More Than a Backdrop: Understanding the Role of Communities in Programming for Adolescent Girls—Action Guide

The structural and social features of a girl’s community play a critical role in determining what effects programs for adolescent girls can achieve. Girls’ communities include both the physical spaces girls must navigate and adults and peers who shape their beliefs about marriage, work, and education. This action guide focuses on key questions to ask when designing programs: How many girls live in a given community? Is the community urban, peri-urban, or rural? Is it formal or informal? How stable or cohesive is a community? Who is considered a “community member”? What resources exist for girls in the community, and who has access to them? How do economic and social pressures shape community norms about marriage, education, work, and gender roles? The action guide offers tips on how to find answers and provides real-world examples that demonstrate how to use community-level insights for action for adolescent girls. It was written for people who design, manage, and assess community-based programming

Girls on the Move: Adolescent Girls & Migration in the Developing World

Adolescent girls in developing countries are migrating to urban areas in ever greater numbers. While migration can be risky, for the majority of girls, migration can increase opportunities and economic stability and provide them with the autonomy to make decisions about their lives. Preventing the worst outcomes and helping girls succeed are essential to unlocking the benefits of migration. When migrant girls can take advantage of the benefits, they can be a powerful force for change in the developing world—improving lives and reducing poverty in their communities and countries. This Girls Count report examines the social and economic determinants of internal migration for adolescent girls in developing countries, and identifies the links between migration, risk, and opportunity. A wide range of evidence on migrant girls is explored, including findings on programs for girls and an agenda for increasing the visibility of migrant girls, reducing their vulnerability, and realizing their full potential

Evidence review: Promoting adolescent girls\u27 health and well-being in low-resource settings in the era of COVID-19

Adolescent girls are among the groups intended to benefit from measures governments enact to control COVID-19, such as travel restrictions and business and school closures. However, given the dual disadvantage adolescent girls face due to age and gender, even approaches that effectively reduce the threat of COVID-19 transmission may exacerbate other threats to their health, safety, and well-being. In response, governments, multilateral agencies, and non-governmental organizations have moved to address these risks, though evidence to support investment decision-making is limited. Clarity on the type, degree, and strength of the evidence in support of interventions that promote adolescent girls’ health and well-being is urgently needed. We are conducting an evidence review to meet this challenge. Based on the findings of a structured literature search of published and selected grey literature sources, we will map the current scope of evidence on relevant interventions in low- and middle-income countries. Based on this mapping, we will identify the implications for interventions and research on girls’ health and well-being as the crisis evolves across diverse contexts

Adolescent girls and COVID-19: Mapping the evidence on interventions

With the COVID-19 crisis continuing to evolve, evidence on the effectiveness of short-term emergency-oriented responses and long-term mitigation strategies is expanding but still limited. There are, and will continue to be, substantial evidence gaps on programming to address risk across outcomes of importance to adolescent girls. More evidence is needed to slow the risks posed by the pandemic for this subpopulation, which can help guide gender- and age-responsive prevention and impact mitigation investments. Evidence from approaches delivered in other unstable contexts may offer important lessons for decision-making in the current context. Recognizing this, the Population Council conducted a structured review of existing evidence collected prior to the pandemic, across low- and middle-income country contexts (under the auspices of the Adolescent Girls Investment Plan). The review aimed to advance the four goals addressed in this report: reducing girls’ risks of contracting COVID-19; identifying longer-term developmental intervention approaches that hold promise in the recovery period; mitigating the secondary effects of COVID-19 on girls; and identifying priority evidence gaps

Secondary Prevention of Cervical Cancer : ASCO Resource–Stratified Guideline Update

Q2Q2PURPOSE: To update resource-stratified, evidence-based recommendations on secondary prevention of cervical cancer globally. METHODS: American Society of Clinical Oncology convened a multidisciplinary, multinational Expert Panel to produce recommendations reflecting four resource-tiered settings. A review of existing guidelines, formal consensus-based process, and modified ADAPTE process to adapt existing guidelines was conducted. Other experts participated in formal consensus. RESULTS: This guideline update reflects changes in evidence since the previous update. Five existing guidelines were identified and reviewed, and adapted recommendations form the evidence base. Cost-effectiveness analyses provided indirect evidence to inform consensus, which resulted in ≥ 75% agreement. RECOMMENDATIONS: Human papillomavirus (HPV) DNA testing is recommended in all resource settings; visual inspection with acetic acid may be used in basic settings. Recommended age ranges and frequencies vary by the following setting: maximal: age 25-65 years, every 5 years; enhanced: age 30-65 years, if two consecutive negative tests at 5-year intervals, then every 10 years; limited: age 30-49 years, every 10 years; basic: age 30-49 years, one to three times per lifetime. For basic settings, visual assessment is used to determine treatment eligibility; in other settings, genotyping with cytology or cytology alone is used to determine treatment. For basic settings, treatment is recommended if abnormal triage results are obtained; in other settings, abnormal triage results followed by colposcopy is recommended. For basic settings, treatment options are thermal ablation or loop electrosurgical excision procedure; for other settings, loop electrosurgical excision procedure or ablation is recommended; with a 12-month follow-up in all settings. Women who are HIV-positive should be screened with HPV testing after diagnosis, twice as many times per lifetime as the general population. Screening is recommended at 6 weeks postpartum in basic settings; in other settings, screening is recommended at 6 months. In basic settings without mass screening, infrastructure for HPV testing, diagnosis, and treatment should be developed.https://orcid.org/0000-0001-7187-9946Revista Internacional - IndexadaCN

American Society of Clinical Oncology Clinical Practice Guideline Update on Chemotherapy for Stage IV Non–Small-Cell Lung Cancer

The purpose of this article is to provide updated recommendations for the treatment of patients with stage IV non–small-cell lung cancer. A literature search identified relevant randomized trials published since 2002. The scope of the guideline was narrowed to chemotherapy and biologic therapy. An Update Committee reviewed the literature and made updated recommendations. One hundred sixty-two publications met the inclusion criteria. Recommendations were based on treatment strategies that improve overall survival. Treatments that improve only progression-free survival prompted scrutiny of toxicity and quality of life. For first-line therapy in patients with performance status of 0 or 1, a platinum-based two-drug combination of cytotoxic drugs is recommended. Nonplatinum cytotoxic doublets are acceptable for patients with contraindications to platinum therapy. For patients with performance status of 2, a single cytotoxic drug is sufficient. Stop first-line cytotoxic chemotherapy at disease progression or after four cycles in patients who are not responding to treatment. Stop two-drug cytotoxic chemotherapy at six cycles even in patients who are responding to therapy. The first-line use of gefitinib may be recommended for patients with known epidermal growth factor receptor (EGFR) mutation; for negative or unknown EGFR mutation status, cytotoxic chemotherapy is preferred. Bevacizumab is recommended with carboplatin-paclitaxel, except for patients with certain clinical characteristics. Cetuximab is recommended with cisplatin-vinorelbine for patients with EGFR-positive tumors by immunohistochemistry. Docetaxel, erlotinib, gefitinib, or pemetrexed is recommended as second-line therapy. Erlotinib is recommended as third-line therapy for patients who have not received prior erlotinib or gefitinib. Data are insufficient to recommend the routine third-line use of cytotoxic drugs. Data are insufficient to recommend routine use of molecular markers to select chemotherapy

Evidence for Transcript Networks Composed of Chimeric RNAs in Human Cells

The classic organization of a gene structure has followed the Jacob and Monod bacterial gene model proposed more than 50 years ago. Since then, empirical determinations of the complexity of the transcriptomes found in yeast to human has blurred the definition and physical boundaries of genes. Using multiple analysis approaches we have characterized individual gene boundaries mapping on human chromosomes 21 and 22. Analyses of the locations of the 5′ and 3′ transcriptional termini of 492 protein coding genes revealed that for 85% of these genes the boundaries extend beyond the current annotated termini, most often connecting with exons of transcripts from other well annotated genes. The biological and evolutionary importance of these chimeric transcripts is underscored by (1) the non-random interconnections of genes involved, (2) the greater phylogenetic depth of the genes involved in many chimeric interactions, (3) the coordination of the expression of connected genes and (4) the close in vivo and three dimensional proximity of the genomic regions being transcribed and contributing to parts of the chimeric RNAs. The non-random nature of the connection of the genes involved suggest that chimeric transcripts should not be studied in isolation, but together, as an RNA network

Evidence review: Promoting adolescent girls’ health and well-being in low-resource settings in the era of COVID-19

Adolescent girls are among the groups intended to benefit from measures governments enact to control COVID-19, such as travel restrictions and business and school closures. However, given the dual disadvantage adolescent girls face due to age and gender, even approaches that effectively reduce the threat of COVID-19 transmission may exacerbate other threats to their health, safety, and well-being. In response, governments, multilateral agencies, and non-governmental organizations have moved to address these risks, though evidence to support investment decision-making is limited. Clarity on the type, degree, and strength of the evidence in support of interventions that promote adolescent girls’ health and well-being is urgently needed. We are conducting an evidence review to meet this challenge. Based on the findings of a structured literature search of published and selected grey literature sources, we will map the current scope of evidence on relevant interventions in low- and middle-income countries. Based on this mapping, we will identify the implications for interventions and research on girls’ health and well-being as the crisis evolves across diverse contexts