Mapping the knowledge and understanding of menarche, menstrual hygiene and menstrual health among adolescent girls in low- and middle-income countries

Abstract Background Menstruation is a natural physiological process that requires proper management. Unlike other normal bodily processes, menstruation is linked with religious and cultural meanings that can affect the perceptions of young girls as well as the ways in which the adults in the communities around them respond to their needs. Objectives This review aims to answer the following questions: (1) how knowledgeable are adolescent girls in low- and middle-income countries about menstruation and how prepared are they for reaching menarche, (2) who are their sources of information regarding menstruation, (3) how well do the adults around them respond to their information needs, (4) what negative health and social effects do adolescents experience as a result of menstruation, and (5) how do adolescents respond when they experience these negative effects and what practices do they develop as a result? Methods Using a structured search strategy, articles that investigate young girls’ preparedness for menarche, knowledge of menstruation and practices surrounding menstrual hygiene in LMIC were identified. A total of 81 studies published in peer-reviewed journals between the years 2000 and 2015 that describe the experiences of adolescent girls from 25 different countries were included. Results Adolescent girls in LMIC are often uninformed and unprepared for menarche. Information is primarily obtained from mothers and other female family members who are not necessarily well equipped to fill gaps in girls’ knowledge. Exclusion and shame lead to misconceptions and unhygienic practices during menstruation. Rather than seek medical consultation, girls tend to miss school, self-medicate and refrain from social interaction. Also problematic is that relatives and teachers are often not prepared to respond to the needs of girls. Conclusion LMIC must recognize that lack of preparation, knowledge and poor practices surrounding menstruation are key impediments not only to girls’ education, but also to self-confidence and personal development. In addition to investment in private latrines with clean water for girls in both schools and communities, countries must consider how to improve the provision of knowledge and understanding and how to better respond to the needs of adolescent girls

Influence of Milling Process Parameters on Machined Surface Quality of Carbon Fibre Reinforced Polymer (CFRP) Composites Using Taguchi Analysis And Grey Relational Analysis

The article presents the milled surface quality of Uni-Directional Carbon Fibre Reinforced Polymer (UD-CFRP) composites from Taguchi’s and grey relational analysis. The novelty is demonstrating the possibility of detecting the surface defects in polymer composites during milling using SEM analysis. The material used for this study is UD-CFRP composite laminates and made by hand-layup process. All the milling operations were carried out using a solid tungsten carbide end milling tool and experiments conducted on CNC milling machine. Taguchi L9, 3-level orthogonal array was considered for experimentation. Analysis of Variance (ANOVA) was conducted to explore the significance of each individual input process parameters on multiple performance characteristics. Optimal process parameters are thoroughly validated by grey relational grade achieved by the grey relational analysis for multi performance characteristics. Finally, experimental results were correlated and analyzed with scanning electron micrographs using Scanning Electron Microscope (SEM)

Studies on haloquinolines: Part I - Synthesis and characterisation of substituted haloquinolines

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A simple method for generating full length cDNA from low abundance partial genomic clones

BACKGROUND: PCR amplification of target molecules involves sequence specific primers that flank the region to be amplified. While this technique is generally routine, its applicability may not be sufficient to generate a desired target molecule from two separate regions involving intron /exon boundaries. For these situations, the generation of full-length complementary DNAs from two partial genomic clones becomes necessary for the family of low abundance genes. RESULTS: The first approach we used for the isolation of full-length cDNA from two known genomic clones of Hox genes was based on fusion PCR. Here we describe a simple and efficient method of amplification for homeobox D13 (HOXD13) full length cDNA from two partial genomic clones. Specific 5' and 3' untranslated region (UTR) primer pairs and website program (primer3_www.cgv0.2) were key steps involved in this process. CONCLUSIONS: We have devised a simple, rapid and easy method for generating cDNA clone from genomic sequences. The full length HOXD13 clone (1.1 kb) generated with this technique was confirmed by sequence analysis. This simple approach can be utilized to generate full-length cDNA clones from available partial genomic sequences

Alternative Strategies to Reduce Maternal Mortality in India: A Cost-Effectiveness Analysis

A cost-effectiveness study by Sue Goldie and colleagues finds that better family planning, provision of safe abortion, and improved intrapartum and emergency obstetrical care could reduce maternal mortality in India by 75% in 5 years

"Eat and you will be eaten": a qualitative study exploring costs and benefits of age-disparate sexual relationships in Tanzania and Uganda: implications for girls' sexual and reproductive health interventions

BACKGROUND: Age-disparate sex is associated with increased HIV risk among adolescent girls and young women (AGYW) in sub-Saharan Africa. However, little has been done to understand the dynamics of such relationships from the perspectives of either AGYW or older men, and the communities in which these relationships are embedded. This article explores the motivations and perceived benefits of such relationships for AGYW and older men, plus the social and sexual and reproductive health (SRH) consequences. METHODS: This study held 37 participatory focus group discussions and 87 in-depth interviews with young people aged 14-24 and adult community members aged 25-49 in rural and urban Tanzania and Uganda. Participants were sampled using purposive and snowball techniques. Thematic analysis was conducted with the aid of NVIVO 10 software. RESULTS: Motivations, perceived benefits and costs for AGYW centred around four main themes: financial motivations, emotional support, meeting social expectations and reflections on sexual health. Specifically, AGYW noted that older partners gave gifts/money of higher value compared with younger men. Men's perceived benefits and costs revolved around the need to satisfy their sexual desire, the perception that AGYW were capable of engaging in new and creative sexual styles and their desire for prestige among male peers. Both AGYW and men recognised the social and SRH consequences as: risk of violence, social stigma, risk of unplanned pregnancy and risk of sexually transmitted infections including HIV. CONCLUSION: Interventions need to acknowledge the perceived benefits of age-disparate sexual relationships for AGYW and older men and engage them in critical reflection on the medium- to longer-term consequences versus the shorter-term satisfaction of needs, desires and aspirations, as a way to navigate the constrained opportunities they face given existing structural limitations. Interventions should also tackle the structural constraints AGYW face by helping them access resources, become empowered and challenge the expectation of having to depend financially on men. Interventions with men should unpack the assumption that men are naturally hypersexual. The role of peers for both girls and men should be acknowledged, and a shift from individual targeted interventions to changing norms at the community level should be considered