Maltreatment of Youth Heads of Households in Rwanda

BackgroundIn Rwanda, the combined effects of the 1994 genocide and the spread of AIDS have resulted in large numbers of orphans. Many of these are not only orphans but also youth heads of households (YHH). Orphans and YHH are particularly vulnerable to maltreatment because of marginalization from the community. The objectives of this study were to: (a) determine the prevalence of maltreatment among YHH after a two year follow-up by age and gender; (b) assess the association between certain behavioral, contextual, and socio-demographic factors and maltreatment; and (c) determine predictors of maltreatment in that community.MethodsCross-sectional survey of 692 YHH, aged 10-24, in Gikongoro, Rwanda, all beneficiaries of a World Vision basic needs program. In addition, four gender-mixed focus groups with youth with a total of 32 participants and nine gender-mixed focus groups with adults from the community with a total 61 participants were held.ResultsThe findings reveal that the prevalence of maltreatment is very high, with 71.5% of YHH self-reporting at least one type of abuse and 88% reporting having land or possessions taken or damaged. Focus group discussions identified four primary factors representing a source for violence and exploitation of YHH and results from the regression analysis showed that factors indicating community connectedness and children’s externalizing behaviors were the most salient predictors of positive treatment or maltreatment of YHH. Additionally, because of the support they had received from World Vision Program, the YHH are perceived as “better-off” or “rich” by some members of the community and this jealousy contributes in the mistreatment of orphans. Survey results are consistent with this assertion as almost 78 % of YHH reported that people were jealous of the services they were receiving.ConclusionThese findings provide new information on the issues surrounding the maltreatment of orphans in a poor, rural setting in Rwanda. Although the results should be regarded as primarily exploratory suggestive for further studies, they call for urgent need to address such a serious problem. The findings also suggest the importance of considering any new programs for orphans and YHH in the context of the wider community so as not to inadvertently add to their problems by creating resentment in the surrounding community

Results of a Community Mentoring Programme for Youth Heads of Household in Rwanda: Effects on Youth Sexual Risk Behaviours and Maltreatment

Background: While mentorship programmes, which connect orphans with adults to whom they can turn to for help and advice, are proliferating in an attempt to prevent high-risk behaviours in adolescents, there are few data to show that mentorship actually makes a difference among youth heads of households (YHH). The purpose of this study was to: (a) investigate the impact of mentoring relationship on sexual risk behaviours outcomes among YHH, and (b) examine the impact of the mentoring programme on youth maltreatment including sexual abuse. Methods: The research used a quasi-experimental design to assess the impact of the adult mentoring programme on sexual risk behaviours and maltreatment of youth living without adult care in four districts of the then Gikongoro province. In the design, which includes a baseline and a follow-up survey, the intervention group (Maraba and Nyamagabe districts) with youth heads of households receiving the home visitation programme were compared to a comparisongroup (Mudasomwa and Nyaruguru districts). Analyses explored linkages between exposure to the intervention and various outcomes: HIV/AIDS knowledge, perception of HIV risk infection, sexual risk behaviours, and maltreatment. Logistic regression was used to examine whether the mentoring programme predicted outcomes of maltreatment or sexual behaviours when controlling for demographic characteristics and any other variables significant at the bivariate level. Results: The overall HIV/AIDS knowledge was higher in the intervention group (16.3% versus 12.5%) and more YHH in this group knew a place where to get a condom (64.5% versus 57.8%). In this group, youth were more likely to report use of condom (20.5 versus 12.4%), to perceive a risk of HIV/AIDS infection at the follow-up survey (44.7% versus 32.8%), and less consumption of alcohol (56.3 versus 41.7%). In the logistic regression, respondents who reported more adult support had a significantly high likelihood of being sexually inexperienced (OR = 1.20, score for adult support=3.67 versus 3.53, p=.05). During the last twelve months, being in school, male gender, and less marginalization were highly associated with being abstinent (AOR=4.68, 2.72, and 1.46, respectively). The level of maltreatment has sensibly diminished in the intervention group (from 1.53 to 1.27) during the last two years. There were more youth who reported physical abuse among the comparison group (24% versus 15.9%) and labour exploitation (29.5% versus 19.6%). YHH exposed to the intervention were less likely to suffer from labour exploitation and physical abuse (AOR = .52 and .63, respectively). Conclusions: Results indicate that the utilization of community adult mentors should be supported as a key strategy in working with YHH to decrease sexual risk behaviours and maltreatment from community members. For interventions to be optimally effective, specific strategies to promote community support and decrease marginalization need to be identified.Key words: Youth heads of household, mentoring, sexual risk behaviours, maltreatment, abuse, Rwand

Association between expatriation and HIV awareness and knowledge among injecting drug users in Kabul, Afghanistan: A cross-sectional comparison of former refugees to those remaining during conflict

BACKGROUND: Little is known about human immunodeficiency virus (HIV) awareness among Afghan injecting drug users (IDUs), many of whom initiated injecting as refugees. We explored whether differences in HIV awareness and knowledge exist between Afghan IDUs who were refugees compared to those never having left Afghanistan. METHODS: A convenience sample of IDUs in Kabul, Afghanistan was recruited into a cross-sectional study through street outreach over a one year period beginning in 2005. Participants completed an interviewer-administered questionnaire and underwent voluntary counseling and testing for HIV, syphilis, hepatitis B surface antigen, and hepatitis C antibody. Differences in HIV awareness and specific HIV knowledge between IDU who lived outside the country in the last decade versus those who had not were assessed with logistic regression. RESULTS: Of 464 IDUs, 463 (99%) were male; median age and age at first injection were 29 and 25 years, respectively. Most (86.4%) had lived or worked outside the country in the past ten years. Awareness of HIV was reported by 46.1%; those having been outside the country in the last decade were significantly more likely to have heard of HIV (48.3% vs. 31.7%; OR = 2.00, 95% CI: 1.14 – 3.53). However, of those aware of HIV, only 38.3% could name three correct transmission routes; specific HIV knowledge was not significantly associated with residence outside the country. CONCLUSION: Accurate HIV knowledge among Afghan IDUs is low, though former refugees had greater HIV awareness. Reported high-risk injecting behavior was not significantly different between IDU that were refugees and those that did not leave the country, indicating that all Afghan IDU should receive targeted prevention programming

Food supplements increase adult tarsus length, but not growth rate, in an island population of house sparrows (Passer domesticus)

<p>Abstract</p> <p>Background</p> <p>Variation in food supply during early development can influence growth rate and body size in many species. However, whilst the detrimental effects of food restriction have often been studied in natural populations, how young individuals respond to an artificial increase in food supply is rarely investigated. Here, we investigated both the short-term and long-term effects of providing house sparrow chicks with food supplements during a key period of growth and development and assessed whether providing food supplements had any persistent effect upon adult size (measured here as tarsus length).</p> <p>Results</p> <p>Male nestlings tended to reach higher mass asymptotes than females. Furthermore, brood size was negatively associated with a chick's asymptotic mass. However, providing food supplements had no influence upon the growth rate or the asymptotic mass of chicks. Adults that received food supplements as chicks were larger, in terms of their tarsus length, than adults that did not receive extra food as chicks. In addition, the variation in tarsus length amongst adult males that were given food supplements as chicks was significantly less than the variance observed amongst males that did not receive food supplements.</p> <p>Conclusions</p> <p>Our results demonstrate that the food supply chicks experience during a critical developmental period can have a permanent effect upon their adult phenotype. Furthermore, providing extra food to chicks resulted in sex-biased variance in a size-related trait amongst adults, which shows that the degree of sexual size dimorphism can be affected by the environment experienced during growth.</p

Age-specific mortality patterns in Central Mozambique during and after the end of the Civil War

<p>Abstract</p> <p>Background</p> <p>In recent years, vigorous debate has developed concerning how conflicts contribute to the spread of infectious diseases, and in particular, the role of post-conflict situations in the epidemiology of HIV/AIDS. This study details the age-specific mortality patterns among the population in the central provincial capital of Beira, Mozambique, during and after the Mozambican civil war which ended in 1992.</p> <p>Methods</p> <p>Data was collected from the death register at Beira's Central Hospital between 1985 and 2003 and descriptively analyzed.</p> <p>Results</p> <p>The data show two distinct periods: before and after the peace agreements in 1992. Before 1992 (during the civil war), the main impact of mortality was on children below 5 years of age, including still births, accounting for 58% of all deaths. After the war ended in 1992, the pattern shifted dramatically and rapidly to the 15-49 year old age group which accounted for 49% of all deaths by 2003.</p> <p>Conclusions</p> <p>As under-5 mortality rates were decreasing at the end of the conflict, rates for 24-49 year old adults began to dramatically increase due to AIDS. This study demonstrates that strategies can be implemented during conflicts to decrease mortality rates in one vulnerable population but post-conflict dynamics can bring together other factors which contribute to the rapid spread of other infectious diseases in other vulnerable populations.</p

HIV-1 prevalence and factors associated with infection in the conflict-affected region of North Uganda

BACKGROUND: Since 1986, northern Uganda has been severely affected by civil strife with most of its population currently living internally displaced in protected camps. This study aims at estimating the HIV-1 prevalence among this population and the factors associated with infection. METHODS: In June-December 2005, a total of 3051 antenatal clinics attendees in Gulu, Kitgum and Pader districts were anonymously tested for HIV-1 infection as part of routine sentinel surveillance. Factors associated with the infection were evaluated using logistic regression models. RESULTS: The age-standardised HIV-1 prevalence was 10.3%, 9.1% and 4.3% in the Gulu, Kitgum and Pader district, respectively. The overall prevalence in the area comprised of these districts was 8.2% when data was weighted according to the districts' population size. Data from all sites combined show that, besides older women [20–24 years: adjusted odds ratio (AOR) = 1.96, 95% confidence interval (CI): 1.29–2.97; 25–29 years: AOR = 2.01, 95% CI: 1.30–3.11; ≥ 30 years: AOR = 1.91, 95% CI: 1.23–2.97], unmarried women (AOR = 1.47, 95% CI: 1.06–2.04), and those with a partner with a non-traditional occupation (AOR = 1.62, 95% CI: 1.18–2.21), women living outside of protected camps for internally displaced persons have a higher risk of being HIV-1 infected than internally displaced women (AOR = 1.55, 95% CI: 1.15–2.08). CONCLUSION: Although published data from Gulu district show a declining HIV-1 prevalence trend that is consistent with that observed at the national level since 1993, the prevalence in North Uganda is still high. Internally displaced women have a lower risk of being infected probably because of their reduced mobility and accessibility, and increased access to health prevention services

Jet energy measurement with the ATLAS detector in proton-proton collisions at root s=7 TeV

The jet energy scale and its systematic uncertainty are determined for jets measured with the ATLAS detector at the LHC in proton-proton collision data at a centre-of-mass energy of √s = 7TeV corresponding to an integrated luminosity of 38 pb-1. Jets are reconstructed with the anti-kt algorithm with distance parameters R=0. 4 or R=0. 6. Jet energy and angle corrections are determined from Monte Carlo simulations to calibrate jets with transverse momenta pT≥20 GeV and pseudorapidities {pipe}η{pipe}<4. 5. The jet energy systematic uncertainty is estimated using the single isolated hadron response measured in situ and in test-beams, exploiting the transverse momentum balance between central and forward jets in events with dijet topologies and studying systematic variations in Monte Carlo simulations. The jet energy uncertainty is less than 2. 5 % in the central calorimeter region ({pipe}η{pipe}<0. 8) for jets with 60≤pT<800 GeV, and is maximally 14 % for pT<30 GeV in the most forward region 3. 2≤{pipe}η{pipe}<4. 5. The jet energy is validated for jet transverse momenta up to 1 TeV to the level of a few percent using several in situ techniques by comparing a well-known reference such as the recoiling photon pT, the sum of the transverse momenta of tracks associated to the jet, or a system of low-pT jets recoiling against a high-pT jet. More sophisticated jet calibration schemes are presented based on calorimeter cell energy density weighting or hadronic properties of jets, aiming for an improved jet energy resolution and a reduced flavour dependence of the jet response. The systematic uncertainty of the jet energy determined from a combination of in situ techniques is consistent with the one derived from single hadron response measurements over a wide kinematic range. The nominal corrections and uncertainties are derived for isolated jets in an inclusive sample of high-pT jets. Special cases such as event topologies with close-by jets, or selections of samples with an enhanced content of jets originating from light quarks, heavy quarks or gluons are also discussed and the corresponding uncertainties are determined. © 2013 CERN for the benefit of the ATLAS collaboration

Designing an intervention to help people with colorectal adenomas reduce their intake of red and processed meat and increase their levels of physical activity: a qualitative study

Background: most cases of colorectal cancer (CRC) arise from adenomatous polyps and malignant potential is greatest in high risk adenomas. There is convincing observational evidence that red and processed meat increase the risk of CRC and that higher levels of physical activity reduce the risk. However, no definitive randomised trial has demonstrated the benefit of behaviour change on reducing polyp recurrence and no consistent advice is currently offered to minimise patient risk. This qualitative study aimed to assess patients' preferences for dietary and physical activity interventions and ensure their appropriate and acceptable delivery to inform a feasibility trial.Methods: patients aged 60-74 included in the National Health Service Bowel Cancer Screening Programme (NHSBCSP) were selected from a patient tracking database. After a positive faecal occult blood test (FOBt), all had been diagnosed with an intermediate or high risk adenoma (I/HRA) at colonoscopy between April 2008 and April 2010. Interested patients and their partners were invited to attend a focus group or interview in July 2010. A topic guide, informed by the objectives of the study, was used. A thematic analysis was conducted in which transcripts were examined to ensure that all occurrences of each theme had been accounted for and compared.Results: two main themes emerged from the focus groups: a) experiences of having polyps and b) changing behaviour. Participants had not associated polyp removal with colorectal cancer and most did not remember being given any information or advice relating to this at the time. Heterogeneity of existing diet and physical activity levels was noted. There was a lack of readiness to change behaviour in many people in the target population.Conclusion: this study has demonstrated the difficulties involved in developing interventions to change dietary and physical activity behaviour in this population. The need to tailor the intervention to individuals, the lack of knowledge about the aetiology of colon cancer and the lack of motivation to change behaviour are critical factors

Dynamics of Socioeconomic Risk Factors for Neglected Tropical Diseases and Malaria in an Armed Conflict

Armed conflict and war and infectious diseases are globally among the leading causes of human suffering and premature death. Moreover, they are closely interlinked, as an adverse public health situation may spur violent conflict, and violent conflict may favor the spread of infectious diseases. The consequences of this vicious cycle are increasingly borne by civilians, often as a hidden and hence neglected burden. We analyzed household data that were collected before and after an armed conflict in a rural part of western Côte d'Ivoire, and investigated the dynamics of socioeconomic risk factors for neglected tropical diseases (NTDs) and malaria. We identified a worsening of the sanitation infrastructure, decreasing use of protective measures against mosquito bites, and increasing difficulties to reach public health care infrastructure. In contrast, household crowding, the availability of soap, and the accessibility of comparatively simple means of health care provision (e.g., traditional healers and community health workers) seemed to be more stable. Knowledge about such dynamics may help to increase crisis-proofness of critical infrastructure and public health systems, and hence mitigate human suffering due to armed conflict and war

Oxidative Stress Mediates Physiological Costs of Begging in Magpie (Pica pica) Nestlings

[Background] Theoretical models predict that a cost is necessary to guarantee honesty in begging displays given by offspring to solicit food from their parents. There is evidence for begging costs in the form of a reduced growth rate and immunocompetence. Moreover, begging implies vigorous physical activity and attentiveness, which should increase metabolism and thus the releasing of pro-oxidant substances. Consequently, we predict that soliciting offspring incur a cost in terms of oxidative stress, and growth rate and immune response (processes that generate pro-oxidants substances) are reduced in order to maintain oxidative balance. [Methodology/Principal Findings] We test whether magpie (Pica pica) nestlings incur a cost in terms of oxidative stress when experimentally forced to beg intensively, and whether oxidative balance is maintained by reducing growth rate and immune response. Our results show that begging provokes oxidative stress, and that nestlings begging for longer bouts reduce growth and immune response, thereby maintaining their oxidative status. [Conclusions/Significance] These findings help explaining the physiological link between begging and its associated growth and immunocompetence costs, which seems to be mediated by oxidative stress. Our study is a unique example of the complex relationships between the intensity of a communicative display (begging), oxidative stress, and life-history traits directly linked to viability.GM-R was supported by the Spanish Government (Ministerio de Ciencia y Tecnología, “Juan de la Cierva” program), and TR was supported by the Consejo Superior de Investigaciones Científicas (CSIC; Proyectos Intramurales Especiales)