Learnings from past interventions in the digital era: Evidence-based considerations for adolescents’ programming using information and communication technologies

This commentary examines key lessons from evidence-based adolescents’ programs—related to intentional recruitment, the role of mentors, and multi-level intervention strategies—and how the adoption of digital technologies can create opportunities to strengthen programs, provided that evidence-based lessons remain at the core of intervention strategies

More Than Brides Alliance (MTBA): Mariage n’est pas un jeu d’enfat, Rapport de référence Niger

L’Alliance « Plus qu’une épouse » vise à améliorer la vie des adolescentes et propose des interventions dans plusieurs domaines (la santé reproductive, l’éducation, les normes de genre et les moyens de subsistance, entre autres). Dans le cadre d’une évaluation des interventions visant à retarder l’âge du mariage, le Population Council a mené des enquêtes de référence sur les adolescentes dans des zones sélectionnées dans deux régions au Niger (Tillabéry et Maradi). Les objectifs de l’étude de référence étaient les suivants : 1) fournir un point de référence permettant de mesurer les changements découlant de l’intervention à mi-parcours et à la fin de l’étude ; 2) fournir des renseignements sur la situation et le contexte actuels des adolescentes dans des zones sélectionnées au Niger afin de documenter l’intervention ; et 3) identifier les thèmes nécessitant un examen approfondi à l’aide de la recherche qualitative. Les résultats suggèrent que les filles vivant dans les communautés de Tillabéry et Maradi ont besoin de ces interventions pour faire face à ces vulnérabilités. Les résultats seront utilisés pour évaluer les changements qui seraient attribuables aux interventions de l’Alliance et pour informer les équipes de programme qui cherchent à mieux comprendre les populations qu’elles servent. --- The More Than Brides Alliance (MTBA) seeks to improve the lives of adolescent girls and includes activities across multiple domains (reproductive health, education, gender norms, and livelihoods, to name a few). The Population Council conducted baseline surveys of adolescents in select areas of two regions in Niger (Tillaberi and Maradi) as part of an evaluation of MTBA interventions to delay marriage. The goals of the baseline study were to: 1) provide a benchmark against which changes resulting from the intervention may be measured at the midline and endline periods; 2) provide information about the current situation and context for adolescent girls in select areas in Niger in order to inform the intervention; and 3) identify themes in need of further exploration through qualitative research. The findings suggest that girls in these communities in Tillaberi and Maradi have a demonstrated need for interventions to address these vulnerabilities. These findings will be used both to evaluate changes over time that may be attributable to the MTBA intervention and to inform programmatic staff seeking to understand the populations they are serving

More Than Brides Alliance: Baseline report, Niger

The More Than Brides Alliance (MTBA) seeks to improve the lives of adolescent girls and includes activities across multiple domains (reproductive health, education, gender norms, and livelihoods, to name a few). The Population Council conducted baseline surveys of adolescents in select areas of two regions in Niger (Tillaberi and Maradi) as part of an evaluation of MTBA interventions to delay marriage. The goals of the baseline study were to: 1) provide a benchmark against which changes resulting from the intervention may be measured at the midline and endline periods; 2) provide information about the current situation and context for adolescent girls in select areas in Niger in order to inform the intervention; and 3) identify themes in need of further exploration through qualitative research. The findings suggest that girls in these communities in Tillaberi and Maradi have a demonstrated need for interventions to address these vulnerabilities. These findings will be used both to evaluate changes over time that may be attributable to the MTBA intervention and to inform programmatic staff seeking to understand the populations they are serving

Microsporidiosis and Malnutrition in Children with Persistent Diarrhea, Uganda

We show that the microsporidian fungus Enterocytozoon bieneusi is associated with lower rates of weight gain in children in Uganda with persistent diarrhea. This relationship remained after controlling for HIV and concurrent cryptosporidiosis. Children with microsporidiosis were predicted to weigh 1.3 kg less than children without microsporidiosis at 5 years of age

More Than Brides Alliance: Midline evaluation report

The More than Brides Alliance (MTBA) was formed to bringing together the strengths of a diverse team skilled in adolescent program implementation and research. The goal of the research presented in this report is to promote an evidence-based programmatic approach to delaying marriage in India, Malawi, Mali, Niger, and Pakistan by gathering detailed quantitative and qualitative information from the program areas over time to examine the impact of the present intervention and inform future strategies. This report highlights data from the midline survey on a set of outcomes approximately midway through the MTBA intervention and compares them with the same indicators that were collected before the interventions began (at baseline). The goal is to assess the successes of the program to date, to contextualize findings in light of larger social trends that may explain changes on some indicators (such as increased political pressure to end child marriage), and to consider programmatic strategies that may be suitable for adaptation based on midline findings. The data provide insights into possible programmatic adaptations that could help MTBA achieve desired outcomes by endline in 2020

More Than Brides Alliance: Endline evaluation report

This endline report presents findings from the More Than Brides Alliance’s (MTBA) project “Marriage: No Child’s Play” (MNCP) carried out in four countries: India, Malawi, Mali, and Niger. The MTBA project sought to empower girls, raise awareness about the risks of child marriage, improve girls’ access to sexual and reproductive health services, and support social norms favorable to girls’ education, economic engagement, and agency in marital decision-making. Results are presented from the MNCP evaluation, including over the final year, which was characterized by significant adaptations in programming and research due to Covid-19. This report explores behavioral outcomes related to child marriage, schooling, work, and pregnancy, as well as indicators related to knowledge and attitudes, based on cross-sectional surveys in intervention and comparison villages conducted with adolescent girls ages 12–19 at three time points (2016/7, 2018, 2020) and with parents of adolescent girls or other adults living in households with adolescent girls at endline (2020). Impact is presented—measured by results from difference-in-differences analysis—using baseline and endline surveys, comparing change in intervention areas to change in comparison areas

Conceptual framework of the drivers of child marriage: A tool to guide programs and policies

This brief presents a simplified framework to provide key entry points for understanding which drivers of child marriage may be most important in particular contexts. Decision-makers such as researchers, donors, and program practitioners can use the framework to help design programs and policies tailored to these contexts

Cross-cultural adaptation of the Brazilian version of the Dentine Hypersensitivity Experience Questionnaire

Abstract The dentine hypersensitivity (DH) is able to impair the oral health related quality of life (OHRQoL). However, there isn't any specific validated questionnaire to be used in Brazil. The objective was to adapt and to validate the English version of the Dentine Hypersensitivity Experience Questionnaire (DHEQ-15) for use in Brazil. DHEQ-15 was cross-culturally adapted into the Brazilian-Portuguese language and then validated in a cross-sectional study with 100 participants recruited at a University clinic. Study sample comprised 2 groups: 100 individuals with DH, and 100 individuals without. The instrument was self-administered twice 7 to 10 days apart. The participants answered a global rating of oral health. The psychometric properties of the Brazilian version of DHEQ-15 were verified through internal consistency (Cronbach's α) and test-retest reliability (intraclass correlation coefficient - ICC), convergent (Spearman correlation) and discriminant (Mann-Whitney test) validity. The significance threshold was set at p<0.05. Sample comprised 69 men and 131 women, of mean age 30.4y. The Brazilian DHEQ-15 demonstrated very good internal consistency (α = 0.945). Test-retest reliability revealed excellent reproducibility (ICC = 0.959, p < 0.001). There was statistically significant correlation between the scores obtained on all DHEQ-15 domains and the global rating of oral health (p<0.001). Participants with DH scored significantly higher than those without DH (p<0.001). This study provides evidence supporting the cross-cultural validity of the Brazilian version of DHEQ-15 for use in Brazil

Inter-Observer Variation in the Pathologic Identification of Minimal Extrathyroidal Extension in Papillary Thyroid Carcinoma

Background: Extrathyroidal extension (ETE) is a significant prognostic factor in papillary thyroid carcinoma (PTC). Minimal extrathyroidal extension (mETE) is characterized by involvement of the sternothyroid muscle or perithyroid soft tissue, and is generally identified by light microscope examination. Patients with mETE, identified pathologically, are automatically upstaged to pT3. However, the prognostic implications of mETE have been a source of controversy in the literature. Moreover, there is also controversy surrounding the identification of mETE on pathological specimens. The objective of this study was to determine the level of agreement among expert pathologists in the identification of mETE in PTC cases. Methods: Eleven expert pathologists from the United States, Italy, and Canada were asked to perform a review of 69 scanned slides of representative permanent sections of PTC specimens. Each slide was evaluated for the presence of mETE. The pathologists were also asked to list the criteria they use to identify mETE. Results: The overall strength of agreement for identifying mETE was slight (??=?0.14). Inter-pathologist agreement was best for perithyroidal skeletal muscle involvement (??=?0.46, moderate agreement) and worst for invasion around thick-walled vascular structures (??=?0.02, slight agreement). In addition, there was disagreement over the constellation of histologic features that are diagnostic for mETE, which affected overall agreement for diagnosing mETE. Conclusions: Overall agreement for the identification of mETE is poor. Disagreement is a result of both variation in individual pathologists' interpretations of specimens and disagreement on the histologic criteria for mETE. Thus, the utility of mETE in staging and treatment of PTC is brought into question. The lack of concordance may explain the apparent lack of agreement regarding the prognostic significance of this pathologic feature.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/140271/1/thy.2015.0508.pd

Inter-Observer Variation in the Pathologic Identification of Extranodal Extension in Nodal Metastasis from Papillary Thyroid Carcinoma

Background: Extranodal extension (ENE) in lymph node metastases has been shown to worsen the prognosis of papillary thyroid cancer (PTC). Despite the clinical significance of ENE, there are no stringent criteria for its microscopic diagnosis, and its identification is subject to inter-observer variability. The objective of this study was to determine the level of agreement among expert pathologists in the identification of ENE in PTC cases. Methods: Eleven expert pathologists from the United States, Italy, and Canada were asked to review 61 scanned slides of representative permanent sections of PTC specimens from Mount Sinai Beth Israel Medical Center in New York. Each slide was evaluated for the presence of ENE. The pathologists were also asked to report the criteria they use to identify ENE. Results: The overall strength of agreement in identifying ENE was only fair (??=?0.35), and the proportion of observed agreement was 0.68. The proportions of observed agreement for the identification of perinodal structures (fat, nerve, skeletal, and thick-walled vessel involvement) ranged from 0.61 to 0.997. Conclusions: Overall agreement for the identification of ENE is poor. The lack of agreement results from both variation in pathologists' identification of features and disagreement on the histologic criteria for ENE. This lack of concordance may help explain some of the discordant information regarding prognosis in clinical studies when this feature is identified.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/140272/1/thy.2015.0551.pd