625 research outputs found

    A combined microfinance and training intervention can reduce HIV risk behaviour in young female participants.

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    OBJECTIVE: To assess effects of a combined microfinance and training intervention on HIV risk behavior among young female participants in rural South Africa. DESIGN: : Secondary analysis of quantitative and qualitative data from a cluster randomized trial, the Intervention with Microfinance for AIDS and Gender Equity study. METHODS: Eight villages were pair-matched and randomly allocated to receive the intervention. At baseline and after 2 years, HIV risk behavior was assessed among female participants aged 14-35 years. Their responses were compared with women of the same age and poverty group from control villages. Intervention effects were calculated using adjusted risk ratios employing village level summaries. Qualitative data collected during the study explored participants' responses to the intervention including HIV risk behavior. RESULTS: After 2 years of follow-up, when compared with controls, young participants had higher levels of HIV-related communication (adjusted risk ratio 1.46, 95% confidence interval 1.01-2.12), were more likely to have accessed voluntary counseling and testing (adjusted risk ratio 1.64, 95% confidence interval 1.06-2.56), and less likely to have had unprotected sex at last intercourse with a nonspousal partner (adjusted risk ratio 0.76, 95% confidence interval 0.60-0.96). Qualitative data suggest a greater acceptance of intrahousehold communication about HIV and sexuality. Although women noted challenges associated with acceptance of condoms by men, increased confidence and skills associated with participation in the intervention supported their introduction in sexual relationships. CONCLUSIONS: In addition to impacts on economic well being, women's empowerment and intimate partner violence, interventions addressing the economic and social vulnerability of women may contribute to reductions in HIV risk behavior

    Early antenatal prediction of gestational diabetes in obese women: development of prediction tools for targeted intervention

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    All obese women are categorised as being of equally high risk of gestational diabetes (GDM) whereas the majority do not develop the disorder. Lifestyle and pharmacological interventions in unselected obese pregnant women have been unsuccessful in preventing GDM. Our aim was to develop a prediction tool for early identification of obese women at high risk of GDM to facilitate targeted interventions in those most likely to benefit. Clinical and anthropometric data and non-fasting blood samples were obtained at 15+0–18+6 weeks’ gestation in 1303 obese pregnant women from UPBEAT, a randomised controlled trial of a behavioural intervention. Twenty one candidate biomarkers associated with insulin resistance, and a targeted nuclear magnetic resonance (NMR) metabolome were measured. Prediction models were constructed using stepwise logistic regression. Twenty six percent of women (n = 337) developed GDM (International Association of Diabetes and Pregnancy Study Groups criteria). A model based on clinical and anthropometric variables (age, previous GDM, family history of type 2 diabetes, systolic blood pressure, sum of skinfold thicknesses, waist:height and neck:thigh ratios) provided an area under the curve of 0.71 (95%CI 0.68–0.74). This increased to 0.77 (95%CI 0.73–0.80) with addition of candidate biomarkers (random glucose, haemoglobin A1c (HbA1c), fructosamine, adiponectin, sex hormone binding globulin, triglycerides), but was not improved by addition of NMR metabolites (0.77; 95%CI 0.74–0.81). Clinically translatable models for GDM prediction including readily measurable variables e.g. mid-arm circumference, age, systolic blood pressure, HbA1c and adiponectin are described. Using a ≥35% risk threshold, all models identified a group of high risk obese women of whom approximately 50% (positive predictive value) later developed GDM, with a negative predictive value of 80%. Tools for early pregnancy identification of obese women at risk of GDM are described which could enable targeted interventions for GDM prevention in women who will benefit the most

    Energy Impacts of Water Based Recreation

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    The overall objective of the study reported here was to determine to what extent energy accounting could supplement and/or complement economic benfit/cost analyses of water management projects and to specifically examine the energy impacts of water based recreation. The energy accounting literature was carefully reviewed and an energy accounting methodology applicable to water management was devised. Data pertaining to receation at five reservoirs in Utah were assembled from visitation recoreds and on-site surveys. Energy requirements for site construction, travel to and from the recreation site, and recreation at the site were estimated. It was determined that energy devoted to water based recreation is not inconsequential. As much energy is devoted to recreation at Lake Powell alone as is required for all of production agriculture in Utah. It is suggested that while the models developed in this study could be used with confidence in the preparation of energy impact statements the authors are not persuaded energy accounting provides additional information to water use planners beyong that obtainable from traditional economic analysis

    The buzz about bees and poverty alleviation: Identifying drivers and barriers of beekeeping in sub-Saharan Africa

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    The potential of beekeeping to mitigate the exposure of rural sub-Sahara African farmers to economic stochasticity has been widely promoted by an array of development agencies. Robust outcome indicators of the success of beekeeping to improve household well-being are unfortunately lacking. This study aimed to identify the key drivers and barriers of beekeeping adoption at the household level, and quantified the associated income contribution in three agro-ecological zones in Uganda. Beekeepers were generally the most economically disadvantaged people in the study areas and tended to adopt beekeeping following contact with non-government organisations and access to training. Whilst incomes were not statistically lower than their non-beekeeping counterparts; their mean household well-being scores were significantly lower than non-beekeeping households. The inability of beekeeping to significantly improve well-being status can in part be attributed to a lack of both training in bee husbandry and protective equipment provision such as suits, gloves and smokers. These are critical tools for beekeepers as they provide the necessary confidence to manage honey bees. Rather than focussing solely on the socio-economic conditions of farmers to effectively adopt beekeeping, future research should also attempt to evaluate the effectiveness of development agencies’ provision to the beekeeping sector

    Isospin splitting in heavy baryons and mesons

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    A recent general analysis of light-baryon isospin splittings is updated and extended to charmed baryons. The measured Σc\Sigma_c and Ξc\Xi_c splittings stand out as being difficult to understand in terms of two-body forces alone. We also discuss heavy-light mesons; though the framework here is necessarily less general, we nevertheless obtain some predictions that are not strongly model-dependent.Comment: 12 pages REVTEX 3, plus 4 uuencoded ps figures, CMU-HEP93-

    Voice and Agency: Empowering women and girls for shared prosperity

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    This document presents Voice and Agency: Empowering women and girls for shared prosperity is a major new report by the World Bank that shines a spotlight on the value of voice and agency, the patterns of constraints that limit their realization, and the associated costs, not only to individual women but to their families, communities, and societies. It highlights promising policies and interventions, and it identifies priority areas where further research and more and better data and evidence are needed. Underlining that agency has both intrinsic and instrumental, concrete value, this report puts advancing women's voice and agency squarely on the international development agenda

    Decisional Informatics for Psychosocial Rehabilitation: A Feasibility Pilot on Tailored and Fluid Treatment Algorithms for Serious Mental Illness

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    This study introduces a computerized clinical decision-support tool, the Fluid Outpatient Rehabilitation Treatment (FORT), that incorporates individual and ever-evolving patient needs to guide clinicians in developing and updating treatment decisions in real-time. In this proof-of-concept feasibility pilot, FORT was compared against traditional treatment planning using similar behavioral therapies in 52 adults with severe mental illness attending community-based day treatment. At posttreatment and follow-up, group differences and moderate-to-large effect sizes favoring FORT were detected in social function, work readiness, self-esteem, working memory, processing speed, and mental flexibility. Of participants who identified obtaining a General Education Diploma as their goal, 73% in FORT passed the examination compared with 18% in traditional treatment planning. FORT was also associated with higher agency cost-effectiveness and a better average benefit-cost ratio, even when considering diagnosis, baseline symptoms, and education. Although the comparison groups were not completely equivalent, the findings suggest computerized decision support systems that collaborate with human decision-makers to personalize psychiatric rehabilitation and address critical decisions may have a role in improving treatment effectiveness and efficiency

    Recovery of the Historical SN1957D in X-rays with Chandra

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    SN1957D, located in one of the spiral arms of M83, is one of the small number of extragalactic supernovae that has remained detectable at radio and optical wavelengths during the decades after its explosion. Here we report the first detection of SN1957D in X-rays, as part of a 729 ks observation of M83 with \chandra. The X-ray luminosity (0.3 - 8 keV) is 1.7 (+2.4,-0.3) 10**37 ergs/s. The spectrum is hard and highly self-absorbed compared to most sources in M83 and to other young supernova remnants, suggesting that the system is dominated at X-ray wavelengths by an energetic pulsar and its pulsar wind nebula. The high column density may be due to absorption within the SN ejecta. HST WFC3 images resolve the supernova remnant from the surrounding emission and the local star field. Photometry of stars around SN1957D, using WFC3 images, indicates an age of less than 10**7 years and a main sequence turnoff mass more than 17 solar masses. New spectra obtained with Gemini-South show that the optical spectrum continues to be dominated by broad [O III] emission lines, the signature of fast-moving SN ejecta. The width of the broad lines has remained about 2700 km/s (FWHM). The [O III] flux dropped precipitously between 1989 and 1991, but continued monitoring shows the flux has been almost constant since. In contrast, radio observations over the period 1990-2011 show a decline rate inf the flux proportional to t**-4, far steeper than the rate observed earlier, suggesting that the primary shock has overrun the edge of a pre-SN wind.Comment: 28 pages, including 3 tables and 7 figures, accepted for publication in Ap
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