Healthcare providers balancing norms and practice : challenges and opportunities in providing contraceptive counselling to young people in Uganda - a qualitative study

BACKGROUND: Pregnancies among young women force girls to compromise education, resulting in low educational attainment with subsequent poverty and vulnerability. A pronounced focus is needed on contraceptive use, pregnancy, and unsafe abortion among young women. OBJECTIVE: This study aims to explore healthcare providers' (HCPs) perceptions and practices regarding contraceptive counselling to young people. DESIGN: We conducted 27 in-depth interviews with doctors and midwives working in seven health facilities in central Uganda. Interviews were open-ended and allowed the participant to speak freely on certain topics. We used a topic guide to cover areas topics of interest focusing on post-abortion care (PAC) but also covering contraceptive counselling. Transcripts were transcribed verbatim and data were analysed using thematic analysis. RESULTS: The main theme, HCPs' ambivalence to providing contraceptive counselling to sexually active young people is based on two sub-themes describing the challenges of contraceptive counselling: A) HCPs echo the societal norms regarding sexual practice among young people, while at the same time our findings B) highlights the opportunities resulting from providers pragmatic approach to contraceptive counselling to young women. Providers expressed a self-identified lack of skill, limited resources, and inadequate support from the health system to successfully provide appropriate services to young people. They felt frustrated with the consultations, especially when meeting young women seeking PAC. CONCLUSIONS: Despite existing policies for young people's sexual and reproductive health in Uganda, HCPs are not sufficiently equipped to provide adequate contraceptive counselling to young people. Instead, HCPs are left in between the negative influence of social norms and their pragmatic approach to address the needs of young people, especially those seeking PAC. We argue that a clear policy supported by a clear strategy with practical guidelines should be implemented alongside in-service training including value clarification and attitude transformation to equip providers to be able to better cater to young people seeking sexual and reproductive health advice.

Aquaculture Research and Development as an Entry-Point and Contributor to Natural Resources and Coastal Management

Recent, fervent international dialogue concerning the existence and magnitude of impacts associated with aquaculture has had both positive and negative outcomes. Aquaculture stakeholders have become sensitized to requirements for improved environmental management of aquaculture. on the other hand, in some cases aquaculture development has been negatively affected by some of the unwarranted and unproved allegations to the detriment of the stakeholders most in need of aquaculture development (i.e., resource users, particularly the poor, who are dependent on natural resources). These resource users are targeted by, and directly influence biodiversity and conservation agendas; hence the need to understand how to gain their active participation. This discussion focuses on examples of how aquaculture research and development can be a useful tool or strategy for resource management initiatives and provide tangible positive including increased stakeholder participation and cooperation, offering alternatives to resource extraction and use in otherwise difficult or intransigent resource management conflicts.

Expression of apoptotic and cell proliferation regulatory proteins in keratoacanthomas and squamous cell carcinomas of the skin

The aim of this study was to investigate the expression of p53, caspase-3, bcl-2, MIB-1, and PCNA to validate more objective methods to differentiate squamous cell carcinoma and keratoacanthoma, as well as to understand their pathogenesis with accuracy. A total of 52 cases of histopathologically diagnosed keratoacanthoma in the proliferative stage and 56 cases of well-differentiated squamous cell carcinoma were selected in this study. The expression was evaluated by means of immunohistochemistry. Bcl-2 immunoreactivity was weak or absent in the majority of cases, either in squamous cell carcinoma or in keratoacanthoma. PCNA-positive cells did not show differences between two lesions evaluated. on the other hand, MIB-1 was statistically significant (p<0.05) between squamous cell carcinomas and keratoacanthomas. Moreover, p53 and caspase-3 were overexpressed in squamous cell carcinomas. Together, these results suggest that the biological behavior of the well-differentiated squanous cell carcinomas of the skin may be associated with cellular proliferation and/or deregulation of cell death, indicated by increased expression of the MIB-1 and apoptotic proteins p53 and caspase-3, respectively. (C) 2007 Elsevier GrnbH. All rights reserved.

Effect of estrogen therapy, soy isoflavones, and the combination therapy on the submandibular gland of ovariectomized rats

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Breastfeeding knowledge and practice of health professionals in public health care services

Objetivou-se avaliar conhecimentos e práticas sobre aleitamento materno de profissionais que atendem lactentes em unidades de atenção básica, ou maternidades públicas, de município do interior paulista, Brasil. É estudo epidemiológico, sendo a população composta por 89 enfermeiros e médicos. Suas respostas a um questionário estruturado foram analisadas no total e segundo o local de trabalho, aplicando-se o teste de diferença de proporções (qui-quadrado), considerando-se p<0,05 como nível crítico. Como parâmetros de acertos foram consideradas as recomendações do Ministério da Saúde. As diferenças significativas para conhecimentos e práticas, segundo o local de trabalho, foram restritas a alguns aspectos, com resultados discretamente melhores dos escores médios de acertos dos profissionais das unidades de atenção básica. Independente do local de trabalho, verificou-se desempenho regular e ruim em diferentes aspectos estudados, indicando que possíveis intervenções para a capacitação nessa temática deverão incluir profissionais de todos os níveis de atenção à saúde.

Chemical communication, aggression, and conspecific recognition in the fish Nile tilapia

The chemical modulation of agonistic behavior and conspecific recognition were tested in juveniles of the fish Nile tilapia, Oreochromis niloticus (L.). After a 7-day isolation period, the fish were grouped (four individuals per aquarium) for 7 days. Then fish of alpha and beta ranks (previously matched for similar size) were paired in a neutral territory for analysis of their agonistic interaction. Pairs composed of alpha and beta fish were established with either fish from the same group (familiar) or from two different groups (unfamiliar). The pairs were tested in contiguous compartments, either with water exchange between the compartments or in the absence of water exchange. In each condition the fish were separated by a transparent glass partition. Twelve pairs were tested in each experimental condition. Fish behavior was videotaped and the following variables were analyzed: (a) frequency of and time spent in agonistic patterns, (b) latency to start fighting, and (c) duration of swimming. Water exchange between compartments decreased agonistic interactions. This effect, however, was more pronounced in pairs of fish coming from the same group (in this case, subordinate fish spent less time in confrontations than dominant ones). We conclude that chemical communication decreases aggression in this species by (1) inducing an alarm reaction and (2) increasing conspecific recognition (thus stabilizing the dominance hierarchy). (C) 1997 Elsevier B.V.

The proliferating cell nuclear antigen index in breast carcinomas does not correlate with mitotic index and estrogen receptor immunoreactivity

To investigate the expression of a marker of cell proliferation (PCNA/Cyclin) and its putative relationship with histological grading, mitotic index and estrogen receptor immunoreactivity, we studied twenty-seven cases of invasive breast carcinoma in formalin-fixed, paraffin-embedded tissue sections. The PCNA and estrogen receptor were detected by the PC10 and H222 monoclonal antibodies respectively, using an avidin-biotin-pernxidase method. The median value of PCNA index was 20.9% with a range from 1.4 to 84.2%. We did not find any significant relationship between PCNA index anti the histological grading, mitotic index and estrogen receptor immunoreactivity. We conclude that PCNA detected by the monoclonal antibody PC10 in formalin-fixed material looks at present unrealiable as a proliferation marker in breast carcinoma.

Effects of research and extension on agricultural growth and equity in Brazil.

Studies the effects of investment in research and extension on total agricultural production and on production of individual crops. Some distributional effects are briefly discussed. Due to the lack of data, the first part of the analysis is restricted to the State of Sao Paulo, and the second part covers the entire country.-from Author

Perception-action coupling in infants with down syndrome: Effects of experience and practice

This study examined the effects of experience and practice on the coupling between visual information and trunk sway in infants with Down syndrome (DS). Five experienced and five novice sitters were exposed to a moving room, which was oscillated at 0.2 and 0.5 Hz. Infants remained in a sitting position and data were collected on the first, fourth, and seventh days. On the first day, experienced sitters were more influenced by room oscillation than were novices. On the following days, however, the influence of room oscillation decreased for experienced but increased for novice sitters. These results suggest that the relationship between sensory information and motor action in infants with DS can be changed with experience and practice.

Theory and practice of industrial policy: evidence from the Latin American experience

Includes bibliography

Communication strategy and migration policy; an exploratory literature survey pertaining to the Latin American situation

Includes bibliography