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Author Chae, S.; Desai, S.; Crowell, M.; Sedgh, G.; Singh, S. url  doi
openurl 
  Title Characteristics of women obtaining induced abortions in selected low- and middle-income countries Type Journal Article
  Year 2017 Publication (down) PloS one Abbreviated Journal PLoS One  
  Volume 12 Issue 3 Pages e0172976  
  Keywords Abortion, Legal/*economics/psychology/*statistics & numerical data; Adolescent; Adult; Africa; Asia; Caribbean Region; Developing Countries/*economics; Educational Status; Europe; Female; Humans; Latin America; Marital Status/statistics & numerical data; Parity/physiology; Poverty/psychology/*statistics & numerical data; Pregnancy; *Pregnancy, Unplanned  
  Abstract BACKGROUND: In 2010-2014, approximately 86% of abortions took place in low- and middle-income countries (LMICs). Although abortion incidence varies minimally across geographical regions, it varies widely by subregion and within countries by subgroups of women. Differential abortion levels stem from variation in the level of unintended pregnancies and in the likelihood that women with unintended pregnancies obtain abortions. OBJECTIVES: To examine the characteristics of women obtaining induced abortions in LMICs. METHODS: We use data from official statistics, population-based surveys, and abortion patient surveys to examine variation in the percentage distribution of abortions and abortion rates by age at abortion, marital status, parity, wealth, education, and residence. We analyze data from five countries in Africa, 13 in Asia, eight in Europe, and two in Latin America and the Caribbean (LAC). RESULTS: Women across all sociodemographic subgroups obtain abortions. In most countries, women aged 20-29 obtained the highest proportion of abortions, and while adolescents obtained a substantial fraction of abortions, they do not make up a disproportionate share. Region-specific patterns were observed in the distribution of abortions by parity. In many countries, a higher fraction of abortions occurred among women of high socioeconomic status, as measured by wealth status, educational attainment, and urban residence. Due to limited data on marital status, it is unknown whether married or unmarried women make up a larger share of abortions. CONCLUSIONS: These findings help to identify subgroups of women with disproportionate levels of abortion, and can inform policies and programs to reduce the incidence of unintended pregnancies; and in LMICs that have restrictive abortion laws, these findings can also inform policies to minimize the consequences of unsafe abortion and motivate liberalization of abortion laws. Program planners, policymakers, and advocates can use this information to improve access to safe abortion services, postabortion care, and contraceptive services.  
  Address Guttmacher Institute, New York, New York, United States of America  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 1932-6203 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:28355285 Approved no  
  Call Number ref @ user @ Serial 97641  
Permanent link to this record
 

 
Author Ross, I.; Mejia, C.; Melendez, J.; Chan, P.A.; Nunn, A.C.; Powderly, W.; Goodenberger, K.; Liu, J.; Mayer, K.H.; Patel, R.R. url  doi
openurl 
  Title Awareness and attitudes of pre-exposure prophylaxis for HIV prevention among physicians in Guatemala: Implications for country-wide implementation Type Journal Article
  Year 2017 Publication (down) PloS one Abbreviated Journal PLoS One  
  Volume 12 Issue 3 Pages e0173057  
  Keywords Adult; Anti-HIV Agents/therapeutic use; *Attitude of Health Personnel; Cross-Sectional Studies; Female; Guatemala; HIV Infections/*prevention & control; *Health Knowledge, Attitudes, Practice; Humans; Logistic Models; Male; Middle Aged; Physicians/psychology; Practice Patterns, Physicians'/*statistics & numerical data; Pre-Exposure Prophylaxis/*statistics & numerical data; Surveys and Questionnaires  
  Abstract INTRODUCTION: HIV continues to be a major health concern with approximately 2.1 million new infections occurring worldwide in 2015. In Central America, Guatemala had the highest incident number of HIV infections (3,700) in 2015. Antiretroviral pre-exposure prophylaxis (PrEP) was recently recommended by the World Health Organization (WHO) as an efficacious intervention to prevent HIV transmission. PrEP implementation efforts are underway in Guatemala and success will require providers that are knowledgeable and willing to prescribe PrEP. We sought to explore current PrEP awareness and prescribing attitudes among Guatemalan physicians in order to inform future PrEP implementation efforts. METHODS: We conducted a cross-sectional survey of adult internal medicine physicians at the main teaching hospital in Guatemala City in March 2015. The survey included demographics, medical specialty, years of HIV patient care, PrEP awareness, willingness to prescribe PrEP, previous experience with post-exposure prophylaxis, and concerns about PrEP. The primary outcome was willingness to prescribe PrEP, which was assessed using a 5-point Likert scale for different at-risk population scenarios. Univariate and multivariate logistic regression was performed to identify predictors for willingness to prescribe PrEP. RESULTS: Eighty-seven physicians completed the survey; 66% were male, 64% were internal medicine residency trainees, and 10% were infectious disease (ID) specialists. Sixty-nine percent of physicians were PrEP aware, of which 9% had previously prescribed PrEP. Most (87%) of respondents were willing to prescribe PrEP to men who have sex with men (MSM), sex workers, injection drug users, or HIV-uninfected persons having known HIV-positive sexual partners. Concerns regarding PrEP included development of resistance (92%), risk compensation (90%), and cost (64%). Univariate logistic regression showed that younger age, being a resident trainee, and being a non-ID specialist were significant predictors for willingness to prescribe PrEP. In multivariate logistic regression, being a non-ID specialist was a significant predictor. CONCLUSIONS: Guatemalan physicians at an urban public hospital were PrEP aware and willing to prescribe, but few have actually done so yet. Future education programs should address the concerns identified, including the low potential for the development of antiretroviral resistance. These findings can aid PrEP implementation efforts in Guatemala.  
  Address Division of Infectious Diseases, Washington University School of Medicine, St. Louis, Missouri, United States of America  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 1932-6203 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:28257475 Approved no  
  Call Number ref @ user @ Serial 97644  
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Author Ferreira, A.A.; Souza-Filho, Z.A.; Goncalves, M.J.F.; Santos, J.; Pierin, A.M.G. url  doi
openurl 
  Title Relationship between alcohol drinking and arterial hypertension in indigenous people of the Mura ethnics, Brazil Type Journal Article
  Year 2017 Publication (down) PloS one Abbreviated Journal PLoS One  
  Volume 12 Issue 8 Pages e0182352  
  Keywords Adolescent; Adult; Aged; Aged, 80 and over; Alcohol Drinking/*adverse effects; Brazil/epidemiology; Cross-Sectional Studies; Female; Humans; Hypertension/epidemiology/*etiology; Male; Middle Aged; Population Groups/*statistics & numerical data; Prevalence; Risk Factors; Smoking/*adverse effects; Young Adult  
  Abstract OBJECTIVE: To identify the consumption of alcoholic beverage and the relation with hypertension, their prevalence and associated factors, in indigenous Mura, Brazil. METHODS: A cross-sectional population-based study was conducted with 455 adult indigenous aged 18 years or more of Mura ethnics in Amazonia, Brazil. Interview was conducted and the alcohol intake was assessed by the Alcohol Use Disorders Identification Test. Blood pressure was measured in three measurements and the mean of the last two measurements was used. Physical examination included the following data: weight, height, waist and neck circumference, bioimpedance, and capillary measurement of glucose, triglycerides and cholesterol. Through multivariate Logistic regression in stepwise, the odds ratios for alcohol consumption and associated factors were identified. RESULTS: The prevalence of alcoholic beverage was 40.2%, with no significant difference for hypertension in those who drink (23.0%) and those who did not drink (29.0%). Referred hypertension in indigenous was associated to less use of alcoholic beverages (14.2% vs 24.3%, P = 0.009). After an adjusted analysis (Odds Ratio, 95% CI), there was a positive association between alcoholic drink intake and male sex (10.27, CI: 5.76-18.30), smoking (4.72, CI: 2.35-9.46) and live in rural areas (9.77, CI: 5.08-18.79). On the other hand, age (0.95, IC: 0.94-0.97), and absence of dyslipidemia (0.41, CI: 0.19-0.89) were associated to lower alcohol consumption. CONCLUSION: The prevalence of alcoholic beverage was high and associated with referred hypertension, but this association was not maintained after adjusted analysis. Changes to habits and inappropriate lifestyles in indigenous populations and living in urban areas may contribute to increase risk for cardiovascular diseases. Therefore, health policies should be implemented to meet the uniqueness of indigenous people.  
  Address Escola de Enfermagem da Universidade de Sao Paulo, Sao Paulo, Brazil  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 1932-6203 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:28777805 Approved no  
  Call Number ref @ user @ Serial 98010  
Permanent link to this record
 

 
Author Derose, K.P.; Payan, D.D.; Fulcar, M.A.; Terrero, S.; Acevedo, R.; Farias, H.; Palar, K. url  doi
openurl 
  Title Factors contributing to food insecurity among women living with HIV in the Dominican Republic: A qualitative study Type Journal Article
  Year 2017 Publication (down) PloS one Abbreviated Journal PLoS One  
  Volume 12 Issue 7 Pages e0181568  
  Keywords Adolescent; Adult; Domestic Violence; Dominican Republic/epidemiology; Female; *Food Supply; HIV/isolation & purification; HIV Infections/*epidemiology; Humans; Middle Aged; Qualitative Research; Social Stigma; Social Support; Socioeconomic Factors; Young Adult  
  Abstract BACKGROUND: Food insecurity contributes to poor health outcomes among people living with HIV. In Latin America and the Caribbean, structural factors such as poverty, stigma, and inequality disproportionately affect women and may fuel both the HIV epidemic and food insecurity. METHODS: We examined factors contributing to food insecurity among women living with HIV (WLHIV) in the Dominican Republic (DR). Data collection included in-depth, semi-structured interviews in 2013 with 30 WLHIV with indications of food insecurity who resided in urban or peri-urban areas and were recruited from local HIV clinics. In-person interviews were conducted in Spanish. Transcripts were coded using content analysis methods and an inductive approach to identify principal and emergent themes. RESULTS: Respondents identified economic instability as the primary driver of food insecurity, precipitated by enacted stigma in the labor and social domains. Women described experiences of HIV-related labor discrimination in formal and informal sectors. Women commonly reported illegal HIV testing by employers, and subsequent dismissal if HIV-positive, especially in tourism and free trade zones. Enacted stigma in the social domain manifested as gossip and rejection by family, friends, and neighbors and physical, verbal, and sexual abuse by intimate partners, distancing women from sources of economic and food support. These experiences with discrimination and abuse contributed to internalized stigma among respondents who, as a result, were fearful and hesitant to disclose their HIV status; some participants reported leaving spouses and/or families, resulting in further isolation from economic resources, food and other support. A minority of participants described social support by friends, spouses, families and support groups, which helped to ameliorate food insecurity and emotional distress. CONCLUSIONS: Addressing food insecurity among WLHIV requires policy and programmatic interventions to enforce existing laws designed to protect the rights of people living with HIV, reduce HIV-related stigma, and improve gender equality.  
  Address Division of HIV, ID and Global Medicine, School of Medicine, University of California – San Francisco, San Francisco, California, United States of America  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 1932-6203 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:28742870 Approved no  
  Call Number ref @ user @ Serial 98011  
Permanent link to this record
 

 
Author Jara-Samaniego, J.; Perez-Murcia, M.D.; Bustamante, M.A.; Paredes, C.; Perez-Espinosa, A.; Gavilanes-Teran, I.; Lopez, M.; Marhuenda-Egea, F.C.; Brito, H.; Moral, R. url  doi
openurl 
  Title Development of organic fertilizers from food market waste and urban gardening by composting in Ecuador Type Journal Article
  Year 2017 Publication (down) PloS one Abbreviated Journal PLoS One  
  Volume 12 Issue 7 Pages e0181621  
  Keywords Analysis of Variance; Carbon/analysis; *Cities; Ecuador; Feasibility Studies; *Fertilizers/analysis/economics; *Food; *Gardening/economics/methods; Nitrogen/analysis; Plants; Recycling/economics/methods; *Soil/chemistry; Temperature; Waste Management/economics/*methods  
  Abstract Currently, the management of urban waste streams in developing countries is not optimized yet, and in many cases these wastes are disposed untreated in open dumps. This fact causes serious environmental and health problems due to the presence of contaminants and pathogens. Frequently, the use of specific low-cost strategies reduces the total amount of wastes. These strategies are mainly associated to the identification, separate collection and composting of specific organic waste streams, such as vegetable and fruit refuses from food markets and urban gardening activities. Concretely, in the Chimborazo Region (Ecuador), more than 80% of municipal solid waste is dumped into environment due to the lack of an efficient waste management strategy. Therefore, the aim of this study was to develop a demonstration project at field scale in this region to evaluate the feasibility of implanting the composting technology not only for the management of the organic waste fluxes from food market and gardening activities to be scaled-up in other developing regions, but also to obtain an end-product with a commercial value as organic fertilizer. Three co-composting mixtures were prepared using market wastes mixed with pruning of trees and ornamental palms as bulking agents. Two piles were created using different proportions of market waste and prunings of trees and ornamental palms: pile 1 (50:33:17) with a C/N ratio 25; pile 2: (60:30:10) with C/N ratio 24 and pile 3 (75:0:25) with C/N ratio 33), prepared with market waste and prunings of ornamental palm. Throughout the process, the temperature of the mixtures was monitored and organic matter evolution was determined using thermogravimetric and chemical techniques. Additionally, physico-chemical, chemical and agronomic parameters were determined to evaluate compost quality. The results obtained indicated that all the piles showed a suitable development of the composting process, with a significant organic matter decomposition, reached in a shorter period of time in pile 3. At the end of the process, all the composts showed absence of phytotoxicity and suitable agronomic properties for their use as organic fertilizers. This reflects the viability of the proposed alternative to be scaled-up in developing areas, not only to manage and recycle urban waste fluxes, but also to obtain organic fertilizers, including added value in economic terms related to nutrient contents.  
  Address Dept. of Agrochemistry and Environment, Miguel Hernandez University, Orihuela, Alicante, Spain  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 1932-6203 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:28727757 Approved no  
  Call Number ref @ user @ Serial 98013  
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