.04-0.07). Similar patterns were observed for anthropometric failure related to underweight and stunting. Paternal height was not associated with child mortality or anemia but was associated with child anthropometric failure. CONCLUSION: In a nationally representative sample of households in India, maternal height was inversely associated with child mortality and anthropometric failure

Hydrogen sulfide ameliorates hyperhomocysteinemia-associated chronic renal failure

Elevated level of homocysteine (Hcy), known as hyperhomocysteinemia (HHcy), is associated with end-stage renal diseases. Hcy metabolizes in the body to produce hydrogen sulfide (H2S), and studies have demonstrated a protective role of H2S in end-stage organ failure. However, the role of H2S in HHcy-associated renal diseases is unclear. The present study was aimed to determine the role of H2S in HHcy-associated renal damage. Cystathionine-β-synthase heterozygous (CBS+/−) and wild-type (WT, C57BL/6J) mice with two kidney (2-K) were used in this study and supplemented with or without NaHS (30 μmol/l, H2S donor) in the drinking water. To expedite the HHcy-associated glomerular damage, uninephrectomized (1-K) CBS(+/−) and 1-K WT mice were also used with or without NaHS supplementation. Plasma Hcy levels were elevated in CBS(+/−) 2-K and 1-K and WT 1-K mice along with increased proteinuria, whereas, plasma levels of H2S were attenuated in these groups compared with WT 2-K mice. Interestingly, H2S supplementation increased plasma H2S level and normalized the urinary protein secretion in the similar groups of animals as above. Increased activity of matrix metalloproteinase (MMP)-2 and -9 and apoptotic cells were observed in the renal cortical tissues of CBS(+/−) 2-K and 1-K and WT 1-K mice; however, H2S prevented apoptotic cell death and normalized increased MMP activities. Increased expression of desmin and downregulation of nephrin in the cortical tissue of CBS(+/−) 2-K and 1-K and WT 1-K mice were ameliorated with H2S supplementation. Additionally, in the kidney tissues of CBS(+/−) 2-K and 1-K and WT 1-K mice, increased superoxide (O2•−) production and reduced glutathione (GSH)-to-oxidized glutathione (GSSG) ratio were normalized with exogenous H2S supplementation. These results demonstrate that HHcy-associated renal damage is related to decreased endogenous H2S generation in the body. Additionally, here we demonstrate with evidence that H2S supplementation prevents HHcy-associated renal damage, in part, through its antioxidant properties