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Background: The use of long-acting reversible contraceptives (LARCs) is globally accepted as a strategy that is successful in decreasing rates of unintended pregnancy, especially in very young women. Currently, Australia has very low uptake rates of LARC., Objective: The aim of this paper is to explore the latest information on using LARCs as first-line contraception in young women., Discussion: Low uptake of LARCs may be related to Australia's prevailing cultural norm of oral contraception, and practitioner and patient misperceptions of the safety and efficacy of LARC, which have been dispelled in recent years. LARCs are widely recommended by professional bodies and the World Health Organization (WHO) as first-line contraception for young women as they are safe, effective and reversible. Young women should be offered the choice of a LARC as part of a fully informed decision for their first form of contraception.

Research suggests that the scale of human population and the current pace of its growth contribute substantially to the loss of biological diversity. Although technological change and unequal consumption inextricably mingle with demographic impacts on the environment, the needs of all human beings-especially for food-imply that projected population growth will undermine protection of the natural world. Numerous solutions have been proposed to boost food production while protecting biodiversity, but alone these proposals are unlikely to staunch biodiversity loss. An important approach to sustaining biodiversity and human well-being is through actions that can slow and eventually reverse population growth: investing in universal access to reproductive health services and contraceptive technologies, advancing women's education, and achieving gender equality., (Copyright © 2017, American Association for the Advancement of Science.)

Created to foster inclusive excellence, Smith College's Achieving Excellence in Mathematics, Engineering, and Science (AEMES) Scholars program provides early faculty-mentored research opportunities and other programming as a way to foster success in academic outcomes for underrepresented women in science. Using academic record data, we compared Scholars' outcomes over time with those of underrepresented students before program launch and to relevant peer comparison groups. Since its launch, AEMES Scholars have achieved significantly higher gateway life sciences course grade point averages (GPAs), rates of persistence in life and natural sciences, and participation in natural sciences advanced research relative to baseline. Gains for Scholars in gateway course GPA eliminated the significant gap that previously existed between science, technology, engineering, and mathematics (STEM)-underrepresented and other students, whereas gains in natural sciences persistence now has Scholars continuing in STEM at significantly higher rates than all other students. Many of the gains for AEMES Scholars were echoed in findings of improved outcomes for our STEM students overall since AEMES' launch. Underrepresented students who were not part of the Scholars program also evidenced increased gateway course GPA over this same period. We discuss potential explanations for these outcomes and ongoing work aimed at achieving further inclusive excellence for women in the sciences., (© 2017 L. A. Katz et al. CBE—Life Sciences Education © 2017 The American Society for Cell Biology. This article is distributed by The American Society for Cell Biology under license from the author(s). It is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).)

Sustainable intensification (SI) is a term increasingly used to describe a type of approach applied to international agricultural projects. Despite its widespread use, there is still little understanding or knowledge of the various facets of this composite paradigm. A review of the literature has led to the formalization of three principles that convey the current characterization of SI, comprising a whole system, participatory, agroecological approach. Specific examples of potential bottlenecks to the SI approach are cited, in addition to various technologies and techniques that can be applied to overcome these obstacles. Models of similar, succcessful approaches to agricultural development are examined, along with higher level processes. Additionally, this review explores the desired end points of SI and argues for the inclusion of gender and nutrition throughout the process. To properly apply the SI approach, its various aspects need to be understood and adapted to different cultural and geographic situations. New modeling systems and examples of the effective execution of SI strategies can assist with the successful application of the SI paradigm within complex developing communities. © 2016 Society of Chemical Industry., (© 2016 Society of Chemical Industry.)

What can be done to encourage and support women of color in STEM fields? Genome Biology spoke with three women of color who have had success in the area of genomics research.

Background: More women are choosing to have a bilateral mastectomy to treat unilateral breast cancer despite it not being considered the standard of care. Women are making this choice for various reasons, including anxiety of follow-up screening of the other breast, risk of cancer recurrence for the rest of their lives, and desire to maintain control over the localized cancer. Currently, evidence-based information is lacking regarding this treatment choice. In addition, the concept of survivorship has yet to be examined in this population of women., Objectives: This study aimed to explore women's educational needs and perceptions about survivorship following bilateral mastectomy as a treatment for unilateral breast cancer., Methods: In-depth interviews were conducted with 23 women using a semistructured interview guide. Data were elicited, coded, and analyzed using thematic analysis., Findings: Two themes were identified that addressed education and survivorship.

The authors highlight a community's response to women's use of force, detail aspects of intervention strategies, and introduce a conceptual model representing the women's change process. In doing so, they encourage community partnerships, continued intervention innovation, and further research. Their observations suggest an intervention philosophy and approach that women have described as one of personal "renewal." The community's experiences are notable in light of national efforts to effectively meet the needs of female survivors of intimate partner violence who have used force., (© The Author(s) 2015.)

According to the American Cancer Society, more than 1,93,000 cases of breast cancer are diagnosed every year with an estimated 40,000 deaths. It is thus very important that women themselves are made aware about the importance of breast self-examination, which is possible through adequate information and motivation by the health-Pare provider itself With the promise that the incidence of breast cancer is preventable and curable with proper awareness through nurses, an evaluator approach pre-test post-test study involving 50 perimenopausal womens was undertaken. The findings proved that planned teaching can improve the knowledge ofthe women to a great extent and improve the practice of breast self-examination. Thus, it is possible to reduce the breast cancer-related mortality and morbidity rate through self-examination ofthe breast.

Background: Few studies have examined recreational physical activity (RPA) after participating in a structured exercise intervention. More specifically, little is known about the long-term effects of exercise interventions in post-menopausal women. This study had two objectives: 1) To compare RPA in postmenopausal women in the exercise group and the control group 12 months after the end of the Alberta Physical Activity and Breast Cancer Prevention (ALPHA) Trial; and 2) To apply the Theory of Planned Behaviour (TPB) to identify predictors of RPA 12 months post-intervention among women in the exercise group., Methods: Self-reported RPA 12-months post-intervention from a validated questionnaire was used to estimate RPA levels for control group (118/160, 74% response) and exercise group participants (126/160, 79% response). Bivariate analysis was used to compare RPA between exercise and control group participants and to identify TPB variables for multivariate analysis. Logistic regression was applied to TPB data collected from self- administered questionnaires at end of trial by exercise group participants (126/160, 79% response) to identify predictors of long-term RPA., Results: At 12 months post-intervention, 62% of women in the exercise group were active compared to 58% of controls (p = 0.52). Of the TPB constructs examined, self-efficacy (OR =2.98 (1.08-8.20)) and behavioural beliefs (OR = 1.46 (1.03-2.06)) were identified as predictors of RPA for exercise group participants., Conclusions: Levels of RPA in the exercise and control groups were comparable 12 months post intervention, indicating that participation in the ALPHA trial was associated with increased physical activity in previously inactive women, regardless of randomization into either the exercise group or in the control group. Exercise interventions that promote self-efficacy and positive behavioural beliefs have the potential to have long-term impacts on physical activity behaviour, although further research is needed to examine additional psychological, social and environmental predictors of long-term RPA in post-menopausal women., Trial Registration: ClinicalTrials.gov NCT00522262.

Objective: Family physicians in Canada as reported in several studies do not recognize the importance of family history in relation to breast/ovarian cancer and thus Canadian women with strong family histories continue to develop early-onset breast cancer without the knowledge of or ability to make choices regarding increased surveillance or preventative strategies. This study explored the feelings of women who learned about their hereditary risk only after their diagnosis younger than 52 years and who eventually tested positive for a BRCA gene mutation., Methods: Thirty-four such women were mailed an invitation to participate in this research including a letter of information, consent form, and discussion prompts for their written narrative response. Rigorous mixed method analyses were performed using Charmaz-based qualitative analyses as well as quantitative analyses., Results: Thirteen women (38.2%) responded with narratives for qualitative analysis from which 4 themes were coconstructed as follows: I, types of emotions; II, emotional response; III, coping with emotions; and IV, advice to women at similar risk. Women felt they should have learned about their hereditary risk from their family physician and through public education before their diagnosis. Although not experienced at the time of diagnosis, anger, frustration, and regret were experienced after receiving their BRCA results. These emotions arose from our research participants' lack of opportunity for prior genetic counseling and testing opportunity for genetic counseling and testing., Conclusions: With increased public and physician education, it is hoped that women with significant family histories of breast/ovarian cancer will be identified before diagnosis and given options regarding cancer surveillance and risk reduction strategies.

Background: This paper presents results of baseline data on the determinants of contraceptive use in 7 districts in northern Ghana where there is an ongoing integrated primary health care systems strengthening projectknown as the Ghana Essential Health Intervention Project (GEHIP)., Methods: We used a household survey data conducted within 66 randomly sampled census enumeration areas in seven rural districts of the Upper East Region of northern Ghana where health systems strengthening interventions are currently ongoing in three of the districts with four of the districts serving as comparison districts. This survey was conducted prior to the introduction of interventions. Data was collected on various indices included geographic information systems (GIS) and contraceptive use. The data was analyzed using survey design techniques that accounts for correct variance estimation. Categorical variables were summarized as proportions and associations between these variables and contraceptive use tested using Chi-square test. Uni-variable and multivariable logistic regression techniques were used to assess the effects of the selected covariates on contraceptive use. All tests were deemed to be statistically significant at 5% level statistical significance., Results: Results show that contraceptive use is generally low (about 13 per cent) and use is nearly evenly for spacing and stopping purposes. Factors associated with the use of contraceptives include exposure to integrated primary healthcare services, the level of education, and socioeconomic status, couple fertility preference, marital status, and parity. For instance, the odds of contraceptive use among 15-45 year old women who live 2 km or more from a CHPS compound is 0.74 compared to women who live less than 2 km from a CHPS compound (p-value = 0.035)., Conclusion: The findings suggest that rapid scale up of the Community based Health Planning and Services (CHPS) program accompanied with improved door-to-door health services would kindle uptake of modern contraceptive use, reduce unwanted pregnancies and hasten the attainment of MDG 4 & 5 in Ghana.

Background: Despite efforts to reduce under-5 mortality rates worldwide, an estimated 6.6 million under-5 children die every year. Community mobilisation through participatory women's groups has been shown to improve maternal and newborn health in rural settings, but little is known about the potential of this approach to improve care and health in children after the newborn period., Methods: Following on from a cluster-randomised controlled trial to assess the effect of participatory women's groups on maternal and neonatal health outcomes in rural Bangladesh, 162 women's groups continued to meet between April 2010 and December 2011 to identify, prioritise and address issues that affect the health of children under 5 years. A controlled before-and-after study design and difference-in-difference analysis was used to assess morbidity outcomes and changes in knowledge and practices related to child feeding, hygiene and care-seeking behaviour., Findings: Significant improvements were measured in mothers' knowledge of disease prevention and management, danger signs and hand washing at critical times. Significant increases were seen in exclusive breast feeding for at least 6 months (15.3% (4.2% to 26.5%)), and mean duration of breast feeding (37.9 days (17.4 to 58.3)). Maternal reports of under-5 morbidities fell in intervention compared with control areas, including reports of fever (-10.5% (-15.1% to -6.0%)) and acute respiratory infections (-12.2% (-15.6% to -8.8%)). No differences were observed in dietary diversity scores or immunisation uptake., Conclusions: Community mobilisation through participatory women's groups can be successfully adapted to address health knowledge and practice in relation to child's health, leading to improvements in a number of child health indicators and behaviours., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.)

This paper examines fertility transition in Kinshasa, capital of the Democratic Republic of the Congo (DRC) and second-largest city in sub-Saharan Africa. Shapiro (1996) documented the onset of fertility transition in the city, using data from 1990. Women's education was strongly inversely related to fertility, beginning with secondary schooling, and increases in women's education were important in initiating fertility transition in the city. The paper uses data from the 2007 Demographic and Health Survey in the DRC to examine fertility in Kinshasa and assess fertility transition since 1990, a period characterized by severe adverse economic conditions in the DRC. Fertility transition has continued at a strong pace. In part this reflects increased educational attainment of women, but it appears also to be largely a consequence of enduring economic hardship. The ongoing fertility decline has been accompanied by substantial delays in entry to marriage and childbearing, reflecting adverse economic conditions, which in turn have contributed to continuing declines in fertility.

Background: Sexual dysfunction is the most common disorder in women. According to the WHO, sexual education programs are considered as a need. Therefore, this study was designed to investigate the effect of educational program on sexual function in women with sexual dysfunction., Methods: This randomized trial, was conducted in 2013 on 90 married women by convenient sampling in Qazvin, central Iran. The demographic, Female Sexual Function Index (FSFI), and Beck's Depression Inventory (BDI) questionnaires were completed during structured interviews. After completing the sample size, subjects were divided randomly into two groups by using the table of random numbers (educational and control groups), then respectively received an educational intervention in the four sessions with one week interval and routine program offered by the center and following-up was done with refilling questionnaires 8 weeks after intervention., Results: Sexual function improved after sex educational programs in all dimensions (sexual desire (P=0.006), sexual exciting (P=0.006), vaginal moisture (P=0.002), sexual satisfaction (P=0.011), and total score of sexual function (P=0.001)., Conclusions: Considering the importance role of sexual function in family strength, health, and development, it can be claimed that educational sex programs can help practitioners to improve sexual function of married women with sexual dysfunction.

Purpose of the Research: To test whether health literacy is associated with sunlight exposure behavior, we interviewed 648 Chinese adults aged 65 years or older., Methods: Using the information-motivation-behavioral skills model and structural equation modeling, we tested whether health literacy was associated with the complex relationships among knowledge about vitamin D, attitudes toward sunlight exposure, doctor recommendations regarding sunlight exposure, and sunlight exposure behavior., Results: Health literacy was directly associated with sunlight exposure (β=.20, p<.01). Indirect relationships also existed between knowledge and sunlight exposure through health literacy (β=.46, p<.001) and between attitudes and sunlight exposure through health literacy (β=-.12, p<.05). The model had good fit (χ(2)/df=2.79; RMSEA=.053, p=.346; CFI=.95; TLI=.92)., Conclusions: Health literacy should be considered when educating older adults about vitamin D supplements and sunlight exposure. Providing relevant knowledge or making doctor recommendations might not be effective. Training should focus on individuals with low health literacy who may be less likely to receive sunlight exposure., (Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.)

There remains resistance to feminist self-defense and resistance training programming for women, despite (a) documented effectiveness of rape resistance strategies in avoiding rape, (b) consistently high rates of sexual victimization on college campuses, and (c) limited evidence of lasting change in sexual assault perpetration reduction within existing men's prevention programs. The current article seeks to discuss (1) the rationale for feminist self-defense and resistance training for women, (2) key components of feminist self-defense and resistance training, (3) barriers to its implementation, (4) outcomes of self-defense and resistance training programming, and (5) recommendations for future work. Such suggestions include increasing funding for large-scale self-defense and rape resistance outcome research to examine program effectiveness. Specifically, outcome research that examines the role of contextual factors (e.g., alcohol use) and women's victimization histories is needed. Finally, self-defense training and resistance training should be combined with bystander intervention and men's programs with the goal of providing synergistic effects on rape reduction., (© The Author(s) 2014.)

Often labeled "ivory towers," colleges are fertile breeding grounds of male to female sexual assault and other types of woman abuse. Still, across the United States and elsewhere, many researchers, practitioners, and activists are involved in an ongoing and ever-changing struggle to curb female victimization in institutions of higher learning. The main objective of this article is to offer a few thoughts about some prevention issues raised by Christine Gidycz. Special attention is devoted to the dangers associated with new electronic technologies, including texting and Internet pornography., (© The Author(s) 2014.)

Background: More than half of Pakistani women are illiterate, marginalized, and experience myriad health problems. These women are also disadvantaged in terms of their restricted mobility and limited access to public space. Nonetheless, user-friendly information and communication technologies (ICTs) have opened up new opportunities to provide them with information that is essential for their health and well-being., Methods: We established an Information and Communication Centre (ICC) in a village in Sialkot (Pakistan) on a pilot basis in 2009. The basic philosophy of the ICC was to provide women with health-related information by exposing them to modern sources of information on their doorstep. By design, the ICC was a community-based and community-managed institution where women could access information through online (e.g., internet, mobile phone etc.) and offline (e.g., CDs, TV etc.) resources. The ICC was managed by a group of local volunteer women who had the capacity and skills to use the devices and tools of modern ICTs., Results: We noted an overwhelming participation and interest from local women in the activities of the ICC. The women wanted to receive information on a wide range of issues, from family planning, antenatal care, and childcare to garbage disposal and prevention of domestic violence. Overall, the ICC was successful in initiating a meaningful "information dialogue" at community level, where much-needed information was retrieved, negotiated, mediated, and disseminated through intimate and trusted relations., Conclusion: We conclude that ICTs have the capacity to cross the barriers of illiteracy and can reach out to disadvantaged women living under a conservative patriarchal regime.

Objective: To evaluate the effect of an intervention based on the Precede-Proceed Model on attitudes towards prevention of Domestic Violence among Iranian girls., Methods: The randomised controlled trial was conducted during 2010-11 at 10 high schools in District 17 ofTehran Municipality in Iran. The subjects were divided into two equal groups of cases and controls. Components of the Precede-Proceed Model for planning, implementation and evaluation of the study. After need assessment, an appropriate environmental and educational intervention was implemented in the intervention group. Changes in predisposing, reinforcing, enabling factors and especially attitudes towards prevention of Domestic Violence immediately and two months after the intervention were assessed in by questionnaires based on the Precede-Proceed Model. SPSS 18 was used for statistical analyses., Results: There were 510 students who comprised the study population, with 255 individuals in each of the two groups. The intervention had significantly positive effect on predisposing, enabling and reinforcing factors immediately and two months after the intervention (p < 0.05). Repeated measures analysis of variance showed a significant positive increase in attitude score in the intervention group from baseline to two months (p < 0.001)., Conclusion: The Precede-Proceed Model is one of the most widely used health planning models for identifying factors that influence health behaviours associated with domestic violence. Implementation of an educational programme based on the model among young girls was effective in changing attitude towards domestic violence.

Objectives of the study were to identify the problems faced by menopausal women and to find out the remedial measures adopted by them, to assess the knowledge of menopausal women regarding menopause & hormone replacement therapy (HRT) before and after administration of self-instructional module (SIM) and to find out the acceptability and utility of the SIM. An evaluative research approach, with pre-experimental one group pre-test post-test design was adopted. Purposive sampling technique was used to obtain an adequate size of the sample. The sample comprised of 100 menopausal women living in selected community of Moradabad (UP). A knowledge questionnaire and opinionnaire were administered, and SIM on menopause and HRT administered. It was found that there was deficit in knowledge of menopausal women regarding menopause and HRT. Mean post-test knowledge scores were significantly higher than mean pre-test knowledge scores. SIM was found highly acceptable and useful by menopausal women.

Objective: The objective of this study is to determine the role of different health belief model components in practice of breast cancer screening among Iranian women., Subjects and Methods: A cross-sectional study of 500 women aged 18-65 years was conducted in an urban population under the coverage of a health therapeutic system in Babol, northern Iran in 2012. Demographic data and data regarding practice of breast self-examination (BSE), breast clinical examination (BCE), and mammography were collected by interview, and a standard health belief model questionnaire was used to assess women's attitudes in six different domains based on a Likert scale that ranked from 1 to 5. The average score of each item for each domain was calculated. The Wilcoxon rank test and a multiple logistic regression model were used to estimate the odds ratio of each domain for performing breast cancer screening (BSE, BCE, and mammography)., Results: The mean age of the women was 31.2 (9.4) years. Overall, the average scores in domains of perceived benefit, self-efficacy, and health motivation were significantly higher among those who performed BSE and BCE, but not for mammography. For the domains of perception of susceptibility, seriousness, and barriers, no significant differences were observed. Higher scores on the scales of perceived benefits, perceived confidence/self-efficacy, and health motivation showed significant positive association with performing BSE [adjusted OR (95 % confidence interval [CI]) 1.73 (1.11, 2.72), 4.01 (2.39, 6.73), and 2.01 (1.30, 3.08), respectively] and BCE [adjusted OR (95 % CI) 1.65 (1.0, 2.95), 2.33 (1.39, 3.91), and 1.58 (1.0, 2.53), respectively], but not for performing mammography. For perceived susceptibility, perceived seriousness, and barriers, no significant association was observed., Conclusions: Positive attitudes toward perceived benefits, perceived confidence/self-efficacy, and health motivation have a strong association with performing BSE and BCE. The impact of health belief model subscales on breast cancer screening may vary with respect to culture and values.

Studies indicate that women in China are not frequently carrying out breast cancer prevention practices. This is assumed to be due to lack of knowledge and/or lack of personalized instruction. This study was to explore the effect of breast cancer health education on women's knowledge and attitudes on breast cancer and breast self-examination, behavior related to breast self-examination among women living in the catchment area of a community health center. A pretest and posttest assessment of a 1-h health education session was conducted with 38 participants. A telephone reminder and questionnaires were administered at 1 and 3 months after the education. Three instruments were administered at each contact to assess the knowledge and attitudes on breast cancer and behavior related to breast self-examination and accuracy of breast self-examination before education, 1- and 3-month follow-ups after education. The findings showed the incidence of self-examination, and scores on the accuracy of breast self-examination practice were significantly increased immediately following the intervention and at 1- and 3-month follow-ups. Furthermore, the scores of the health belief regarding perceived benefits, perceived competency, and perceived seriousness significantly improved. The current findings imply community-based intervention could be used to teach women about the general knowledge of breast cancer and how to perform breast self-examination correctly, especially for women who are lack of such information.

Estimates suggest that between 41% and 94% of breast cancer survivors may develop the chronic condition of secondary lymphedema at some point during their lifetimes. Self-care is critical for effective lymphedema management and risk-reduction. At the same time, women in general have been characterized as engaging in self-sacrificing behaviors in which they choose other-care over self-care. This study explored the self-care experiences of women with breast cancer within the contexts of complex and demanding familial and work-related responsibilities. Participants (N=14) were enrolled in a behavioral-educational intervention aimed at lymphedema risk-reduction. This feminist family theory-informed secondary analysis of qualitative data focused on women's familial roles and the balance or lack of balance between self-sacrifice and self-care. Findings included participants' struggles with time management and prioritizing self-care over care of others as well as making a commitment to self-care. Findings have implications for patient and family-level education and research with regard to gender role-based barriers to self-care and self-care within complex social contexts.

Background: Socioeconomic and racial/ethnic disparities in breast and cervical cancer screening persist. An exploratory study was conducted to better understand co-occurring risk factors in underserved groups that could inform interventions to improve screening adherence. The objective of this study was to examine associations between breast and cervical cancer screening adherence and co-occurring risk factors in three racial/ethnic groups of underserved women., Methods: Black, Latina, and Arab women (N=514), ages 21 to 70 years, were enrolled into the Kin Keeper(SM) randomized controlled trial in communities around Detroit, Michigan. We used participant baseline assessments (e.g., demographic characteristics, health literacy) to explore screening risks using an additive approach and multivariate logistic analyses., Results: For black women, having more health literacy risks were associated with reduced odds of a clinical breast exam (CBE), mammogram, and Papanicolaou (Pap) test; more competing priorities were associated with reduced odds of a Pap test; lack of doctor mammogram recommendation was significantly associated with decreased odds of CBE. For Latina women, lack of doctor recommendations were significantly associated with decreased odds of CBE, mammogram, and Pap test. For Arab women, lack of doctor recommendations were significantly associated with decreased odds of CBE, mammogram, and Pap test; more competing priorities were significantly associated with reduced odds of CBE and Pap test. All results were significant at p<0.05., Conclusions: Characteristics associated with breast and cervical screening adherence differs among Black, Latina, and Arab underserved women. Interventions to improve screening should be tailored for racial/ethnic groups with particular attention to competing survival priorities, health literacy risks factors, and provider recommendations.

Over the past half century the gap in mortality across education levels has grown in the United States, and since the mid-1980s, the growth has been especially pronounced among white women. The reasons for the growth among white women are unclear. We investigated three explanations-social-psychological factors, economic circumstances, and health behaviors-for the widening education gap in mortality from 1997 to 2006 among white women aged 45 to 84 years using data from the National Health Interview Survey Linked Mortality File (N = 46,744; 4,053 deaths). Little support was found for social-psychological factors, but economic circumstances and health behaviors jointly explained the growing education gap in mortality to statistical nonsignificance. Employment and smoking were the most important individual components. Increasing high school graduation rates, reducing smoking prevalence, and designing work-family policies that help women find and maintain desirable employment may reduce mortality inequalities among women.

Objective: To determine whether a women's group intervention involving participatory learning and action has a sustainable and replicable effect on neonatal survival in rural, eastern India., Methods: From 2004 to 2011, births and neonatal deaths in 36 geographical clusters in Jharkhand and Odisha were monitored. Between 2005 and 2008, these clusters were part of a randomized controlled trial of how women's group meetings involving participatory learning and action influence maternal and neonatal health. Between 2008 and 2011, groups in the original intervention clusters (zone 1) continued to meet to discuss post-neonatal issues and new groups in the original control clusters (zone 2) met to discuss neonatal health. Logistic regression was used to examine neonatal mortality rates after 2008 in the two zones., Findings: Data on 41,191 births were analysed. In zone 1, the intervention's effect was sustained: the cluster-mean neonatal mortality rate was 34.2 per 1000 live births (95% confidence interval, CI: 28.3-40.0) between 2008 and 2011, compared with 41.3 per 1000 live births (95% CI: 35.4-47.1) between 2005 and 2008. The effect of the intervention was replicated in zone 2: the cluster-mean neonatal mortality rate decreased from 61.8 to 40.5 per 1000 live births between two periods: 2006-2008 and 2009-2011 (odds ratio: 0.69, 95% CI: 0.57-0.83). Hygiene during delivery, thermal care of the neonate and exclusive breastfeeding were important factors., Conclusion: The effect of participatory women's groups on neonatal survival in rural India, where neonatal mortality is high, was sustainable and replicable.

Objectives: To determine the effectiveness of birth plans in increasing use of skilled care at delivery and in the postnatal period among antenatal care (ANC) attendees in a rural district with low occupancy of health units for delivery but high antenatal care uptake in northern Tanzania., Methods: Cluster randomised trial in Ngorongoro district, Arusha region, involving 16 health units (8 per arm). Nine hundred and five pregnant women at 24 weeks of gestation and above (404 in the intervention arm) were recruited and followed up to at least 1 month postpartum., Results: Skilled delivery care uptake was 16.8% higher in the intervention units than in the control [95% CI 2.6-31.0; P = 0.02]. Postnatal care utilisation in the first month of delivery was higher (difference in proportions: 30.0% [95% CI 1.3-47.7; P < 0.01]) and also initiated earlier (mean duration 6.6 ± 1.7 days vs. 20.9 ± 4.4 days, P < 0.01) in the intervention than in the control arm. Women's and providers' reports of care satisfaction (received or provided) did not differ greatly between the two arms of the study (difference in proportion: 12.1% [95% CI -6.3-30.5] P = 0.17 and 6.9% [95% CI -3.2-17.1] P = 0.15, respectively)., Conclusion: Implementation of birth plans during ANC can increase the uptake of skilled delivery and post delivery care in the study district without negatively affecting women's and providers' satisfaction with available ANC services. Birth plans should be considered along with the range of other recommended interventions as a strategy to improve the uptake of maternal health services., (© 2013 Blackwell Publishing Ltd.)

The founding of Britain's first horticultural college in 1889 advanced a scientific and coeducational response to three troubling national concerns: a major agricultural depression; the economic distress of single, unemployed women; and imperatives to develop the colonies. Buoyed by the technical instruction and women's movements, the Horticultural College and Produce Company, Limited, at Swanley, Kent, crystallized a transformation in the horticultural profession in which new science-based, formalized study threatened an earlier emphasis on practical apprenticeship training, with the effect of opening male-dominated trades to women practitioners. By 1903, the college closed its doors to male students, and new pathways were forged for women students interested in pursuing further scientific study. Resistance to the Horticultural College's model of science-based women's horticultural education positioned science and women as contested subjects throughout this period of horticulture's expansion in the academy.

Background: Drug-using women remain at high risk for HIV infection. Female condoms (FC) have proven potential and cervical barriers have promise to reduce HIV risk; their effective use may be boosted by familiarity and confidence about female anatomy. Women with high levels of crack cocaine use were assessed for their knowledge about reproductive anatomy, HIV/STI risk, as well as cancer screening behaviors., Methods: Women were recruited for a randomized trial of a behavioral intervention via mobile vans in Philadelphia known for high crack use and sex exchange. Knowledge and behavioral data on 198 women were collected via interviewer-administered questionnaire. Women were randomized into control (n=99) and intervention (n=99) arms. Five weekly, small-group, intervention sessions stressed "body empowerment" and teaching use of female-initiated barrier methods. Follow-up body knowledge data were collected at 12 months. Changes in and correlates of body knowledge were analyzed and compared., Results: Most participants were African-American (66%); their mean age was 39.6 years. At baseline, 44% of the sample erroneously believed women have sex and urinate from the same place; 62% erroneously believed that tampons could get lost in the abdominal cavity. Only 27% knew douching increased STI transmission risk; only 10% knew condoms reduce cervical cancer risk. At follow-up, overall body knowledge improved substantially, across both arms. Race was associated with high body knowledge at baseline but not at follow-up., Conclusions: Knowledge favoring use of women-initiated methods and cervical cancer prevention was very low in this hard-to-reach sample. Body knowledge improved substantially with enhanced voluntary counseling and testing (VCT) as well as the women-focused intervention. Body knowledge education must be targeted and tailored to drug-using women.

Although this is in many ways a good era for women, many things have yet to improve. Women continue to lag behind men with regard to salaries, are under-represented in position of leadership, and still take on greater responsibility for child rearing and family responsibilities. Careers dominated by women tend to be associated with lower salaries and lower prominence and by the same token, women tend to dominate leadership positions when the field becomes less prestigious. Although women now outnumber men in graduating classes, the feminization of clinical psychology brings new challenges. This special series comes out of the 2009 trailblazer panel held at the ABCT convention in New York City, which explored the experiences faced by pioneering women in behavior therapy and discussed ways to help women overcome the glass ceiling. This introductory paper summarizes the lessons learned by these trailblazers with a view toward helping women in academia today., (Copyright © 2012. Published by Elsevier Ltd.)

Background: The intervention reported in this paper was a follow up to an empirical study conducted in Malawi with the aim of assessing trial participants' understanding of randomisation, double-blinding and placebo use. In the empirical study, the majority of respondents (61.1%; n=124) obtained low scores (lower than 75%) on understanding of all three concepts under study. Based on these findings, an intervention based on a narrative which included all three concepts and their personal implications was designed. The narrative used daily examples from the field of Agriculture because Malawi has an agro-based economy., Methods: The intervention was tested using a sample of 36 women who had been identified as low scorers during the empirical study. The 36 low scorers were randomly assigned to control (n=18) and intervention arms (n=18). The control arm went through a session in which they were provided with standard informed consent information for the microbicide trial. The intervention arm went through a session in which they were provided with a narrative in ChiChewa, the local language, with the assistance of a power point presentation which included pictures as well as discussions on justification and personal implications of the concepts under study., Results: The findings on the efficacy of the intervention suggest that the 3 scientific concepts and their personal implications can be understood by low literacy populations using simple language and everyday local examples. The findings also suggest that the intervention positively impacted on understanding of trial procedures under study, as 13 of the 18 women in the intervention arm, obtained high scores (above 75%) during the post intervention assessment and none of the 18 in the control arm obtained a high score. Using Fischer's exact test, it was confirmed that the effect of the intervention on understanding of the three procedures was statistically significant (p=0.0001)., Conclusions: Potential trial participants can be assisted to understand key clinical trial procedures, their justification and personal implications by using innovative tailored local narratives.