Assessment of the Effects of Tribulus Terrestris on Sexual Function of Menopausal Women

Objective The aim of this study was to study the effects of Tribulus terrestris on sexual function in menopausal women. Methods This was a prospective, randomized, double-blind, placebo-controlled clinical trial that included 60 postmenopausal women with sexual dysfunction. The women were divided into two groups, placebo group and Tribulus group, and evaluated by using the Sexual Quotient-female version (SQ-F) and Female Intervention Efficacy Index (FIEI) questionnaires. Results There was no significant difference between the groups in age, age at menopause, civil status, race, and religion. In the evaluation with the SQ-F questionnaire, there were significant differences between the placebo (7.6±3.2) and Tribulus (10.2±3.2) groups in the domains of desire and sexual interest (p d" 0.001), foreplay (3.3±1.5 versus 4.2±1.0) (p d" 0.01), arousal and harmonious interaction with the partner (5.7±2.1 versus 7.2±2.6) (p d" 0.01), and comfort in sexual intercourse (6.5±2.4 versus 8.0±1.9) (p d" 0.01). There was no significant difference between the placebo and Tribulus groups in the domains of orgasm and sexual satisfaction (p = 0.28). In the FIEI questionnaire, there was a significant improvement (p < 0.001) in the domains of vaginal lubrication during coitus and/or foreplay (20 versus 83.3%), sensation in the genitalia during sexual intercourse or other stimuli (16.7 versus 76.7%), sensation in the genital region (20 versus 70%), sexual intercourse and/or other sexual stimulations (13.3 versus 43.3%), and the ability to reach orgasm (20% versus 73.3%). There was no significant difference in adverse effects between the two groups. Conclusions After 90 days of treatment, at the doses used, we found Tribulus terrestris to be effective in treating sexual problems among menopausal women.

Poor sleep in middle-aged women is not associated with menopause per se

Whether sleep problems of menopausal women are associated with vasomotor symptoms and/or changes in estrogen levels associated with menopause or age-related changes in sleep architecture is unclear. This study aimed to determine if poor sleep in middle-aged women is correlated with menopause. This study recruited women seeking care for the first time at the menopause outpatient department of our hospital. Inclusion criteria were an age ≥40 years, not taking any medications for menopausal symptoms, and no sleeping problems or depression. Patients were assessed with the Pittsburgh Sleep Quality Index (PSQI), modified Kupperman Index (KI), and Menopause Rating Scale (MRS). A PSQI score of <7 indicated no sleep disorder and ≥7 indicated a sleep disorder. Blood specimens were analyzed for follicle-stimulating hormone and estradiol levels. A total of 244 women were included in the study; 103 (42.2%) were identified as having a sleep disorder and 141 as not having one. In addition, 156 (64%) women were postmenopausal and 88 (36%) were not menopausal. Follicle-stimulating hormone and estradiol levels were similar between the groups. Patients with a sleep disorder had a significantly higher total modified KI score and total MRS score (both, P<0.001) compared with those without a sleep disorder. Correlations of the PSQI total score with the KI and MRS were similar in menopausal and non-menopausal women. These results do not support that menopause per se specifically contributes to sleep problems.

Gender and human security : the challenge facing Canada's human security policy /

During the 1980's and for much of the 1990's, many countries in the Asia Pacific were renowned for their economic development and prosperity. The Asian tigers were a source of great interest for many economists and international investors. The 1997 Asian financial crisis, however, dramatically altered the growth and the performance of these economies. The crisis sent several ofAsia's best performing economies on a downward spiral from which many have yet to fully recover. The crisis exposed the financial and the political weaknesses ofmany countries in the region. Moreover, the crisis severely affected the wellbeing and the security ofmany ofthe region's citizens. This text will examine the economic crisis in greater detail and explore current debates in the study of international relations theory. More specifically, this paper will examine recent challenges posed to traditional international relations theory and address alternative approaches to this field of study. This paper will examine Critical theory and its role in shifting the referent object of security from the state to the individual. In this context, this paper will also assess Critical theory's role in enabling such issues as gender and human security to find a place on the agendas of international relations scholars and foreign policy makers. The central focus ofthis study will be the financial crisis and its impact on human security in the Southeast Asia. Furthermore, this paper will assess the recovery efforts ofthe domestic governments, international organizations and various Canadian sponsored initiatives in the context ofhuman security.

Motivational model of problem drinking for men and women /

This thesis tested a path model of the relationships of reasons for drinking and reasons for limiting drinking with consumption of alcohol and drinking problems. It was hypothesized that reasons for drinking would be composed of positively and negatively reinforcing reasons, and that reasons for limiting drinking would be composed of personal and social reasons. Problem drinking was operationalized as consisting of two factors, consumption and drinking problems, with a positive relationship between the two. It was predicted that positively and negatively reinforcing reasons for drinking would be associated with heavier consumption and, in turn, more drinking problems, through level of consumption. Negatively reinforcing reasons were also predicted to be associated with drinking problems directly, independent of level of consumption. It was hypothesized that reasons for limiting drinking would be associated with lower levels of consumption and would be related to fewer drinking problems, through level of consumption. Finally, among women, reasons for limiting drinking were expected to be associated with drinking problems directly, independent of level of consumption. The sample, was taken from the second phase of the Niagara Young Aduh Health Study, a community sample of young adult men and women. Measurement models of reasons for drinking, reasons for limiting drinking, and problem drinking were tested using Confirmatory Factor Analysis. After adequate fit of each measurement model was obtained, the complete structural model, with all hypothesized paths, was tested for goodness of fit. Cross-group equality constraints were imposed on all models to test for gender differences. The results provided evidence supporting the hypothesized structure of reasons for drinking and problem drinking. A single factor model of reasons for limiting drinking was used in the analyses because a two-factor model was inadequate. Support was obtained for the structural model. For example, the resuhs revealed independent influences of Positively Reinforcing Reasons for Drinking, Negatively Reinforcing Reasons for Drinking, and Reasons for Limiting Drinking on consumption. In addition. Negatively Reinforcing Reasons helped to account for Drinking Problems independent of the amount of alcohol consumed. Although an additional path from Reasons for Limiting Drinking to Drinking Problems was hypothesized for women, it was of marginal significance and did not improve the model's fit. As a result, no sex differences in the model were found. This may be a result of the convergence of drinking patterns for men and women. Furthermore, it is suggested that gender differences may only be found in clinical samples of problem drinkers, where the relative level of consumption for women and men is similar.

Medicalization and women : O, the Oprah Magazine diagnosed through critical discourse analysis

This thesis uses critical discourse analysis (COAl to explore and examine direct-toconsumer (OTC) pharmaceutical drug advertisements appearing in four issues of 0, The Oprah Magazine in 2006. The theoretical underpinnings of this thesis emerge from social scientists and feminists analyses regarding the medicalization of everyday life. The findings of this study highlight three types of discourses used by pharmaceutical companies. First, I explore the use of historical and contemporary gender norms to seJi pharmacological products; second, J examine discourses which normalize the use of chemical solutions as the first line of defense to address a wide range of everyday problems; and finally, I assess how phannaceutical advertisements provide an illusion of autonomy by responsibilizing individuals as patients, at the same time as they suggest that real independence can only be achieved with medication. My discussion of these themes also includes an analysis of why 0 Magazine, which explicitly promotes women's empowerment through holistic approaches to health and personal growthmight support such advertising. Thus I explore: how does OTC advertising benefit both pharmaceutical companies and 0 Magazine itself? I conclude through a brief discussion of the larger implications of OTC advertising for women's health.

Breaking the silence : exploring the workplace experiences of six women with learning disabilities

In the current economic climate, employees are expected to upgrade their skills in order to remain productive and competitive in the workplace, and many women with learning disabilities! may feel doubly challenged when dealing with such expectations. Although the number of people with reported learning disabilities who enter the workforce is expected to increase, a dearth of research focuses on work-related experiences of women with learning disabilities; consequently, employers and educators often are unaware ofthe obstacles and demands facing such individuals. This qualitative narrative study sheds light on the work experiences of women with diagnosed or suspected learning disabilities. The study used semistructured interviews to explore their perspectives and reflections on learnlng in order to: (a) raise awareness of the needs of women with learning disabilities, (b) enhance their opportunities to learn in the workplace, and (c) draw attention to the need for improvement of inclusiveness in the workplace, especially for hidden disabilities. Study findings reveal that participants' learning was influenced by work relationships, the learning environments, self-determination, and taking personal responsibility. Moreover, the main accommodation requested was to have supportive and understanding work relationships and environments. Recommendations are made for future research and workplace improvements, most notably that no employees should be left behind through an employee-centered approach.

Understanding the Intersectoral Collaboration of Rural Community Health Workers and Teachers: The Example of Addressing Violence against Women and Girls in Vulindlela, South Africa

Objectifs: Cette étude a documenté la collaboration intersectorielle entre les agents de santé communautaires (ASC) et les enseignants visant à combattre la violence à l’égard des femmes et des filles à Vulindlela, une communauté rurale Sud-Africaine. La collaboration entre ces acteurs, les facteurs qui influencent leur collaboration et les avenues possibles pour une amélioration de cette collaboration ont été explorés. Méthodes: Six ASC et cinq enseignants ont pris part à cette recherche participative qui a inclut l'utilisation du dessin comme méthodologie visuelle. La collecte de données a été réalisée en quatre phases, avec un total de huit entretiens de groupes. La stratégie d’analyse principale a inclus une approche dirigée du contenu narratif et une approche de comparaison constante. Résultats: Le système de collaboration entre les enseignants et les ASC manque de définition et ces acteurs ne peuvent donc en faire l’utilisation. Par conséquent la collaboration actuelle entre ces acteurs a été jugée peu développé, impromptue et informelle. De nombreuses contraintes à la collaboration ont été identifiées, y compris le manque de motivation de la part des enseignants, la nature des relations entre les acteurs, et la capacité individuelle limitée des ASC. Conclusion: Compte tenu des nombreuses contraintes à la collaboration entre ces ASC et les enseignants, il n'est pas évident que cette collaboration conduira aux résultats espérés. Dans l'absence de motivation suffisante et d’une prise de conscience réaliste des défis par les acteurs eux-mêmes, les initiatives externes pour améliorer la collaboration sont peu susceptibles de succès.

Do romantic partners' responses to entry dyspareunia affect women's experience of pain? : the roles of catastrophizing and self-efficacy.

Introduction Entry dyspareunia is a sexual health concern which affects about 21% of women in the general population. Characterized by pain provoked during vaginal penetration, introital dyspareunia has been shown by controlled studies to have a negative impact on the psychological well-being, sexual function, sexual satisfaction, and quality of life of afflicted women. Many cognitive and affective variables may influence the experience of pain and associated psychosexual problems. However, the role of the partner's cognitive responses has been studied very little. Aim The aim of the present study was to examine the associations between partners' catastrophizing and their perceptions of women's self-efficacy at managing pain on one side and women's pain intensity, sexual function, and sexual satisfaction on the other. Methods One hundred seventy-nine heterosexual couples (mean age for women = 31, SD = 10.0; mean age for men = 33, SD = 10.6) in which the woman suffered from entry dyspareunia participated in the study. Both partners completed quantitative measures. Women completed the Pain Catastrophizing Scale and the Painful Intercourse Self-Efficacy Scale. Men completed the significant-other versions of these measures. Main Outcome Measures Dependent measures were women's responses to (i) the Pain Numeric Visual Analog Scale; (ii) the Female Sexual Function Index; and (iii) the Global Measure of Sexual Satisfaction scale. Results Controlled for women's pain catastrophizing and self-efficacy, results indicate that higher levels of partner-perceived self-efficacy and lower levels of partner catastrophizing are associated with decreased pain intensity in women with entry dyspareunia, although only partner catastrophizing contributed unique variance. Partner-perceived self-efficacy and catastrophizing were not significantly associated with sexual function or satisfaction in women. Conclusions The findings suggest that partners' cognitive responses may influence the experience of entry dyspareunia for women, pointing toward the importance of considering the partner when treating this sexual health problem.

Problems and Prospects of Tea Plantation Industry in Kerala

The overall objective of the study is to examine the problems and prospects of the tea on industry in Kerala. The specific objectives are to trace the historical evolution of the tea plantation industry in India with special reference to Kerala and to study the performance of tea plantation industry in Kerala. In order to analyse the growth performance of tea plantation industry in Kerala in a comparative perspective, growth rates for the neighbouring states of Karnataka and Tamilnadu are estimated along with the National, South Indian and North Indian estimates. Tea plantation industry is a labour intensive activity. Productivity has been low primarily because of the over aging. In all the factories visited only Black tea is produced. In factories outmoded machines which installed years ago is still used which will increase the cost of production. The major problem is high cost of production and low price realization. The workers are found to be not satisfied with their working conditions- long journey to work place, absence of resting places, latrine facilities etc. and also the problems arising from dust in the factory. At a macro level the tea plantation industry has been facing the adverse impacts of globalisation and trade liberalization. There is only one solution to this problem that is to improve the competitiveness in production of raw leaf and manufacturing of tea. Government has a very important role with specification of strict quality control

International Human Rights Movements and Protection of Women's Rights

This thesis is an attempt to explore the problems faced by Indian Women and to examine the ways in which the human rights of women could be better protected in the light of international movements with special reference to national legislation and judicial decisions.The evolution of human rights from early period to Universal Declaration of Human Rights, 1948 is traced in the first chapter. The second chapter deals with the evolution of human rights in India. The evolution of fundamental rights and directive principles and the role played by the Indian Judiciary in enforcing the human rights enumerated in various international instruments dealing with human rights are also dealt with in this chapter. The rights guaranteed to women under the various international documents have been dealt with in the third chapter.It is noticed that the international documents have had their impact in India leading to creation of machinery for protection of human rights. Organised violations of women's rights such as prostitution, devadasi system, domestic violence, sexual harassment at workplaces, the evil of dowry, female infanticide etc. have been analysed in the light of existing laws and decisional jurisprudence in the fourth chapter. The fifth chapter analyses the decisions and consensus that emerged from the world conferences on women and their impact on the Indian Society and Judiciary. The constitutional provisions and legislative provisions protecting the rights of women have been critically examined in the sixth chapter. Chapter seven deals with various mechanisms evolved to protect the human rights of women. The eighth chapter contains conclusions and suggestions.

Cashew industry in Kerala problems and potentials

India is the largest producer and processor of cashew in the world. The export value of cashew is about Rupees 2600 crore during 2004-05. Kerala is the main processing and exporting center of cashew. In Kerala most of the cashew processing factories are located in Kollam district. The industry provides livelihood for about 6-7 lakhs of employees and farmers, the cashew industry has national importance. In Kollam district alone there are more than 2.5 lakhs employees directly involved in the industry, which comes about 10 per cent of the population of the district, out of which 95 per cent are women workers. It is a fact that any amount received by a woman worker will be utilized directly for the benefit of the family and hence the link relating to family welfare is quite clear. Even though the Government of Kerala has incorporated the Kerala State Cashew Development Corporation (KSCDC) and Kerala State Cashew Workers Apex Industrial Co—operative Society (CAPEX) to develop the Cashew industry, the cashew industry and ancillary industries did not grow as per the expectation. In this context, an attempt has been made to analyze the problems and potential of the industry so as to make the industry viable and sustainable for the perpetual employment and income generation as well as the overall development of the Kollam district.

“Rights of Women against Domestic Violence - The Law and Emerging Challenges”

Domestic violence is a gender based violation of human rights having multi- dimensional repercussions in the well- being of individuals in family and society. The Indian legislation to protect the women from domestic violence is significant in providing a mechanism for enforcing positive civil rights of protection and injunction orders to the victims of domestic violence along with the existing remedies of criminal sanctions. However the Act was brought in the backdrop of an established tradition of cohesive and stable family setting. This, in turn, results in the emergence of new issues and challenges which necessitates deeper understandings of indigenous sociocultural institutions in India i.e., marriage and family. This study is an attempt to analyse the Indian law on domestic violence and to assess whether the law addresses and answers the problems of domestic violence effectively in the culture specific setting of India

Nachhaltige Energie für ländliche Entwicklung in dem Sub-Sahara Afrika: interdisziplinäre Herangehensweise und organisatorische Herausforderung

Angesichts der Geschichte der Entwicklungspolitik, ist diese Arbeit darauf ausgerichtet, einige Beobachtungen in Bezug auf die so genannte Entwicklung hervorzuheben; insbesondere auf die andauernde prekäre Situation und Armut in ländlichen afrikanischen Gebieten. Armut ist nach Amartya SEN – weiter präzisiert von J.L. Dubois – die Deprivation von „Fähigkeiten“, die Individuen und lokale Gemeinschaften zu ausgeschlossenen und vergessenen Akteuren des Systems machen. Das nennt Paulo Freire, das Menschen zu „Objekten“ gemacht werden. Es rechtfertigt die starke Annahme, die in dieser Studie getroffen wird, dass vielmehr die Menschen als „Subjekte“ ihrer Veränderung und Entwicklung im Mittelpunkt stehen. Die Arbeit zeigt und erklärt in historischer Chronologie, wie die Entwicklungspolitiken und unterschiedliche Beteiligte auf allen Ebenen diese Situation verursachen. Trotz alledem bleiben die Individuen und lokalen Gemeinschaften, die in Symbiose mit ihrer natürlichen Umwelt leben, die reich an verschiedenen Ressourcen und Potentialen ist, als Reaktion darauf und gleichzeitig als Überlebensstrategie zutiefst verbunden mit dem, was sie vor Ort haben, womit sie eine tiefere und intensive Beziehung besitzen, wenn man von ihrer Geschichte, ihrer Kultur und der Handlungslogik ausgeht. Für externe Akteure, die sie über das vorhandene System dominieren und beeinflussen bleiben sie „Objekte“, aber in der Vielzahl ihrer endogenen Initiativen, zeigen sie die Fähigkeit und Substanz, die beweisen, dass sie auf ihrer Ebene das eigentliche Subjekt sind, die dynamischen Akteure. Aber isolierte Initiativen auf spezifische reale Bedürfnisse bei gleichzeitiger Dominierung durch das System mit seiner Marktlogik, führt dies langfristig nur zu dem Zirkulus Vitiosus der Armut. Daher ist eine ganzheitliche Sicht entscheidend für nachhaltige Entwicklung und für die notwendige Veränderung. Es geht nicht nur um die Veränderung des Systems und die Wahl politischer Maßnahmen, sondern genau genommen um das Verhalten der Akteure auf allen Ebenen und die Art der Beziehungen zwischen ihnen allen. Es ist eine Frage des erneuten Überdenkens des Entwicklungspfades, der andere Logik, Visionen, Interessen und Strategien aller Beteiligten, unserer so genannten Akteure einschließt. Ob dies von endogenen Initiativen oder neuen gemeinsamen Projekten ausgeht: man wird in einen Prozess kollektiven Lernens eintreten, den Paul Singer und Clarita Müller-Plantenberg erläutern und entwickeln in dem Konzept der Inkubation und Solidarischen Ökonomie, die Eigeninitiative, Selbstbestimmung und Selbstverwaltung von lokalen Gemeinschaften und die Öffnung für eine Neu-Konzeptualisierung und Institutionalisierung einschließt. So ein Prozess ist nur mit einem interdisziplinären Rahmen möglich. Dieser Rahmen soll auf einer zusätzlicher Kommunikation zwischen den Akteuren und Sozialwissenschaften beruhen und mit jenen, die auf dem Feld der Technologie arbeiten. So können dann technische „Experten“ angesichts eines technischen Projektfehlers, der aufgrund von bestimmten sozialen und kulturellen Realitäten zustande kam sagen, „es ist kein Scheitern ; es war ein Schritt innerhalb eines Lernprozesse der in die technischen Projekte und Studien einbezogen werden muss“. Wir haben das Energiethema gewählt; und insbesondere, Energie für eine nachhaltige ländliche Entwicklung in Subsahara-Afrika, um den Weg von der Theorie in die Praxis zu illustrieren und experimentell auszuprobieren, den Weg von den Beobachtungen zu der Veränderung, wobei Fragen, Annahmen, Strategien und konkrete Aktionen für den Wandel behandelt werden. Wir nennen unseren experimentellen Weg: DRIEE, das heißt auf Deutsch Ländliche Entwicklung und Inkubation von Energieunternehmen. Dabei gehen wir davon aus, dass: - Energie im Allgemeinen auf der internationalen Ebene fast gleichbedeutend mit Elektrizität ist. Heute bestehen die wichtigsten Bedürfnisse nach Energie dort wo die agro-pastorale Produktion, das Kochen, die Nahrungsmittelkonservierung und Verarbeitung …etc. stattfindet. - Diese ländliche Bevölkerung zu etwa 80% der nationalen Wirtschaft ausmacht. Dass sie gleichzeitig aber nur zu weniger als 5% der Energieproduktion Zugang hat, was oft auf Licht reduziert ist und nicht einmal ihrer Produktion zugute kommen kann. - Die Projekte für Energie und Elektrizität vor allem auf die Technologischen Fragen konzentriert sind und weniger auf die Bedürfnisse. Fast die Gesamtheit der Fonds für Energie wird in Bezug auf die Investitionen Infrastruktur der Produktion und Verteilung durch die konventionellen zentralisierten Netze geplant. Angesichts dieser Analysen gehen die in dieser Arbeit vorgenommenen Studien in Gambia und Kamerun von Bestandsaufnahmen und / oder beschreibenden regionalen Analysen aus: - von Bedürfnissen, von Praktiken und lokalen Initiativen von Fragen der Energie, für einzelne Professionen, Haushalte, Gruppen, spezifische Gruppen, wie Frauen, ländliche Gemeinden mit ihren spezifischen Charakteristika. - Von Potentialen: natürliche lokale Energieressourcen, soziokulturelle Ressourcen – so z.B. die empirisch feststellbaren menschliche Ressourcen wie endogenes Wissen und praktische organisatorische Fähigkeiten gegenüber den Problemen der Energie. Dieser experimentelle Schritt von Handlungsforschung (DRIEE) in Kamerun führte zu der Gründung einer Organisation, über die und mit der wir die Logik der Inkubation und Solidarischen Ökonomie einführen. Das ist FERDEDSI, das heißt auf Deutsch „Forum für Erneuerbare Energie – Nachhaltige Entwicklung und Internationale Solidarität“. Zunächst war dies eine Energiegenossenschaft und dann (im Prozess) wurde es zu einer institutionellen Nische von mehreren Mikro Initiativen in ländlichen Gebieten. FERDEDSI ist ein Prozess der Inkubation und ein Inkubator ist also gleichzeitig ein inkubiertes Energieunternehmen aber auch ein Inkubator für lokale Organisationen. Die ersten Aktionen finden in den Departments von Noun und Ménoua in der westlichen Provinz von Kamerun statt. Während der Forschungsperiode findet akademische Austausch statt (Nord-Süd und Süd-Süd), diese ist dabei zu formalen Partnerschaften zu werden, nicht nur zwischen Universitäten sondern genauer lokale Organisationen und Universitäten. Dieser letzte Typ von Partnerschaften, die die solidarische Ökonomie ausmachen ist auch eine Innovation des Prozesses für die afrikanischen Fälle, die dem Beispiel dessen, was in Lateinamerika geschieht, folgen. So kommt es zu gegenseitiger sinnvoller Ausbildung in den internationalen Arbeitsgruppen und Seminaren der Universität.

La experiencia de los receptores en el trasplante de órganos y tejidos

El trasplante de órganos y/o tejidos es considerado como una opción terapéutica viable para el tratamiento tanto de enfermedades crónicas o en estadios terminales, como de afectaciones no vitales, pero que generen una disminución en la calidad de vida percibida por el paciente. Este procedimiento, de carácter multidimensional, está compuesto por 3 actores principales: el donante, el órgano/tejido, y el receptor. Si bien un porcentaje significativo de investigaciones y planes de intervención han girado en torno a la dimensión biológica del trasplante, y a la promoción de la donación; el interés por la experiencia psicosocial y la calidad de vida de los receptores en este proceso ha aumentado durante la última década. En relación con esto, la presente monografía se plantea como objetivo general la exploración de la experiencia y los significados construidos por los pacientes trasplantados, a través de una revisión sistemática de la literatura sobre esta temática. Para ello, se plantearon unos objetivos específicos derivados del general, se seleccionaron términos o palabras claves por cada uno de estos, y se realizó una búsqueda en 5 bases de datos para revistas indexadas: Ebsco Host (Academic Search; y Psychology and Behavioral Sciences Collection); Proquest; Pubmed; y Science Direct. A partir de los resultados, se establece que si bien la vivencia de los receptores ha comenzado a ser investigada, aún es necesaria una mayor exploración sobre la experiencia de estos pacientes; exploración que carecería de objetivo si no se hiciera a través de las narrativas o testimonios de los mismos receptores

The re-urbanization of the city center of Manaus , Brazil - Facing the challenges of informal settlements

Illegal occupation of urban land in Brazil is a widespread phenomenon. Slum dwellers are excluded from the attributes of urban citizenship although they provide the labor force required by low productivity urban services needed by cities. Illegal settlements generate multiple problems for the rest of the city . Its solution is of key relevance to the city in general but also provide an opportunity for the social and economic advancement of slum dwellers. The programs required to attain these results are complex and difficult to implement underscoring the challenges countries will face to attain the Millennium Development Goals of reducing the population living in slums.