Scaling up, sustaining, and enhancing school-based sexuality education programs in resource-constrained and conservative contexts: Replicable lessons from positive-deviant countries

Despite considerable efforts, progress in the implementationof sexuality education (SE) has been uneven. This study identi-fied six “positive-deviant” low- and middle-income countries,i.e., countries that had scaled up, sustained and enhancedtheir SE programs when many others—in similar social, cul-tural and economic circumstances—were not able to do so. Inother words, they were significantly and consistently moresuccessful than the norm. Countries were shortlisted using avalidated framework and were analyzed using three other vali-dated frameworks on political priority setting, scaling up, andstakeholder engagement. The study found that India, Pakistan,Nigeria, Senegal, Mexico, and Uruguay had scaled up (eithernationwide or in some states/provinces), sustained andenhanced their SE programs in very different contexts. In allsix, SE was a political priority, the national or state/provincelevel SE scale up effort had been carefully planned and man-aged, and a mix of methods were used to build support and/or to overcome resistance. The study points to what needs tobe done better/more energetically/differently in research, pro-gram support-tool development, and policy and program sup-port to change the status quo

Rate-dependence of the compressive and tensile strength of granites

The strength and rupture of geomaterials are integral to subsurface engineering practices, such as those required to optimise geothermal energy extraction. Of particular importance is the time- and strain-rate-dependence of material strength, which dictates the energy released upon failure, and impacts the magnitude of induced seismicity, fracture architecture and thus hydraulic conductivity and system permeability. Here, we performed a series of uniaxial compression and Brazilian tensile strength measurements at a range of deformation rates in order to constrain the impact of strain rate on the strength of G603 granite. The dense, low permeability, medium-grained granites were mechanically tested at 4 strain rates (or diametric equivalent strain rates in the case of Brazilian tests) from 10−5 to 10−2 s−1, such that sample failure was achieved in anything from below 1s at the fastest rate in tension, to over 1000s at the slowest rate in compression. The applied rates encompassed those recommended by ISRM and ASTM material testing standards for compressive and Brazilian tensile testing. We found a significant rate strengthening effect, whereby compressive and tensile strength both increased by approximately 35 % across the 4 orders of magnitude of strain rate tested. We found that the static Young's modulus remained relatively constant across this range of deformation rates, however variability was reduced at faster rates, owing to the reduced time for equilibration of the system to imposed stresses. The lower strength at slower strain rates causes smaller stress drops, indicating that rocks driven to compressive and tensile failure at slower rates release less energy upon failure. Such constraints of the strain-rate-dependence of material strength, in contrast to the use of standardised material characteristics conventionally used in Engineering Geology applications, will prove useful as we develop increasingly sophisticated strategies such as cyclic soft stimulation to access resources using less energy, whilst reducing environmental risk and producing less waste.</p

Feasibility and acceptability of delivering adolescent health interventions alongside HPV vaccination in Tanzania.

BACKGROUND: Human papillomavirus (HPV) vaccination offers an opportunity to strengthen provision of adolescent health interventions (AHI). We explored the feasibility of integrating other AHI with HPV vaccination in Tanzania. METHODS: A desk review of 39 policy documents was preceded by a stakeholder meeting with 38 policy makers and partners. Eighteen key informant interviews (KIIs) with health and education policy makers and district officials were conducted to further explore perceptions of current programs, priorities and AHI that might be suitable for integration with HPV vaccination. RESULTS: Fourteen school health interventions (SHI) or AHI are currently being implemented by the Government of Tanzania. Most are delivered as vertical programmes. Coverage of current programs is not universal, and is limited by financial, human resource and logistic constraints. Limited community engagement, rumours, and lack of strategic advocacy has affected uptake of some interventions, e.g. tetanus toxoid (TT) immunization. Stakeholder and KI perceptions and opinions were limited by a lack of experience with integrated delivery and AHI that were outside an individual's area of expertise and experience. Deworming and educational sessions including reproductive health education were the most frequently mentioned interventions that respondents considered suitable for integrated delivery with HPV vaccine. CONCLUSIONS: Given programme constraints, limited experience with integrated delivery and concern about real or perceived side-effects being attributed to the vaccine, it will be very important to pilot-test integration of AHI/SHI with HPV vaccination. Selected interventions will need to be simple and quick to deliver since health workers are likely to face significant logistic and time constraints during vaccination visits

Using three indicators to understand the parity-specific contribution of adolescent childbearing to all births.

INTRODUCTION: A strong focus on sexual and reproductive health of female adolescents is a key to achieving sustainable development goals, due to the large size of the current cohort in low-income and middle-income countries (LMICs) and adolescents' biological and social vulnerability. Several indicators of fertility among adolescents are in wide use, but the contribution of adolescent births to all births is poorly understood. We propose and calculate a package of three indicators capturing the contribution of adolescent births to all births, stratified by parity (first and second/higher). METHODS: We used Demographic and Health Survey data for 30 LMICs and vital registration for two high-income countries (to calculate levels and trends across a range of countries) for three time periods: 1990-1999, 2000-2009 and 2010-2015. The three indicators were calculated overall and by age thresholds (<16, <18  and <20  years) and exact ages, for each country and time point. Patterns of changes in indicators for the three cumulative thresholds over time are described. RESULTS: In the 30 LMICs, the percentage of all live births occurring to adolescents varied across countries, with a median of 18% for adolescents <20  years. Three countries (Jordan, Indonesia and Rwanda) had levels below 10%; Bangladesh had the highest at 33%. The contribution of adolescent first-order births to all first-order births was high; a median of 49%. Even among second-order and higher-order births, the contribution of adolescent childbearing was appreciable (median of 6%). Over the period under examination, the proportion of adolescent births among all live births declined in the majority of the LMICs. CONCLUSION: These three indicators add to our understanding of the scale of adolescent childbearing and can be used in conjunction with population estimates to assess the absolute need for age-appropriate and parity-appropriate reproductive, maternal and newborn healthcare and to monitor progress in improving young people's health

Effect of Addition of PET in the Thermal Properties of Polymer-Mortar Composite Materials

The polymer-mortar composites are often used as low-cost promising materials for preventing or repairing various reinforced concrete structures. The Thermal behavior of the ¶building materials ¶is relevant to any use of concrete or composite, especially in relation to structures where it is desirable to have low thermal conductivity, dimensional stability, high specific heat and little or no decrease of stiffness upon heating. Although much work has been done on the effect of admixture and the mechanical properties of concrete or composite, relatively little work has been done on the thermal conductivity. So, Thermal conductivity (l), thermal resistance (R) and the surface coefficients of transmission (U) of polymer-mortar composites made up of mixtures of polyethylene terephthalate PET waste were measured. To determine the effect of the PET on the thermal conductivity of PET-mortar composites, PET was added as replacement for cement by decreasing the cement weights in the ratios of 2.5%, 5% and 7.5% by weight. The highest thermal conductivity of 1.45 W/mK was observed with the samples containing only plain cement. It decreased with the increase of PET as replacement for cement. The lowest value of thermal conductivity and the surface coefficient of transmission were obtained with the samples prepared with PET waste polymer at 7.5 % replacement of cement. The composites were also observed by DTA, MOP led to the positive identification of the products’. In this way, the results obtained highlight the beneficial effect of waste PET as thermal insulation in comparison with other insulation materials. In addition, the obtained PET-mortar composites would appear to be low-cost materials which would contribute to resolving some of the solid waste problems in addition to conserving energy