| 1. Title: Contraceptive use among postpartum women - 12 states and New York City, 2004-2006. Author: Centers for Disease Control and Prevention (CDC) Source: MMWR. Morbidity and Mortality Weekly Report. 2009 Aug 7;58(30):821-6. Abstract: Postpartum use of highly effective contraceptive methods can prevent unintended pregnancies and ensure adequate birth spacing. Unintended pregnancies and short interpregnancy intervals are associated with adverse maternal and infant outcomes. In 2001, the year for which the most recent data are available, 49% of all pregnancies were unintended, and 21% of women gave birth within 24 months of a previous birth. Two Healthy People 2010 goals are to increase the percentage of intended pregnancies to 70% (objective 9-1) and to reduce the percentage of births occurring within 24 months of a previous birth to 6% (objective 9-2). To estimate the prevalence and types of contraception being used by women 2-9 months postpartum, CDC analyzed data from the 2004-2006 Pregnancy Risk Assessment Monitoring System (PRAMS) from 12 states and New York City. This report summarizes those results, which indicated that 88.0% of postpartum women reported current use of at least one contraceptive method; 61.7% reported using a method defined as highly effective, 20.0% used a method defined as moderately effective, and 6.4% used less effective methods. Rates of using highly effective contraceptive methods postpartum were lowest among Asian/Pacific Islanders (35.3%), women who had wanted to get pregnant sooner (49.9%), women aged >or=35 years (53.0%), and women who had no prenatal care (54.5%). State policy makers and health-care providers can use these results to promote use of highly effective contraception among postpartum women and target interventions for those with particularly low rates of usage, including women with no prenatal care. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | DATA ANALYSIS | POSTPARTUM WOMEN | ETHNIC GROUPS | CDC | CONTRACEPTIVE USAGE | CONTRACEPTIVE METHODS CHOSEN | CONTRACEPTIVE EFFECTIVENESS | PREGNANCY, UNPLANNED | AGE FACTORS | TITLE 19 MEDICAL ASSISTANCE | Developed Countries | North America | Americas | Research Methodology | Puerperium | Reproduction | Cultural Background | Population Characteristics | Demographic Factors | Population | USPHS | Government Agencies | Organizations | Political Factors | Sociocultural Factors | Contraception | Family Planning | Reproductive Behavior | Fertility | Population Dynamics | Public Assistance | Grants | Financial Activities | Economic Factors Document Number: 342395 |
2.  Title: [Global Burden of Diseases, Injuries and Risk Factors Study] operations manual. Final draft. Author: Harvard University; University of Washington. Institute for Health Metrics and Evaluation; Johns Hopkins University; University of Queensland; World Health Organization [WHO] Source: [Cambridge, Massachusetts, Harvard University, 2009 Jan 20 142 p. Abstract: The final draft of the Global Burden of Diseases, Injuries and Risk Factors Study Operations Manual is intended to serve as a guide for the Expert Groups working on the GBD Study. There are opportunities to provide input and feedback, and instructions to do so are included in the operations manual. The new Global Burden of Diseases, Injuries, and Risk Factors Study (the GBD 2005 Study), which commenced in the spring of 2007, is led by a consortium including Harvard University, the Institute for Health Metrics and Evaluation at the University of Washington, Johns Hopkins University, the University of Queensland, and the World Health Organization WHO). It is the first major effort since the GBD 1990 Study to carry out a complete systematic assessment of the data on all diseases and injuries, and produce comprehensive and comparable estimates of the burden of diseases, injuries and risk factors for two time periods, 1990 and 2005. By November 2010 the project will produce a final set of estimates. (Excerpts) Language: English Keywords: GLOBAL | MANUAL | DATA ANALYSIS | ESTIMATION TECHNIQUES | DISABLED PERSONS AND DISABILITIES | DISEASES | ACCIDENTS AND INJURIES | MORTALITY | RISK FACTORS | EPIDEMIOLOGY | INCIDENCE | PREVALENCE | RISK ASSESSMENT | BIAS | Research Methodology | Population Characteristics | Demographic Factors | Population | Health | Population Dynamics | Public Health | Measurement | Evaluation | Error Sources Document Number: 331797 |
| 3. Title: Spatial analysis of logistics indicator data for health commodities. Author: John Snow [JSI]. DELIVER Source: Arlington, Virginia, JSI, DELIVER, 2009 Jul. 6 p. Abstract: The USAID | DELIVER PROJECT has developed robust monitoring and evaluation tools to quantitatively and qualitatively assess the performance of logistics systems for essential health commodities. The purpose of this paper is to explore how analysis of stock indicators by location provides added value to these data sets, through a relatively minor investment in GPS devices and GIS software. Beginning with visual examination of logistics indicator data within a geographic context and progressing to network analysis, each of the spatial analysis methods presented in this paper presents its own set of strengths and weaknesses, yet they all excel in providing insights into the logistics system that might not otherwise be understood or even observed by simply looking at tabular data of stock levels for different facilities in the health system. Since a logistics system is inherently a geographically heterogeneous entity, using cartographic and spatial analysis tools may prove to be a crucial asset in assisting managers to identify key questions related to the performance of the logistics system and focus on potential causes and solutions. Moving forward, it will be useful to build off of the descriptive strengths of the spatial analysis methods described herein and begin building more robust statistical models that measure correlation between different components of the logistics system and commodity availability, while still accounting for the geographical variability of the data. (Excerpts) Language: English Keywords: ZAMBIA | PARAGUAY | SUMMARY REPORT | PILOT PROJECTS | DATA COLLECTION | DATA ANALYSIS | USAID | LOGISTICS | GEOGRAPHY | INFORMATION RETRIEVAL SYSTEMS | DISTANCE | STREETS AND ROADS | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | South America, Central | South America | Latin America | Americas | Studies | Research Methodology | Government Agencies | Organizations | Political Factors | Sociocultural Factors | Management | Organization and Administration | Social Sciences | Science | Data Storage and Retrieval | Information Processing | Information | Geographic Factors | Population | Transportation | Economic Factors Document Number: 331660 |
4.  Title: The quality of family planning services and client satisfaction in the public and private sectors in Kenya. Author: Agha S; Do M Source: International Journal For Quality In Health Care. 2009 Apr;21(2):87-96. Abstract: OBJECTIVE: To compare the quality of family planning services delivered at public and private facilities in Kenya. METHODS: Data from the 2004 Kenya Service Provision Assessment were analysed. The Kenya Service Provision Assessment is a representative sample of health facilities in the public and private sectors, and comprises data obtained from a facility inventory, service provider interviews, observations of client-provider interactions and exit interviews. Quality-of-care indicators are compared between the public and private sectors along three dimensions: structure, process and outcome. RESULTS: Private facilities were superior to public sector facilities in terms of physical infrastructure and the availability of services. Public sector facilities were more likely to have management systems in place. There was no difference between public and private providers in the technical quality of care provided. Private providers were better at managing interpersonal aspects of care. The higher level of client satisfaction at private facilities could not be explained by differences between public and private facilities in structural and process aspects of care. CONCLUSIONS: Formal private sector facilities providing family planning services exhibit greater readiness to provide services and greater attention to client needs than public sector facilities in Kenya. Consistent with this, client satisfaction is much higher at private facilities. Technical quality of care provided is similar in public and private facilities. Language: English Keywords: KENYA | RESEARCH REPORT | DATA ANALYSIS | CLIENTS | FAMILY PLANNING | SATISFACTION | PUBLIC SECTOR | PRIVATE SECTOR | QUALITY OF HEALTH CARE | HEALTH SERVICES | REPRODUCTIVE HEALTH | PROGRAM EVALUATION | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Program Activities | Programs | Organization and Administration | Psychological Factors | Behavior | Macroeconomic Factors | Economic Factors | Health Services Evaluation | Delivery of Health Care | Health Document Number: 342098 |
| 5. Title: Perception and practice of emergency contraception among female undergraduates of the University of Ibadan, Nigeria. Author: Bello FA; Olayemi O; Fawole AO; Ogunbode OO; Sobukunola T Source: Journal of Reproduction and Contraception. 2009 Jun;20(2):113-121. Abstract: The authors performed a cross-sectional questionnaire study with 383 female undergraduates in Nigeria in June 2006 to assess their perceptions about and proper use of emergency contraception (EC). One hundred and five (48.2%) of the students had been sexually exposed. Only 32 (30.5%) used regular contraception. Seventy-three (24.3%) female undergraduates were aware of EC. Only 29 (7.6%) had used EC before. Most would not use EC drugs in the future due to lack of awareness (64.8%), fear for future fertility, and fear that EC was injurious to health. Use of EC was associated with awareness of correct interval for use. The authors concluded that there was poor knowledge about EC and poor use. Most knowledge was acquired from peers and was inaccurate. Language: English Keywords: NIGERIA | RESEARCH REPORT | DATA ANALYSIS | YOUTH | STUDENTS | ADOLESCENTS, FEMALE | EMERGENCY CONTRACEPTION | CONTRACEPTIVE AGENTS, POSTCOITAL | KNOWLEDGE | PEER EDUCATORS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Research Methodology | Age Factors | Population Characteristics | Demographic Factors | Population | Education | Adolescents | Contraception | Family Planning | Contraceptive Agents, Female | Contraceptive Agents | Sociocultural Factors Document Number: 339903 |
| 6. Peer Reviewed Title: Preventive service needs of young people perinatally infected with HIV in Uganda. Author: Birungi H; Obare F; Mugisha JF; Evelia H; Nyombi J Source: AIDS Care. 2009 Jun;21(6):725-731. Abstract: This study examines the sexual expressions and experiences as well as the preventive practices of 732 adolescent boys and girls aged 15-19 years who were born with HIV. The data come from a project on the sexuality of young people perinatally infected with HIV conducted in 2007 in four districts of Uganda. The analysis involves both quantitative and qualitative approaches. The quantitative approach entails cross-tabulations with chi-square tests as well as significance tests of proportions. The qualitative approach involves an analysis of individual case stories, in-depth probes, and focus group discussions for content. The findings show disconnect between: (1) the information service providers give to young people and young people's actual needs and desires; (2) adolescents' fears and their actual preventive practices; and (3) the high level of reported condom use and the frequency of use. Programs need to recognize that young people perinatally infected with HIV are sexually active or anticipatebeing so in future. Language: English Keywords: UGANDA | RESEARCH REPORT | DATA ANALYSIS | YOUTH | PERSONS LIVING WITH HIV/AIDS | ADOLESCENT PREGNANCY | HIV INFECTIONS | AIDS | HIV PREVENTION | SEX BEHAVIOR | FEAR | CONDOM USE | PREGNANCY, UNWANTED | REPRODUCTIVE HEALTH | HEALTH SERVICES | NEEDS | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Age Factors | Population Characteristics | Demographic Factors | Population | Viral Diseases | Diseases | Reproductive Behavior | Fertility | Population Dynamics | Behavior | Emotions | Psychological Factors | Risk Reduction Behavior | Health | Delivery of Health Care | Economic Factors Document Number: 339860 |
| 7. Title: Community characteristics, sexual initiation, and condom use among young Black South Africans. Author: Burgard SA; Lee-Rife SM Source: Journal of Health and Social Behavior. 2009 Sep;50(3):293-309. Abstract: Individual and household-level characteristics that influence sexual behavior have been extensively studied in South Africa, but community characteristics have received limited attention. We use multilevel discrete time hazard models and multilevel logistic regression models to analyze data from a representative sample of young people in KwaZulu Natal, and from several sources of community data. Results suggest that, net of individual and household characteristics, higher levels of community concentrated disadvantage are associated with increased hazard of sexual initiation and higher risk of unprotected sex. Social disorder increases the hazard of sexual initiation, while greater community social cohesion is associated with delayed sexual debut, although the latter association appears stronger for young men than for young women. We discuss these results and the ways they vary from predictions based on US. theory in light of conditions prevailing in contemporary South Africa. Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | DATA ANALYSIS | BLACKS | YOUTH | HOUSEHOLDS | SEX BEHAVIOR | AGE FACTORS | SOCIOECONOMIC FACTORS | RISK FACTORS | EXPOSURE | POPULATION CHARACTERISTICS | COMMUNITY | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Research Methodology | Ethnic Groups | Cultural Background | Demographic Factors | Population | Family and Household | Sociocultural Factors | Behavior | Economic Factors | Health | Residence Characteristics | Population Distribution | Geographic Factors Document Number: 342565 |
| 8. Title: Evolution of the nourishing condition on children submitted to additional feeding program in county of state of Sao Paulo, Brazil. Evolucao do estado nutricional de criancas submetidas a um programa de suplementacao alimentar em municipio do estado de Sao Paulo. Author: Carvalho LG; Saldiva SR; da Costa Rosa TE; Lei DL Source: Revista de Nutricao / Brazilian Journal of Nutrition. 2009 Mar-Apr;22(2):207-217. Abstract: The objective of this study was to assess the impact of the Program Incentive to Fight Nutritional Deficiencies in the city of Assis, state of Sao Paulo. Methods A total of 132 children under 24 months who participated in the Program Incentive to Fight Nutritional Deficiencies for one year were followed. Their nutritional status was determined by comparing their weight-for-age in z-scores at baseline and after 2, 6, 9 and 12 months of follow-up to that of the reference population median given by the National Center for Health Statistics. Results Most (70%) of the children were classified as undernourished or at risk or malnutrition when they joined the Program Incentive to Fight Nutritional Deficiencies. After 12 months in the program, 64% of the children presented an increase in their weight-for-age z-score. Analysis of the mean weight-for-age z-score variation over time, according to age group and nutritional status at baseline, showed that children under 12 months of age had a significant increase in weight-for-age z-score. Conclusion Malnourished children under one year of age were the ones who benefited most from the Program Incentive to Fight Nutritional Deficiencies. Language: Portuguese Keywords: BRAZIL | RESEARCH REPORT | DATA ANALYSIS | CHILDREN | DEFICIENCY DISEASES | NUTRITION DISORDERS | MALNUTRITION | NUTRITION INDEXES | INFANT NUTRITION | BODY WEIGHT | IMPACT | NUTRITION PROGRAMS | PROGRAM EVALUATION | South America, Eastern | South America | Latin America | Americas | Developing Countries | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Diseases | Nutrition | Health | Physiology | Biology | Communication | Primary Health Care | Health Services | Delivery of Health Care | Programs | Organization and Administration Document Number: 340199 |
| 9. Peer Reviewed Title: National expansion of antiretroviral treatment in Thailand, 2000-2007: program scale-up and patient outcomes. Author: Chasombat S; McConnell MS; Siangphoe U; Yuktanont P; Jirawattanapisal T; Fox K; Thanprasertsuk S; Mock PA; Ningsanond P; Lertpiriyasuwat C; Pinyopornpanich S Source: Journal of Acquired Immune Deficiency Syndromes. 2009 Apr 15;50(5):506-12. Abstract: OBJECTIVE: Thailand began a national antiretroviral (ARV) treatment program in 2000, and all government and some private and university hospitals now provide treatment to eligible HIV-infected patients. We describe program scale-up and patient outcomes from 2000 to 2007. METHODS: Data from 839 hospitals in all 76 provinces of Thailand were included in this analysis. Outcomes were assessed for patients initiating ARV treatment from January 2000 to December 2005. Follow-up data through March 2007 were included; lost to follow-up was defined as >3 months late for a follow-up visit. A Cox proportional hazard model was used to assess risk factors for death; the Kaplan-Meier method was used to estimate survival probabilities. RESULTS: Outcome data are reported for 58,008 patients. Among these, 52.2% were male; at treatment initiation, the median age was 34 years, the median CD4 count was 41 cells per cubic millimeter, and 50.5% had AIDS. The initial regimen was nevirapine and 2 nonnucleoside reverse transcriptase inhibitors for 92.4% of patients; median follow-up time was 1.6 years (interquartile range = 0.8-2.4 years). Lost to follow-up occurred in 8.8% of patients. Overall 1-year survival was 0.89 (95% confidence interval = 0.88 to 0.89). Death was significantly associated with male sex, age >40 years, baseline CD4 count <100 cells per cubic millimeter, symptomatic HIV or AIDS, receipt of services at a district or community hospital, and treatment initiation before 2005. CONCLUSIONS: National ARV treatment programs can be scaled up rapidly with good patient outcomes. Treatment outcomes among patients in Thailand are comparable to those reported in smaller cohorts in other countries, and survival rates have improved since 2004. Language: English Keywords: THAILAND | RESEARCH REPORT | DATA ANALYSIS | PERSONS LIVING WITH HIV/AIDS | ANTIRETROVIRAL THERAPY | TREATMENT | PROGRAM EVALUATION | Developing Countries | Asia, Southeastern | Asia | Research Methodology | HIV Infections | Viral Diseases | Diseases | HIV | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Programs | Organization and Administration Document Number: 331223 |
| 10. Peer Reviewed Title: Trends in primary and secondary abstinence among Kenyan youth. Author: Chiao C; Mishra V Source: AIDS Care. 2009 Jul;Calverton, Maryland, Macro International, Demographic and Health Research Division, MEASURE DHS, 2007 Nov. 21(7):881-892. 15 p. (DHS Working Papers No. 36USAID Contract No. GPO-C-00-03-00002-00) Abstract: The authors used data from Kenya Demographic and Health Surveys in 1993, 1998, and 2003 to examine 10-year trends in primary and secondary abstinence among never-married youth ages 15–24 and to explore the role of HIV prevention knowledge, schooling, and contextual factors in affecting their abstinence behaviors. Their analysis shows that both primary and secondary abstinence levels have risen in the past 10 years, with the abstinence levels higher among females than among males. Logistic regression models indicate that knowledge that abstinence can prevent HIV infection was positively associated with the likelihood of practicing abstinence. However, knowledge that condom use can prevent HIV infection was associated with lower abstinence practice. In-school youth were more likely to abstain from sex than those working. Effects of the contextual variables were only significant on the likelihood of primary abstinence among female youth. Language: English Keywords: KENYA | TECHNICAL REPORT | DEMOGRAPHIC AND HEALTH SURVEYS | DATA ANALYSIS | YOUTH | ADOLESCENTS | STUDENTS | PRIMARY SCHOOLS | SECONDARY SCHOOLS | ABSTINENCE | HIV INFECTIONS | TRANSMISSION | HIV PREVENTION | KNOWLEDGE | CONDOM USE | BEHAVIOR | SEX EDUCATION | PROGRAM EFFECTIVENESS | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Research Methodology | Age Factors | Population Characteristics | Education | Schools | Family Planning, Behavioral Methods | Family Planning | Viral Diseases | Diseases | Infections | Sociocultural Factors | Risk Reduction Behavior | Program Evaluation | Programs | Organization and Administration Document Number: 322987 |
| 11. Peer Reviewed Title: Comparison of laboratory methods for analysis of non-nucleoside reverse transcriptase inhibitor resistance in Ugandan infants. Author: Church JD; Huang W; Parkin N; Marlowe N; Guay LA; Omer SB; Musoke P; Jackson JB; Eshleman SH Source: AIDS Research and Human Retroviruses. 2009 Jul;25(7):657-63. Abstract: Detailed comparisons of HIV drug resistance assays are needed to identify the most useful assays for research studies, and to facilitate comparison of results from studies that use different methods. We analyzed nonnucleoside reverse transcriptase inhibitor (NNRTI) resistance in 40 HIV-infected Ugandan infants who had received nevirapine (NVP)-based prophylaxis using the following assays: an FDA-cleared HIV genotyping assay (the ViroSeq HIV-1 Genotyping System v2.0), a commercially available HIV genotyping assay (GeneSeq HIV), a commercially available HIV phenotyping assay (PhenoSense HIV), and a sensitive point mutation assay (LigAmp). ViroSeq and GeneSeq HIV results (NVP resistance yes/no) were similar for 38 (95%) of 40 samples. In 6 (15%) of 40 samples, GeneSeq HIV detected mutations in minor subpopulations that were not detected by ViroSeq, which identified two additional infants with NVP resistance. LigAmp detected low-level mutations in 12 samples that were not detected by ViroSeq; however, LigAmp testing identified only one additional infant with NVP resistance. GeneSeq HIV and PhenoSense HIV determinations of susceptibility differed for specific NNRTIs in 12 (31%) of the 39 samples containing mixtures at relevant mutation positions. PhenoSense HIV did not detect any infants with NVP resistance who were not identified with GeneSeq HIV testing. In this setting, population sequencing-based methods (ViroSeq and GeneSeq HIV) were the most informative and had concordant results for 95% of the samples. LigAmp was useful for the detection and quantification of minority variants. PhenoSense HIV provided a direct and quantitative measure of NNRTI susceptibility. Language: English Keywords: UGANDA | RESEARCH REPORT | DATA ANALYSIS | COMPARATIVE STUDIES | RESEARCH METHODOLOGY | INFANT | PERSONS LIVING WITH HIV/AIDS | HIV | POPULATION GENETICS | LABORATORY PROCEDURES | HIV TESTING | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Studies | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | Genetics | Biology | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 342880 |
| 12. Peer Reviewed Title: Malaria transmission in two localities in north-western Argentina. Author: Dantur Juri MJ; Zaidenberg M; Claps GL; Santana M; Almiron WR Source: Malaria Journal. 2009;8:18. Abstract: BACKGROUND: Malaria is one of the most important tropical diseases that affects people globally. The influence of environmental conditions in the patterns of temporal distribution of malaria vectors and the disease has been studied in different countries. In the present study, ecological aspects of the malaria vector Anopheles (Anopheles) pseudopunctipennis and their relationship with climatic variables, as well as the seasonality of malaria cases, were studied in two localities, El Oculto and Aguas Blancas, in north-western Argentina. METHODS: The fluctuation of An. pseudopunctipennis and the malaria cases distribution was analysed with Random Effect Poisson Regression. This analysis takes into account the effect of each climatic variable on the abundance of both vector and malaria cases, giving as results predicted values named Incidence Rate Radio. RESULTS: The number of specimens collected in El Oculto and Aguas Blancas was 4224 (88.07%) and 572 (11.93%), respectively. In El Oculto no marked seasonality was found, different from Aguas Blancas, where high abundance was detected at the end of spring and the beginning of summer. The maximum mean temperature affected the An. pseudopunctipennis fluctuation in El Oculto and Aguas Blancas. When considering the relationship between the number of malaria cases and the climatic variables in El Oculto, maximum mean temperature and accumulated rainfall were significant, in contrast with Aguas Blancas, where mean temperature and humidity showed a closer relationship to the fluctuation in the disease. CONCLUSION: The temporal distribution patterns of An. pseudopunctipennis vary in both localities, but spring appears as the season with better conditions for mosquito development. Maximum mean temperature was the most important variable in both localities. Malaria cases were influenced by the maximum mean temperature in El Oculto, while the mean temperature and humidity were significant in Aguas Blancas. In Aguas Blancas peaks of mosquito abundance and three months later, peaks of malaria cases were observed. The study reported here will help to increase knowledge about not only vectors and malaria seasonality but also their relationships with the climatic variables that influence their appearances and abundances. Language: English Keywords: ARGENTINA | RESEARCH REPORT | DATA ANALYSIS | MALARIA | SEASONAL VARIATION | South America, Southern | South America | Latin America | Americas | Developing Countries | Research Methodology | Parasitic Diseases | Diseases | Population Dynamics | Demographic Factors | Population Document Number: 330545 |
| 13. Title: Factor structure of the Condoms Barriers Scale with a sample of men at high risk for HIV. Author: Doyle SR; Calsyn DA; Ball SA Source: Assessment. 2009 Mar;16(1):3-15. Abstract: This study assesses the psychometric properties of the Condom Barriers Scale (CBS), an instrument originally designed to measure women's perceptions and attitudes regarding male condom use, with a sample of men at high risk for human immunodeficiency virus (HIV). Participants include 590 male patients in drug abuse treatment involved in a gender-specific HIV prevention intervention for teaching safer sex skills. Second-order confirmatory factor analysis generally supported the underlying four-factor subscale structure of the CBS. However, exploratory factor analysis revealed a few specific discrepancies in the factor structure between men and women. Internal consistency and test-retest reliability estimates were moderate to high in value. CBS scores correlated with use of condoms for men with high-risk sexual partners, supporting criterion-related validity. Overall, the analysis indicates that the CBS is a potentially valid and reliable instrument and has utility for assessing barriers to condom use with men, but may need some item content modifications to allow appropriate assessment of gender differences and comparisons across studies. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | DATA ANALYSIS | RELIABILITY | PRE-POST TESTS | MEN | CONDOMS | SEX EDUCATION | RISK REDUCTION BEHAVIOR | BARRIER METHODS | PREVENTION AND CONTROL | Developed Countries | North America | Americas | Research Methodology | Measurement | Program Evaluation | Programs | Organization and Administration | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning | Education | Behavior | Diseases Document Number: 330489 |
| 14. Title: [Analysis of the mortality due to diarrhea in younger children, before and after the introduction of rotavirus vaccine] Mortalidad por enfermedad diarreica en menores, antes y despues de la Author: Esparza-Aguilar M; Bautista-Marquez A; Gonzalez-Andrade Mdel C; Richardson-Lopez-Collada VL Source: Salud Publica de Mexico. 2009 Jul-Aug;51(4):285-90. Abstract: OBJECTIVE: To analyze the mortality due to acute diarrhea in children younger than five years old, before and after the introduction of rotavirus vaccine in Mexico. MATERIAL AND METHODS: Number of deaths and mortality rates due to acute diarrhea were compared by children's age and states' vaccine status using annual percentage differences before (2000-2005) and after (2006-2007) the introduction of the HRV. RESULTS: From 2000-2007, deaths due to acute diarrhea in children under five years of age dropped 42%. In those states that received the HRV early in 2006, diarrhea mortality decreased between 2006-2007 15.8% in children younger than one year old and 22.7% in children 1-4 years old. DISCUSSION: The observed reduction in mortality due to acute diarrhea in children under five years of age after 2005 can be, in part, attributed to the HRV. Language: Spanish Keywords: MEXICO | RESEARCH REPORT | DATA ANALYSIS | CHILDREN | DIARRHEA | ROTAVIRUS | CHILD MORTALITY | AGE FACTORS | North America | Americas | Developing Countries | Research Methodology | Youth | Population Characteristics | Demographic Factors | Population | Diseases | Viral Diseases | Mortality | Population Dynamics Document Number: 342523 |
| 15. Peer Reviewed Title: Role of breastfeeding cessation in mediating the relationship between maternal HIV disease stage and increased child mortality among HIV-exposed uninfected children. Author: Fox MP; Brooks DR; Kuhn L; Aldrovandi G; Sinkala M; Kankasa C; Horsburgh R; Thea DM Source: International Journal of Epidemiology. 2009 Apr;38(2):569-76. Abstract: BACKGROUND: Maternal CD4 count predicts child mortality in HIV-uninfected children born to HIV-infected women. METHODS: To explore the mediating role of breastfeeding cessation in this relationship, we compared marginal structural models of maternal CD4 count on child death with and without adjustment for breastfeeding. RESULTS: In crude analyses, children of mothers with CD4<200 during pregnancy were 3.2 times more likely to die by 18 months (CI 1.3-8.1) as children whose mothers had CD4>500. Earlier breastfeeding cessation was also associated with low CD4 (HR 1.8; CI 1.2-2.7). After adjusting for breastfeeding and low birth weight using a marginal structural model, the low CD4 count-child mortality association through 18 months was reduced 17%. The change was overestimated using a traditional Cox proportional hazards model (35% reduction in HR from 3.4 to 2.5). CONCLUSIONS: Our analysis suggests that only a small part of the effect of low vs high CD4 count on child mortality through 18 months is mediated through breastfeeding cessation. Our results must be taken into account when deciding whether or not to recommend breastfeeding for infants of HIV-infected mothers. Language: English Keywords: AFRICA | RESEARCH REPORT | DATA ANALYSIS | CHILDREN | CHILD MORTALITY | BREASTFEEDING | INFANT MORTALITY | HIV | RESEARCH METHODOLOGY | Developing Countries | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Mortality | Population Dynamics | Infant Nutrition | Nutrition | Health | HIV Infections | Viral Diseases | Diseases Document Number: 341015 |
| 16. Title: Trends of abortion complications in a transition of abortion law revisions in Ethiopia. Author: Gebrehiwot Y; Liabsuetrakul T Source: Journal of Public Health. 2009 Mar;31(1):81-7. Abstract: BACKGROUND: Evidence from developed countries has shown that abortion-related mortality and morbidity has decreased with the liberalization of the abortion law. This study aimed to assess the trend of hospital-based abortion complications during the transition of legalization in Ethiopia in May 2005. METHODS: Medical records of women with abortion complications from 2003 to 2007 were reviewed (n = 773). Abortion and its complications with regard to legalization were described by rates and ratios, and predictors of fatal outcomes were analyzed by logistic regression. RESULTS: The overall and abortion-related maternal mortality ratios (AMMRs) showed a non-statistically significant downward trend over the 5-year period. However, the case fatality rate of abortion increased from 1.1% in 2003 to 3.6% in 2007. Late gestational age, history of interference and presenting after new abortion legislation passed have been found to be significant predictors of mortality. CONCLUSION: Decreased trends of abortion ratio and the AMMR were identified, but the severity of abortion complications and the case fatality rate increased during the transition of legal revision. Language: English Keywords: ETHIOPIA | RESEARCH REPORT | DATA ANALYSIS | CLIENTS | ABORTION | ABORTION LAW | MATERNAL MORTALITY | MORTALITY CHANGES | ABORTION RATE | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Program Activities | Programs | Organization and Administration | Fertility Control, Postconception | Family Planning | Mortality | Population Dynamics | Demographic Factors | Population Document Number: 341640 |
| 17. Peer Reviewed Title: Tackling health inequities in Chile: maternal, newborn, infant, and child mortality between 1990 and 2004. Author: Gonzalez R; Requejo JH; Nien JK; Merialdi M; Bustreo F; Betran AP Author: Chile Maternal, Newborn, and Child Health Writing Group Source: American Journal of Public Health. 2009 Jul;99(7):1220-6. Abstract: OBJECTIVES: We analyzed trends in maternal, newborn, and child mortality in Chile between 1990 and 2004, after the introduction of national interventions and reforms, and examined associations between trends and interventions. METHODS: Data were provided by the Chilean Ministry of Health on all pregnancies between 1990 and 2004 (approximately 4,000,000). We calculated yearly maternal mortality ratios, stillbirth rates, and mortality rates for neonates, infants (aged > 28 days and < 1 year), and children aged 1 to 4 years. We also calculated these statistics by 5-year intervals for Chile's poorest to richest district quintiles. RESULTS: During the study period, the maternal mortality ratio decreased from 42.1 to 18.5 per 100,000 live births. The mortality rate for neonates decreased from 9.0 to 5.7 per 1000 births, for infants from 7.8 to 3.1 per 1000 births, and for young children from 3.1 to 1.7 per 1000 live births. The stillbirth rate declined from 6.0 to 5.0 per 1000 births. Disparities in these mortality statistics between the poorest and richest district quintiles also decreased, with the largest mortality reductions in the poorest quintile. CONCLUSIONS: During a period of socioeconomic development and health sector reforms, Chile experienced significant mortality and inequity reductions. Language: English Keywords: CHILE | RESEARCH REPORT | DATA ANALYSIS | INFANT | CHILDREN | CHILD MORTALITY | MATERNAL MORTALITY | DEATH RATE | PARITY SPECIFIC BIRTH RATE | INEQUALITIES | PREVENTION AND CONTROL | Developing Countries | South America, Southern | South America | Latin America | Americas | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Mortality | Population Dynamics | Fertility Rate | Birth Rate | Fertility Measurements | Fertility | Socioeconomic Factors | Economic Factors | Diseases Document Number: 342239 |
| 18. Peer Reviewed Title: Recent increase in sex ratio at birth in Viet Nam. Author: Guilmoto CZ; Hoang X; Van TN Source: PLoS One. 2009;4(2):e4624. Abstract: INTRODUCTION: Since the 1980s, sex ratio at birth (male births per 100 female births) has increased in many Asian countries as a result of selective abortions, but to date there has been no such evidence for Viet Nam. Our aim in this paper is to ascertain the situation with respect to sex ratio at birth in Viet Nam over the past five years. MATERIALS AND METHODS: Original data were obtained from sample population surveys in Viet Nam recording annual birth rates since 2000 of about 450,000 women, as well as from two successive birth surveys conducted for the first time in 2007 (1.1 million births). The annual population surveys include specific information on birth history and mothers' characteristics to be used for the analysis of trends and differentials in sex ratio at birth. RESULTS AND DISCUSSION: Birth history statistics indicate that the SRB in Viet Nam has recorded a steady growth since 2001. Starting from a level probably close to the biological standard of 105, the SRB reached 108 in 2005 and 112 in 2006, a value significantly above the normal level. An independent confirmation of these results comes from the surveys of births in health facilities which yielded a SRB of 110 in 2006-07. High SRB is linked to various factors such as access to modern health care, number of prenatal visits, level of higher education and employment status, young age, province of residence and prenatal sex determination. These results suggest that prenatal sex determination followed by selective abortion has recently become more common in Viet Nam. This recent trend is a consequence of various factors such as preference for sons, declining fertility, easy access to abortion, economic development as well as the increased availability of ultrasonography facilities. Language: English Keywords: VIETNAM | RESEARCH REPORT | DATA ANALYSIS | SONS | SEX RATIO | MATERNAL HEALTH SERVICES | EMPLOYMENT STATUS | SOCIOECONOMIC STATUS | ABORTION | EDUCATIONAL STATUS | ANTENATAL CARE | SEX PREFERENCE | Asia, Southeastern | Asia | Developing Countries | Research Methodology | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Sex Distribution | Sex Factors | Population Characteristics | Demographic Factors | Population | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Health | Socioeconomic Factors | Economic Factors | Fertility Control, Postconception | Family Planning | Value Orientation | Psychological Factors | Behavior Document Number: 331220 Notification |
| 19. Title: Interim data monitoring to enroll higher-risk participants in HIV prevention trials. Author: Halpern V; Obunge O; Ogunsola F; Otusanya S; Umo-Otong J; Wang CH; Mehta N Source: BMC Medical Research Methodology. 2009;9:44. Abstract: BACKGROUND: Lower-than-expected incidence of HIV undermines sample size calculations and compromises the power of a HIV prevention trial. We evaluated the effectiveness of interim monitoring of HIV infection rates and on-going modification of recruitment strategies to enroll women at higher risk of HIV in the Cellulose Sulfate Phase III study in Nigeria. METHODS: We analyzed prevalence and incidence of HIV and other sexually transmitted infections, demographic and sexual behavior characteristics aggregated over the treatment groups on a quarterly basis. The site investigators were advised on their recruitment strategies based on the findings of the interim analyses. RESULTS: A total of 3619 women were screened and 1644 enrolled at the Ikeja and Apapa clinics in Lagos, and at the Central and Peripheral clinics in Port Harcourt. Twelve months after study initiation, the overall incidence of HIV was less than one-third of the pre-study assumption, with rates of HIV that varied substantially between clinics. Due to the low prevalence and incidence rates of HIV, it was decided to close the Ikeja clinic in Lagos and to find new catchment areas in Port Harcourt. This strategy was associated with an almost two-fold increase in observed HIV incidence during the second year of the study. CONCLUSION: Given the difficulties in estimating HIV incidence, a close monitoring of HIV prevalence and incidence rates during a trial is warranted. The on-going modification of recruitment strategies based on the regular analysis of HIV rates appeared to be an efficient method for targeting populations at greatest risk of HIV infection and increasing study power in the Nigeria trial. TRIAL REGISTRATION: The trial was registered with the ClinicalTrials.gov registry under #NCT00120770 http://clinicaltrials.gov/ct2/show/NCT00120770. Language: English Keywords: NIGERIA | RESEARCH REPORT | CLINICAL TRIALS | DATA ANALYSIS | WOMEN | RECRUITMENT ACTIVITIES | HIV INFECTIONS | INCIDENCE | PREVALENCE | MONITORING | SEXUALLY TRANSMITTED DISEASES | SEX BEHAVIOR | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Clinical Research | Research Methodology | Demographic Factors | Population | Program Activities | Programs | Organization and Administration | Viral Diseases | Diseases | Measurement | Evaluation | Reproductive Tract Infections | Infections | Behavior Document Number: 342632 |
| 20. Peer Reviewed Title: Evaluation of cluster-randomized trials on maternal and child health research in developing countries. Author: Handlos LN; Chakraborty H; Sen PK Source: Tropical Medicine and International Health. 2009 Aug;14(8):947-56. Abstract: OBJECTIVE: To summarize and evaluate all publications including cluster-randomized trials used for maternal and child health research in developing countries during the last 10 years. METHODS: All cluster-randomized trials published between 1998 and 2008 were reviewed, and those that met our criteria for inclusion were evaluated further. The criteria for inclusion were that the trial should have been conducted in maternal and child health care in a developing country and that the conclusions should have been made on an individual level. Methods of accounting for clustering in design and analysis were evaluated in the eligible trials. RESULTS: Thirty-five eligible trials were identified. The majority of them were conducted in Asia, used community as randomization unit, and had less than 10,000 participants. To minimize confounding, 23 of the 35 trials had stratified, blocked, or paired the clusters before they were randomized, while 17 had adjusted for confounding in the analysis. Ten of the 35 trials did not account for clustering in sample size calculations, and seven did not account for the cluster-randomized design in the analysis. The number of cluster-randomized trials increased over time, and the trials generally improved in quality. CONCLUSIONS: Shortcomings exist in the sample-size calculations and in the analysis of cluster-randomized trials conducted during maternal and child health research in developing countries. Even though there has been improvement over time, further progress in the way that researchers utilize and analyse cluster-randomized trials in this field is needed. Language: English Keywords: DEVELOPING COUNTRIES | RESEARCH REPORT | EVALUATION | DATA ANALYSIS | MATERNAL HEALTH | CHILD HEALTH | MATERNAL-CHILD HEALTH SERVICES | QUALITY OF HEALTH CARE | Research Methodology | Health | Primary Health Care | Health Services | Delivery of Health Care | Health Services Evaluation | Program Evaluation | Programs | Organization and Administration Document Number: 342974 |
| 21. Peer Reviewed Title: Parity and subfertility effects of continuous oral contraceptive on fertility are important. Author: Hitchcock CL; Prior JC Source: Fertility and Sterility. 2009 Aug 21; Abstract: This letter to the editor discusses parity and subfertility effects of continuous oral contraceptive on fertility and states concerns related to recent articles by Barnhart and colleagues. It expresses issues about the role of parity in the time to conception and concerns that an uncritical acceptance of this conclusion may cause harm. Language: English Keywords: CANADA | CRITIQUE | DATA ANALYSIS | CONTRACEPTION CONTINUATION | PARITY | ORAL CONTRACEPTIVES | Developed Countries | North America, Northern | Americas | Research Methodology | Contraceptive Usage | Contraception | Family Planning | Fertility Measurements | Fertility | Population Dynamics | Demographic Factors | Population | Contraceptive Methods Document Number: 342593 |
| 22. Peer Reviewed Title: Traces of the second demographic transition in four selected countries in Central and Eastern Europe: union formation as a demographic manifestation. Author: Hoem JM; Kostova D; Jasilioniene A; Muresan C Source: European Journal of Population. 2009 Aug;25(3):239-255. Abstract: Using data from the first round of the national Gender and Generations Surveys of Russia, Romania, and Bulgaria, and from a similar survey of Hungary, which were all collected in recent years, we study rates of entry into marital and non-marital unions. We have used elements from the narrative of the Second Demographic Transition (SDT) as a vehicle to give our analysis of the data from the four countries some coherence, and find what can be traces of the SDT in these countries. The details vary by country; in particular, latter-day developments in union formation patterns did not start at the same time in all countries, but in our assessment it began everywhere before communism fell, that is, before the societal transition to a market economy got underway in 1990. Language: English Keywords: RUSSIA | EUROPE | ROMANIA | HUNGARY | BULGARIA | RESEARCH REPORT | DEMOGRAPHIC TRANSITION | DATA ANALYSIS | MARRIAGE | LIVING ARRANGEMENTS | MARRIAGE AGE | Developing Countries | Asia, Northern | Asia | Developed Countries | Europe, Southeastern | Europe, Central | Population Dynamics | Demographic Factors | Population | Research Methodology | Nuptiality | Residence Characteristics | Population Distribution | Geographic Factors | Marriage Patterns Document Number: 339896 |
| 23. Peer Reviewed Title: The role of biological fertility in predicting family size. Author: Joffe M; Key J; Best N; Jensen TK; Keiding N Source: Human Reproduction. 2009 Aug;24(8):1999-2006. Abstract: BACKGROUND: It is plausible that a couple's ability to achieve the desired number of children is limited by biological fertility, especially if childbearing is postponed. Family size has declined and semen quality may have deteriorated in much of Europe, although studies have found an increase rather than a decrease in couple fertility. METHODS: Using four high-quality European datasets, we took the reported time to pregnancy (TTP) as the predictor variable; births reported as following contraceptive failure were an additional category. The outcome variable was final or near-final family size. Potential confounders were maternal age when unprotected sex began prior to the first birth, and maternal smoking. Desired family size was available in only one of the datasets. RESULTS: Couples with a TTP of at least 12 months tended to have smaller families, with odds ratios for the risk of not having a second child approximately 1.8, and for the risk of not having a third child approximately 1.6. Below 12 months no association was observed. Findings were generally consistent across datasets. There was also a more than 2-fold risk of not achieving the desired family size if TTP was 12 months or more for the first child. CONCLUSIONS: Within the limits of the available data quality, family size appears to be predicted by biological fertility, even after adjustment for maternal age, if the woman was at least 20 years old when the couple's first attempt at conception started. The contribution of behavioural factors to this result also needs to be investigated. Language: English Keywords: EUROPE | RESEARCH REPORT | DATA ANALYSIS | STATISTICAL STUDIES | COUPLES | FERTILITY DETERMINANTS | FAMILY SIZE, COMPLETED | FAMILY SIZE, DESIRED | FIRST PREGNANCY INTERVALS | CONTRACEPTION FAILURE | REPRODUCTIVE BEHAVIOR | MATERNAL AGE | TOBACCO USE | Developed Countries | Research Methodology | Studies | Family Characteristics | Family and Household | Sociocultural Factors | Fertility | Population Dynamics | Demographic Factors | Population | Family Size | Pregnancy Intervals | Fertility Measurements | Contraceptive Usage | Contraception | Family Planning | Parental Age | Age Factors | Population Characteristics | Behavior Document Number: 342795 |
| 24. Title: Correlates of condom use among male high school students in Nairobi, Kenya. Author: Kabiru CW; Orpinas P Source: Journal of School Health. 2009 Sep;79(9):425-32. Abstract: This study examined sociodemographic, behavioral, and psychosocial characteristics of three groups of adolescent males: those who use condoms consistently, those who use them sporadically, and non-condom users. The sample consisted of 931 sexually experienced male high school students in Nairobi, Kenya. Cross tabulations and general linear models were used to test the relation between each explanatory variable and condom user group. Fifty-three percent of respondents reported having used condoms. Compared with nonusers and sporadic users, consistent users engaged in sexual intercourse for the first time at an older age and reported higher condom use self-efficacy, more positive peer attitudes toward safe sex, and stronger attitudes toward condom use. Compared with sporadic and consistent users, nonusers reported fewer sexual partners, less substance use, and more frequent intercourse with nonromantic partners. Sporadic users, compared with the other two groups, had more sexual partners and stronger attitudes that support that males and females have separate roles. The three groups did not differ in HIV/AIDS knowledge. All groups perceived their risk of contracting an STI as low, and this perception did not differ by condom use. Differences in participants' age by group were minimal. Language: English Keywords: KENYA | RESEARCH REPORT | DATA ANALYSIS | STUDENTS | SECONDARY SCHOOLS | REPRODUCTIVE HEALTH | RISK BEHAVIOR | CHILD HEALTH | ADOLESCENT HEALTH | RISK FACTORS | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Education | Schools | Health | Behavior Document Number: 342558 |
| 25. Peer Reviewed Title: Intrapartum antibiotic exposure and early neonatal, morbidity, and mortality in Africa. Author: Kafulafula G; Mwatha A; Chen YQ; Aboud S; Martinson F; Hoffman I; Fawzi W; Read JS; Valentine M; Mwinga K; Goldenberg R; Taha TE Source: Pediatrics. 2009 Jul;124(1):e137-44. Abstract: BACKGROUND: Infants born to women who receive intrapartum antibiotics may have higher rates of infectious morbidity and mortality than unexposed infants. OBJECTIVE: Our goal was to determine the association of maternal intrapartum antibiotics and early neonatal morbidity and mortality. METHODS: We performed secondary analysis of data from a multisite randomized, placebo-controlled clinical trial of antibiotics to prevent chorioamnionitis-associated mother-to-child transmission of HIV-1 and preterm birth in sub-Saharan Africa. Early neonatal morbidity and mortality were analyzed. In an intention-to-treat (ITT) analysis, infants born to women randomly assigned to antibiotics or placebo were compared. In addition, non-ITT analysis was performed because some women received nonstudy antibiotics for various clinical indications. RESULTS: Overall, 2659 pregnant women were randomly assigned. Of these, 2466 HIV-1-infected and HIV-1-uninfected women delivered 2413 live born and 84 stillborn infants. In the ITT analysis, there were no significant associations between exposure to antibiotics and early neonatal outcomes. Non-ITT analyses showed more illness at birth (11.2% vs 8.6%, P = .03) and more admissions to the special care infant unit (12.6% vs 9.8%, P = .04) among infants exposed to maternal intrapartum antibiotics than among unexposed infants. Additional analyses revealed greater early neonatal morbidity and mortality among infants of mothers who received nonstudy antibiotics than of mothers who received study antibiotics. CONCLUSIONS: There is no association between intrapartum exposure to antibiotics and early neonatal morbidity or mortality. The associations observed in non-ITT analyses are most likely the result of women with peripartum illnesses being more likely to receive nonstudy antibiotics. Language: English Keywords: AFRICA, SUB SAHARAN | RESEARCH REPORT | DATA ANALYSIS | CLINICAL TRIALS | PREGNANT WOMEN | PREMATURE BIRTH | NEONATAL DISEASES AND ABNORMALITIES | ANTIBIOTICS | MORBIDITY | NEONATAL MORTALITY | Africa | Developing Countries | Research Methodology | Clinical Research | Population Characteristics | Demographic Factors | Population | Pregnancy Outcomes | Pregnancy | Reproduction | Diseases | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Infant Mortality | Mortality | Population Dynamics Document Number: 342887 |
| 26. Peer Reviewed Title: Effects of neighbourhood-level educational attainment on HIV prevalence among young women in Zambia. Author: Kayeyi N; Sandoy IF; Fylkesnes K Source: BMC Public Health. 2009 Aug 25;9(310):1-11. Abstract: This study reanalyzed data from a cross-sectional population survey conducted in Zambia in 2003. The analyses were restricted to women ages 15–24 years (n=1,295). Stratified random cluster sampling was used to select 10 urban and 10 rural clusters. A measure for neighborhood-level educational attainment was constructed by aggregating individual-level years-in-school. Multi-level mixed effects regression models were run to examine the neighborhood-level educational effect on HIV prevalence after adjusting for individual-level underlying variables (education, currently a student, marital status) and selected proximate determinants (ever given birth, sexual activity, lifetime sexual partners). HIV prevalence among young women ages 15–24 years was 12.5% in the urban and 6.8% in the rural clusters. Neighborhood educational attainment was found to be a strong determinant of HIV infection in both urban and rural populations. HIV prevalence decreased substantially by increasing level of neighborhood education. The likelihood of infection in low educational attainment areas was 3.4 times higher among rural women and 1.8 times higher among the urban women after adjusting for age and other individual-level underlying variables, including education. However, the association was not significant for urban young women after this adjustment. After adjusting for level of education in the neighborhood, the effect of the individual-level education differed by residence: there was a strong protective effect among urban women whereas it tended to be a risk factor among rural women. Language: English Keywords: ZAMBIA | RESEARCH REPORT | DATA ANALYSIS | YOUTH | WOMEN | HIV INFECTIONS | PREVALENCE | EDUCATIONAL STATUS | GEOGRAPHIC FACTORS | SEX BEHAVIOR | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Research Methodology | Age Factors | Population Characteristics | Demographic Factors | Population | Viral Diseases | Diseases | Measurement | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Behavior Document Number: 339907 |
| 27. Peer Reviewed Title: Fourteen years of surveillance of HIV-1 prevalence among pregnant women attending antenatal care clinics in western Uganda. Author: Kipp W; Chapman E; Jhangri GS; Veugelers P; Kilian A; Rubaale T; Kabagambe G Source: International Journal of STD and AIDS. 2009 Jul;20(7):499-502. Abstract: This study monitored long-term temporal trends in HIV-1 prevalence in antenatal clinic attendees living in western Uganda. Semi-annual data collection was done from 1991 to 2004. For each woman the following data were recorded: HIV-1 status, age, educational status, marital status, occupation and parity. The results show that the overall HIV-1 prevalence was 15.3% during the entire time period (urban 21.3%, semi-urban 12.7% and rural 7.1%). Between 1991 and 2004, we observed a gradual decline in the HIV-1 prevalence. The decline was most pronounced in urban women aged 15-19 years old and least pronounced in rural women aged 20-24 years. Women above 25 years of age did not show any decline in HIV-1 prevalence over time. The declining HIV-1 prevalence in the younger age groups (15-24 years) likely represents a declining risk for acquiring HIV infection as we have previously shown in the urban sub-sample of this data set. Language: English Keywords: UGANDA | RESEARCH REPORT | SAMPLING STUDIES | DATA ANALYSIS | PREGNANT WOMEN | HIV INFECTIONS | PREVALENCE | ANTENATAL CARE | MONITORING | AGE FACTORS | TIME FACTORS | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Viral Diseases | Diseases | Measurement | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Health | Evaluation | Population Dynamics Document Number: 342826 |
| 28. Peer Reviewed Title: Prognostic accuracy of WHO growth standards to predict mortality in a large-scale nutritional program in Niger. Author: Lapidus N; Luquero FJ; Gaboulaud V; Shepherd S; Grais RF Source: PLoS Medicine. 2009 Mar 3;6(3):e39. Abstract: BACKGROUND: Important differences exist in the diagnosis of malnutrition when comparing the 2006 World Health Organization (WHO) Child Growth Standards and the 1977 National Center for Health Statistics (NCHS) reference. However, their relationship with mortality has not been studied. Here, we assessed the accuracy of the WHO standards and the NCHS reference in predicting death in a population of malnourished children in a large nutritional program in Niger. METHODS AND FINDINGS: We analyzed data from 64,484 children aged 6-59 mo admitted with malnutrition (<80% weight-for-height percentage of the median [WH]% [NCHS] and/or mid-upper arm circumference [MUAC] <110 mm and/or presence of edema) in 2006 into the Medecins Sans Frontieres (MSF) nutritional program in Maradi, Niger. Sensitivity and specificity of weight-for-height in terms of Z score (WHZ) and WH% for both WHO standards and NCHS reference were calculated using mortality as the gold standard. Sensitivity and specificity of MUAC were also calculated. The receiver operating characteristic (ROC) curve was traced for these cutoffs and its area under curve (AUC) estimated. In predicting mortality, WHZ (NCHS) and WH% (NCHS) showed AUC values of 0.63 (95% confidence interval [CI] 0.60-0.66) and 0.71 (CI 0.68-0.74), respectively. WHZ (WHO) and WH% (WHO) appeared to provide higher accuracy with AUC values of 0.76 (CI 0.75-0.80) and 0.77 (CI 0.75-0.80), respectively. The relationship between MUAC and mortality risk appeared to be relatively weak, with AUC = 0.63 (CI 0.60-0.67). Analyses stratified by sex and age yielded similar results. CONCLUSIONS: These results suggest that in this population of children being treated for malnutrition, WH indicators calculated using WHO standards were more accurate for predicting mortality risk than those calculated using the NCHS reference. The findings are valid for a population of already malnourished children and are not necessarily generalizable to a population of children being screened for malnutrition. Future work is needed to assess which criteria are best for admission purposes to identify children most likely to benefit from therapeutic or supplementary feeding programs. Language: English Keywords: NIGER | RESEARCH REPORT | DATA ANALYSIS | CHILDREN | MALNUTRITION | DEATH RATE | CHILD MORTALITY | SUPPLEMENTARY FEEDING | Africa, Western | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Nutrition Disorders | Diseases | Mortality | Population Dynamics | Infant Nutrition | Nutrition | Health Document Number: 341230 |
| 29. Peer Reviewed Title: Brazilian mothers' beliefs, attitudes and practices related to child weight status and early feeding within the context of nutrition transition. Author: Lindsay AC; Machado MT; Sussner KM; Hardwick CK; Kerr LR; Peterson KE Source: Journal of Biosocial Science. 2009 Jan;41(1):21-37. Abstract: With the rapid pace of the nutrition transition worldwide, understanding influences of child feeding practices within a context characterized by the co-existence of overweight and undernutrition in the same population has increasing importance. This qualitative study describes Brazilian mothers' child feeding practices and their perceptions of their association with child weight status and explores the role of socioeconomic, cultural and organizational factors on these relationships. Forty-one women enrolled in the Family Health/Community Health Workers Programme were selected from rural, urban, coastal and indigenous areas in Ceara State, north-east Brazil, to participate in four focus group discussions. Content analysis identified fourteen emergent themes showing mothers' child feeding practices in this setting were influenced by economic resources, mothers' immediate social support networks (e.g. neighbours and family members) and participation in nutrition assistance programmes. Child malnutrition was the most common nutritional concern; nevertheless, mothers were aware of the negative health consequences of obesity but misunderstood its causes (e.g. foods filled with fat would make a person fat; others thought that birth control pills and stimulants given to children were causes of obesity); several reported their own struggles with overweight. Food assistance programmes emerged as an important influence on children's dietary adequacy, especially among mothers describing dire economic situations. The findings have implications for targeting food assistance as well as health and nutrition education strategies in low-income families undergoing the nutrition transition in north-east Brazil. Language: English Keywords: BRAZIL | RESEARCH REPORT | DATA ANALYSIS | FOCUS GROUPS | LOW INCOME POPULATION | MOTHERS | INFANT | INFANT NUTRITION | BODY WEIGHT | PERCEPTION | BEHAVIOR | DIET | CALORIC INTAKE | South America, Eastern | South America | Latin America | Americas | Developing Countries | Research Methodology | Data Collection | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Nutrition | Health | Physiology | Biology | Psychological Factors Document Number: 330517 |
| 30. Peer Reviewed Title: Relationship dynamics and consistency of condom use among adolescents. Author: Manning WD; Flanigan CM; Giordano PC; Longmore MA Source: Perspectives On Sexual and Reproductive Health. 2009 Sep;41(3):181-90. Abstract: CONTEXT: Research on adolescent condom use often focuses on the influence of parents, peers and environmental factors. Although most sexually active teenagers have sex within dating relationships, little is known about associations between the characteristics of these relationships and consistency of condom use. METHODS: Data on 269 participants in Wave 1 of the Toledo Adolescent Relationships Study who had had sex in their current or most recent dating relationship were analyzed in logistic regression models to examine how positive and negative relationship qualities are associated with consistent condom use. RESULTS: Among teenagers who had had sex with their dating partner, both negative relationship dynamics (conflict, partner's controlling behavior, mistrust, jealousy, perceived partner inferiority) and positive qualities (love, enmeshment, salience, self-disclosure) were negatively associated with consistent condom use (odds ratios, 0.7-0.9). Asymmetries in partners' age, race and school were not related to consistent condom use. Relationship duration was negatively associated with consistency (0.98-0.99), but the association was explained by feelings of relationship importance. Findings for relationship qualities were similar for males and females, with the exception of conflict, which was positively associated with consistent condom use among females but not males. CONCLUSIONS: Although the relationship processes associated with consistent condom use are complex, such processes appeared to be more strongly associated with consistent condom use than were social and demographic characteristics. Programs should focus on relationship qualities and dynamics, recognizing that both negative and positive relationship features are associated with consistent condom use. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | DATA ANALYSIS | ADOLESCENTS | CONDOM USE | SEX BEHAVIOR | GENDER RELATIONS | Developed Countries | North America | Americas | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Risk Reduction Behavior | Behavior | Gender Issues | Sociocultural Factors Document Number: 342712 |
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