Community-Based Management of Child Malnutrition in Zambia: HIV/AIDS Infection and Other Risk Factors on Child Survival.

PubMed

Moramarco, Stefania; Amerio, Giulia; Ciarlantini, Clarice; Chipoma, Jean Kasengele; Simpungwe, Matilda Kakungu; Nielsen-Saines, Karin; Palombi, Leonardo; Buonomo, Ersilia

2016-07-01

(1) BACKGROUND: Supplementary feeding programs (SFPs) are effective in the community-based treatment of moderate acute malnutrition (MAM) and prevention of severe acute malnutrition (SAM); (2) METHODS: A retrospective study was conducted on a sample of 1266 Zambian malnourished children assisted from 2012 to 2014 in the Rainbow Project SFPs. Nutritional status was evaluated according to WHO/Unicef methodology. We performed univariate and multivariate Cox proportional risk regression to identify the main predictors of mortality. In addition, a time-to event analysis was performed to identify predictors of failure and time to cure events; (3) RESULTS: The analysis included 858 malnourished children (19 months ± 9.4; 49.9% males). Program outcomes met international standards with a better performance for MAM compared to SAM. Cox regression identified SAM (3.8; 2.1-6.8), HIV infection (3.1; 1.7-5.5), and WAZ <-3 (3.1; 1.6-5.7) as predictors of death. Time to event showed 80% of children recovered by SAM/MAM at 24 weeks. (4) CONCLUSIONS: Preventing deterioration of malnutrition, coupled to early detection of HIV/AIDS with adequate antiretroviral treatment, and extending the duration of feeding supplementation, could be crucial elements for ensuring full recovery and improve child survival in malnourished Zambian children.

Do neuropsychological test norms from African Americans in the United States generalize to a Zambian population?

PubMed

Hestad, Knut A; Menon, J Anitha; Serpell, Robert; Kalungwana, Lisa; Mwaba, Sidney O C; Kabuba, Norma; Franklin, Donald R; Umlauf, Anya; Letendre, Scott; Heaton, Robert K

2016-01-01

Healthy Zambian adults (N = 324) were evaluated to determine to what degree a Western neuropsychological (NP) test battery, with African American norms adjusted for age, gender, and education could be used in healthy Zambians, including 157 men (48.46%) and 167 women (51.54%) with an average age of 38.48 (SD = 12.80) years and an average education level of 11.02 (SD = 2.58) years. The NP battery included tests of attention/working memory, executive function, verbal fluency, processing speed, verbal and visual episodic memory, and fine motor skills. The Zambian Achievement Test (ZAT) and the U.S. Wide Range Achievement Test-4 (WRAT-4) reading subtest also were administered to assess literacy and quality of education. Similar to findings in Western countries, the Zambian results show substantial age and education effects on most tests and smaller, less consistent effects of gender. Beyond the basic demographic effects, urban/rural background had small effects on some cognitive variables, and the ZAT (but not WRAT-4) reading level was a robust predictor of performance on many NP tests, even when other background characteristics were controlled. Women in the United States tend to outperform men on tests of processing speed and episodic memory. However, Zambian women showed modest but statistically significant disadvantages versus their male counterparts. The results show that tests developed in the United States may be used in Zambia. Nevertheless, development and use of local cultural norms remains very important and is a must. New demographically corrected norms were developed for the cohort that was examined. (c) 2016 APA, all rights reserved).

Pollen-mediated gene flow and seed exchange in small-scale Zambian maize farming, implications for biosafety assessment

NASA Astrophysics Data System (ADS)

Bøhn, Thomas; Aheto, Denis W.; Mwangala, Felix S.; Fischer, Klara; Bones, Inger Louise; Simoloka, Christopher; Mbeule, Ireen; Schmidt, Gunther; Breckling, Broder

2016-10-01

Gene flow in agricultural crops is important for risk assessment of genetically modified (GM) crops, particularly in countries with a large informal agricultural sector of subsistence cultivation. We present a pollen flow model for maize (Zea mays), a major staple crop in Africa. We use spatial properties of fields (size, position) in three small-scale maize farming communities in Zambia and estimate rates of cross-fertilisation between fields sown with different maize varieties (e.g. conventional and transgene). As an additional factor contributing to gene flow, we present data on seed saving and sharing among farmers that live in the same communities. Our results show that: i) maize fields were small and located in immediate vicinity of neighboring fields; ii) a majority of farmers saved and shared seed; iii) modeled rates of pollen-mediated gene flow showed extensive mixing of germplasm between fields and farms and iv) as a result, segregation of GM and non-GM varieties is not likely to be an option in these systems. We conclude that the overall genetic composition of maize, in this and similar agricultural contexts, will be strongly influenced both by self-organised ecological factors (pollen flow), and by socially mediated intervention (seed recycling and sharing).

Pollen-mediated gene flow and seed exchange in small-scale Zambian maize farming, implications for biosafety assessment

PubMed Central

Bøhn, Thomas; Aheto, Denis W.; Mwangala, Felix S.; Fischer, Klara; Bones, Inger Louise; Simoloka, Christopher; Mbeule, Ireen; Schmidt, Gunther; Breckling, Broder

2016-01-01

Gene flow in agricultural crops is important for risk assessment of genetically modified (GM) crops, particularly in countries with a large informal agricultural sector of subsistence cultivation. We present a pollen flow model for maize (Zea mays), a major staple crop in Africa. We use spatial properties of fields (size, position) in three small-scale maize farming communities in Zambia and estimate rates of cross-fertilisation between fields sown with different maize varieties (e.g. conventional and transgene). As an additional factor contributing to gene flow, we present data on seed saving and sharing among farmers that live in the same communities. Our results show that: i) maize fields were small and located in immediate vicinity of neighboring fields; ii) a majority of farmers saved and shared seed; iii) modeled rates of pollen-mediated gene flow showed extensive mixing of germplasm between fields and farms and iv) as a result, segregation of GM and non-GM varieties is not likely to be an option in these systems. We conclude that the overall genetic composition of maize, in this and similar agricultural contexts, will be strongly influenced both by self-organised ecological factors (pollen flow), and by socially mediated intervention (seed recycling and sharing). PMID:27694819

Pollen-mediated gene flow and seed exchange in small-scale Zambian maize farming, implications for biosafety assessment.

PubMed

Bøhn, Thomas; Aheto, Denis W; Mwangala, Felix S; Fischer, Klara; Bones, Inger Louise; Simoloka, Christopher; Mbeule, Ireen; Schmidt, Gunther; Breckling, Broder

2016-10-03

Gene flow in agricultural crops is important for risk assessment of genetically modified (GM) crops, particularly in countries with a large informal agricultural sector of subsistence cultivation. We present a pollen flow model for maize (Zea mays), a major staple crop in Africa. We use spatial properties of fields (size, position) in three small-scale maize farming communities in Zambia and estimate rates of cross-fertilisation between fields sown with different maize varieties (e.g. conventional and transgene). As an additional factor contributing to gene flow, we present data on seed saving and sharing among farmers that live in the same communities. Our results show that: i) maize fields were small and located in immediate vicinity of neighboring fields; ii) a majority of farmers saved and shared seed; iii) modeled rates of pollen-mediated gene flow showed extensive mixing of germplasm between fields and farms and iv) as a result, segregation of GM and non-GM varieties is not likely to be an option in these systems. We conclude that the overall genetic composition of maize, in this and similar agricultural contexts, will be strongly influenced both by self-organised ecological factors (pollen flow), and by socially mediated intervention (seed recycling and sharing).

Willingness to Pay for a Maternity Waiting Home Stay in Zambia.

PubMed

Vian, Taryn; White, Emily E; Biemba, Godfrey; Mataka, Kaluba; Scott, Nancy

2017-03-01

Complications of pregnancy and childbirth can pose serious risks to the health of women, especially in resource-poor settings. Zambia has been implementing a program to improve access to emergency obstetric and neonatal care, including expansion of maternity waiting homes-residential facilities located near a qualified medical facility where a pregnant woman can wait to give birth. Yet it is unclear how much support communities and women would be willing to provide to help fund the homes and increase sustainability. We conducted a mixed-methods study to estimate willingness to pay for maternity waiting home services based on a survey of 167 women, men, and community elders. We also collected qualitative data from 16 focus group discussions to help interpret our findings in context. The maximum willingness to pay was 5.0 Zambian kwacha or $0.92 US dollars per night of stay. Focus group discussions showed that willingness to pay is dependent on higher quality of services such as food service and suggested that the pricing policy (by stay or by night) could influence affordability and use. While Zambians seem to value and be willing to contribute a modest amount for maternity waiting home services, planners must still address potential barriers that may prevent women from staying at the shelters. These include cash availability and affordability for the poorest households. © 2016 by the American College of Nurse-Midwives.

Willingness to Pay for a Maternity Waiting Home Stay in Zambia

PubMed Central

White, Emily E.; Biemba, Godfrey; Mataka, Kaluba; Scott, Nancy

2016-01-01

Introduction Complications of pregnancy and childbirth can pose serious risks to the health of women, especially in resource‐poor settings. Zambia has been implementing a program to improve access to emergency obstetric and neonatal care, including expansion of maternity waiting homes‐residential facilities located near a qualified medical facility where a pregnant woman can wait to give birth. Yet it is unclear how much support communities and women would be willing to provide to help fund the homes and increase sustainability. Methods We conducted a mixed‐methods study to estimate willingness to pay for maternity waiting home services based on a survey of 167 women, men, and community elders. We also collected qualitative data from 16 focus group discussions to help interpret our findings in context. Results The maximum willingness to pay was 5.0 Zambian kwacha or $0.92 US dollars per night of stay. Focus group discussions showed that willingness to pay is dependent on higher quality of services such as food service and suggested that the pricing policy (by stay or by night) could influence affordability and use. Discussion While Zambians seem to value and be willing to contribute a modest amount for maternity waiting home services, planners must still address potential barriers that may prevent women from staying at the shelters. These include cash availability and affordability for the poorest households. PMID:28419708

Practicalities and challenges in re-orienting the health system in Zambia for treating chronic conditions.

PubMed

Aantjes, Carolien J; Quinlan, Tim K C; Bunders, Joske F G

2014-07-08

The rapid evolution in disease burdens in low- and middle income countries is forcing policy makers to re-orient their health system towards a system which has the capability to simultaneously address infectious and non-communicable diseases. This paper draws on two different but overlapping studies which examined how actors in the Zambian health system are re-directing their policies, strategies and service structures to include the provision of health care for people with chronic conditions. Study methods in both studies included semi-structured interviews with government health officials at national level, and governmental and non-governmental health practitioners operating from community-, primary health care to hospital facility level. Focus group discussions were conducted with staff, stakeholders and caregivers of programmes providing care and support at community- and household levels. Study settings included urban and rural sites. A series of adaptations transformed the HIV programme from an emergency response into the first large chronic care programme in the country. There are clear indications that the Zambian government is intending to expand this reach to patients with non-communicable diseases. Challenges to do this effectively include a lack of proper NCD prevalence data for planning, a concentration of technology and skills to detect and treat NCDs at secondary and tertiary levels in the health system and limited interest by donor agencies to support this transition. The reorientation of Zambia's health system is in full swing and uses the foundation of a decentralised health system and presence of local models for HIV chronic care which actively involve community partners, patients and their families. There are early warning signs which could cause this transition to stall, one of which is the financial capability to resource this process.

Prevalence and Predictors of Food Insecurity among People Living with HIV Enrolled in Antiretroviral Therapy and Livelihood Programs in Two Rural Zambian Hospitals

PubMed Central

Masa, Rainier; Chowa, Gina; Nyirenda, Victor

2018-01-01

The objective of this study was to examine the prevalence and predictors of food insecurity among people living with HIV (PLHIV) in two rural communities in Zambia. A cross-sectional sample of 101 PLHIV was surveyed using the Household Food Insecurity Access Scale. In multivariable linear regression models, income, household possessions, and perceived coping strategies were significantly associated with decreased food insecurity. Debt and perceived mental distress were significantly associated with increased food insecurity. Programs that tackle economic disadvantage and its adverse effect on stress may be an appropriate strategy to improve food security of PLHIV in low-resource communities. PMID:28418728

Exploring the Effects of the HIV/AIDS Pandemic on Teacher Retention in a Zambian School

ERIC Educational Resources Information Center

Appel, Anize M.

2014-01-01

The HIV/AIDS pandemic's dramatic impact on African life and culture has influenced educational sector significantly. As a result of the chronic crisis, teacher retention in Zambia has reached abysmal lows. This qualitative narrative inquiry study explored teacher retention in a Zambian school through the lens of social constructivism. The study…

Poor continuity of care for TB diagnosis and treatment in Zambian Prisons: a situation analysis.

PubMed

Hatwiinda, S; Topp, S M; Siyambango, M; Harris, J B; Maggard, K R; Chileshe, C; Kapata, N; Reid, S E; Henostroza, G

2018-02-01

Prisons act as infectious disease reservoirs. We aimed to explore the challenges of TB control and continuity of care in prisons in Zambia. We evaluated treatment outcomes for a cohort of inmates diagnosed with TB during a TB REACH funded screening programme initiated by the Zambia Prisons Service and the Centre for Infectious Disease Research in Zambia. Between October 2010 and September 2011, 6282 inmates from six prisons were screened for TB, of whom 374 (6.0%) were diagnosed. TB treatment was initiated in 345 of 374 (92%) inmates. Of those, 66% were cured or completed treatment, 5% died and 29% were lost to follow-up. Among those lost to follow-up, 11% were released into the community and 13% were transferred to other prisons. Weak health systems within the Zambian prison service currently undermines continuity of care, despite intensive TB screening and case-finding interventions. To prevent TB transmission and the development of drug resistance, we need sufficient numbers of competent staff for health care, reliable health information systems including electronic record keeping for prison facilities, and standard operating procedures to guide surveillance, case-finding and timely treatment initiation and completion. © 2017 John Wiley & Sons Ltd.

Zambian Pre-Service Chemistry Teachers' Views on Chemistry Education Goals and Challenges for Achieving Them in Schools

ERIC Educational Resources Information Center

Banda, Asiana; Mumba, Frackson; Chabalengula, Vivien M.

2014-01-01

This study examined Zambian preservice chemistry teachers' views on the goals of chemistry education, the importance of the goals, and challenges for achieving them in schools. The study sample was comprised of 59 pre-service chemistry teachers at the University of Zambia. Data were collected using a modified Likert-scale questionnaire that was…

Early Literacy among Zambian Second Graders: The Role of Adult Mediation of Word Writing in Bemba

ERIC Educational Resources Information Center

Kalindi, Sylvia C.; McBride, Catherine; Dan, Lin

2018-01-01

Considering the importance attached to writing as a life skill, this study investigated the nature and variability of adults' aid to Zambian second graders in the context of shared writing in Bemba (first language), and the relations between this support and students' literacy and cognitive-metalinguistic skills. Fifty-seven children and their…

Teachers' Understanding of the Particulate Nature of Matter: The Case of Zambian Pre-Service Science Teachers

ERIC Educational Resources Information Center

Banda, Asiana; Mumba, Frackson; Chabalengula, Vivien M.; Mbewe, Simeon

2011-01-01

This study assessed Zambian Junior High School pre-service science teachers' understanding of the particulate nature of matter. A sample comprised 30 pre-service science teachers at a teacher training college. Data was collected through a questionnaire adopted from Ozmen and Kenan (2007). Results show that most teachers had correct views on the…

Analysis of New Zambian High School Physics Syllabus and Practical Examinations for Levels of Inquiry and Inquiry Skills

ERIC Educational Resources Information Center

Mumba, Frackson; Chabalengula, Vivien Mweene; Wise, Kevin; Hunter, William J. F.

2007-01-01

The purpose of this study was to analyze the new Zambian high school physics syllabus and practical examinations for levels of inquiry and inquiry skills. Several inquiry skills are explicitly emphasized in the introduction, aims, content objectives and assessment sections in the national high school physics syllabus. However, the syllabus is less…

Linguistic Diversity: A Contributory Factor to Reading Problems in Zambian Schools

ERIC Educational Resources Information Center

Tambulukani, Geofrey; Bus, Adriana G.

2012-01-01

A lack of familiarity with the language of teaching is blamed for illiteracy rates beyond 40% among people who live in nations in Africa or Asia in which dozens of languages are spoken. For a critical test of the importance of familiarity with the language in which initial reading is practiced, we took the Zambian situation as a natural experiment…

"The way the country has been carved up by researchers": ethics and power in north-south public health research.

PubMed

Walsh, Aisling; Brugha, Ruairi; Byrne, Elaine

2016-12-12

Despite the recognition of power as being central to health research collaborations between high income countries and low and middle income countries, there has been insufficient detailed analysis of power within these partnerships. The politics of research in the global south is often considered outside of the remit of research ethics. This article reports on an analysis of power in north-south public health research, using Zambia as a case study. Primary data were collected in 2011/2012, through 53 in-depth interviews with: Zambian researchers (n = 20), Zambian national stakeholders (n = 8) and northern researchers who had been involved in public health research collaborations involving Zambia and the global north (n = 25). Thematic analysis, utilising a situated ethics perspective, was undertaken using Nvivo 10. Most interviewees perceived roles and relationships to be inequitable with power remaining with the north. Concepts from Bourdieu's theory of Power and Practice highlight new aspects of research ethics: Northern and southern researchers perceive that different habituses exist, north and south - habituses of domination (northern) and subordination (Zambian) in relation to researcher relationships. Bourdieu's hysteresis effect provides a possible explanation for why power differentials continue to exist. In some cases, new opportunities have arisen for Zambian researchers; however, they may not immediately recognise and grasp them. Bourdieu's concept of Capitals offers an explanation of how diverse resources are used to explain these power imbalances, where northern researchers are often in possession of more economic, symbolic and social capital; while Zambian researchers possess more cultural capital. Inequities and power imbalances need to be recognised and addressed in research partnerships. A situated ethics approach is central in understanding this relationship in north-south public health research.

Retail Sugar From One Zambian Community Does Not Meet Statutory Requirements for Vitamin A Fortification.

PubMed

Greene, Matthew D; Kabaghe, Gladys; Musonda, Mofu; Palmer, Amanda C

2017-12-01

Industrial food fortification is a major strategy to improve dietary micronutrient intakes and prevent deficiencies. Zambia introduced mandatory sugar fortification with vitamin A, at a target of 10 mg/kg, in 1998. Representative surveys conducted since that time do not support marked improvement in vitamin A status. To describe vitamin A concentrations in retail sugar, as well as vendor practices, perceptions of fortified foods, and sugar use practices. We conducted a census of sugar vendors in one Zambian community, capturing information on vendors, available brands and packaging options, and storage conditions. We purchased all brands and package types of sugar available at each vendor. In a 15% subsample, we conducted semi-structured interviews with vendor-consumer pairs. We tested 50% of sugar samples at random for vitamin A using an iCheck portable fluorimeter. The distribution of vitamin A in sugar in market samples was highly skewed, with a median of 3.1 mg/kg (25th-75th percentiles: 1.8-5.5) and a range from 0.2 to 29.9 mg/kg. Only 11.3% of samples met the 10 mg/kg statutory requirement. Sugar was primarily repackaged and sold in small quantities, with rapid turnover of stocks. Perceptions of fortification by vendors and consumers were generally positive. Vitamin A in fortified sugar fell well below statutory requirements. Our data point to challenges at regional depot and/or poor adherence to fortification standards at the factory level. A renewed commitment to monitoring and enforcement will be required for Zambia to benefit from a food fortification strategy.

200 junior doctors sacked in Zambia.

PubMed

Ahmad, K

2000-07-29

Since December 1999 junior doctors in Zambia have been on strike, demanding from the government better working conditions, better pay, and improvements in hospital services. However, on June 20, 2000, around 200 junior doctors were dismissed by the Zambian government, who asserts that the action was taken in the public¿s interest. Nevertheless, the doctors argue that the move came at a time when the country is struggling with a critical shortage of doctors and with an HIV/AIDS crisis. In addition, health policy experts say that the dismissal could further undermine the alarming conditions of Zambia's health care system. It is noted that there are only 800 doctors registered with the Zambian Medical Council, but WHO estimates that the country needs 1500 clinicians. To meet such a shortage, the government has hired Cuban and Chinese doctors. They are paid more and given more benefits than the Zambian doctors, generating complaints from the president of the junior doctors' representative body.

Serum retinol concentrations demonstrate high specificity after correcting for inflammation but questionable sensitivity compared with liver stores calculated from isotope dilution in determining vitamin A deficiency in Thai and Zambian children.

PubMed

Suri, Devika J; Tanumihardjo, Jacob P; Gannon, Bryan M; Pinkaew, Siwaporn; Kaliwile, Chisela; Chileshe, Justin; Tanumihardjo, Sherry A

2015-11-01

The WHO estimates that 190 million preschool children have vitamin A deficiency (VAD). Serum retinol (SR) concentration is a common indicator of vitamin A (VA) status, but SR is homeostatically controlled and suppressed during inflammation, which may lead to misdiagnosis. The sensitivity and specificity of SR compared with VA total liver reserves (TLRs) were evaluated for VAD in children from Thailand (n = 37) and Zambia (n = 128). SR was adjusted for inflammation in the Zambian children. Each child was classified as VA-deficient or not based on cutoffs of <0.1 μmol VA/g liver with the use of retinol isotope dilution and <0.7 μmol/L for SR concentrations. Four categories of infection status in the Zambian children were based on elevated C-reactive protein (CRP) and α1-acid glycoprotein (AGP). Sensitivity and specificity were calculated with the use of unadjusted and inflammation marker-adjusted SR cutoffs. VAD was 65% and 0% according to TLRs and SR, respectively, in Thai children and 0% and 17%, respectively, in Zambian children. No true positive VAD cases occurred; thus, sensitivity was 0% and indeterminable, respectively; specificity was 100% and 82.8%, respectively. CRP was elevated in 26.6% of Zambian children, whereas 97.7% had elevated AGP, categorizing them as having no infection (2.3%) or in early (26.6%) or late (58.6%) convalescence. With the use of marker-adjusted SR cutoffs of 0.6 μmol/L for late convalescence and 0.5 μmol/L for early convalescence, the adjusted prevalence of SR deficiency was 2.3%, increasing specificity to 97.3%. No cases of VAD were identified by both TLRs and SR (true positives) in Thai or Zambian children. Specificity of SR to evaluate VAD was high, but additional research is needed to investigate sensitivity. Adjusting SR cutoffs for inflammation improved specificity by reducing false positives. SR as a VAD indicator may depend on infection rates, which should be taken into consideration. These studies were registered at clinicaltrials.gov as NCT01061307 (for Thailand) and NCT01814891 (for Zambia). © 2015 American Society for Nutrition.

Cultural differences in self-recognition: the early development of autonomous and related selves?

PubMed

Ross, Josephine; Yilmaz, Mandy; Dale, Rachel; Cassidy, Rose; Yildirim, Iraz; Suzanne Zeedyk, M

2017-05-01

Fifteen- to 18-month-old infants from three nationalities were observed interacting with their mothers and during two self-recognition tasks. Scottish interactions were characterized by distal contact, Zambian interactions by proximal contact, and Turkish interactions by a mixture of contact strategies. These culturally distinct experiences may scaffold different perspectives on self. In support, Scottish infants performed best in a task requiring recognition of the self in an individualistic context (mirror self-recognition), whereas Zambian infants performed best in a task requiring recognition of the self in a less individualistic context (body-as-obstacle task). Turkish infants performed similarly to Zambian infants on the body-as-obstacle task, but outperformed Zambians on the mirror self-recognition task. Verbal contact (a distal strategy) was positively related to mirror self-recognition and negatively related to passing the body-as-obstacle task. Directive action and speech (proximal strategies) were negatively related to mirror self-recognition. Self-awareness performance was best predicted by cultural context; autonomous settings predicted success in mirror self-recognition, and related settings predicted success in the body-as-obstacle task. These novel data substantiate the idea that cultural factors may play a role in the early expression of self-awareness. More broadly, the results highlight the importance of moving beyond the mark test, and designing culturally sensitive tests of self-awareness. © 2016 John Wiley & Sons Ltd.

Cytokine activation is predictive of mortality in Zambian patients with AIDS-related diarrhoea.

PubMed

Zulu, Isaac; Hassan, Ghaniah; Njobvu R N, Lungowe; Dhaliwal, Winnie; Sianongo, Sandie; Kelly, Paul

2008-11-13

Mortality in Zambian AIDS patients is high, especially in patients with diarrhoea, and there is still unacceptably high mortality in Zambian patients just starting anti-retroviral therapy. We set out to determine if high concentrations of serum cytokines correlate with mortality. Serum samples from 30 healthy controls (HIV seropositive and seronegative) and 50 patients with diarrhoea (20 of whom died within 6 weeks) were analysed. Concentrations of tumour necrosis factor receptor p55 (TNFR p55), macrophage migration inhibitory factor (MIF), interleukin (IL)-6, IL-12, interferon (IFN)-gamma and C-reactive protein (CRP) were measured by ELISA, and correlated with mortality after 6 weeks follow-up. Apart from IL-12, concentrations of all cytokines, TNFR p55 and CRP increased with worsening severity of disease, showing highly statistically significant trends. In a multivariable analysis high TNFR p55, IFN-gamma, CRP and low CD4 count (CD4 count <100) were predictive of mortality. Although nutritional status (assessed by body mass index, BMI) was predictive in univariate analysis, it was not an independent predictor in multivariate analysis. High serum concentrations of TNFR p55, IFN-gamma, CRP and low CD4 count correlated with disease severity and short-term mortality in HIV-infected Zambian adults with diarrhoea. These factors were better predictors of survival than BMI. Understanding the cause of TNFR p55, IFN-gamma and CRP elevation may be useful in development of interventions to reduce mortality in AIDS patients with chronic diarrhoea in Africa.

Counselor and Participant Perspectives of Trauma-Focused Cognitive Behavioral Therapy for Children in Zambia: A Qualitative Study

PubMed Central

Murray, Laura K.; Skavenski, Stephanie; Michalopoulos, Lynn M.; Bolton, Paul A.; Bass, Judith K.; Familiar, Itziar; Imasiku, Mwiya; Cohen, Judy

2014-01-01

Objective This study examined Zambian counselors, children, and caregivers' perceptions of an evidence-based treatment (EBT) for trauma (Trauma-Focused Cognitive Behavioral Therapy, TF-CBT) utilized in Zambia to address mental health problems in children. Method Semi-structured interviews were conducted with local counselors trained in TF-CBT (N=19; 90% of those trained; 12 Female) and children/caregivers who had received TF-CBT in a small feasibility study (N=18; 86% of the children and N=16; 76% of the caregivers) who completed TF-CBT (Total completed; N=21). Each client was asked six open-ended questions, and domain analysis was used to explore the data. Results Counselors were positive about the program, liked the structure and flexibility, reported positive changes in their clients, and discussed the cultural adaptation around activities and language. Counselors stated the training was too short, and the supervision was necessary. Challenges included client engagement and attendance, availability of location, funding, and a lack of community understanding of “therapy.” Children and caregivers stated multiple positive changes they attributed to TF-CBT, such as better family communication, reduction of problem behaviors, and ability to speak about the trauma. They recommended continuing the program. Conclusion This study brings a critical examination of providers' and clients' perspectives of the implementation of an EBT for children in a low-resource setting. Clinical implications include changing implementation methods based on responses. Research implications include future study directions such as an effectiveness trial of TF-CBT and an examination of implementation factors. PMID:24400677

Screening for tuberculosis and testing for human immunodeficiency virus in Zambian prisons

PubMed Central

Maggard, Katie R; Hatwiinda, Sisa; Harris, Jennifer B; Phiri, Winifreda; Krüüner, Annika; Kaunda, Kaunda; Topp, Stephanie M; Kapata, Nathan; Ayles, Helen; Chileshe, Chisela; Henostroza, German

2015-01-01

Abstract Objective To improve the Zambia Prisons Service’s implementation of tuberculosis screening and human immunodeficiency virus (HIV) testing. Methods For both tuberculosis and HIV, we implemented mass screening of inmates and community-based screening of those residing in encampments adjacent to prisons. We also established routine systems – with inmates as peer educators – for the screening of newly entered or symptomatic inmates. We improved infection control measures, increased diagnostic capacity and promoted awareness of tuberculosis in Zambia’s prisons. Findings In a period of 9 months, we screened 7638 individuals and diagnosed 409 new patients with tuberculosis. We tested 4879 individuals for HIV and diagnosed 564 cases of infection. An additional 625 individuals had previously been found to be HIV-positive. Including those already on tuberculosis treatment at the time of screening, the prevalence of tuberculosis recorded in the prisons and adjacent encampments – 6.4% (6428/100 000) – is 18 times the national prevalence estimate of 0.35%. Overall, 22.9% of the inmates and 13.8% of the encampment residents were HIV-positive. Conclusion Both tuberculosis and HIV infection are common within Zambian prisons. We enhanced tuberculosis screening and improved the detection of tuberculosis and HIV in this setting. Our observations should be useful in the development of prison-based programmes for tuberculosis and HIV elsewhere. PMID:25883402

Quantification of absorption, retention and elimination of two different oral doses of vitamin A in Zambian boys using accelerator mass spectrometry

DOE Office of Scientific and Technical Information (OSTI.GOV)

Aklamati, E K; Mulenga, M; Dueker, S R

A recent survey indicated that high-dose vitamin A supplements (HD-VAS) had no apparent effect on vitamin A (VA) status of Zambian children <5 y of age. To explore possible reasons for the lack of response to HD-VAS among Zambian children, we quantified the absorption, retention, and urinary elimination of either a single HDVAS (60 mg) or a smaller dose of stable isotope (SI)-labeled VA (5 mg), which was used to estimate VA pool size, in 3-4 y old Zambian boys (n = 4 for each VA dose). A 25 nCi tracer dose of [{sup 14}C{sub 2}]-labeled VA was co-administered withmore » the HD-VAS or SI-labeled VA, and 24-hr stool and urine samples were collected for 3 and 7 consecutive days, respectively, and 24-hr urine samples at 4 later time points. Accelerator Mass Spectrometry (AMS) was used to measure the cumulative excretion of {sup 14}C in stool and urine 3d after dosing to estimate, respectively, absorption and retention of the VAS and SI-labeled VA. The urinary elimination rate (UER) was estimated by plotting {sup 14}C in urine vs. time, and fitting an exponential equation to the data. Estimates of mean absorption, retention and the UER were 83.8 {+-} 7.1%, 76.3 {+-} 6.7%, and 1.9 {+-} 0.6%/d, respectively, for the HD-VAS and 76.5 {+-} 9.5%, 71.1 {+-} 9.4%, and 1.8 {+-} 1.2%/d, respectively for the smaller dose of SI-labeled VA. Estimates of absorption, retention and the UER did not differ by size of the VA dose administered (P=0.26, 0.40, 0.88, respectively). Estimated absorption and retention were negatively associated with reported fever (P=0.011) and malaria (P =0.010). HD-VAS and SI-labeled VA were adequately absorbed, retained and utilized in apparently healthy Zambian preschool-age boys, although absorption and retention may be affected by recent infections.« less

High provitamin A carotenoid serum concentrations, elevated retinyl esters, and saturated retinol-binding protein in Zambian preschool children are consistent with the presence of high liver vitamin A stores.

PubMed

Mondloch, Stephanie; Gannon, Bryan M; Davis, Christopher R; Chileshe, Justin; Kaliwile, Chisela; Masi, Cassim; Rios-Avila, Luisa; Gregory, Jesse F; Tanumihardjo, Sherry A

2015-08-01

Biomarkers of micronutrient status are needed to best define deficiencies and excesses of essential nutrients. We evaluated several supporting biomarkers of vitamin A status in Zambian children to determine whether any of the biomarkers were consistent with high liver retinol stores determined by using retinol isotope dilution (RID). A randomized, placebo-controlled, biofortified maize efficacy trial was conducted in 140 rural Zambian children from 4 villages. A series of biomarkers were investigated to better define the vitamin A status of these children. In addition to the assessment of total-body retinol stores (TBSs) by using RID, tests included analyses of serum carotenoids, retinyl esters, and pyridoxal-5'-phosphate (PLP) by using high-pressure liquid chromatography, retinol-binding protein by using ELISA, and alanine aminotransferase (ALT) activity by using a colorimetric assay. Children (n = 133) were analyzed quantitatively for TBSs by using RID. TBSs, retinyl esters, some carotenoids, and PLP differed by village site. Serum carotenoids were elevated above most nonintervened reference values for children. α-Carotene, β-carotene, and lutein values were >95th percentile from children in the US NHANES III, and 13% of children had hypercarotenemia (defined as total carotenoid concentration >3.7 μmol/L). Although only 2% of children had serum retinyl esters >10% of total retinol plus retinyl esters, 16% of children had >5% as esters, which was consistent with high liver retinol stores. Ratios of serum retinol to retinol-binding protein did not deviate from 1.0, which indicated full saturation. ALT activity was low, which was likely due to underlying vitamin B-6 deficiency, which was confirmed by very low serum PLP concentrations. The finding of hypervitaminosis A in Zambian children was supported by high circulating concentrations of carotenoids and mildly elevated serum retinyl esters. ALT-activity assays may be compromised with co-existing vitamin B-6 deficiency. Nutrition education to improve intakes of whole grains and animal-source foods may enhance vitamin B-6 status in Zambians. © 2015 American Society for Nutrition.

Cytokine activation is predictive of mortality in Zambian patients with AIDS-related diarrhoea

PubMed Central

Zulu, Isaac; Hassan, Ghaniah; Njobvu RN, Lungowe; Dhaliwal, Winnie; Sianongo, Sandie; Kelly, Paul

2008-01-01

Background Mortality in Zambian AIDS patients is high, especially in patients with diarrhoea, and there is still unacceptably high mortality in Zambian patients just starting anti-retroviral therapy. We set out to determine if high concentrations of serum cytokines correlate with mortality. Methods Serum samples from 30 healthy controls (HIV seropositive and seronegative) and 50 patients with diarrhoea (20 of whom died within 6 weeks) were analysed. Concentrations of tumour necrosis factor receptor p55 (TNFR p55), macrophage migration inhibitory factor (MIF), interleukin (IL)-6, IL-12, interferon (IFN)-γ and C-reactive protein (CRP) were measured by ELISA, and correlated with mortality after 6 weeks follow-up. Results Apart from IL-12, concentrations of all cytokines, TNFR p55 and CRP increased with worsening severity of disease, showing highly statistically significant trends. In a multivariable analysis high TNFR p55, IFN-γ, CRP and low CD4 count (CD4 count <100) were predictive of mortality. Although nutritional status (assessed by body mass index, BMI) was predictive in univariate analysis, it was not an independent predictor in multivariate analysis. Conclusion High serum concentrations of TNFR p55, IFN-γ, CRP and low CD4 count correlated with disease severity and short-term mortality in HIV-infected Zambian adults with diarrhoea. These factors were better predictors of survival than BMI. Understanding the cause of TNFR p55, IFN-γ and CRP elevation may be useful in development of interventions to reduce mortality in AIDS patients with chronic diarrhoea in Africa. PMID:19014537

Adapting the emergency first aid responder course for Zambia through curriculum mapping and blueprinting.

PubMed

Pigoga, Jennifer L; Cunningham, Charmaine; Kafwamfwa, Muhumpu; Wallis, Lee A

2017-12-10

Community members are often the first to witness and respond to medical and traumatic emergencies, making them an essential first link to emergency care systems. The Emergency First Aid Responder (EFAR) programme is short course originally developed to help South Africans manage emergencies at the community level, pending arrival of formal care providers. EFAR was implemented in two rural regions of Zambia in 2015, but no changes were originally made to tailor the course to the new setting. We undertook this study to identify potential refinements in the original EFAR curriculum, and to adapt it to the local context in Zambia. The EFAR curriculum was mapped against available chief complaint data. An expert group used information from the map, in tandem with personal knowledge, to rank each course topic for potential impact on patient outcomes and frequency of use in practice. Individual blueprints were compiled to generate a refined EFAR curriculum, the time breakdown of which reflects the relative weight of each topic. This study was conducted based on data collected in Kasama, a rural region of Zambia's Northern Province. An expert group of five physicians practising emergency medicine was selected; all reviewers have expertise in the Zambian context, EFAR programme and/or curriculum development. The range of emergencies that Zambian EFARs encounter indicates that the course must be broad in scope. The refined curriculum covers 54 topics (seven new) and 25 practical skills (five new). Practical and didactic time devoted to general patient care and scene management increased significantly, while time devoted to most other clinical, presentation-based categories (eg, trauma care) decreased. Discrepancies between original and refined curricula highlight a mismatch between the external curriculum and local context. Even with limited data and resources, curriculum mapping and blueprinting are possible means of resolving these contextual issues. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Health and human rights of women imprisoned in Zambia

PubMed Central

2011-01-01

Background The healthcare needs and general experience of women in detention in sub-Saharan Africa are rarely studied and poorly understood. Methods A mixed-methods study was conducted including in-depth interviews with 38 adult female prisoners and 21 prison officers in four Zambian prisons to assess the health and human rights concerns of female detainees. Key informant interviews with 46 officials from government and non-governmental organizations and a legal and policy review were also conducted. Results Despite special protection under international and regional law, incarcerated women's health needs–including prenatal care, prevention of mother-to-child transmission of HIV, and nutritional support during pregnancy and breastfeeding–are not being adequately met in Zambian prisons. Women are underserved by general healthcare programs including those offering tuberculosis and HIV testing, and reported physical and sexual abuse conducted by police and prison officers that could amount to torture under international law. Conclusions There is an urgent need for women's healthcare services to be expanded, and for general prison health campaigns, including HIV and tuberculosis testing and treatment, to ensure the inclusion of female inmates. Abuses against women in Zambian police and prison custody, which violate their rights and compromise their health, must be halted immediately. PMID:21696625

Health and human rights of women imprisoned in Zambia.

PubMed

Todrys, Katherine W; Amon, Joseph J

2011-06-22

The healthcare needs and general experience of women in detention in sub-Saharan Africa are rarely studied and poorly understood. A mixed-methods study was conducted including in-depth interviews with 38 adult female prisoners and 21 prison officers in four Zambian prisons to assess the health and human rights concerns of female detainees. Key informant interviews with 46 officials from government and non-governmental organizations and a legal and policy review were also conducted. Despite special protection under international and regional law, incarcerated women's health needs-including prenatal care, prevention of mother-to-child transmission of HIV, and nutritional support during pregnancy and breastfeeding-are not being adequately met in Zambian prisons. Women are underserved by general healthcare programs including those offering tuberculosis and HIV testing, and reported physical and sexual abuse conducted by police and prison officers that could amount to torture under international law. There is an urgent need for women's healthcare services to be expanded, and for general prison health campaigns, including HIV and tuberculosis testing and treatment, to ensure the inclusion of female inmates. Abuses against women in Zambian police and prison custody, which violate their rights and compromise their health, must be halted immediately.

Developmental assessment, cultural context, gender, and schooling in Zambia.

PubMed

Serpell, Robert; Jere-Folotiya, Jacqueline

2008-04-01

Multiple perspectives on the assessment of children's development at the school-community interface in rural areas of Zambia are discussed in the light of several empirical studies conducted between 1974 and 2005. A longitudinal trace study of a cohort of 46 young people born into a rural, Chewa community in Katete District found that girls' scores in early childhood on a battery of ecoculturally grounded cognitive tests correlated less well than they did for boys with two educational outcomes: number of grades of schooling completed, and adult literacy scores. Conversely, ratings of the children on indigenous conceptions of intelligence by adults familiar with the children in the context of their home village lives predicted the same outcomes better for girls than for boys. A separate, linked experiment compared the performance of 76 Katete school children with that of 84 school children in the capital city of Lusaka on the US standardized Draw-a-Person Test (DPT) and the Panga Munthu Test (PMT), an expanded version of one of the tests developed for the Zambian trace study. Analysis of the correlations among scores on these two tests, age, and teacher ratings suggests that aptitudes evident in the home and school domains are less well integrated for rural girls than for urban boys, and that for a low-income, rural population, the PMT taps the domain of home cognition better than school cognition, while the converse is true of the DPT. Implications for educational assessment in Zambia are discussed, and supportive documentation is cited from two ongoing programs of test development. The authors conclude that if educational testing is to support the process of enhancing educational equity across gender, family socioeconomic status, and residential location, its focus should be broadened to include other dimensions of psychological development such as multilingual and personal-social competencies.

Lithostratigraphical correlation of the Neoproterozoic Roan Supergroup from Shaba (Zaire) and Zambia, in the central African copper-cobalt metallogenic province

NASA Astrophysics Data System (ADS)

Cailteux, J.; Binda, P. L.; Katekesha, W. M.; Kampunzu, A. B.; Intiomale, M. M.; Kapenda, D.; Kaunda, C.; Ngongo, K.; Tshiauka, T.; Wendorff, M.

1994-11-01

New data on the lower Katangan sequences in Shaba (Zaire) and Zambia, collected during the 1989 and 1990 UNESCO-sponsored Geotraverses, reveal an important development on friction breccias throughout the Zambian Copperbelt, which still remains poorly documented, and shows that the Zairean and Zambian facies of the Roan Supergroup can be correlated in detail. As in Zaire, the deformation of Katangan terranes during the Lufilian orogeny produced important friction breccias in Zambia. Such breccias occur mostly between the upper part of the Lower Roan Supergroup and the Mwashya Group (R-4): above the shale with grit (RL3) at Konkola and Mindola, or within the Upper Roan Dolomite at Chambishi South, Muliashi and Nchanga. At Mufulira, a typical fragment of Shaba Mines Group was observed within a major heterogeneous tectonic breccia. This situation is similar to that reported at Kipapila (Kimpe) and Lubembe in Zaire, both located on the same tectonic trend as Mufulira. However, a continuous stratigraphical succession can be observed in Zambia from the basal unconformity to the Mwashya Group. Strong lithological similarities were found, formation by formation, between the Roan sequences of Zambia and Zaire. In particular, the complete Mines Group of Zaire (R-2) and the units from the RL6 to the RL4 in Zambia were deposited under comparable conditions of sedimentation and show a similar and correlatable evolution of lithologies. Furthermore, the overlying Dipeta Group (R-3) of Zaire and the RL3, RU2/RU1 of Zambia, are equally comparable. Above the Upper Roan Dolomite, Lower Mwashya dolomitic rocks, identical with the ones of Shaba, have been noted to occur in Zambia in stratigraphical continuity with the typical black shales of the Upper Mwashya. The correlation between the coarse clastics of the Zambian footwall (RL7) and the red dolomitic argillites and sandstones of the Zairean R.A.T. (Roches Argillo Talqueuses: R-1) remains uncertain. However these two sequences show some similarities suggesting a lateral facies change from high-energy siliciclastic sedimentation in Zambia, to quieter, less clastic and more carbonate rich sedimentation in Zaire. In agreement with the proposed lithostratigraphical correlation, volcanic and pyroclastic rocks, occurring both in Zaire and Zambia in the Lower Mwashya, testify to a major period of igneous activity in the region. Intrusive rocks found in the Zambian Roan Group and in the Zairean Dipeta Group can probably be attributed to the same episode of magmatism. Finally it can be shown that several copper-cobalt orebodies are found at the same lithostratigraphical position in Zambia and Zaire: the Zambian ore shale corresponds to the classical Shaba orebodies at the base of the Mines Group (R-2), the Nchanga upper orebody to the lower R-2.3 mineralization and the Zambian RL3 anomalous copper occurrences to those of the R-3.1.2 Dipeta unit.

Promotion of couples' voluntary HIV counseling and testing: a comparison of influence networks in Rwanda and Zambia.

PubMed

Kelley, April L; Hagaman, Ashley K; Wall, Kristin M; Karita, Etienne; Kilembe, William; Bayingana, Roger; Tichacek, Amanda; Kautzman, Michele; Allen, Susan A

2016-08-08

Many African adults do not know that partners in steady or cohabiting relationships can have different HIV test results. Despite WHO recommendations for couples' voluntary counseling and testing (CVCT), fewer than 10 % of couples have been jointly tested and counseled. We examine the roles and interactions of influential network leaders (INLs) and influential network agents (INAs) in promoting CVCT in Kigali, Rwanda and Lusaka, Zambia. INLs were identified in the faith-based, non-governmental, private, and health sectors. Each INL recruited and mentored several INAs who promoted CVCT. INLs and INAs were interviewed about demographic characteristics, promotional efforts, and working relationships. We also surveyed CVCT clients about sources of CVCT information. In Zambia, 53 INAs and 31 INLs were surveyed. In Rwanda, 33 INAs and 27 INLs were surveyed. Most (75 %-90 %) INAs believed that INL support was necessary for their promotional work. Zambian INLs reported being more engaged with their INAs than Rwandan INLs, with 58 % of Zambian INLs reporting that they gave a lot of support to their INAs versus 39 % in Rwanda. INAs in both Rwanda and Zambia reported promoting CVCT via group forums (77 %-97 %) and speaking to a community leader about CVCT (79 %-88 %) in the past month. More Rwandan INAs and INLs reported previous joint or individual HIV testing compared with their Zambian counterparts, of which more than half had not been tested. In Zambia and Rwanda, 1271 and 3895 CVCT clients were surveyed, respectively. Hearing about CVCT from INAs during one-on-one promotions was the most frequent source of information reported by clients in Zambia (71 %). In contrast, Rwandan couples who tested were more likely to have heard about CVCT from a previously tested couple (59 %). CVCT has long been endorsed for HIV prevention but few couples have been reached. Influential social networks can successfully promote evidence-based HIV prevention in Africa. Support from more senior INLs and group presentations leveraged INAs' one-on-one promotions. The INL/INA model was effective in promoting couples to seek joint HIV testing and counseling and may have broader application to other sub-Saharan African countries to sustainably increase CVCT uptake.

An outbreak of influenza A/H3N2 in a Zambian school dormitory.

PubMed

Mizuta, K; Oshitani, H; Mpabalwani, E M; Kasolo, F C; Luo, N P; Suzuki, H; Numazaki, Y

1995-03-01

There was an outbreak of "a mysterious disease" at a Zambian school dormitory in September, 1993. Investigation with questionnaire and collection of throat swab specimens for virus isolation were carried out on 46 patients to identify the causative agent. In this outbreak, most of the patients showed similar symptoms such as fever, headache, sore throat, cough, etc. The disease had spread to all dormitories within a couple of days after the onset of the first cases. From these patients, 13 influenza viruses A/H3N2 were isolated on MDCK cell line. This was a first ever confirmed outbreak of influenza virus infection in Zambia.

Economic booms and risky sexual behavior: evidence from Zambian copper mining cities.

PubMed

Wilson, Nicholas

2012-12-01

Existing studies suggest that individual and household level economic shocks affect the demand for and supply of risky sex. However, little evidence exists on the effects of an aggregate shock on equilibrium risky sexual behavior. This paper examines the effects of the early twenty-first century copper boom on risky sexual behavior in Zambian copper mining cities. The results suggest that the copper boom substantially reduced rates of transactional sex and multiple partnerships in copper mining cities. These effects were partly concentrated among young adults and copper boom induced in-migration to mining cities appears to have contributed to these reductions. Copyright © 2012. Published by Elsevier B.V.

Suboptimal Vitamin B Intakes of Zambian Preschool Children: Evaluation of 24-Hour Dietary Recalls.

PubMed

Titcomb, Tyler J; Schmaelzle, Samantha T; Nuss, Emily T; Gregory, Jesse F; Tanumihardjo, Sherry A

2018-06-01

Hidden hunger affects individuals who chronically consume an inadequate intake of at least 1 micronutrient and is associated with low dietary diversity. Little data are available on dietary intake or status assessment of B vitamins among preschool children in Zambia. The aim of this study was to assess 24-hour dietary recall records obtained from Zambian children aged 3 to 7 years for B vitamin intake in relation to adequacy and change over time in the same community. Twenty-four-hour dietary recalls were collected from 2 studies that were 2 years apart in the same district of Zambia. Data were retrospectively analyzed for B vitamin intake, that is, biotin, vitamin B 12 , folate, niacin, pantothenic acid, vitamin B 6 , riboflavin, and thiamin. The estimated average requirement (EAR) cut point method was used to assess inadequacy prevalence for EARs established by the Institute of Medicine in the United States. For all B vitamins, mean values were below the EARs established for children 4 to 8 years old. Relative to the EAR, children had the highest intakes of vitamin B 6 with inadequacies of 77.9% and 60.1% in 2010 and 2012, respectively. The highest prevalence of inadequate intake was associated with folate, where ≥95% of the children had intakes below the EAR in both studies. All median vitamin B intakes were inadequate among these young children in rural Zambia. Future researchers and policy makers may need to consider B vitamin status in resource-poor areas of the country.

The cholinesterase variants found in some African tribes living in Rhodesia.

PubMed

Whittaker, M; Lowe, R F

1976-01-01

Blood samples from 1,614 Africans living in Rhodesia have been phenotyped for the cholinesterase variants at the E1 and E2 loci. 24% of the African population were non-Rhodesian by birth. 1,227 Rhodesians aligned themselves to 20 tribes, 191 Malawians to 8 tribes. 162 Mozambique Africans to 9 tribes and 34 Zambians to 8 tribes. A high frequency of 0.036 for the Ef1 gene, which varies from tribe to tribe, has been found in Rhodesian and Malawian Africans. Similar high frequencies for this gene are recorded for Zambian (0.045) and Mozambique Africans (0.034). The frequencies of the Es1 gene in these groups are 0.013 (Rhodesian), 0.009 (Malawian), and 0.016 (Mozambique African). The small Zambian sample showed evidence for neither the Es1 nor the C5+ electrophoretic variant. The absence of the Ea1 gene in the 1,613 Africans provides additional evidence of the rarity of this gene in negroid populations. The frequency of the C5+ variant in Rhodesian, Malawian and Mozambique Africans, although varying from tribe to tribe within the range of 0-8%, averages 3% in each group. These represent low frequencies for this variant when compared to other populations. No rare or 'private' electrophoretic variant has been found.

Health professional feedback on HPV vaccination roll-out in a developing country.

PubMed

Venturas, Collette; Umeh, Kanayo

2017-04-04

Worldwide, Zambia has the highest cervical cancer incidence rates (58.4/100,000 per year) and mortality rates (36.2/100,000 per year). The human papilloma virus (HPV) vaccine is considered a vital preventative measure against cervical cancer, particularly in sub-Saharan countries, such as Zambia. Past research suggests health professionals' experiences with HPV vaccination rollout can have practical implications for effective delivery. To explore health professionals' perspectives on the HPV vaccination programme in Zambia. Researcher travelled to Zambia and conducted semi-structured interviews with fifteen health professionals working in private, government, and missionary clinics/hospitals. Observation was conducted for triangulation purposes. Thematic analysis was used to analyse the data. Five main themes emerged; medical misconceptions about the HPV vaccination, particularly with regards to infertility; fear of the unknown, including possible side effects and inadequate empirical research; need for prior desensitisation to resolve cultural barriers prior to vaccination rollout; a rural-urban divide in health awareness, particularly in relation to cancer vaccines; and economic concerns associated with access to the HPV vaccination for most of the Zambian population. Overall, the findings indicate that an essential avenue for facilitating HPV vaccination rollout in Zambia is by implementing a pre-rollout community effort that removes or softens cultural barriers, particularly in rural areas. It is also essential to correct erroneous HPV presumptions health professionals may have around infertility. Affordability remains a seemingly intractable hindrance that hampers HPV vaccination rollout in Zambia. Copyright © 2017 Elsevier Ltd. All rights reserved.

Community attitudes towards childbearing and abortion among HIV-positive women in Nigeria and Zambia.

PubMed

Kavanaugh, Megan L; Moore, Ann M; Akinyemi, Odunayo; Adewole, Isaac; Dzekedzeke, Kumbutso; Awolude, Olutosin; Arulogun, Oyedunni

2013-01-01

Although stigma towards HIV-positive women for both continuing and terminating a pregnancy has been documented, to date few studies have examined relative stigma towards one outcome versus the other. This study seeks to describe community attitudes towards each of two possible elective outcomes of an HIV-positive woman's pregnancy - induced abortion or birth - to determine which garners more stigma and document characteristics of community members associated with stigmatising attitudes towards each outcome. Data come from community-based interviews with reproductive-aged men and women, 2401 in Zambia and 2452 in Nigeria. Bivariate and multivariate analyses revealed that respondents from both countries overwhelmingly favoured continued childbearing for HIV-positive pregnant women, but support for induced abortion was slightly higher in scenarios in which anti-retroviral therapy (ART) was unavailable. Zambian respondents held more stigmatising attitudes towards abortion for HIV-positive women than did Nigerian respondents. Women held more stigmatising attitudes towards abortion for HIV-positive women than men, particularly in Zambia. From a sexual and reproductive health and rights perspective, efforts to assist HIV-positive women in preventing unintended pregnancy and to support them in their pregnancy decisions when they do become pregnant should be encouraged in order to combat the social stigma documented in this paper.

The role of electronic media in the health services of Zambia.

PubMed

Chirwa, B U

1989-01-01

The Zambian government has shifted its emphasis from a hospital-oriented approach to healthcare to a primary health care, community approach. This new approach demands that health education be promoted through mass media and/or interpersonally. The Health Education Unit in Zambia has used television and radio to sensitize individuals and communities to health and health-related problems, as well as to motivate them to initiate activities to solve those problems. 57% of the target population, however, lives in rural areas where they do not have access to television and only poor radio reception, if that. An improved state of television and radio reception in remote areas will go far in disseminating health education to these people in need. For now, the Ministry of Health, together with UNICEF, is undertaking a pilot project on group radio listenership in rural areas to determine the feasibility of small communities coming together and listening to health programs for the purpose of initiating health action in the community. Reception could be improved be either improving transmission facilities at the center or by establishing booster services at each of the six rural provincial headquarters. The latter approach seems the most likely of the two options to provide the desired results.

A cluster randomized controlled trial to increase the availability and acceptability of voluntary medical male circumcision in Zambia: The Spear and Shield Project

PubMed Central

Weiss, Stephen M; Zulu, Robert; Jones, Deborah L; Redding, Colleen A; Cook, Ryan; Chitalu, Ndashi

2015-01-01

Background Widespread voluntary medical male circumcision (VMMC) in Africa could avert an estimated 3·436 million HIV infections and 300,000 deaths over the next 10 years. Most Zambian men, however, have expressed little interest in undergoing VMMC. This study tested the effect of an intervention designed to increase demand for VMMC among these “hard to reach” men. Methods This cluster randomized controlled trial was conducted from 2012 to 2014 in Lusaka, Zambia (HIV prevalence = 20·8%). 13 Community Health Centers (CHCs) were stratified by HIV voluntary counseling and testing (VCT) rates and patient census and randomly assigned (5:5:3) to Experimental, Control or Observation Only conditions. CHC health care providers at all 13 sites received VMMC training. Trial statisticians did not participate in randomization. 800 uncircumcised HIV-, post-VCT men, 400 per condition, were recruited; female partners were invited to participate. The primary outcome was the likelihood of VMMC by 12 months post-intervention. The trial registration is NCT 01688167. Findings 161 participants in the Experimental condition underwent VMMC as compared to 96 Control participants [adjusted odds ratio = 2·45, 95% CI = (1·24, 4·90) p = ·0166]. Post-VMMC condom use among Experimental condition participants increased compared to baseline, with no change among Control participants. No adverse events related to study participation were reported. Interpretation The Spear and Shield intervention combined with VMMC training was associated with a significant increase in the number of VMMCs performed as well as in condom use among “hard to reach” Zambian men. Results support the importance of comprehensive HIV prevention programs that increase supply of and demand for VMMC services. Funding NIH/NIMH R01MH095539. PMID:26120594

Poverty, physical stature, and cognitive skills: Mechanisms underlying children's school enrollment in Zambia.

PubMed

McCoy, Dana Charles; Zuilkowski, Stephanie Simmons; Fink, Günther

2015-05-01

Past research suggests robust positive associations between household socioeconomic status and children's early cognitive development in Western countries. Relatively little is known about these relations in low-income country settings characterized by economic adversity, high prevalence of malnutrition and infectious disease, and relatively lower school enrollment. The present study develops and empirically evaluates an adapted model of early childhood development using a sample of 2,711 Zambian 6-year-olds. Early learning in and out of the home was found to explain much of the relation between socioeconomic status and children's cognitive skills, including language, nonverbal reasoning, and executive function. Child height-for-age (a proxy for overall nutritional status and health) was also predictive of children's cognitive skills and both early and on-time school enrollment. Implications for global child development, intervention, and future work are discussed. (c) 2015 APA, all rights reserved).

Understanding controls on biotic assemblages and ecological status in Zambian rivers for the development of sustainable monitoring protocols

NASA Astrophysics Data System (ADS)

Kennedy, Michael; Gibbins, Chris; Lowe, Steven; Dallas, Helen; Taylor, Jonathan; Lang, Pauline; Saili, Kothelani; Sichingabula, Henry; Murphy, Kevin

2014-05-01

The water resources of Zambia are likely to experience increasing multiple pressures in the future as a result of very high predicted population growth, industrial development, land use change, and potentially, altered regional rainfall patterns. It is well known that rivers in tropical regions typically have a rich biodiversity, controlled in part by inter-annual variability in climate and discharge, and in part by local catchment conditions. However, till recently little country-wide work had had been carried out on the biota of Zambian rivers, and little was therefore known about the ecological status, or degree of catchment alteration of many of the rivers. To underpin sustainable water management, protocols have been developed to assess the ecological status of Zambian rivers. This paper describes the development of the protocols and their application to provide the first extensive assessment of the ecological status of rivers in the country. The protocols were designed to be simple, and hence rapid, easy and relatively inexpensive to apply. Status scores were derived for individual sites using sensitivity weightings from 3 major groups (macrophytes, diatoms and macroinvertebrates). The general approach was based on schemes used successfully elsewhere, with species and family sensitivity weightings modified so as be appropriate to Zambia. Modifications were based on a survey of 140 Zambian rivers, incorporating data on species distributions, physical habitat conditions and water quality. Analysis of historical data suggests that established Freshwater Ecoregions reflect hydro-climatic variability across Zambia. Survey data indicate that most of the spatial variation in biological assemblages across the country reflects these same hydro-climatic gradients, in addition to hydrochemical differences linked to geology. Site status scores suggest that rivers are generally in good health, although exceptions occur in some large urban areas and a small number of catchments with major industrial activity. Data form an important baseline against which to assess future changes related to population growth and climate change, and will therefore help inform policy within Zambia for sustainable river monitoring and management.

NIH Abroad: Inspiring the Next Generation of Global Health Researchers

MedlinePlus

... Global Health Researchers Fogarty scholar helps Zambians fight cervical cancer Medical student and Fogarty scholar Krista Pfaendler (right) assists with surgery on a patient with cervical cancer in Zambia. Photo courtesy of Krista Pfaendler An ...

How did rapid scale-up of HIV services impact on workplace and interpersonal trust in Zambian primary health centres: a case-based health systems analysis

PubMed Central

Topp, Stephanie M; Chipukuma, Julien M

2016-01-01

Background In sub-Saharan Africa, large amounts of funding continue to be directed towards HIV-specific care and treatment, often with claims of ‘health system strengthening’ effect. Such claims rarely account for the impact on human relationships and decisions that are core to functional health systems. This research examined how establishment of externally funded HIV services influenced trusting relationships in Zambian health centres. Methods An in-depth, multicase study included four health centres selected for urban, peri-urban and rural characteristics. Case data included healthcare worker (HCW) interviews (60); patient interviews (180); direct observation of facility operations (2 weeks/centre) and key informant interviews (14) which were recorded and transcribed verbatim. Thematic analysis adopted inductive and deductive coding guided by a framework incorporating concepts of workplace trust, patient–provider trust, intrinsic and extrinsic motivation. Results HIV service scale-up impacted trust in positive and negative ways. Investment in HIV-specific infrastructure, supplies and quality assurance mechanisms strengthened workplace trust, HCW motivation and patient–provider trust in HIV departments in the short-term. In the health centres more broadly and over time, however, non-governmental organisation-led investment and support of HIV departments reinforced HCW's perceptions of the government as uninterested or unable to provide a quality work environment. Exacerbating existing perceptions of systemic workplace inequity and nepotism, uneven distribution of personal and professional opportunities related to HIV service establishment contributed to interdepartmental antagonism and reinforced workplace practices designed to protect individual HCW's interests. Conclusions Findings illustrate long-term negative effects of the vertical HIV resourcing and support structures which failed to address and sometimes exacerbated HCW (dis)trust with their own government and supervisors. The short-term and long-term effects of weakened workplace trust on HCWs' motivation and performance signal the importance of understanding how such relationships play a role in generating virtuous or perverse cycles of actor interactions, with implications for service outcomes. PMID:28588985

Female Partner Acceptance as a Predictor of Men's Readiness to Undergo Voluntary Medical Male Circumcision in Zambia: The Spear and Shield Project.

PubMed

Cook, Ryan; Jones, Deborah; Redding, Colleen A; Zulu, Robert; Chitalu, Ndashi; Weiss, Stephen M

2016-11-01

The World Health Organization has recommended the scale-up of voluntary medical male circumcision (VMMC) for HIV prevention in sub-Saharan Africa; however, men are often uninterested in undergoing VMMC. The Spear & Shield project enrolled 668 men and female partners from ten Zambian community health centers into parallel interventions promoting VMMC for HIV prevention or time-matched control conditions. A mediation model was utilized to examine the relationships between changes in women's acceptance of VMMC and men's readiness to undergo the procedure. Results demonstrated that, at 12 months post-intervention, a 5.9 % increase in the likelihood of undergoing VMMC among men in the experimental condition could be attributed to increased women's acceptance. From a public health perspective, involving women in VMMC promotion interventions such as the Spear & Shield project could significantly impact the demand for VMMC in Zambia.

Acceptability, Knowledge, Beliefs, and Partners as Determinants of Zambian Men's Readiness to Undergo Medical Male Circumcision

PubMed Central

Jones, Deborah; Cook, Ryan; Arheart, Kris; Redding, Colleen A.; Zulu, Robert; Castro, Jose; Weiss, Stephen M.

2013-01-01

There is limited information about the influence of partners on medical male circumcision (MMC) uptake. This study aimed to evaluate attitudes, knowledge, and preferences about MMC among men and their partners, and their relative impact on male readiness to undergo the MMC procedure. Male participants (n = 354) and their partners (n = 273) were recruited from community health centers in Lusaka, Zambia. Men reported their readiness to undergo MMC, and both men and women were assessed regarding their attitudes and knowledge regarding MMC. Men who had discussed MMC with their partners, those who endorsed MMC for HIV risk reduction, and those viewing MMC as culturally acceptable reported increased readiness to undergo MMC. Additionally, endorsement of MMC by female partners was associated with increased men’s readiness. Results support promotion of cultural acceptability of MMC, and efforts to increase MMC uptake may benefit from incorporating partners in the decision making process. PMID:23757123

Improving paediatric asthma care in Zambia

PubMed Central

Jumbe-Marsden, Emilia; Mateyo, Kondwelani; Senkwe, Mutale Nsakashalo; Sotomayor-Ruiz, Maria; Musuku, John; Soriano, Joan B; Ancochea, Julio; Fishman, Mark C

2015-01-01

Abstract Problem In 2008, the prevalence of paediatric asthma in Zambia was unknown and the national treatment guideline was outdated. Approach We created an international partnership between Zambian clinicians, the Zambian Government and a pharmaceutical company to address shortcomings in asthma treatment. We did two studies, one to estimate prevalence in the capital of Lusaka and one to assess attitudes and practices of patients. Based on the information obtained, we educated health workers and the public. The information from the studies was also used to modernize government policy for paediatric asthma management. Local setting The health-care system in Zambia is primarily focused on acute care delivery with a focus on infectious diseases. Comprehensive services for noncommunicable diseases are lacking. Asthma management relies on treatment of acute exacerbations instead of disease control. Relevant changes Seven percent of children surveyed had asthma (255/3911). Of the 120 patients interviewed, most (82/120, 68%) used oral short-acting β2-agonists for symptom control; almost half (59/120, 49%) did not think the symptoms were preventable and 43% (52/120) thought inhalers were addictive. These misconceptions informed broad-based educational programmes. We used a train-the-trainer model to educate health-care workers and ran public awareness campaigns. Access to inhalers was increased and the Zambian standard treatment guideline for paediatric asthma was revised to include steroid inhalers as a control treatment. Lessons learnt Joint activities were required to change paediatric asthma care in Zambia. Success will depend on local sustainability, and it may be necessary to shift resources to mirror the disease burden. PMID:26600616

Present-day African analogue of a pre-European Amazonian floodplain fishery shows convergence in cultural niche construction.

PubMed

McKey, Doyle B; Durécu, Mélisse; Pouilly, Marc; Béarez, Philippe; Ovando, Alex; Kalebe, Mashuta; Huchzermeyer, Carl F

2016-12-27

Erickson [Erickson CL (2000) Nature 408 (6809):190-193] interpreted features in seasonal floodplains in Bolivia's Beni savannas as vestiges of pre-European earthen fish weirs, postulating that they supported a productive, sustainable fishery that warranted cooperation in the construction and maintenance of perennial structures. His inferences were bold, because no close ethnographic analogues were known. A similar present-day Zambian fishery, documented here, appears strikingly convergent. The Zambian fishery supports Erickson's key inferences about the pre-European fishery: It allows sustained high harvest levels; weir construction and operation require cooperation; and weirs are inherited across generations. However, our comparison suggests that the pre-European system may not have entailed intensive management, as Erickson postulated. The Zambian fishery's sustainability is based on exploiting an assemblage dominated by species with life histories combining high fecundity, multiple reproductive cycles, and seasonal use of floodplains. As water rises, adults migrate from permanent watercourses into floodplains, through gaps in weirs, to feed and spawn. Juveniles grow and then migrate back to dry-season refuges as water falls. At that moment fishermen set traps in the gaps, harvesting large numbers of fish, mostly juveniles. In nature, most juveniles die during the first dry season, so that their harvest just before migration has limited impact on future populations, facilitating sustainability and the adoption of a fishery based on inherited perennial structures. South American floodplain fishes with similar life histories were the likely targets of the pre-European fishery. Convergence in floodplain fish strategies in these two regions in turn drove convergence in cultural niche construction.

Managing the vitamin A program portfolio: a case study of Zambia, 2013-2042.

PubMed

Fiedler, John L; Lividini, Keith

2014-03-01

Micronutrient deficiencies continue to constitute a major burden of disease, particularly in Africa and South Asia. Programs to address micronutrient deficiencies have been increasing in number, type, and scale in recent years, creating an ever-growing need to understand their combined coverage levels, costs, and impacts so as to more effectively combat deficiencies, avoid putting individuals at risk for excess intakes, and ensure the efficient use of public health resources. To analyze combinations of the two current programs--sugar fortification and Child Health Week (CHW)--together with four prospective programs--vegetable oil fortification, wheat flour fortification, maize meal fortification, and biofortified vitamin A maize--to identify Zambia's optimal vitamin A portfolio. Combining program cost estimates and 30-year Zambian food demand projections, together with the Zambian 2005 Living Conditions Monitoring Survey, the annual costs, coverage, impact, and cost-effectiveness of 62 Zambian portfolios were modeled for the period from 2013 to 2042. Optimal portfolios are identified for each of five alternative criteria: average cost-effectiveness, incremental cost-effectiveness, coverage maximization, health impact maximization, and affordability. The most likely scenario is identified to be one that starts with the current portfolio and takes into account all five criteria. Starting with CHW and sugar fortification, it phases in vitamin A maize, oil, wheat flour, and maize meal (in that order) to eventually include all six individual interventions. Combining cost and Household Consumption and Expenditure Survey (HCES) data provides a powerful evidence-generating tool with which to understand how individual micronutrient programs interact and to quantify the tradeoffs involved in selecting alternative program portfolios.

"You cannot eat rights": a qualitative study of views by Zambian HIV-vulnerable women, youth and MSM on human rights as public health tools.

PubMed

Muzyamba, Choolwe; Broaddus, Elena; Campbell, Catherine

2015-10-05

Human rights approaches now dominate the HIV prevention landscape across sub-Saharan Africa, yet little is known about how they are viewed by the populations they are designed to serve. Health interventions are most effective when they resonate with the worldviews and interests of target groups. This study examined local Zambian understandings of human rights approaches to HIV-prevention among three highly HIV-vulnerable groups: women, youth, and men-who-have-sex-with-men (MSM). Focus groups included 23 women, youth, and MSM who had participated in activities organized by local non-governmental organizations (NGOs) using rights-based approaches, and interviews included 10 Zambian employees of these NGOs. Topics included participants' experiences and views of the utility of these activities. Thematic analysis mapped out diverse ways participants viewed the concept of human rights in relation to HIV-prevention. Whilst NGO workers noted the need for human rights programs to address the complex drivers of the HIV epidemic, they struggled to tailor them to the Zambian context due to donor stipulations. Women program beneficiaries noted that the concept of human rights helped challenge harmful sexual practices and domestic abuse, and youth described rights-based approaches as more participatory than previous HIV-prevention efforts. However, they criticized the approach for conflicting with traditional values such as respect for elders and 'harmonious' marital relationships. They also critiqued it for threatening the social structures and relationships that they relied on for material survival, and for failing to address issues like poverty and unemployment. In contrast, MSM embraced the rights approach, despite being critical of its overly confrontational implementation. A rights-based approach seeks to tackle the symbolic drivers of HIV-its undeniable roots in cultural and religious systems of discrimination. Yet, it fails to resonate with youth and women's own understandings of their needs and priorities due to its neglect of material drivers of HIV such as poverty and unemployment. MSM, who suffer extreme stigma and discrimination, have less to lose and much to gain from an approach that challenges inequitable social systems. Developing effective HIV-prevention strategies requires careful dialogue with vulnerable groups and greater flexibility for context-specific implementation rather than a one-size-fits-all conceptualization of human rights.

The Zambian wildlife ranching industry: scale, associated benefits, and limitations affecting its development.

PubMed

Lindsey, Peter A; Barnes, Jonathan; Nyirenda, Vincent; Pumfrett, Belinda; Tambling, Craig J; Taylor, W Andrew; t'Sas Rolfes, Michael

2013-01-01

The number and area of wildlife ranches in Zambia increased from 30 and 1,420 km(2) in 1997 to 177 and ∼6,000 km(2) by 2012. Wild ungulate populations on wildlife ranches increased from 21,000 individuals in 1997 to ∼91,000 in 2012, while those in state protected areas declined steeply. Wildlife ranching and crocodile farming have a turnover of ∼USD15.7 million per annum, compared to USD16 million from the public game management areas which encompass an area 29 times larger. The wildlife ranching industry employs 1,200 people (excluding jobs created in support industries), with a further ∼1,000 individuals employed through crocodile farming. Wildlife ranches generate significant quantities of meat (295,000 kg/annum), of which 30,000 kg of meat accrues to local communities and 36,000 kg to staff. Projected economic returns from wildlife ranching ventures are high, with an estimated 20-year economic rate of return of 28%, indicating a strong case for government support for the sector. There is enormous scope for wildlife ranching in Zambia due to the availability of land, high diversity of wildlife and low potential for commercial livestock production. However, the Zambian wildlife ranching industry is small and following completion of field work for this study, there was evidence of a significant proportion of ranchers dropping out. The industry is performing poorly, due to inter alia: rampant commercial bushmeat poaching; failure of government to allocate outright ownership of wildlife to landowners; bureaucratic hurdles; perceived historical lack of support from the Zambia Wildlife Authority and government; a lack of a clear policy on wildlife ranching; and a ban on hunting on unfenced lands including game ranches. For the wildlife ranching industry to develop, these limitations need to be addressed decisively. These findings are likely to apply to other savanna countries with large areas of marginal land potentially suited to wildlife ranching.

The Zambian Wildlife Ranching Industry: Scale, Associated Benefits, and Limitations Affecting Its Development

PubMed Central

Lindsey, Peter A.; Barnes, Jonathan; Nyirenda, Vincent; Pumfrett, Belinda; Tambling, Craig J.; Taylor, W. Andrew; Rolfes, Michael t’Sas

2013-01-01

The number and area of wildlife ranches in Zambia increased from 30 and 1,420 km2 in 1997 to 177 and ∼6,000 km2 by 2012. Wild ungulate populations on wildlife ranches increased from 21,000 individuals in 1997 to ∼91,000 in 2012, while those in state protected areas declined steeply. Wildlife ranching and crocodile farming have a turnover of ∼USD15.7 million per annum, compared to USD16 million from the public game management areas which encompass an area 29 times larger. The wildlife ranching industry employs 1,200 people (excluding jobs created in support industries), with a further ∼1,000 individuals employed through crocodile farming. Wildlife ranches generate significant quantities of meat (295,000 kg/annum), of which 30,000 kg of meat accrues to local communities and 36,000 kg to staff. Projected economic returns from wildlife ranching ventures are high, with an estimated 20-year economic rate of return of 28%, indicating a strong case for government support for the sector. There is enormous scope for wildlife ranching in Zambia due to the availability of land, high diversity of wildlife and low potential for commercial livestock production. However, the Zambian wildlife ranching industry is small and following completion of field work for this study, there was evidence of a significant proportion of ranchers dropping out. The industry is performing poorly, due to inter alia: rampant commercial bushmeat poaching; failure of government to allocate outright ownership of wildlife to landowners; bureaucratic hurdles; perceived historical lack of support from the Zambia Wildlife Authority and government; a lack of a clear policy on wildlife ranching; and a ban on hunting on unfenced lands including game ranches. For the wildlife ranching industry to develop, these limitations need to be addressed decisively. These findings are likely to apply to other savanna countries with large areas of marginal land potentially suited to wildlife ranching. PMID:24367493

Present-day African analogue of a pre-European Amazonian floodplain fishery shows convergence in cultural niche construction

PubMed Central

McKey, Doyle B.; Durécu, Mélisse; Pouilly, Marc; Béarez, Philippe; Ovando, Alex; Kalebe, Mashuta; Huchzermeyer, Carl F.

2016-01-01

Erickson [Erickson CL (2000) Nature 408 (6809):190–193] interpreted features in seasonal floodplains in Bolivia’s Beni savannas as vestiges of pre-European earthen fish weirs, postulating that they supported a productive, sustainable fishery that warranted cooperation in the construction and maintenance of perennial structures. His inferences were bold, because no close ethnographic analogues were known. A similar present-day Zambian fishery, documented here, appears strikingly convergent. The Zambian fishery supports Erickson’s key inferences about the pre-European fishery: It allows sustained high harvest levels; weir construction and operation require cooperation; and weirs are inherited across generations. However, our comparison suggests that the pre-European system may not have entailed intensive management, as Erickson postulated. The Zambian fishery’s sustainability is based on exploiting an assemblage dominated by species with life histories combining high fecundity, multiple reproductive cycles, and seasonal use of floodplains. As water rises, adults migrate from permanent watercourses into floodplains, through gaps in weirs, to feed and spawn. Juveniles grow and then migrate back to dry-season refuges as water falls. At that moment fishermen set traps in the gaps, harvesting large numbers of fish, mostly juveniles. In nature, most juveniles die during the first dry season, so that their harvest just before migration has limited impact on future populations, facilitating sustainability and the adoption of a fishery based on inherited perennial structures. South American floodplain fishes with similar life histories were the likely targets of the pre-European fishery. Convergence in floodplain fish strategies in these two regions in turn drove convergence in cultural niche construction. PMID:27980030

Usual nutrient intake adequacy among young, rural Zambian children.

PubMed

Caswell, Bess L; Talegawkar, Sameera A; Siamusantu, Ward; West, Keith P; Palmer, Amanda C

2018-01-01

Inadequate nutrient intakes put children at risk for impaired growth and development. We described diet, usual intakes of energy and macro- and micronutrients and prevalence of nutrient intake adequacies among 4-8-year-old Zambian children. Children not yet in school and living in Mkushi District, Central Province, Zambia were enrolled into an efficacy trial of pro-vitamin A biofortified maize. Children in the non-intervened arm were included in this analysis (n 202). Dietary intake data were collected by tablet-based 24-h recall on a monthly basis over the 6-month trial. Observed nutrient intakes were derived from reported food quantities, standard recipes and food composition tables. Usual nutrient intake distributions were modelled based on observed intakes. Prevalence of inadequacy was estimated by comparing the usual nutrient intake distribution to the nutrient requirement distribution. Frequency and quantity of consumption of commonly reported foods were described and key sources of energy and nutrients were identified. Median usual energy intake was 6422 kJ/d (1535 kcal/d). Most childrens' macronutrient intakes fell within recommended ranges (74-98 %). Estimated prevalences of inadequate intakes of Fe, folate, vitamin B12 and Ca were 25, 57, 76 and >99 %, respectively. Estimated prevalences of inadequacy for other micronutrients were low (0·1-2·2 %). Commonly consumed foods included maize, vegetable oil, tomatoes, rape leaves and small fish (>0·6 servings/d), whereas meat, eggs or dairy were rarely eaten (<0·2 servings/d). These findings suggest that the heavily plant-based diet of rural Zambian children provides inadequate Ca, folate, vitamin B12 and Fe to meet recommended nutrient intakes.

An exploration of facilitators and challenges in the scale-up of a national, public sector community health worker cadre in Zambia: a qualitative study.

PubMed

Phiri, Sydney Chauwa; Prust, Margaret Lippitt; Chibawe, Caroline Phiri; Misapa, Ronald; van den Broek, Jan Willem; Wilmink, Nikhil

2017-06-24

In 2010 a public sector cadre of community health workers called Community Health Assistants (CHAs) was created in Zambia through the National Community Health Worker Strategy to expand access to health services. This cadre continues to be scaled up to meet the growing demands of Zambia's rural population. We summarize factors that have facilitated the scale-up of the CHA program into a nationwide CHW cadre and the challenges of introducing and institutionalizing the cadre within the Zambian health system. Semi-structured, individual interviews were held across 5 districts with 16 CHAs and 6 CHA supervisors, and 10 focus group discussions were held with 93 community members. Audio recordings of interviews and focus group discussions were transcribed and thematically coded using Dedoose web-based software. The study showed that the CHAs play a critical role in providing a wide range of services at the community level, as described by supervisors and community members. Some challenges still remain, that may inhibit the CHAs ability to provide health services effectively. In particular, the respondents highlighted infrequent supervision, lack of medical and non-medical supplies for outreach services, and challenges with the mobile data reporting system. The study shows that in order to optimize the impact of CHAs or other community health workers, key health-system support structures need to be functioning effectively, such as supervision, community surveillance systems, supplies, and reporting. The Ministry of Health with support from partners are currently addressing these challenges through nationwide supervisor and community data trainings, as well as advocating for adding primary health care as a specific focus area in the new National Health Strategy Plan 2017-2021. This study contributes to the evidence base on the introduction of formalized community health worker cadres in developing countries.

Serials Acquisition Problems in Developing Countries: The Zambian Experience.

ERIC Educational Resources Information Center

Lungu, Charles B. M.

1985-01-01

Analysis of serial acquisition problems in developing nations cites specific references from University of Zambia Library. Discussion covers underdeveloped economic circumstances of Third World nations, overdependence on serials of foreign origin, geographical locations of Third World countries, ill-defined acquisition policies, staffing for…

Nutritional characterisation of Zambian Moringa oleifera: acceptability and safety of short-term daily supplementation in a group of malnourished girls.

PubMed

Barichella, Michela; Pezzoli, Gianni; Faierman, Samanta A; Raspini, Benedetta; Rimoldi, Martina; Cassani, Erica; Bertoli, Simona; Battezzati, Alberto; Leone, Alessandro; Iorio, Laura; Ferri, Valentina; Pinelli, Giovanna; Pusani, Chiara; Bolliri, Carlotta; Cilia, Roberto; Caronni, Serena; De Marco, Patrizia; Cereda, Emanuele

2018-05-24

In Zambia, chronic malnutrition still is one of the most common problem among children. To fight against malnutrition, the easiest short-term solution could be to combine specific types of food with affordable local plants. A large variety of natural food resources grow in Zambia, such as Moringa oleifera (MO), whose leaves are known for their health benefits, but are not consumed much by local populations. We analysed Zambian MO powder obtained from dried leaves and found that it contains large amounts of protein, minerals and vitamins, such as iron, calcium and carotenoids. These characteristics make MO a good and sustainable complementary solution to malnutrition. We also evaluated the acceptability and the safety of dietary supplementation with MO powder in malnourished children for 30 days. A daily dose of 14 g daily was safe and well accepted. Its regular use in the menu of local populations may be viable proposition.

Lessons Learned From Transitioning PEPFAR Track 1.0 Care and Treatment Programs: Case Studies in Financial Management Capacity Building in Zambia and Botswana.

PubMed

Kuehn, Chuck; Tidwell, George; Vhugen, Jann; Sharma, Anjali

2015-01-01

In 2008, the United States government mandated transition of internationally managed HIV care and treatment programs to local country ownership. Three case studies illustrate the US Health Resources Services Administration's fiscal assessment and technical assistance (TA) processes to strengthen local organizations' capabilities to absorb and manage United States government funding. Review of initial, TA and follow-up reports reveal that the 1 Botswanan and 2 Zambian organizations closed 10 of 17 financial capacity gaps, with Health Resources Services Administration assisting on 2. Zambian organizations requested and absorbed targeted TA on the basis of the consultant's desk review, their finance staff revised fiscal policies and procedures, and accordingly trained other staff. In Botswana, delays in integrating recommendations necessitated on-site TA for knowledge building and role modeling. Organizational maturity may explain differences in responsiveness, ownership, and required TA approaches. Clarifying expectations of capacity building, funding agreement, and nonmonetary donor involvement can help new organizations determine and act on intervening actions.

Southern Africa’s Transnational Threats

DTIC Science & Technology

2013-04-01

14 &15. The smugglers load boats with Zimbabwean ivory , cigarettes, liquor and fish to sell to Zambians. Firearms Angola Namibia Page 18. Firearm...between SADC countries in this regard and more alignment in the region’s policies on abalone poaching ." Annette Hubschle, “Organized Crime in Southern

Fire management assessment of Eastern Province, Zambia

Treesearch

L. T. Hollingsworth; D. Johnson; G. Sikaundi; S. Siame

2015-01-01

The mission that produced this assessment was prompted by requests from Forestry Department personnel in Zambia to the United States Agency for International Development (USAID) for formal fire management training. USAID contacted the United States Forest Service's (USFS) International Programs (IP) with the training request. Together, USFS, USAID, and Zambian...

Creating an African HIV Clinical Research and Prevention Trials Network: HIV Prevalence, Incidence and Transmission

PubMed Central

Kamali, Anatoli; Price, Matt A.; Lakhi, Shabir; Karita, Etienne; Inambao, Mubiana; Sanders, Eduard J.; Anzala, Omu; Latka, Mary H.; Bekker, Linda-Gail; Kaleebu, Pontiano; Asiki, Gershim; Ssetaala, Ali; Ruzagira, Eugene; Allen, Susan; Farmer, Paul; Hunter, Eric; Mutua, Gaudensia; Makkan, Heeran; Tichacek, Amanda; Brill, Ilene K.; Fast, Pat; Stevens, Gwynn; Chetty, Paramesh; Amornkul, Pauli N.; Gilmour, Jill

2015-01-01

HIV epidemiology informs prevention trial design and program planning. Nine clinical research centers (CRC) in sub-Saharan Africa conducted HIV observational epidemiology studies in populations at risk for HIV infection as part of an HIV prevention and vaccine trial network. Annual HIV incidence ranged from below 2% to above 10% and varied by CRC and risk group, with rates above 5% observed in Zambian men in an HIV-discordant relationship, Ugandan men from Lake Victoria fishing communities, men who have sex with men, and several cohorts of women. HIV incidence tended to fall after the first three months in the study and over calendar time. Among suspected transmission pairs, 28% of HIV infections were not from the reported partner. Volunteers with high incidence were successfully identified and enrolled into large scale cohort studies. Over a quarter of new cases in couples acquired infection from persons other than the suspected transmitting partner. PMID:25602351

A randomized-control trial for the teachers' diploma programme on psychosocial care, support and protection in Zambian government primary schools.

PubMed

Kaljee, Linda; Zhang, Liying; Langhaug, Lisa; Munjile, Kelvin; Tembo, Stephen; Menon, Anitha; Stanton, Bonita; Li, Xiaoming; Malungo, Jacob

2017-04-01

Orphaned and vulnerable children (OVC) experience poverty, stigma, and abuse resulting in poor physical, emotional, and psychological outcomes. The Teachers' Diploma Programme on Psychosocial Care, Support, and Protection is a child-centered 15-month long-distance learning program focused on providing teachers with the knowledge and skills to enhance their school environments, foster psychosocial support, and facilitate school-community relationships. A randomized controlled trial was implemented in 2013-2014. Both teachers (n=325) and students (n=1378) were assessed at baseline and 15-months post-intervention from randomly assigned primary schools in Lusaka and Eastern Provinces, Zambia. Multilevel linear mixed models (MLM) indicate positive significant changes for intervention teachers on outcomes related to self-care, teaching resources, safety, social support, and gender equity. Positive outcomes for intervention students related to future orientation, respect, support, safety, sexual abuse, and bullying. Outcomes support the hypothesis that teachers and students benefit from a program designed to enhance teachers' psychosocial skills and knowledge.

Implementation of an electronic fingerprint-linked data collection system: a feasibility and acceptability study among Zambian female sex workers.

PubMed

Wall, Kristin M; Kilembe, William; Inambao, Mubiana; Chen, Yi No; Mchoongo, Mwaka; Kimaru, Linda; Hammond, Yuna Tiffany; Sharkey, Tyronza; Malama, Kalonde; Fulton, T Roice; Tran, Alex; Halumamba, Hanzunga; Anderson, Sarah; Kishore, Nishant; Sarwar, Shawn; Finnegan, Trisha; Mark, David; Allen, Susan A

2015-06-27

Patient identification within and between health services is an operational challenge in many resource-limited settings. When following HIV risk groups for service provision and in the context of vaccine trials, patient misidentification can harm patient care and bias trial outcomes. Electronic fingerprinting has been proposed to identify patients over time and link patient data between health services. The objective of this study was to determine 1) the feasibility of implementing an electronic-fingerprint linked data capture system in Zambia and 2) the acceptability of this system among a key HIV risk group: female sex workers (FSWs). Working with Biometrac, a US-based company providing biometric-linked healthcare platforms, an electronic fingerprint-linked data capture system was developed for use by field recruiters among Zambian FSWs. We evaluated the technical feasibility of the system for use in the field in Zambia and conducted a pilot study to determine the acceptability of the system, as well as barriers to uptake, among FSWs. We found that implementation of an electronic fingerprint-linked patient tracking and data collection system was feasible in this relatively resource-limited setting (false fingerprint matching rate of 1/1000 and false rejection rate of <1/10,000) and was acceptable among FSWs in a clinic setting (2% refusals). However, our data indicate that less than half of FSWs are comfortable providing an electronic fingerprint when recruited while they are working. The most common reasons cited for not providing a fingerprint (lack of privacy/confidentiality issues while at work, typically at bars or lodges) could be addressed by recruiting women during less busy hours, in their own homes, in the presence of "Queen Mothers" (FSW organizers), or in the presence of a FSW that has already been fingerprinted. Our findings have major implications for key population research and improved health services provision. However, more work needs to be done to increase the acceptability of the electronic fingerprint-linked data capture system during field recruitment. This study indicated several potential avenues that will be explored to increase acceptability.

The association of hyperglycaemia with prevalent tuberculosis: a population-based cross-sectional study.

PubMed

Bailey, Sarah Lou; Ayles, Helen; Beyers, Nulda; Godfrey-Faussett, Peter; Muyoyeta, Monde; du Toit, Elizabeth; Yudkin, John S; Floyd, Sian

2016-12-05

Systematic reviews suggest that the incidence of diagnosed tuberculosis is two- to- three times higher in those with diabetes mellitus than in those without. Few studies have previously reported the association between diabetes or hyperglycaemia and the prevalence of active tuberculosis and none in a population-based study with microbiologically-defined tuberculosis. Most have instead concentrated on cases of diagnosed tuberculosis that present to health facilities. We had the opportunity to measure glycaemia alongside prevalent tuberculosis. A focus on prevalent tuberculosis enables estimation of the contribution of hyperglycaemia to the population prevalence of tuberculosis. A population-based cross-sectional study was conducted among adults in 24 communities from Zambia and the Western Cape (WC) province of South Africa. Prevalent tuberculosis was defined by the presence of a respiratory sample that was culture positive for M. tuberculosis. Glycaemia was measured by random blood glucose (RBG) concentration. Association with prevalent tuberculosis was explored across the whole spectrum of glycaemia. Among 27,800 Zambian and 11,367 Western Cape participants, 4,431 (15.9%) and 1,835 (16.1%) respectively had a RBG concentration ≥7.0 mmol/L, and 405 (1.5%) and 322 (2.8%) respectively had a RBG concentration ≥11.1 mmol/L. In Zambia, the prevalence of tuberculosis was 0 · 5% (142/27,395) among individuals with RBG concentration <11.1 mmol/L and also ≥11.1 mmol/L (2/405); corresponding figures for WC were 2 · 5% (272/11,045) and 4 · 0% (13/322). There was evidence for a positive linear association between hyperglycaemia and pulmonary prevalent tuberculosis. Taking a RBG cut-off 11.1 mmol/L, a combined analysis of data from Zambian and WC communities found evidence of association between hyperglycaemia and TB (adjusted odds ratio = 2 · 15, 95% CI [1 · 17-3 · 94]). The population attributable fraction of prevalent tuberculosis to hyperglycaemia for Zambia and WC combined was 0.99% (95% CI 0 · 12%-1.85%) for hyperglycaemia with a RBG cut-off of 11.1 mmol/L. This study demonstrates an association between hyperglycaemia and prevalent tuberculosis in a large population-based survey in Zambia and Western Cape. However, assuming causation, this association contributes little to the prevalence of TB in these populations.

Intergenerational Perspectives on Education and Employment in the Zambian Copperbelt

ERIC Educational Resources Information Center

Bajaj, Monisha

2010-01-01

This article explores intergenerational perspectives on the link between secondary schooling and employment held by students, parents, and teachers in Ndola, Zambia. The author argues that the differentiated meanings of schooling must be understood in light of the economic effects of the shift away from a state-controlled economy during the…

Zambian Pre-Service Teachers' Voices about Successful Inclusive Education

ERIC Educational Resources Information Center

Muwana, Florence C.; Ostrosky, Michaelene M.

2014-01-01

While inclusion has been studied in many parts of the world, there is a dearth of research on this topic in Zambia. This study investigated the perceptions of pre-service teachers about the benefits of inclusion and the resources needed to successfully include students with disabilities in general education settings in Zambia. Participants…

Early Childhood Care and Education and School Readiness in Zambia

ERIC Educational Resources Information Center

McCoy, Dana Charles; Zuilkowski, Stephanie Simmons; Yoshikawa, Hirokazu; Fink, Günther

2017-01-01

Despite increased investment in early childhood care and education (ECCE) globally, little is known about its effectiveness in low-income countries. Using kernel exact matching within a national sample of 1,623 Zambian 6-year-olds, we test the associations between ECCE participation and seven domains of children's school readiness. We find ECCE…

Inquiry-Based Science Education: A Scenario on Zambia's High School Science Curriculum

ERIC Educational Resources Information Center

Chabalengula, Vivien M.; Mumba, Frackson

2012-01-01

This paper is aimed at elucidating the current state of inquiry-based science education (IBSE) in Zambia's high school science curriculum. Therefore, we investigated Zambian teachers' conceptions of inquiry; determined inquiry levels in the national high school science curriculum materials, which include syllabi, textbooks and practical exams; and…

Language Teaching Projects for the Third World. ELT Documents 116.

ERIC Educational Resources Information Center

Brumfit, C. J., Ed.

This collection of papers, most of them originating with the British Council, concern programs of language instruction undertaken in developing countries as a form of international technical assistance. The following are included: "The Role and Status of English as a Subject in the Zambian English-Medium Context" (Roy Wigzell);…

Inductive Reasoning in Zambia, Turkey, and the Netherlands Establishing Cross-Cultural Equivalence.

ERIC Educational Resources Information Center

van de Vijver, Fons J. R.

2002-01-01

Administered tasks of inductive reasoning to 704 Zambian, 877 Turkish, and 632 Dutch students from the highest 2 grades of primary and the lowest 2 grades of secondary school. Results show strong evidence for structural equivalence and partial evidence for measurement unit equivalence, but did not support full score equivalence. (SLD)

Increasing access to legal termination of pregnancy and postabortion contraception at the University Teaching Hospital, Lusaka, Zambia.

PubMed

Macha, Swebby; Muyuni, Mutinta; Nkonde, Scholastica; Faúndes, Anibal

2014-07-01

The Zambian Association of Gynecology and Obstetrics is one of the International Federation of Gynecology and Obstetrics (FIGO) member societies participating in the FIGO Initiative for the Prevention of Unsafe Abortion and its Consequences from the East, Central, and Southern Africa region. The activities included in this country's plan of action were to provide access to safe abortion within the full extent of the law to women receiving care at the University Teaching Hospital in Lusaka, and to increase the proportion of women leaving the hospital with a contraceptive method. Zambian law regarding abortion is liberal, but in general it was not applied until very recently. The proportion of legal terminations of pregnancy among patients receiving abortion care at the hospital increased from 3.2% in 2009 to 7.7% in 2011, while the percentage of women leaving the hospital with a contraceptive method increased from 25.3% to 69.4% over the same period. Copyright © 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Diabetes mellitus and comorbid depression in Zambia.

PubMed

Hapunda, G; Abubakar, A; Pouwer, F; van de Vijver, F

2015-06-01

To replicate, in Zambia, a recent global study by the WHO, which reported that the odds of depression were not increased in African people with diabetes, and to explore the sociodemographic and clinical factors associated with depression. A total of 773 control subjects and 157 Zambian patients with diabetes completed the Major Depression Inventory and a list of demographic indicators. Compared with control subjects (mean ± sd Major Depression Inventory score 15.10 ± 9.19), depressive symptoms were significantly more common in patients with diabetes (mean ± sd Major Depression Inventory score 19.12 ± 8.95; P < 0.001). ancova showed that having diabetes [F(1,698) = 16.50, P < 0.001], being female [F(1,698) = 7.35, P < 0.01] and having low socio-economic status (F(1,698) = 13.35, P < 0.001) were positive predictors of depression. Contrary to the WHO study, we found that depression was a common comorbid health problem among Zambian people with diabetes. Clinicians should consider patients' health status, sex and socio-economic status as potential factors predicting depression. © 2014 The Authors. Diabetic Medicine © 2014 Diabetes UK.

Struggling for inclusive education in the North and the South: educators' perceptions on inclusive education in Finland and Zambia.

PubMed

Moberg, Sakari; Savolainen, Hannu

2003-03-01

A survey assessed the perceptions of 1350 Zambian teachers and parents and 512 Finnish teachers regarding inclusive education and consequently the best placement for children with different disabilities. On the whole, perceptions varied but were quite critical. On inclusion in general, the regular (also termed "ordinary") Finnish teachers were the most critical group and the Finnish special education teachers the most optimistic. Most respondents felt that inclusive education enhances social justice. However, the pursuit of inclusion in practice, especially the guarantee of good and effective education for all, was seen as problematic. Compared with Finnish respondents, the Zambian respondents preferred a more segregated educational environment for children with different disabilities. Type and severity of disability affected the preferred educational setting and there were clear differences in this regard between the respondents from the two countries. The findings support the idea that educators' attitudes towards inclusion are important in developing inclusive school systems and that inclusive education is best understood as a multidimensional concept that, at the practical level, is highly context-dependent.

The extent of arsenic and of metal uptake by aboveground tissues of Pteris vittata and Cyperus involucratus growing in copper- and cobalt-rich tailings of the Zambian copperbelt.

PubMed

Kříbek, Bohdan; Mihaljevič, Martin; Sracek, Ondra; Knésl, Ilja; Ettler, Vojtěch; Nyambe, Imasiku

2011-08-01

The extent of arsenic (As) and metal accumulation in fronds of the As hyperaccumulator Pteris vittata (Chinese brake fern) and in leaves of Cyperus involucratus, which grow on the surface of an old flotation tailings pond in the Zambian Copperbelt province, was studied. The tailings consist of two types of material with distinct chemical composition: (1) reddish-brown tailings rich in As, iron (Fe), and other metals, and (2) grey-green tailings with a lower content of As, Fe, and other metals, apart from manganese (Mn). P. vittata accumulates from 2350 to 5018 μg g(-1) As (total dry weight [dw]) in its fronds regardless of different total and plant-available As concentrations in both types of tailings. Concentrations of As in C. involucratus leaves are much lower (0.24-30.3 μg g(-1) dw). Contents of copper (Cu) and cobalt (Co) in fronds of P. vittata (151-237 and 18-38 μg g(-1) dw, respectively) and in leaves of C. involucratus (96-151 and 9-14 μg g(-1) dw, respectively) are high, whereas concentrations of other metals (Fe, Mn, and zinc [Zn]) are low and comparable with contents of the given metals in common plants. Despite great differences in metal concentrations in the two types of deposited materials, concentrations of most metals in plant tissues are very similar. This indicates an exclusion or avoidance mechanism operating when concentrations of the metals in substrate are particularly high. The results of the investigation show that Chinese brake fern is not only a hyperaccumulator of As but has adapted itself to high concentrations of Cu and Co in flotation tailings of the Zambian Copperbelt.

A 12-Month Study of Food Crops Contaminated by Heavy Metals, Lusaka, Zambia

NASA Astrophysics Data System (ADS)

Holden, J. A.; Malamud, B. D.; Chishala, B. H.; Kapungwe, E.; Volk, J.; Harpp, K. S.

2009-04-01

We investigate heavy-metal contamination of irrigation water used for urban agriculture and subsequent contamination of food crops in Chunga, NW Lusaka, the capital of Zambia. Inhabitants of the Chunga area rely on urban agriculture as both a major source of income and food. From August 2004 to July 2005, monthly samples of irrigation water used and edible portions of food crops were taken from a farmer's plot at Chunga. The food crops (cabbage, Chinese cabbage, pumpkin leaves, rape, sweet potato leaves and tomatoes) are grown using irrigation throughout the year. Irrigation water samples and digested food crop samples were analysed using ICP-MS at the Department of Geology, Colgate University, USA for Al, V, Cr, Mn, Fe, Co, Ni, Cu, Zn, As, Se, Cd, Ba, Hg, Tl, Pb, and U. We find heavy-metal concentrations present in both irrigation water and food crop samples. Zambian sample concentrations were compared to Zambian and international legislative and guideline limits for concentrations of heavy metals in industrial effluent, heavy metals in irrigation water and heavy metals in foods. In irrigation water samples recommended national and/or international legislative limits for Al, Cr, Mn, Fe, Cu, Hg, Pb and U were exceeded. Limits for Hg were exceeded by up to 130 times. There were heavy-metal concentrations above recommended limits in food crops for Cr, Fe, Ni, Cu, Zn, Cd, Hg and Pb throughout the different food crops grown and throughout the year. In all 14 samples recommended limits for Cr, Fe and Hg were exceeded. Zambian legislated limits for food crops were exceeded by up to 16 times for Pb and 58 times for Hg. The results of this study show that heavy metal contamination is present in irrigation water used and food crops grown in urban agriculture in Chunga, Lusaka, Zambia. Recommended maximum limits for heavy metals in irrigation water and food are exceeded in some samples indicating there may be a risk to health.

Rich micronutrient fortification of locally produced infant food does not improve mental and motor development of Zambian infants: a randomised controlled trial

PubMed Central

Manno, Daniela; Kowa, Priscilla K.; Bwalya, Hellen K.; Siame, Joshua; Grantham-McGregor, Sally; Baisley, Kathy; De Stavola, Bianca L.; Jaffar, Shabbar; Filteau, Suzanne

2013-01-01

It is uncertain whether multiple micronutrients benefit the mental and psychomotor development of young children in developing countries. We conducted a randomised double-blind controlled trial to evaluate the effect of a richly micronutrient-fortified v. a basal fortified porridge on mental and psychomotor development in Zambian infants. Infants (n 743) were randomised at age 6 months to receive either the richly fortified or the basal fortified infant food and were followed up until 18 months of age. All the infants were evaluated monthly for achievement of a series of developmental milestones. The Bayley scales of infant development II were administered to a subsample of 502 infants at 6, 12 and 18 months. Rich micronutrient fortification had no significant benefit on the following: (a) number of developmental milestones achieved (rate ratio at 12 months = 1·00; 95 % CI 0·96, 1·05; P=0·81, adjusted for sex, socio-economic status and maternal education, with similar results at 15 and 18 months); (b) ages of walking unsupported (hazard ratio (HR) 1·04; 95 % CI 0·88, 1·24; P=0·63, adjusted for the above covariates) and of speaking three or four clear words (HR 1·01; 95 % CI 0·84, 1·20; P=0·94, adjusted for the above covariates); (c) mental development index (MDI) and psychomotor development index (PDI) of the Bayley scales (scores difference adjusted for baseline scores, age at the assessment, sex, socio-economic status, maternal education, language, age and HIV status: MDI 0·3 (95 % CI −0·5, 1·1), P=0·43; PDI −0·1 (95 % CI −0·9, 0·7), P=0·78). In conclusion, the results do not support the hypothesis that rich micronutrient fortification improves Zambian infants’ mental and motor development. PMID:21733297

Association of chemokine receptor gene (CCR2-CCR5) haplotypes with acquisition and control of HIV-1 infection in Zambians

PubMed Central

2011-01-01

Background Polymorphisms in chemokine (C-C motif) receptors 2 and 5 genes (CCR2 and CCR5) have been associated with HIV-1 infection and disease progression. We investigated the impact of CCR2-CCR5 haplotypes on HIV-1 viral load (VL) and heterosexual transmission in an African cohort. Between 1995 and 2006, cohabiting Zambian couples discordant for HIV-1 (index seropositive and HIV-1 exposed seronegative {HESN}) were monitored prospectively to determine the role of host genetic factors in HIV-1 control and heterosexual transmission. Genotyping for eight CCR2 and CCR5 variants resolved nine previously recognized haplotypes. By regression and survival analytic techniques, controlling for non-genetic factors, we estimated the effects of these haplotypic variants on a) index partner VL, b) seroconverter VL, c) HIV-1 transmission by index partners, d) HIV-1 acquisition by HESN partners. Results Among 567 couples, 240 virologically linked transmission events had occurred through 2006. HHF*2 homozygosity was associated with significantly lower VL in seroconverters (mean beta = -0.58, log10 P = 0.027) and the HHD/HHE diplotype was associated with significantly higher VL in the seroconverters (mean beta = 0.54, log10 P = 0.014) adjusted for age and gender in multivariable model. HHD/HHE was associated with more rapid acquisition of infection by the HESNs (HR = 2.0, 95% CI = 1.20-3.43, P = 0.008), after adjustments for index partner VL and the presence of genital ulcer or inflammation in either partner in Cox multivariable models. The HHD/HHE effect was stronger in exposed females (HR = 2.1, 95% CI = 1.14-3.95, P = 0.018). Conclusions Among Zambian discordant couples, HIV-1 coreceptor gene haplotypes and diplotypes appear to modulate HIV-1 VL in seroconverters and alter the rate of HIV-1 acquisition by HESNs. These associations replicate or resemble findings reported in other African and European populations. PMID:21429204

Nutrient and nontraditional food intakes by Zambian children in a controlled feeding trial.

PubMed

Schmaelzle, Samantha; Kaliwile, Chisela; Arscott, Sara A; Gannon, Bryan; Masi, Cassim; Tanumihardjo, Sherry A

2014-03-01

Many programs aim to alleviate vitamin A deficiency. Biofortification is an approach to improve provitamin A carotenoid concentrations of staple crops in some developing countries. In rural Zambia, maize accounts for the majority of energy intake. Provitamin A-biofortified (orange) maize has been released in Zambia. This study quantified food intake of Zambian children from records collected in a feeding trial in 2012 in order to compare adoption of orange maize and a new vegetable (green beans) with white maize and traditional foods. One hundred thirty-six children with a mean age of 71.5 +/- 6.9 months were fed three meals a day for 6 days a week for 15 weeks at four feeding centers. Breakfast consisted of maize porridge, and lunch and dinner were stiff porridge (nshima) with various side dishes (relishes). There were three treatment groups, which received orange maize and placebo oil, white maize and placebo oil, or white maize and a daily vitamin A supplement. Food was weighed before and after consumption. Nutritionists were trained to interview the children's caregivers about the previous day's intake using dietary recalls. Nine dietary recalls for each child were recorded and analyzed. Total food intake did not differ among the groups (p = .31) and energy intakes on Sundays (< or = 880 kcal) were below recommendations. Nshima intake was lower in the orange-maize group (p = .008), largely due to a genotype effect. Intakes of relish, green bean, and porridge did not differ among the groups (p > .19). Dietary recalls revealed that children living in sites closer to the main road consumed more on Sundays than children living about 8 km from the main road, but less in the evenings when children were off site. The intakes of energy of these Zambian children were low. Implementation and adoption of new and biofortified foods is possible with promotion.

The impact of human immunodeficiency virus (HIV) service scale-up on mechanisms of accountability in Zambian primary health centres: a case-based health systems analysis.

PubMed

Topp, Stephanie M; Black, Jim; Morrow, Martha; Chipukuma, Julien M; Van Damme, Wim

2015-02-18

Questions about the impact of large donor-funded HIV interventions on low- and middle-income countries' health systems have been the subject of a number of expert commentaries, but comparatively few empirical research studies. Aimed at addressing a particular evidence gap vis-à-vis the influence of HIV service scale-up on micro-level health systems, this article examines the impact of HIV scale-up on mechanisms of accountability in Zambian primary health facilities. Guided by the Mechanisms of Effect framework and Brinkerhoff's work on accountability, we conducted an in-depth multi-case study to examine how HIV services influenced mechanisms of administrative and social accountability in four Zambian primary health centres. Sites were selected for established (over 3 yrs) antiretroviral therapy (ART) services and urban, peri-urban and rural characteristics. Case data included provider interviews (60); patient interviews (180); direct observation of facility operations (2 wks/centre) and key informant interviews (14). Resource-intensive investment in HIV services contributed to some early gains in administrative answerability within the four ART departments, helping to establish the material capabilities necessary to deliver and monitor service delivery. Simultaneous investment in external supervision and professional development helped to promote transparency around individual and team performance and also strengthened positive work norms in the ART departments. In the wider health centres, however, mechanisms of administrative accountability remained weak, hindered by poor data collection and under capacitated leadership. Substantive gains in social accountability were also elusive as HIV scale-up did little to address deeply rooted information and power asymmetries in the wider facilities. Short terms gains in primary-level service accountability may arise from investment in health system hardware. However, sustained improvements in service quality and responsiveness arising from genuine improvements in social and administrative accountability require greater understanding of, and investment in changing, the power relations, work norms, leadership and disciplinary mechanisms that shape these micro-level health systems.

Introduction of Syphilis Point-of-Care Tests, from Pilot Study to National Programme Implementation in Zambia: A Qualitative Study of Healthcare Workers' Perspectives on Testing, Training and Quality Assurance.

PubMed

Ansbro, Éimhín M; Gill, Michelle M; Reynolds, Joanna; Shelley, Katharine D; Strasser, Susan; Sripipatana, Tabitha; Tshaka Ncube, Alexander; Tembo Mumba, Grace; Terris-Prestholt, Fern; Peeling, Rosanna W; Mabey, David

2015-01-01

Syphilis affects 1.4 million pregnant women globally each year. Maternal syphilis causes congenital syphilis in over half of affected pregnancies, leading to early foetal loss, pregnancy complications, stillbirth and neonatal death. Syphilis is under-diagnosed in pregnant women. Point-of-care rapid syphilis tests (RST) allow for same-day treatment and address logistical barriers to testing encountered with standard Rapid Plasma Reagin testing. Recent literature emphasises successful introduction of new health technologies requires healthcare worker (HCW) acceptance, effective training, quality monitoring and robust health systems. Following a successful pilot, the Zambian Ministry of Health (MoH) adopted RST into policy, integrating them into prevention of mother-to-child transmission of HIV clinics in four underserved Zambian districts. We compare HCW experiences, including challenges encountered in scaling up from a highly supported NGO-led pilot to a large-scale MoH-led national programme. Questionnaires were administered through structured interviews of 16 HCWs in two pilot districts and 24 HCWs in two different rollout districts. Supplementary data were gathered via stakeholder interviews, clinic registers and supervisory visits. Using a conceptual framework adapted from health technology literature, we explored RST acceptance and usability. Quantitative data were analysed using descriptive statistics. Key themes in qualitative data were explored using template analysis. Overall, HCWs accepted RST as learnable, suitable, effective tools to improve antenatal services, which were usable in diverse clinical settings. Changes in training, supervision and quality monitoring models between pilot and rollout may have influenced rollout HCW acceptance and compromised testing quality. While quality monitoring was integrated into national policy and training, implementation was limited during rollout despite financial support and mentorship. We illustrate that new health technology pilot research can rapidly translate into policy change and scale-up. However, training, supervision and quality assurance models should be reviewed and strengthened as rollout of the Zambian RST programme continues.

Introduction of Syphilis Point-of-Care Tests, from Pilot Study to National Programme Implementation in Zambia: A Qualitative Study of Healthcare Workers’ Perspectives on Testing, Training and Quality Assurance

PubMed Central

Ansbro, Éimhín M.; Gill, Michelle M.; Reynolds, Joanna; Shelley, Katharine D.; Strasser, Susan; Sripipatana, Tabitha; Ncube, Alexander Tshaka; Tembo Mumba, Grace; Terris-Prestholt, Fern; Peeling, Rosanna W.; Mabey, David

2015-01-01

Syphilis affects 1.4 million pregnant women globally each year. Maternal syphilis causes congenital syphilis in over half of affected pregnancies, leading to early foetal loss, pregnancy complications, stillbirth and neonatal death. Syphilis is under-diagnosed in pregnant women. Point-of-care rapid syphilis tests (RST) allow for same-day treatment and address logistical barriers to testing encountered with standard Rapid Plasma Reagin testing. Recent literature emphasises successful introduction of new health technologies requires healthcare worker (HCW) acceptance, effective training, quality monitoring and robust health systems. Following a successful pilot, the Zambian Ministry of Health (MoH) adopted RST into policy, integrating them into prevention of mother-to-child transmission of HIV clinics in four underserved Zambian districts. We compare HCW experiences, including challenges encountered in scaling up from a highly supported NGO-led pilot to a large-scale MoH-led national programme. Questionnaires were administered through structured interviews of 16 HCWs in two pilot districts and 24 HCWs in two different rollout districts. Supplementary data were gathered via stakeholder interviews, clinic registers and supervisory visits. Using a conceptual framework adapted from health technology literature, we explored RST acceptance and usability. Quantitative data were analysed using descriptive statistics. Key themes in qualitative data were explored using template analysis. Overall, HCWs accepted RST as learnable, suitable, effective tools to improve antenatal services, which were usable in diverse clinical settings. Changes in training, supervision and quality monitoring models between pilot and rollout may have influenced rollout HCW acceptance and compromised testing quality. While quality monitoring was integrated into national policy and training, implementation was limited during rollout despite financial support and mentorship. We illustrate that new health technology pilot research can rapidly translate into policy change and scale-up. However, training, supervision and quality assurance models should be reviewed and strengthened as rollout of the Zambian RST programme continues. PMID:26030741

Zambian Peer Educators for HIV Self-Testing (ZEST) study: rationale and design of a cluster randomised trial of HIV self-testing among female sex workers in Zambia.

PubMed

Oldenburg, Catherine E; Ortblad, Katrina F; Chanda, Michael M; Mwanda, Kalasa; Nicodemus, Wendy; Sikaundi, Rebecca; Fullem, Andrew; Barresi, Leah G; Harling, Guy; Bärnighausen, Till

2017-04-20

HIV testing and knowledge of status are starting points for HIV treatment and prevention interventions. Among female sex workers (FSWs), HIV testing and status knowledge remain far from universal. HIV self-testing (HIVST) is an alternative to existing testing services for FSWs, but little evidence exists how it can be effectively and safely implemented. Here, we describe the rationale and design of a cluster randomised trial designed to inform implementation and scale-up of HIVST programmes for FSWs in Zambia. The Zambian Peer Educators for HIV Self-Testing (ZEST) study is a 3-arm cluster randomised trial taking place in 3 towns in Zambia. Participants (N=900) are eligible if they are women who have exchanged sex for money or goods in the previous 1 month, are HIV negative or status unknown, have not tested for HIV in the previous 3 months, and are at least 18 years old. Participants are recruited by peer educators working in their communities. Participants are randomised to 1 of 3 arms: (1) direct distribution (in which they receive an HIVST from the peer educator directly); (2) fixed distribution (in which they receive a coupon with which to collect the HIVST from a drug store or health post) or (3) standard of care (referral to existing HIV testing services only, without any offer of HIVST). Participants are followed at 1 and 4 months following distribution of the first HIVST. The primary end point is HIV testing in the past month measured at the 1-month and 4-month visits. This study was approved by the Institutional Review Boards at the Harvard T.H. Chan School of Public Health in Boston, USA and ERES Converge in Lusaka, Zambia. The findings of this trial will be presented at local, regional and international meetings and submitted to peer-reviewed journals for publication. Pre-results; NCT02827240. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Financial Operations of Distance Education and Campus-Based Education: A Zambian Case

ERIC Educational Resources Information Center

Chakupalesa, Anna Bucheba; Panda, Santosh

2012-01-01

Distance education is often hailed as the answer to the worlds problems of educational provision particularly in the developing countries of which African governments are no exception. Distance education has been used for both pre-service and in-service education, and at most levels of education. However, other than the structural differences…

Poverty Reduction in Zambia: A Conceptual Analysis of the Zambian Poverty Reduction Strategy Paper

ERIC Educational Resources Information Center

Imboela, Bruce Lubinda

2005-01-01

Poverty reduction strategy papers (PRSPs) present a recipient country's program of intent for the utilization of World Bank loans and grants to alleviate debt under the bank's programs of action for poverty reduction in highly indebted poor countries (HIPCs). This article argues that structural transformation is a prerequisite for poverty…

Can Education Innovations Be Sustained after the End of Donor Funding? The Case of a Reading Intervention Programme in Zambia

ERIC Educational Resources Information Center

Kombe, Charity Lengwe Meki Kombe; Herman, Chaya

2017-01-01

This article explores the sustainability of donor-supported innovations in the education sector. Accordingly, a case study was conducted of a programme (Primary Reading Programme) implemented in Zambian primary schools which was intended to improve literacy levels. The programme was initially supported by the Department for International…

Implementation of Intrapreneurship inside Large, Mature Zambian Companies--A Method. Educational and Psychological Interactions No. 116.

ERIC Educational Resources Information Center

Thuresson, Jonas

"Intrapreneurship" is a coined word to describe people who function as entrepreneurs within corporations by implementing new ideas inside established companies and/or by creating and marketing their own ideas while employed in corporate positions. A field study examined the feasibility of using the concept of intrapreneurship to help…

Engaging with Teachers' Knowledge: Promoting Inclusion in Zambian Schools

ERIC Educational Resources Information Center

Miles, Susie

2009-01-01

Current efforts to ensure that every child completes a full cycle of primary education are hampered by chronic poverty and prolonged conflict in the South. It is estimated that 75 million children of primary age are out of school and that one-third are disabled. This paper contrasts the exclusionary impact of the global digital and communication…

Innovative approaches to promoting cervical health and raising cervical cancer awareness by use of existing cultural structures in resource-limited countries: experiences with traditional marriage counseling in Zambia.

PubMed

Kapambwe, Sharon; Parham, Groesbeck; Mwanahamuntu, Mulindi; Chirwa, Susan; Mwanza, Jacob; Amuyunzu-Nyamongo, Mary

2013-12-01

The Cervical Cancer Prevention Program in Zambia (CCPPZ) has increasingly used community-level structures to increase the uptake and ensure the sustainability of the program. Traditional marriage counselors, the alangizi, who have existed in the Zambian society for many years, are one of the structures used by the program to impart cervical cancer knowledge and increase access to screening and care using an existing community structure. Several steps were followed in developing this intervention: (a) ensuring the alangizi understood the process of screening by encouraging them to go through the screening process; (b) workshops were arranged for the alangizi to meet and share experiences during which lessons were given on cervical cancer by health workers as well; and (c) eight alangizi were chosen to help document the lessons as part of ensuring that cervical cancer information is accurate and passed in a consistent manner. Over 70 alangizi, who had undergone cervical cancer screening, were trained by CCPPZ. A 'Cervical Cancer Training Manual for Marriage Counsellors' was developed to help the alangizi integrate cervical cancer lessons in their routine teachings. An evaluation was conducted during the training of the alangizi that forms the basis for this paper. The results show that although the alangizi face key challenges in their work (e.g. changing social contexts), they are still considered relevant by most communities in Zambia and are potentially an important avenue for cervical cancer and other health information. This paper shows that it is possible to integrate sexual and reproductive health messages into existing structures in the community. However, it is important to design culturally specific and sensitive healthcare strategies that embrace locally accepted good practices.

Practical Field Survey Approach with Handle Device for Lead Contamination Assessment in Kabwe, Zambia

NASA Astrophysics Data System (ADS)

Nakamura, S.; Hirose, K.; Takeda, T.; Uchida, Y.; Nakata, H.; Nakayama, S.; Ishizuka, M.; Yabe, J.; Ito, M.; Igarashi, T.

2017-12-01

International joint research project for assessing lead soil contamination in Kabwe, Zambia was started by Zambian and Japanese scientists in 2008. Various scientific data and results have been obtained up to now. Data sharing among researchers and government officials is necessary for understanding current situation of lead contamination in Kabwe comprehensively. As lead contamination affects on local communities seriously, local community participation is important to solve the environmental issue in near future. This study, therefore, aims to develop GIS Data Integration System (GDIS as followed) consisted of GIS Data Sharing System (GDSS as followed) as web-GIS, FIELDNAUT as Android App for field survey and opensource SNS instance named Mastodon. GDIS will provide local communities to participate easily and support researchers to collect and understand about everyday situation and visualize lead contamination status in Kabwe, Zambia. GDIS is developed with opensource programs. GDSS was simply designed and developed on one desktop PC (Hirose et al., 2015) although common web-GIS requires many servers (Suresh et al., 2015). FIELDNAUT was developed in 2016. FIELDNAUT provides researchers plotting their locations on satellite images and thematic maps, filming and texting with their locations, and compiling and sharing data through GDSS. Mastodon will be used as a new FIELDNAUT communication function between local communities and researchers. It is an independent SNS instance, and the closed and secure communication system will be able to be developed. With this function, local communities will share photos and texts about their daily lives and situation around Kabwe by FIELDNAUT, and those data will be collected into GDSS. Researchers provide their results as hazard maps to local communities through FIELDNAUT. GDIS consisted of GDSS, FIELDNAUT and Mastodon encourages local community participation and let local communities be interested in their environmental issues and provide a chance to act on the issues spontaneously. GDIS on the project, moreover, can be a model case for local community participation in the scientific sustainable programs of environmental issues. GDIS is also necessary to be install any areas where have same heavy metal contamination problems in Africa and other regions.

Feedback Study on Developing Critical Literacy among Malawian and Zambian Undergraduate University Students Using a Freirean Praxis

ERIC Educational Resources Information Center

Mkandawire, Matthews Tiwaone; Walubita, Gabriel

2015-01-01

Educators in Malawi and Zambia have always been concerned with their student's abilities to become analytical, logical and proficient readers of texts. This has been due to the fear that there is an increased overemphasis on knowledge of the fundamental literacy skills and other basics at the expense of critical thinking. This scenario has…

Representative Nature of Scientific Literacy Themes in a High School Chemistry Course: The Case of Zambia

ERIC Educational Resources Information Center

Mumba, Frackson; Hunter, William J. F.

2009-01-01

The purpose of this study was to find out how the scientific literacy themes are represented in the current Zambian high school chemistry syllabus, textbooks and grade twelve chemistry examination papers in an attempt to find out whether or not the chemistry course has adequate potential to contribute to the preparation of scientifically literate…

School-Based Professional Development in a Developing Context: Lessons Learnt from a Case Study in Zambia

ERIC Educational Resources Information Center

Haßler, Björn; Hennessy, Sara; Cross, Andrew; Chileshe, Eness; Machiko, Brian

2015-01-01

This paper reports on the development and outcomes of the second phase of OER4Schools, a school-based professional development programme supporting interactive forms of subject teaching in conjunction with Open Educational Resources (OER) and technology in Zambian primary schools. We worked with partners to identify the needs of school-based…

Perceptions of Multigrade Teaching: A Narrative Inquiry into the Voices of Stakeholders in Multigrade Contexts in Rural Zambia

ERIC Educational Resources Information Center

Kivunja, Charles; Sims, Margaret

2015-01-01

Multigrade teaching is used widely in primary schools throughout the Majority World. This study reports the findings of a narrative inquiry undertaken to answer the question: what are the perceptions of stakeholders in rural Zambian multigrade contexts about multigrade teaching as an education strategy? We were interested in exploring the reality…

Pedagogic Change by Zambian Primary School Teachers Participating in the OER4Schools Professional Development Programme for One Year

ERIC Educational Resources Information Center

Hennessy, S.; Haßler, B.; Hofmann, R.

2016-01-01

Supporting and upskilling teachers are essential to enhancing the quality of learning in developing contexts -- the focus of Education For All -- yet little evidence exists concerning what kinds of teacher education are actually most effective and what changes in "quality" are desired and feasible. This paper illustrates how a concrete,…

Predictors of Attitudes toward Intimate Partner Violence: A Comparative Study of Men in Zambia and Kenya

ERIC Educational Resources Information Center

Lawoko, Stephen

2008-01-01

Attitudes toward intimate partner violence (IPV) were compared between Zambian and Kenyan men on sociodemographic, attitudinal, and structural predictors of such attitudes. Data were retrieved from the latest Demographic and Health Surveys in each country. The results showed that many men in Zambia (71%) and Kenya (68%) justified IPV to punish a…

Educating through Sport? Examining HIV/AIDS Education and Sport-for-Development through the Perspectives of Zambian Young People

ERIC Educational Resources Information Center

Jeanes, Ruth

2013-01-01

The sport-for-development movement has grown exponentially in the last decade generating increasing academic attention. However, existing research has rarely sought the views of young people despite them being both the main target audience of initiatives and frequently the deliverers. This paper seeks to address young people's absence within…

Distribution and phenology of ixodid ticks in southern Zambia.

PubMed

Speybroeck, N; Madder, M; Van Den Bossche, P; Mtambo, J; Berkvens, N; Chaka, G; Mulumba, M; Brandt, J; Tirry, L; Berkvens, D

2002-12-01

Distribution data for epidemiologically important ticks (Acari: Ixodidae) in the Southern Province of Zambia, one of the main cattle areas of the country, are presented. Boophilus microplus (Canestrini) was not recorded in southern Zambia, whereas Boophilus decoloratus (Koch) is present throughout the area. New distribution patterns for less economically important ixodid ticks are also discussed. Southern Zambia is a transition zone because it is the most northern area in Africa where mixed Rhipicephalus appendiculatus Neumann and Rhipicephalus zambeziensis Walker, Norval & Corwin populations were reported. Although a second generation of adult R. appendiculatus/R. zamnbeziensis was encountered, simulations indicated that this phenomenon is very rare in southern Zambia, mainly because of the colder temperatures during the early dry season and lower rainfall. These simulations were supported by a development trial under experimental conditions. Tick body size measurements showed that southern Zambian ticks are larger than eastern Zambian R. appendiculatus. It is hypothesized that body size is related to diapausing intensity in this species. The epidemiological consequences are that a different approach to control Theileria parva (Theiler) (Piroplasmida: Theileriidae) and other tick-borne diseases is needed in southern Zambia, compared to the one adopted in eastern Zambia.

Evaluation Of A Maternal Health Program In Uganda And Zambia Finds Mixed Results On Quality Of Care And Satisfaction.

PubMed

Kruk, Margaret E; Vail, Daniel; Austin-Evelyn, Katherine; Atuyambe, Lynn; Greeson, Dana; Grépin, Karen Ann; Kibira, Simon P S; Macwan'gi, Mubiana; Masvawure, Tsitsi B; Rabkin, Miriam; Sacks, Emma; Simbaya, Joseph; Galea, Sandro

2016-03-01

Saving Mothers, Giving Life is a multidonor program designed to reduce maternal mortality in Uganda and Zambia. We used a quasi-random research design to evaluate its effects on provider obstetric knowledge, clinical confidence, and job satisfaction, and on patients' receipt of services, perceived quality, and satisfaction. Study participants were 1,267 health workers and 2,488 female patients. Providers' knowledge was significantly higher in Ugandan and Zambian intervention districts than in comparison districts, and in Uganda there were similar positive differences for providers' clinical confidence and job satisfaction. Patients in Ugandan intervention facilities were more likely to give high ratings for equipment availability, providers' knowledge and communication skills, and care quality, among other factors, than patients in comparison facilities. There were fewer differences between Zambian intervention and comparison facilities. Country differences likely reflect differing intensity of program implementation and the more favorable geography of intervention districts in Uganda than in Zambia. National investments in the health system and provider training and the identification of intervention components most associated with improved performance will be required for scaling up and sustaining the program. Project HOPE—The People-to-People Health Foundation, Inc.

Age of the Zambian Copperbelt

NASA Astrophysics Data System (ADS)

Sillitoe, Richard H.; Perelló, José; Creaser, Robert A.; Wilton, John; Wilson, Alan J.; Dawborn, Toby

2017-12-01

The sediment-hosted stratiform Cu ± Co deposits and prospects of the Central African Copperbelt are characterized by two intimately associated mineralization styles: disseminated sulfides and sulfide-bearing quartz-carbonate veins and veinlets. It has been widely accepted that the disseminated mineralization was introduced during sediment diagenesis in a rift setting, and possibly in multiple events spanning several hundred million years. In contrast, the veinlet-hosted mineralization is commonly thought to have been derived either by remobilization of the disseminated sulfides during the Lufilian collisional orogeny or introduced at broadly the same time(s) as the disseminated sulfides during diagenesis and subsequent orogeny. The results of 15 Re-Os molybdenite age determinations from Cu ± Co deposits and prospects across the Zambian part of the Central African Copperbelt suggest that both the disseminated and veinlet mineralization styles were indeed generated together, but in a 50-myr Cambrian window ( 540-490 Ma) during the later stages of the Lufilian collisional orogeny. The molybdenite ages for the disseminated stratiform mineralization at two localities do not support the notion of syndiagenetic Cu introduction. The molybdenite ages also show that individual deposits formed over minimum time intervals of 10-24 myr.

Challenges of controlling contagious bovine pleuropneumonia in sub-Saharan Africa: a Zambian perspective.

PubMed

Muuka, Geoffrey; Songolo, Nadi; Kabilika, Swithine; Hang'ombe, Bernard M; Nalubamba, King S; Muma, John B

2013-01-01

Contagious bovine pleuropneumonia (CBPP) is a disease of economic importance that is widely distributed in sub-Saharan African and contributes significantly to cattle morbidity and mortality. Control of CBPP offers a number of challenges as a result many developing countries in Africa are still struggling with this disease. In this study, we look at the challenges encountered in CBPP control in sub-Saharan Africa from the Zambian perspective. In conducting this study, we reviewed scientific literature and reports from the Ministry of Agriculture and Livestock and related animal institutions, and also made interviews with experts and key government officials involved in CBPP control in Zambia. Among the challenges identified for the successful control of CBPP were as follows: failure in the delivery of veterinary services, lack of a cattle identification system, natural phenomenon, livestock husbandry systems in the traditional sector, human movements, traditional practices among cattle farmers and cattle marketing systems. It was seen that the epidemiology of CBPP in Zambia is influenced by both ecological and anthological factors. Therefore, design and implementation of any control or eradication programme should be area/regional-dependent taking into account the different factors influencing disease transmission and maintenance.

Mapping an HIV/STD prevention curriculum for Zambian in-school settings.

PubMed

Mpofu, Elias; Lawrence, Frank; Ngoma, Mary Shilalukey; Siziya, Seter; Malungo, Jacob R S

2008-04-01

HIV/AIDS poses grave risk to human development in sub-Saharan Africa. Evidence-based interventions that are rooted in local culture could help efforts to prevent threats to human development from HIV/AIDS. We used concept mapping (Concept System, 2006 ) to construct the components and content of a locally developed HIV/AIDS curriculum for use by secondary schools in Lusaka, Zambia. Participants were school counsellors (n = 14), youth health program officers (n = 7), and regular education teachers (n = 3) from the education, health, and youth development agencies in Lusaka, Zambia (males = 11; females = 13; mean age 38; SD = 15 years). Concept mapping yielded six statement clusters defining preliminary components of a locally grounded in-school HIV/AIDS prevention curriculum and the content items that define these components: (1) life skills education (18 items), (2) sexuality and reproductive health (10 items), (3) treatment, care and support (13 items), (4) counselling (12 items), (5) basic facts about HIV/AIDS (11 items), and (6) dissemination of information about HIV/AIDS (11 items). Zambian locally constructed constructs for an HIV/STD prevention curriculum overlap those promoted by public health programs in the country and internationally.

Linking Environmental Exposure with Public Health: Dichlorodiphenyltrichloroethane Extracted from Soils and Water of Recently Exposed Communities of Selected Locations in Zambia

PubMed Central

Sipilanyambe Munyinda, Nosiku; Michelo, Charles; Sichilongo, Kwenga

2015-01-01

Background. In 2000, a Zambian private mining company reintroduced the use of dichlorodiphenyltrichloroethane (DDT) to control malaria in two districts. From 2000 to 2010, DDT had been applied in homes without any studies conducted to ascertain its fate in the environment. We aimed to quantify the presence of DDT and its metabolites in the soil and water around communities where it was recently used. Methods. We collected superficial soil and water samples from drinking sources of three study areas. DDT was extracted by QuEChERS method and solid phase extraction for soils and water, respectively. Analysis was by gas chromatography-mass spectrometry. A revalidated method with limits of detection ranging from 0.034 to 0.04 ppb was used. Results. Median levels of total DDT were found at 100.4 (IQR 90.9–110) and 725.4 ng/L (IQR 540–774.5) for soils and water, respectively. No DDT above detection limits was detected in the reference area. These results are clinically significant given the persistent characteristics of DDT. Conclusion. DDT presence in these media suggests possible limitations in the environmental safeguards during IRS. Such occurrence could have potential effects on humans, especially children; hence, there is a need to further examine possible associations between this exposure and humans. PMID:26579199

The "Teachers Diploma Program" in Zambian Government Schools: A Baseline Qualitative Assessment of Teachers' and Students' Strengths and Challenges in the Context of a School-Based Psychosocial Support Program

ERIC Educational Resources Information Center

Kaljee, Linda; Munjile, Kelvin; Menon, Anitha; Tembo, Stephen; Li, Xiaoming; Zhang, Liying; Malungo, Jacob; Stanton, Bonita; Langhaug, Lisa

2017-01-01

In Zambia, as elsewhere throughout sub-Saharan Africa, orphaned and vulnerable children (OVC) face multiple physical, emotional, social and psychological challenges which often negatively affect opportunities for educational attainment. REPSSI (Regional Psychosocial Support Initiative), in collaboration with, the University of Cape Town and other…

The Effect of Using a Mobile Literacy Game to Improve Literacy Levels of Grade One Students in Zambian Schools

ERIC Educational Resources Information Center

Jere-Folotiya, Jacqueline; Chansa-Kabali, Tamara; Munachaka, Jonathan C.; Sampa, Francis; Yalukanda, Christopher; Westerholm, Jari; Richardson, Ulla; Serpell, Robert; Lyytinen, Heikki

2014-01-01

This intervention study was conducted to document conditions under which a computer based literacy game (GraphoGame™) could enhance literacy skills of first grade students in an African city. The participants were first grade students from Government schools (N = 573). These students were randomly sampled into control (N = 314) and various…

Bismarck in the Bush: Year 12 Write Zambia's History for Zambian Students

ERIC Educational Resources Information Center

Gray, Peter

2011-01-01

Peter Gray explains how his Year 12 students came to research and write a resource on the history of Zambia, for history teachers "in" Zambia. The construction of the resource stretched the Year 12 students in new ways: the Internet was useless and there were no easy digests in A-Level textbooks to get them started. They would have to…

A Reflection on the Past Trends in the Delivery of Literacy Education in Zambia: Challenges and Prospects

ERIC Educational Resources Information Center

Luchembe, Musonda

2016-01-01

This paper examines the different views about the definition of "literacy" and how it is applied in the Zambian context. It argues that the absence of a contextual definition of literacy or illiteracy has raised some doubt on the magnitude of the problem and the extent to which success has been achieved through various literacy…

Improving access to child health services at the community level in Zambia: a country case study on progress in child survival, 2000–2013

PubMed Central

Kipp, Aaron M; Maimbolwa, Margaret; Brault, Marie A; Kalesha-Masumbu, Penelope; Katepa-Bwalya, Mary; Habimana, Phanuel; Vermund, Sten H; Mwinga, Kasonde; Haley, Connie A

2017-01-01

Abstract Reductions in under-five mortality in Africa have not been sufficient to meet the Millennium Development Goal #4 (MDG#4) of reducing under-five mortality by two-thirds by 2015. Nevertheless, 12 African countries have met MDG#4. We undertook a four country study to examine barriers and facilitators of child survival prior to 2015, seeking to better understand variability in success across countries. The current analysis presents indicator, national document, and qualitative data from key informants and community women describing the factors that have enabled Zambia to successfully reduce under-five mortality over the last 15 years and achieve MDG#4. Results identified a Zambian national commitment to ongoing reform of national health strategic plans and efforts to ensure universal access to effective maternal, neonatal and child health (MNCH) interventions, creating an environment that has promoted child health. Zambia has also focused on bringing health services as close to the family as possible through specific community health strategies. This includes actively involving community health workers to provide health education, basic MNCH services, and linking women to health facilities, while supplementing community and health facility work with twice-yearly Child Health Weeks. External partners have contributed greatly to Zambia’s MNCH services, and their relationships with the government are generally positive. As government funding increases to sustain MNCH services, national health strategies/plans are being used to specify how partners can fill gaps in resources. Zambia’s continuing MNCH challenges include basic transportation, access-to-care, workforce shortages, and financing limitations. We highlight policies, programs, and implementation that facilitated reductions in under-five mortality in Zambia. These findings may inform how other countries in the African Region can increase progress in child survival in the post-MDG period. PMID:28453711

Effect of deploying community health assistants on appropriate treatment for diarrhoea, malaria and pneumonia: quasi-experimental study in two districts of Zambia.

PubMed

Biemba, Godfrey; Yeboah-Antwi, Kojo; Vosburg, Kathryn Bradford; Prust, Margaret L; Keller, Brett; Worku, Yekoyesew; Zulu, Happy; White, Emily; Hamer, Davidson H

2016-08-01

A critical shortage of human resources for health in Zambia remains a great challenge. In response, the Zambian Ministry of Health developed a national community health assistant (CHA) programme, aiming to create a well-trained and motivated community-based health workforce. This study assessed whether CHAs increased treatment rates for diarrhoea, confirmed malaria or pneumonia in the first programme year. This study used a quasi-experimental difference-in-difference design, comparing changes in the catchment areas of health posts with CHAs to those without. Baseline and end line household surveys were conducted to measure the proportion of children under 5 years treated for diarrhoea, malaria or pneumonia in the 2 weeks before the survey and immunisation rates and malaria rapid diagnostic test rates. We surveyed 2330 women with children under five from the intervention area and 2314 from comparison areas at baseline and end line. Treatment for diarrhoea, malaria or pneumonia increased by 18.0% (P < 0.01) and 23.5% (P < 0.01) in the intervention and comparison groups, respectively, but DID analysis was not significant (P = 0.27). The proportion of fully immunised children grew by 7.5% in the intervention, but shrank by 7.5% in the comparison group (DID: 0.14; 95% CI 0.12-0.16, P < 0.01). Although we observed no significant difference between the intervention and comparison groups in the DID estimates for the primary outcome, there were significant increases after one year in treatment for all three diseases in the intervention group from baseline to end line and in the proportion of fully immunised children. © 2016 John Wiley & Sons Ltd.

Making the connections: AIDS and water.

PubMed

Ball, Anna-Marie

2006-01-01

Acknowledging AIDS as a crosscutting development issue, a Zambian rural water supply project that provides safe accessible water to rural communities embarked on a new initiative to mainstream AIDS into the water sector. The work of providing safe water takes the predominantly male workforce away from their spouses and families, into the rural villages of Zambia's Eastern Province, for long periods of time. With an HIV prevalence rate of 16.1%, the risk of HIV exposure exists for both employees and rural villagers. AIDS mainstreaming activities were designed to target both groups. An AIDS mainstreaming strategy was developed by identifying components that could be influenced in the external domain (the organization's usual work) and the internal domain (the workplace). Basic questions were addressed such as: how does AIDS affect the organization, how might the usual work aggravate susceptibility to HIV infection, and where is the comparative advantage? A workplace program including peer education, employee health education (including condoms) and a workplace policy was established for employees. For the target population, a series of five messages connecting safe water and AIDS was developed and disseminated through educational drama, community meetings and trainings, and integrated into the regular water, sanitation and hygiene activities. As an efficient utilization of resources that makes a broad impact, AIDS mainstreaming does not change the sector's mandate but takes advantage of the extensive geographic coverage and natural distribution system of water projects to disseminate AIDS information and make linkages with AIDS partners.

Effectiveness of a girls' empowerment programme on early childbearing, marriage and school dropout among adolescent girls in rural Zambia: study protocol for a cluster randomized trial.

PubMed

Sandøy, Ingvild Fossgard; Mudenda, Mweetwa; Zulu, Joseph; Munsaka, Ecloss; Blystad, Astrid; Makasa, Mpundu C; Mæstad, Ottar; Tungodden, Bertil; Jacobs, Choolwe; Kampata, Linda; Fylkesnes, Knut; Svanemyr, Joar; Moland, Karen Marie; Banda, Richard; Musonda, Patrick

2016-12-09

Adolescent pregnancies pose a risk to the young mothers and their babies. In Zambia, 35% of young girls in rural areas have given birth by the age of 18 years. Pregnancy rates are particularly high among out-of-school girls. Poverty, low enrolment in secondary school, myths and community norms all contribute to early childbearing. This protocol describes a trial aiming to measure the effect on early childbearing rates in a rural Zambian context of (1) economic support to girls and their families, and (2) combining economic support with a community intervention to enhance knowledge about sexual and reproductive health and supportive community norms. This cluster randomized controlled trial (CRCT) will have three arms. The clusters are rural schools with surrounding communities. Approximately 4900 girls in grade 7 in 2016 will be recruited from 157 schools in 12 districts. In one intervention arm, participating girls and their guardians will be offered cash transfers and payment of school fees. In the second intervention arm, there will be both economic support and a community intervention. The interventions will be implemented for approximately 2 years. The final survey will be 4.5 years after recruitment. The primary outcomes will be "incidence of births within 8 months of the end of the intervention period", "incidence of births before girls' 18th birthday" and "proportion of girls who sit for the grade 9 exam". Final survey interviewers will be unaware of the intervention status of respondents. Analysis will be by intention-to-treat and adjusted for cluster design and confounders. Qualitative process evaluation will be conducted. This is the first CRCT to measure the effect of combining economic support with a community intervention to prevent adolescent childbearing in a low- or middle-income country. We have designed a programme that will be sustainable and feasible to scale up. The findings will be relevant for programmes for adolescent reproductive health in Zambia and similar contexts. ISRCTN registry: ISRCTN12727868 , (4 March 2016).

Bayesian modelling to estimate the test characteristics of coprology, coproantigen ELISA and a novel real-time PCR for the diagnosis of taeniasis.

PubMed

Praet, Nicolas; Verweij, Jaco J; Mwape, Kabemba E; Phiri, Isaac K; Muma, John B; Zulu, Gideon; van Lieshout, Lisette; Rodriguez-Hidalgo, Richar; Benitez-Ortiz, Washington; Dorny, Pierre; Gabriël, Sarah

2013-05-01

To estimate and compare the performances of coprology, copro-Ag ELISA and real-time polymerase chain reaction assay (copro-PCR) for detection of Taenia solium tapeworm carriers. The three diagnostic tests were applied on 817 stool samples collected in two Zambian communities where taeniasis is endemic. A Bayesian approach was used to allow estimation of the test characteristics. Two (0.2%; 95% Confidence Interval (CI): 0-0.8), 67 (8.2%; 95% CI: 6.4-10.3) and 10 (1.2%; 95% CI: 0.5-2.2) samples were positive using coprology, copro-Ag ELISA and copro-PCR, respectively. Specificities of 99.9%, 92.0% and 99.0% were determined for coprology, copro-Ag ELISA and copro-PCR, respectively. Sensitivities of 52.5%, 84.5% and 82.7% were determined for coprology, copro-Ag ELISA and copro-PCR, respectively. We urge for additional studies exploring possible cross-reactions of the copro-Ag ELISA and for the use of more sensitive tests, such as copro-PCR, for the detection of tapeworm carriers, which is a key factor in controlling the parasite in endemic areas. © 2013 Blackwell Publishing Ltd.

Inquiry into the Indigenous, Cultural and Traditional Astronomical Knowledge: A case of the Lamba land of Zambia

NASA Astrophysics Data System (ADS)

Simpemba, Prospery C.

2015-08-01

Indigenous astronomy in the context of Zambia is the oral astronomy knowledge, culture and beliefs which relate to celestial bodies, astronomy events and related behaviour that are held by the elderly persons and passed on to younger generations. Much is not written down and with the passing away of the custodians, this knowledge is threatened to be extinct. A mini study of the astronomical beliefs and culture of the ancient Zambian community during the International Year of Astronomy (IYA) 2009 revealed that such knowledge existed. A comprehensive study assesses cultural and traditional knowledge on astronomy and to ascertain how much of this knowledge has been passed on to the younger generations. Open-ended interviews were conducted using questionnaires and focus group discussions. Respondents were identified by snowball sampling of the elderly people and random sampling of the middle aged and young. Nine randomly sampled districts of the Copperbelt Province were considered. The collected data has been analysed using MAXQDA software. Knowledge of traditional astronomy is high among the elderly people and declining with age hence the need for documenting and introducing it in the school curriculum and regular public discourse.

Barriers and Facilitators to HIV Testing Among Zambian Female Sex Workers in Three Transit Hubs.

PubMed

Chanda, Michael M; Perez-Brumer, Amaya G; Ortblad, Katrina F; Mwale, Magdalene; Chongo, Steven; Kamungoma, Nyambe; Kanchele, Catherine; Fullem, Andrew; Barresi, Leah; Bärnighausen, Till; Oldenburg, Catherine E

2017-07-01

Zambia has a generalized HIV epidemic, and HIV is concentrated along transit routes. Female sex workers (FSWs) are disproportionately affected by the epidemic. HIV testing is the crucial first step for engagement in HIV care and HIV prevention activities. However, to date little work has been done with FSWs in Zambia, and little is known about barriers and facilitators to HIV testing in this population. FSW peer educators were recruited through existing sex worker organizations for participation in a trial related to HIV testing among FSWs. We conducted five focus groups with FSW peer educators (N = 40) in three transit towns in Zambia (Livingstone, Chirundu, and Kapiri Mposhi) to elicit community norms related to HIV testing. Emerging themes demonstrated barriers and facilitators to HIV testing occurring at multiple levels, including individual, social network, and structural. Stigma and discrimination, including healthcare provider stigma, were a particularly salient barrier. Improving knowledge, social support, and acknowledgment of FSWs and women's role in society emerged as facilitators to testing. Interventions to improve HIV testing among FSWs in Zambia will need to address barriers and facilitators at multiple levels to be maximally effective.

Attitudes and decision-making about early-infant versus early-adolescent male circumcision: Demand-side insights for sustainable HIV prevention strategies in Zambia and Zimbabwe.

PubMed

Sgaier, Sema K; Sharma, Sunny; Eletskaya, Maria; Prasad, Ram; Mugurungi, Owen; Tambatamba, Bushimbwa; Ncube, Getrude; Xaba, Sinokuthemba; Nanga, Alice; Gumede-Moyo, Sehlulekile; Kretschmer, Steve

2017-01-01

As countries approach their scale-up targets for the voluntary medical male circumcision program for HIV prevention, they are strategizing and planning for the sustainability phase to follow. Global guidance recommends circumcising adolescent (below 14 years) and/or early infant boys (aged 0-60 days), and countries need to consider several factors before prioritizing a cohort for their sustainability phase. We provide community and healthcare provider-side insights on attitudes and decision-making process as a key input for this strategic decision in Zambia and Zimbabwe. We studied expectant parents, parents of infant boys (aged 0-60 days), family members and neo-natal and ante-natal healthcare providers in Zambia and Zimbabwe. Our integrated methodology consisted of in-depth qualitative and quantitative one-on-one interviews, and a simulated-decision-making game, to uncover attitudes towards, and the decision-making process for, early adolescent or early infant medical circumcision (EAMC or EIMC). In both countries, parents viewed early infancy and early adolescence as equally ideal ages for circumcision (38% EIMC vs. 37% EAMC in Zambia; 24% vs. 27% in Zimbabwe). If offered for free, about half of Zambian parents and almost 2 in 5 Zimbabwean parents indicated they would likely circumcise their infant boy; however, half of parents in each country perceived that the community would not accept EIMC. Nurses believed their facilities currently could not absorb EIMC services and that they would have limited ability to influence fathers, who were seen as having the primary decision-making authority. Our analysis suggests that EAMC is more accepted by the community than EIMC and is the path of least resistance for the sustainability phase of VMMC. However, parents or community members do not reject EIMC. Should countries choose to prioritize this cohort for their sustainability phase, a number of barriers around information, decision-making by parents, and supply side will need to be addressed.

Attitudes and decision-making about early-infant versus early-adolescent male circumcision: Demand-side insights for sustainable HIV prevention strategies in Zambia and Zimbabwe

PubMed Central

Sgaier, Sema K.; Sharma, Sunny; Eletskaya, Maria; Prasad, Ram; Mugurungi, Owen; Tambatamba, Bushimbwa; Ncube, Getrude; Xaba, Sinokuthemba; Nanga, Alice; Gumede-Moyo, Sehlulekile; Kretschmer, Steve

2017-01-01

As countries approach their scale-up targets for the voluntary medical male circumcision program for HIV prevention, they are strategizing and planning for the sustainability phase to follow. Global guidance recommends circumcising adolescent (below 14 years) and/or early infant boys (aged 0–60 days), and countries need to consider several factors before prioritizing a cohort for their sustainability phase. We provide community and healthcare provider-side insights on attitudes and decision-making process as a key input for this strategic decision in Zambia and Zimbabwe. We studied expectant parents, parents of infant boys (aged 0–60 days), family members and neo-natal and ante-natal healthcare providers in Zambia and Zimbabwe. Our integrated methodology consisted of in-depth qualitative and quantitative one-on-one interviews, and a simulated-decision-making game, to uncover attitudes towards, and the decision-making process for, early adolescent or early infant medical circumcision (EAMC or EIMC). In both countries, parents viewed early infancy and early adolescence as equally ideal ages for circumcision (38% EIMC vs. 37% EAMC in Zambia; 24% vs. 27% in Zimbabwe). If offered for free, about half of Zambian parents and almost 2 in 5 Zimbabwean parents indicated they would likely circumcise their infant boy; however, half of parents in each country perceived that the community would not accept EIMC. Nurses believed their facilities currently could not absorb EIMC services and that they would have limited ability to influence fathers, who were seen as having the primary decision-making authority. Our analysis suggests that EAMC is more accepted by the community than EIMC and is the path of least resistance for the sustainability phase of VMMC. However, parents or community members do not reject EIMC. Should countries choose to prioritize this cohort for their sustainability phase, a number of barriers around information, decision-making by parents, and supply side will need to be addressed. PMID:28749979

The quest for a framework for sustainable and institutionalised priority-setting for health research in a low-resource setting: the case of Zambia.

PubMed

Kapiriri, Lydia; Chanda-Kapata, Pascalina

2018-02-17

Priority-setting for health research in low-income countries remains a major challenge. While there have been efforts to systematise and improve the processes, most of the initiatives have ended up being a one-off exercise and are yet to be institutionalised. This could, in part, be attributed to the limited capacity for the priority-setting institutions to identify and fund their own research priorities, since most of the priority-setting initiatives are driven by experts. This paper reports findings from a pilot project whose aim was to develop a systematic process to identify components of a locally desirable and feasible health research priority-setting approach and to contribute to capacity strengthening for the Zambia National Health Research Authority. Synthesis of the current literature on the approaches to health research prioritisations. The results of the synthesis were presented and discussed with a sample of Zambian researchers and decision-makers who are involved in health research priority-setting. The ultimate aim was for them to explore the different approaches available for guiding health research priority-setting and to identify an approach that would be relevant and feasible to implement and sustain within the Zambian context. Based on the evidence that was presented, the participants were unable to identify one approach that met the criteria. They identified attributes from the different approaches that they thought would be most appropriate and proposed a process that they deemed feasible within the Zambian context. While it is easier to implement prioritisation based on one approach that the initiator might be interested in, researchers interested in capacity-building for health research priority-setting organisations should expose the low-income country participants to all approaches. Researchers ought to be aware that sometimes one shoe may not fit all, as in the case of Zambia, instead of choosing one approach, the stakeholders may select desirable attributes from the different approaches and piece together an approach that would be feasible and acceptable within their context. An approach that builds on the decision-makers' understanding of their contexts and their input to its development would foster local ownership and has a greater potential for sustainability.

Hypertension management in rural primary care facilities in Zambia: a mixed methods study.

PubMed

Yan, Lily D; Chirwa, Cindy; Chi, Benjamin H; Bosomprah, Samuel; Sindano, Ntazana; Mwanza, Moses; Musatwe, Dennis; Mulenga, Mary; Chilengi, Roma

2017-02-03

Improved primary health care is needed in developing countries to effectively manage the growing burden of hypertension. Our objective was to evaluate hypertension management in Zambian rural primary care clinics using process and outcome indicators to assess the screening, monitoring, treatment and control of high blood pressure. Better Health Outcomes through Mentoring and Assessment (BHOMA) is a 5-year, randomized stepped-wedge trial of improved clinical service delivery underway in 46 rural Zambian clinics. Clinical data were collected as part of routine patient care from an electronic medical record system, and reviewed for site performance over time according to hypertension related indicators: screening (blood pressure measurement), management (recorded diagnosis, physical exam or urinalysis), treatment (on medication), and control. Quantitative data was used to develop guides for qualitative in-depth interviews, conducted with health care providers at a proportional sample of half (20) of clinics. Qualitative data was iteratively analyzed for thematic content. From January 2011 to December 2014, 318,380 visits to 46 primary care clinics by adults aged ≥ 25 years with blood pressure measurements were included. Blood pressure measurement at vital sign screening was initially high at 89.1% overall (range: 70.1-100%), but decreased to 62.1% (range: 0-100%) by 48 months after intervention start. The majority of hypertensive patients made only one visit to the clinics (57.8%). Out of 9022 patients with at least two visits with an elevated blood pressure, only 49.3% had a chart recorded hypertension diagnosis. Process indicators for monitoring hypertension were <10% and did not improve with time. In in-depth interviews, antihypertensive medication shortages were common, with 15/20 clinics reporting hydrochlorothiazide-amiloride stockouts. Principal challenges in hypertension management included 1) equipment and personnel shortages, 2) provider belief that multiple visits were needed before official management, 3) medication stock-outs, leading to improper prescriptions and 4) poor patient visit attendance. Our findings suggest that numerous barriers stand in the way of hypertension diagnosis and management in Zambian primary health facilities. Future work should focus on performance indicator development and validation in low resource contexts, to facilitate regular and systematic data review to improve patient outcomes. ClinicalTrials.gov, Identifier NCT01942278 . Date of Registration: September 2013.

The influence of distance and level of care on delivery place in rural Zambia: a study of linked national data in a geographic information system.

PubMed

Gabrysch, Sabine; Cousens, Simon; Cox, Jonathan; Campbell, Oona M R

2011-01-25

Maternal and perinatal mortality could be reduced if all women delivered in settings where skilled attendants could provide emergency obstetric care (EmOC) if complications arise. Research on determinants of skilled attendance at delivery has focussed on household and individual factors, neglecting the influence of the health service environment, in part due to a lack of suitable data. The aim of this study was to quantify the effects of distance to care and level of care on women's use of health facilities for delivery in rural Zambia, and to compare their population impact to that of other important determinants. Using a geographic information system (GIS), we linked national household data from the Zambian Demographic and Health Survey 2007 with national facility data from the Zambian Health Facility Census 2005 and calculated straight-line distances. Health facilities were classified by whether they provided comprehensive EmOC (CEmOC), basic EmOC (BEmOC), or limited or substandard services. Multivariable multilevel logistic regression analyses were performed to investigate the influence of distance to care and level of care on place of delivery (facility or home) for 3,682 rural births, controlling for a wide range of confounders. Only a third of rural Zambian births occurred at a health facility, and half of all births were to mothers living more than 25 km from a facility of BEmOC standard or better. As distance to the closest health facility doubled, the odds of facility delivery decreased by 29% (95% CI, 14%-40%). Independently, each step increase in level of care led to 26% higher odds of facility delivery (95% CI, 7%-48%). The population impact of poor geographic access to EmOC was at least of similar magnitude as that of low maternal education, household poverty, or lack of female autonomy. Lack of geographic access to emergency obstetric care is a key factor explaining why most rural deliveries in Zambia still occur at home without skilled care. Addressing geographic and quality barriers is crucial to increase service use and to lower maternal and perinatal mortality. Linking datasets using GIS has great potential for future research and can help overcome the neglect of health system factors in research and policy. Please see later in the article for the Editors' Summary.

Reexamining epilepsy-associated stigma: validation of the Stigma Scale of Epilepsy in Zambia.

PubMed

Elafros, Melissa A; Bowles, Ryan P; Atadzhanov, Masharip; Mbewe, Edward; Haworth, Alan; Chomba, Elwyn; Birbeck, Gretchen L

2015-06-01

Epilepsy-associated stigma is an important patient-centered outcome, yet quantification remains challenging. Jacoby's 3-item Stigma Scale is commonly used to assess felt stigma among people with epilepsy (PWE) yet has ceiling effects. The Stigma Scale of Epilepsy (SSE) is a 24-item instrument that measures felt stigma among PWE and stigmatizing attitudes among others. If cross-culturally valid, the SSE may elucidate stigma determinants and provide an outcome measure for interventions. We assessed the properties of the SSE in 102 Zambian PWE using exploratory and confirmatory item response theories and compared the latent traits assessed by the SSE to those assessed by Jacoby's Stigma Scale. Differential item functioning based on forced disclosure of epilepsy was examined. The SSE yielded two latent traits--the first reflected difficulties faced by PWE; the second reflected emotions associated with epilepsy. Jacoby's Stigma Scale was associated only with the first latent trait. Forced disclosure was associated with "worry" and "pity" that were associated with the second latent trait. In Zambian PWE, the SSE captured two latent traits. One trait represents feelings associated with epilepsy, which is theorized as a substantial yet unmeasured part of stigma. The SSE performs well across cultures and may more comprehensively assess felt stigma than other instruments. Further validation is required to determine whether the SSE adequately assesses stigmatizing attitudes among people without epilepsy.

Kidney injury molecule-1 and microalbuminuria levels in Zambian population: biomarkers of kidney injury.

PubMed

Zulu, Mildred; Kaile, Trevor; Kantenga, Timothy; Chileshe, Chisanga; Nkhoma, Panji; Sinkala, Musalula

2016-01-01

Kidney injury affects renal excretion of plasma analytes and metabolic waste products with grave pathologic consequences. Early detection, thus of kidney injury is essential for injury specific intervention that may avert permanent renal damage and delay progression of kidney injury. We aimed to evaluate Kidney Injury Molecule-1 (KIM-1) and Microalbuminuria (MAU), as biomarkers of kidney injury, in comparison with creatinine. We compared the levels of urine MAU, urine KIM-1 and other plasma biochemical tests in specimens from 80 individuals with and without kidney disease. We found no difference in KIM-1 levels between the kidney disease group (2.82± 1.36ng/mL) and controls (3.29 ± 1.14ng/mL), p = 0.122. MAU was higher in participants with kidney disease (130.809± 84.744 µg/mL) than the controls (15.983± 20.442µg/mL), p ?0.001. KIM-1 showed a weak negative correlation with creatinine (r = -0.279, p = 0.09), whereas MAU was positively correlated with creatinine in participants with kidney disease with statistical significance (r = 0.556, p = 0.001). The study demonstrated that in Zambian setting MAU and creatinine are sensitive biomarkers in the diagnosis of kidney damage. We moreover propose further evaluation of KIM-1 as a biomarker of kidney injury.

Kidney injury molecule-1 and microalbuminuria levels in Zambian population: biomarkers of kidney injury

PubMed Central

Zulu, Mildred; Kaile, Trevor; Kantenga, Timothy; Chileshe, Chisanga; Nkhoma, Panji; Sinkala, Musalula

2016-01-01

Introduction Kidney injury affects renal excretion of plasma analytes and metabolic waste products with grave pathologic consequences. Early detection, thus of kidney injury is essential for injury specific intervention that may avert permanent renal damage and delay progression of kidney injury. We aimed to evaluate Kidney Injury Molecule-1 (KIM-1) and Microalbuminuria (MAU), as biomarkers of kidney injury, in comparison with creatinine. Methods We compared the levels of urine MAU, urine KIM-1 and other plasma biochemical tests in specimens from 80 individuals with and without kidney disease. Results We found no difference in KIM-1 levels between the kidney disease group (2.82± 1.36ng/mL) and controls (3.29 ± 1.14ng/mL), p = 0.122. MAU was higher in participants with kidney disease (130.809± 84.744 µg/mL) than the controls (15.983± 20.442µg/mL), p ?0.001. KIM-1 showed a weak negative correlation with creatinine (r = -0.279, p = 0.09), whereas MAU was positively correlated with creatinine in participants with kidney disease with statistical significance (r = 0.556, p = 0.001). Conclusion The study demonstrated that in Zambian setting MAU and creatinine are sensitive biomarkers in the diagnosis of kidney damage. We moreover propose further evaluation of KIM-1 as a biomarker of kidney injury. PMID:27642395

Changes in Measles Serostatus Among HIV-Infected Zambian Children Initiating Antiretroviral Therapy Before and After the 2010 Measles Outbreak and Supplemental Immunization Activities

PubMed Central

Rainwater-Lovett, Kaitlin; Nkamba, Hope C.; Mubiana-Mbewe, Mwangelwa; Bolton-Moore, Carolyn; Moss, William J.

2013-01-01

Background. In 2010, Zambia had a large measles outbreak, providing an opportunity to measure changes in measles serostatus following highly active antiretroviral therapy (HAART), exposure to measles virus, and revaccination among children infected with human immunodeficiency virus (HIV). Methods. A prospective cohort study of 169 HIV-infected Zambian children aged 9–60 months with a history of measles vaccination was conducted to characterize the effects of HAART and revaccination on measles immunoglobulin G (IgG) serostatus by enzyme immunoassay. Results. Prior to the measles outbreak, only 23% of HIV-infected children were measles IgG seropositive at HAART initiation. After adjusting for 6-month changes in baseline age and 5% changes in nadir CD4+ T-cell percentage, HAART was not associated with measles IgG seroconversion. However, 18 of 19 children seroconverted after revaccination. Eight children seroconverted during the outbreak without revaccination and were likely exposed to wild-type measles virus, but none were reported to have had clinical measles. Conclusions. Immune reconstitution after HAART initiation did not restore protective levels of measles IgG antibodies, but almost all children developed protective antibody levels after revaccination. Some previously vaccinated HIV-infected children had serological evidence of exposure to wild-type measles virus without a reported history of measles. PMID:23911708

Challenges and Economic Implications in the Control of Foot and Mouth Disease in Sub-Saharan Africa: Lessons from the Zambian Experience

PubMed Central

Sinkala, Y.; Simuunza, M.; Pfeiffer, D. U.; Munang'andu, H. M.; Mulumba, M.; Kasanga, C. J.; Muma, J. B.; Mweene, A. S.

2014-01-01

Foot and mouth disease is one of the world's most important livestock diseases for trade. FMD infections are complex in nature and there are many epidemiological factors needing clarification. Key questions relate to the control challenges and economic impact of the disease for resource-poor FMD endemic countries like Zambia. A review of the control challenges and economic impact of FMD outbreaks in Zambia was made. Information was collected from peer-reviewed journals articles, conference proceedings, unpublished scientific reports, and personal communication with scientists and personal field experiences. The challenges of controlling FMD using mainly vaccination and movement control are discussed. Impacts include losses in income of over US$ 1.6 billion from exports of beef and sable antelopes and an annual cost of over US$ 2.7 million on preventive measures. Further impacts included unquantified losses in production and low investment in agriculture resulting in slow economic growth. FMD persistence may be a result of inadequate epidemiological understanding of the disease and ineffectiveness of the control measures that are being applied. The identified gaps may be considered in the annual appraisal of the FMD national control strategy in order to advance on the progressive control pathway. PMID:25276472

Challenges and economic implications in the control of foot and mouth disease in sub-saharan Africa: lessons from the zambian experience.

PubMed

Sinkala, Y; Simuunza, M; Pfeiffer, D U; Munang'andu, H M; Mulumba, M; Kasanga, C J; Muma, J B; Mweene, A S

2014-01-01

Foot and mouth disease is one of the world's most important livestock diseases for trade. FMD infections are complex in nature and there are many epidemiological factors needing clarification. Key questions relate to the control challenges and economic impact of the disease for resource-poor FMD endemic countries like Zambia. A review of the control challenges and economic impact of FMD outbreaks in Zambia was made. Information was collected from peer-reviewed journals articles, conference proceedings, unpublished scientific reports, and personal communication with scientists and personal field experiences. The challenges of controlling FMD using mainly vaccination and movement control are discussed. Impacts include losses in income of over US$ 1.6 billion from exports of beef and sable antelopes and an annual cost of over US$ 2.7 million on preventive measures. Further impacts included unquantified losses in production and low investment in agriculture resulting in slow economic growth. FMD persistence may be a result of inadequate epidemiological understanding of the disease and ineffectiveness of the control measures that are being applied. The identified gaps may be considered in the annual appraisal of the FMD national control strategy in order to advance on the progressive control pathway.

Community point distribution of insecticide-treated bed nets and community health worker hang-up visits in rural Zambia: a decision-focused evaluation.

PubMed

Wang, Paul; Connor, Alison L; Joudeh, Ammar S; Steinberg, Jeffrey; Ndhlovu, Ketty; Siyolwe, Musanda; Ntebeka, Bristol; Chibuye, Benjamin; Hamainza, Busiku

2016-03-03

In 2013, the Zambian Ministry of Health through its National Malaria Control Programme distributed over two million insecticide-treated bed nets (ITNs) in four provinces using a door-to-door distribution strategy, and more than 6 million ITNs were allocated to be distributed in 2014. This study was commissioned to measure attendance rates at a community point distribution and to examine the impact of follow-up community health worker (CHW) hang-up visits on short and medium-term ITN retention and usage with a view of informing optimal ITN distribution strategy in Zambia. Households received ITNs at community point distributions conducted in three rural communities in Rufunsa District, Zambia. Households were then randomly allocated into five groups to receive CHW visits to hang any unhung ITNs at different intervals: 1-3, 5-7, 10-12, 15-17 days, and no hang-up visit. Follow-up surveys were conducted among all households at 7-11 weeks after distribution and at 5-6 months after distribution to measure short- and medium-term household retention and usage of ITNs. Of the 560 pre-registered households, 540 (96.4 %) attended the community point distribution. Self-installation of ITNs by households increased over the first 10 days after the community point distribution. Retention levels remained high over time with 90.2 % of distributed ITNs still in the household at 7-11 weeks and 85.7 % at 5-6 months. Retention did not differ between households that received a CHW visit and those that did not. At 7-11 weeks, households had an average of 73.8 % of sleeping spaces covered compared to 80.3 % at 5-6 months. On average, 65.6 % of distributed ITNs were hanging at 7-11 weeks compared to 63.1 % at 5-6 months. While a CHW hang-up visit was associated with increased usage at 7-11 weeks, this difference was no longer apparent at 5-6 months. This evaluation revealed that (1) the community point distributions achieved high attendance rates followed by acceptable rates of short-term and medium-term ITN retention and usage, as compared to reported rates achieved by door-to-door distributions in the recent past, (2) CHW hang-up visits had a modest short-term impact on ITN usage but no medium-term effect, and (3) community point distributions can yield sizeable time savings compared to door-to-door distributions.

Biofortified orange maize is as efficacious as a vitamin A supplement in Zambian children even in the presence of high liver reserves of vitamin A: a community-based, randomized placebo-controlled trial123456

PubMed Central

Gannon, Bryan; Kaliwile, Chisela; Arscott, Sara A; Schmaelzle, Samantha; Chileshe, Justin; Kalungwana, Ngándwe; Mosonda, Mofu; Pixley, Kevin; Masi, Cassim; Tanumihardjo, Sherry A

2014-01-01

Background: Biofortification is a strategy to relieve vitamin A (VA) deficiency. Biofortified maize contains enhanced provitamin A concentrations and has been bioefficacious in animal and small human studies. Objective: The study sought to determine changes in total body reserves (TBRs) of vitamin A with consumption of biofortified maize. Design: A randomized, placebo-controlled biofortified maize efficacy trial was conducted in 140 rural Zambian children. The paired 13C-retinol isotope dilution test, a sensitive biomarker for VA status, was used to measure TBRs before and after a 90-d intervention. Treatments were white maize with placebo oil (VA−), orange maize with placebo (orange), and white maize with VA in oil [400 μg retinol activity equivalents (RAEs) in 214 μL daily] (VA+). Results: In total, 133 children completed the trial and were analyzed for TBRs (n = 44 or 45/group). Change in TBR residuals were not normally distributed (P < 0.0001); median changes (95% CI) were as follows: VA−, 13 (−19, 44) μmol; orange, 84 (21, 146) μmol; and VA+, 98 (24, 171) μmol. Nonparametric analysis showed no statistical difference between VA+ and orange (P = 0.34); both were higher than VA− (P = 0.0034). Median (95% CI) calculated liver reserves at baseline were 1.04 (0.97, 1.12) μmol/g liver, with 59% >1 μmol/g, the subtoxicity cutoff; none were <0.1 μmol/g, the deficiency cutoff. The calculated bioconversion factor was 10.4 μg β-carotene equivalents/1 μg retinol by using the middle 3 quintiles of change in TBRs from each group. Serum retinol did not change in response to intervention (P = 0.16) but was reduced with elevated C-reactive protein (P = 0.0029) and α-1-acid glycoprotein (P = 0.0023) at baseline. Conclusions: β-Carotene from maize was efficacious when consumed as a staple food in this population and could avoid the potential for hypervitaminosis A that was observed with the use of preformed VA from supplementation and fortification. Use of more sensitive methods other than serum retinol alone, such as isotope dilution, is required to accurately assess VA status, evaluate interventions, and investigate the interaction of VA status and infection. This trial was registered at clinicaltrials.gov as NCT01814891. PMID:25411289

Biofortified orange maize is as efficacious as a vitamin A supplement in Zambian children even in the presence of high liver reserves of vitamin A: a community-based, randomized placebo-controlled trial.

PubMed

Gannon, Bryan; Kaliwile, Chisela; Arscott, Sara A; Schmaelzle, Samantha; Chileshe, Justin; Kalungwana, Ngándwe; Mosonda, Mofu; Pixley, Kevin; Masi, Cassim; Tanumihardjo, Sherry A

2014-12-01

Biofortification is a strategy to relieve vitamin A (VA) deficiency. Biofortified maize contains enhanced provitamin A concentrations and has been bioefficacious in animal and small human studies. The study sought to determine changes in total body reserves (TBRs) of vitamin A with consumption of biofortified maize. A randomized, placebo-controlled biofortified maize efficacy trial was conducted in 140 rural Zambian children. The paired (13)C-retinol isotope dilution test, a sensitive biomarker for VA status, was used to measure TBRs before and after a 90-d intervention. Treatments were white maize with placebo oil (VA-), orange maize with placebo (orange), and white maize with VA in oil [400 μg retinol activity equivalents (RAEs) in 214 μL daily] (VA+). In total, 133 children completed the trial and were analyzed for TBRs (n = 44 or 45/group). Change in TBR residuals were not normally distributed (P < 0.0001); median changes (95% CI) were as follows: VA-, 13 (-19, 44) μmol; orange, 84 (21, 146) μmol; and VA+, 98 (24, 171) μmol. Nonparametric analysis showed no statistical difference between VA+ and orange (P = 0.34); both were higher than VA- (P = 0.0034). Median (95% CI) calculated liver reserves at baseline were 1.04 (0.97, 1.12) μmol/g liver, with 59% >1 μmol/g, the subtoxicity cutoff; none were <0.1 μmol/g, the deficiency cutoff. The calculated bioconversion factor was 10.4 μg β-carotene equivalents/1 μg retinol by using the middle 3 quintiles of change in TBRs from each group. Serum retinol did not change in response to intervention (P = 0.16) but was reduced with elevated C-reactive protein (P = 0.0029) and α-1-acid glycoprotein (P = 0.0023) at baseline. β-Carotene from maize was efficacious when consumed as a staple food in this population and could avoid the potential for hypervitaminosis A that was observed with the use of preformed VA from supplementation and fortification. Use of more sensitive methods other than serum retinol alone, such as isotope dilution, is required to accurately assess VA status, evaluate interventions, and investigate the interaction of VA status and infection. This trial was registered at clinicaltrials.gov as NCT01814891. © 2014 American Society for Nutrition.

Plasma Cytokines and Chemokines in Zambian Children With Measles: Innate Responses and Association With HIV-1 Coinfection and In-Hospital Mortality.

PubMed

Lin, Wen-Hsuan W; Nelson, Ashley N; Ryon, Judith J; Moss, William J; Griffin, Diane E

2017-03-01

To identify immune factors present during the acute rash phase of measles and associations with outcome and human immunodeficiency virus type 1 (HIV-1) coinfection, we measured the plasma levels of 22 cytokines and chemokines in Zambian children hospitalized with measles (n = 148) and control children (n = 44). Children with measles had higher levels of innate cytokines tumor necrosis factor (TNF) α, interleukin 1β (IL-1β), interleukin 18, and interleukin 6; chemokines CCL2, CCL4, CCL11, CCL22, CXCL8, and CXCL10; and T-cell cytokines interferon γ, and interleukin 2, 10, and 17. Children who died in the hospital had higher levels of TNF-α, IL-1β, interleukin 12p70; CCL2, CCL4, CCL13, CCL17, CXCL8, CXCL10; and interleukin 2 and interferon γ than children who survived, and lower levels of interleukin 4. Children coinfected with HIV-1 had higher levels of TNF-α and IL-1β than HIV-uninfected children with measles, and lower levels of interleukin 4 and 5. Therefore, acute measles was characterized by activation of macrophages and T cells producing type 1, but not type 2, cytokines, which was more pronounced in fatal disease. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

Physical growth and non-verbal intelligence: Associations in Zambia

PubMed Central

Hein, Sascha; Reich, Jodi; Thuma, Philip E.; Grigorenko, Elena L.

2014-01-01

Objectives To investigate normative developmental BMI trajectories and associations of physical growth indicators (ie, height, weight, head circumference [HC], body mass index [BMI]) with non-verbal intelligence in an understudied population of children from Sub-Saharan Africa. Study design A sample of 3981 students (50.8% male), grades 3 to 7, with a mean age of 12.75 years was recruited from 34 rural Zambian schools. Children with low scores on vision and hearing screenings were excluded. Height, weight and HC were measured, and non-verbal intelligence was assessed using UNIT-symbolic memory and KABC-II-triangles. Results Results showed that students in higher grades have a higher BMI over and above the effect of age. Girls showed a marginally higher BMI, although that for both boys and girls was approximately 1 SD below the international CDC and WHO norms. Controlling for the effect of age, non-verbal intelligence showed small but significant positive relationships with HC (r = .17) and BMI (r = .11). HC and BMI accounted for 1.9% of the variance in non-verbal intelligence, over and above the contribution of grade and sex. Conclusions BMI-for-age growth curves of Zambian children follow observed worldwide developmental trajectories. The positive relationships between BMI and intelligence underscore the importance of providing adequate nutritional and physical growth opportunities for children worldwide and in sub-Saharan Africa in particular. Directions for future studies are discussed with regard to maximizing the cognitive potential of all rural African children. PMID:25217196

Health systems analysis of eye care services in Zambia: evaluating progress towards VISION 2020 goals.

PubMed

Bozzani, Fiammetta Maria; Griffiths, Ulla Kou; Blanchet, Karl; Schmidt, Elena

2014-02-28

VISION 2020 is a global initiative launched in 1999 to eliminate avoidable blindness by 2020. The objective of this study was to undertake a situation analysis of the Zambian eye health system and assess VISION 2020 process indicators on human resources, equipment and infrastructure. All eye health care providers were surveyed to determine location, financing sources, human resources and equipment. Key informants were interviewed regarding levels of service provision, management and leadership in the sector. Policy papers were reviewed. A health system dynamics framework was used to analyse findings. During 2011, 74 facilities provided eye care in Zambia; 39% were public, 37% private for-profit and 24% owned by Non-Governmental Organizations. Private facilities were solely located in major cities. A total of 191 people worked in eye care; 18 of these were ophthalmologists and eight cataract surgeons, equivalent to 0.34 and 0.15 per 250,000 population, respectively. VISION 2020 targets for inpatient beds and surgical theatres were met in six out of nine provinces, but human resources and spectacles manufacturing workshops were below target in every province. Inequalities in service provision between urban and rural areas were substantial. Shortage and maldistribution of human resources, lack of routine monitoring and inadequate financing mechanisms are the root causes of underperformance in the Zambian eye health system, which hinder the ability to achieve the VISION 2020 goals. We recommend that all VISION 2020 process indicators are evaluated simultaneously as these are not individually useful for monitoring progress.

Reexamining epilepsy-associated stigma: validation of the Stigma Scale of Epilepsy in Zambia

PubMed Central

Bowles, Ryan P.; Atadzhanov, Masharip; Mbewe, Edward; Haworth, Alan; Chomba, Elwyn; Birbeck, Gretchen L.

2017-01-01

Purpose Epilepsy-associated stigma is an important patient-centered outcome, yet quantification remains challenging. Jacoby’s 3-item Stigma Scale is commonly used to assess felt stigma among people with epilepsy (PWE) yet has ceiling effects. The Stigma Scale of Epilepsy (SSE) is a 24-item instrument that measures felt stigma among PWE and stigmatizing attitudes among others. If cross-culturally valid, the SSE may elucidate stigma determinants and provide an outcome measure for interventions. Methods We assessed the properties of the SSE in 102 Zambian PWE using exploratory and confirmatory item response theories and compared the latent traits assessed by the SSE to those assessed by Jacoby’s Stigma Scale. Differential item functioning based on forced disclosure of epilepsy was examined. Results The SSE yielded two latent traits—the first reflected difficulties faced by PWE; the second reflected emotions associated with epilepsy. Jacoby’s Stigma Scale was associated only with the first latent trait. Forced disclosure was associated with “worry” and “pity” that were associated with the second latent trait. Conclusions In Zambian PWE, the SSE captured two latent traits. One trait represents feelings associated with epilepsy, which is theorized as a substantial yet unmeasured part of stigma. The SSE performs well across cultures and may more comprehensively assess felt stigma than other instruments. Further validation is required to determine whether the SSE adequately assesses stigmatizing attitudes among people without epilepsy. PMID:25416086

Stakeholder perceptions of aid coordination implementation in the Zambian health sector.

PubMed

Sundewall, Jesper; Jönsson, Kristina; Cheelo, Caesar; Tomson, Göran

2010-05-01

In this study, we analysed stakeholder perceptions of the process of implementing the coordination of health-sector aid in Zambia, Africa. The aim of coordination of health aid is to increase the effectiveness of health systems and to ensure that donors comply with national priorities. With increases in the number of donors involved and resources available for health aid globally, the attention devoted to coordination worldwide has risen. While the theoretical basis of coordination has been relatively well-explored, less research has been carried out on the practicalities of how such coordination is to be implemented. In our study, we focused on potential differences between the views of the stakeholders, both government and donors, on the systems by which health aid is coordinated. A qualitative case study was conducted comprising interviews with government and donor stakeholders in the health sector, as well as document review and observations of meetings. Results suggested that stakeholders are generally satisfied with the implementation of health-sector aid coordination in Zambia. However, there were differences in perceptions of the level of coordination of plans and agreements, which can be attributed to difficulties in harmonizing and aligning organizational requirements with the Zambian health-sector plans. In order to achieve the aims of the Paris Declaration; to increase harmonization, alignment and ownership--resources from donors must be better coordinated in the health sector planning process. This requires careful consideration of contextual constraints surrounding each donor. Copyright (c) 2009 Elsevier Ireland Ltd. All rights reserved.

DEFB1 polymorphisms and HIV-1 mother-to-child transmission in Zambian population.

PubMed

Zupin, Luisa; Polesello, Vania; Segat, Ludovica; Kamada, Anselmo Jiro; Kuhn, Louise; Crovella, Sergio

2018-03-20

Human Beta Defensin-1 (hBD-1) is a component of the innate immune system, the first line of defence against pathogens, already reported as involved in the susceptibility to HIV-1 infection and HIV-1 mother-to-child transmission (MTCT) in different populations. We investigated the role of DEFB1 gene (encoding for hBD-1) functional polymorphisms in the susceptibility to HIV-1 MTCT in a population from Zambia. Four selected polymorphisms within DEFB1 gene, three at the 5' untranslated region (UTR), namely -52G > A (rs1799946), -44C > G (rs1800972) and -20G > A (rs11362) and one in the 3'UTR, c.*87A > G (rs1800972), were genotyped in 101 HIV-1 positive mothers (26 transmitters -27% and 75 not transmitters -73%) and 331 infants born to HIV-1 infected mothers (85 HIV-1 positive -26% and 246 exposed but not infected -74%). DEFB1 c.*87-A allele was more frequent among HIV- children with respect to HIV+ (with intrauterine MTCT). Concerning DEFB1 haplotypes, GCGA haplotype resulted more represented in HIV- than HIV+ infants and DEFB1 ACGG haplotype presented increased frequency in HIV- children respect to HIV+ (with intra-partum MTCT) (p = .02, p = .002 and p = .006, respectively). DEFB1 polymorphisms were significantly associated with decreased risk of HIV-1 infection acquisition in the studied Zambian population suggesting that they may play a role in HIV-1 MTCT.

Let us fight and support one another: adolescent girls and young women on contributors and solutions to HIV risk in Zambia

PubMed Central

Butts, Stefani A; Parmley, Lauren E; Alcaide, Maria L; Rodriguez, Violeta J; Kayukwa, Annette; Chitalu, Ndashi; Weiss, Stephen M; Jones, Deborah L

2017-01-01

In Zambia, adolescent girls and young women (AGYW) are disproportionately affected by human immunodeficiency virus (HIV), social, cultural and economic factors making them particularly vulnerable. This study was designed to understand the context in which AGYW are at risk and to identify perceived drivers of the epidemic and potential strategies to reduce HIV risk. Focus group discussions were conducted with AGYW in Zambian districts with the highest HIV prevalence from February through August 2016. The focus group guide addressed HIV risk factors and strategies for HIV prevention in AGYW. Focus group discussions were recorded, translated and transcribed, themes identified and responses coded. Results suggest that gender inequality undermined potentially protective factors against HIV among AGYW. Poverty and stigmatization were major barriers to accessing available HIV prevention services as well as primary risk factors for HIV infection. Sponsorship to support AGYW school attendance, programs for boys and girls to foster gender equality and financial assistance from the government of Zambia to support AGYW most in need were proposed as strategies to reduce HIV risk. Results highlight the utility of using community-based research to guide potential interventions for the affected population. Future research should explore the use of multilevel interventions to combat HIV among AGYW. PMID:29033613

Let us fight and support one another: adolescent girls and young women on contributors and solutions to HIV risk in Zambia.

PubMed

Butts, Stefani A; Parmley, Lauren E; Alcaide, Maria L; Rodriguez, Violeta J; Kayukwa, Annette; Chitalu, Ndashi; Weiss, Stephen M; Jones, Deborah L

2017-01-01

In Zambia, adolescent girls and young women (AGYW) are disproportionately affected by human immunodeficiency virus (HIV), social, cultural and economic factors making them particularly vulnerable. This study was designed to understand the context in which AGYW are at risk and to identify perceived drivers of the epidemic and potential strategies to reduce HIV risk. Focus group discussions were conducted with AGYW in Zambian districts with the highest HIV prevalence from February through August 2016. The focus group guide addressed HIV risk factors and strategies for HIV prevention in AGYW. Focus group discussions were recorded, translated and transcribed, themes identified and responses coded. Results suggest that gender inequality undermined potentially protective factors against HIV among AGYW. Poverty and stigmatization were major barriers to accessing available HIV prevention services as well as primary risk factors for HIV infection. Sponsorship to support AGYW school attendance, programs for boys and girls to foster gender equality and financial assistance from the government of Zambia to support AGYW most in need were proposed as strategies to reduce HIV risk. Results highlight the utility of using community-based research to guide potential interventions for the affected population. Future research should explore the use of multilevel interventions to combat HIV among AGYW.

Stratigraphy of Zambian copperbelt orebodies

NASA Astrophysics Data System (ADS)

Binda, Pier L.

1994-11-01

The subdivision of the Roan Supergroup in three informal units instead of the traditional Lower Roan/Upper Roan allows a better understanding of facies relationships. The lower division (Siliciclastic Unit) consists of a variable thickness of continental conglomerates and erenites. The middle division (Mixed Unit) consists of a wedge of carbonate and siliciclastic lithologies tapering to the south-west and deposited in a shallow sea. The upper division (Carbonate Unit or Upper Roan s.s.) is a thick succession of dolostones, subordinate argillites and breccias that directly overlies, but is probably in tectonic contact with, the Siliciclastic Unit in the south-western part of the Copperbelt. Reference boundaries for the Mixed and Siliciclastic Units are given for all mining localities of the Zambian Copperbelt. The basal part of the Mixed Unit, host to the most important CuCo orebodies, was deposited during a major marine transgression which, proceeding from SW-NE, swiftly inundated the whole Copperbelt basin. Thus, the Mufulira Ore Formation can be considered as the near-shore facies of the basinal ore shale. The transition from the Mufulira arenites to the Chambishi silty, ore shale has been effaced by erosional or tectonic stripping of the Roan sediments on the Kafue anticline, whereas the transition from silty to carbonaceous ore shale is well documented in the southern part of the Chambishi-Nkana basin. Concomitant with the NE-SW lithofacies changes within the basal Mixed Unit, there is marked decrease in Cu grade and content from the Mufulira wacke and arenite to the silty ore shale of the northern Chambishi basin and the carbonaceous and pyritic ore shale of the southern Chambishi basin. Cobalt is virtually absent in the Mufulira Ore Formation, reaches ore grade in the silty ore shale and occurs in trace amounts in the carbonaceous ore shale. Thus, the correlation of the basal Mixed Unit reveals a hitherto undetected regional metal zoning akin to that noted in parts of individual Copperbelt basin. The middle portion of the Mixed Unit contains at least one laterally continuous Cu mineralization in the arkosic arenite with minor occurrences of local significance. The Siliciclastic Unit contains Cu concentrations at several stratigraphical levels, but precise correlation of footwall orebodies is precluded by the heterogeneity of the clastic wedges of local provenance. The Mixed Unit of the Zambian Copperbelt can be correlated lithostratigraphically with the Serie des Mines of Shaba. A bed-by-bed correlation of the Kamoto (Zaire) and Mindola (Zambia) Ore Formations is proposed. The southern provenance of the Shaba nappes is supported.

The Influence of Distance and Level of Care on Delivery Place in Rural Zambia: A Study of Linked National Data in a Geographic Information System

PubMed Central

Gabrysch, Sabine; Cousens, Simon; Cox, Jonathan; Campbell, Oona M. R.

2011-01-01

Background Maternal and perinatal mortality could be reduced if all women delivered in settings where skilled attendants could provide emergency obstetric care (EmOC) if complications arise. Research on determinants of skilled attendance at delivery has focussed on household and individual factors, neglecting the influence of the health service environment, in part due to a lack of suitable data. The aim of this study was to quantify the effects of distance to care and level of care on women's use of health facilities for delivery in rural Zambia, and to compare their population impact to that of other important determinants. Methods and Findings Using a geographic information system (GIS), we linked national household data from the Zambian Demographic and Health Survey 2007 with national facility data from the Zambian Health Facility Census 2005 and calculated straight-line distances. Health facilities were classified by whether they provided comprehensive EmOC (CEmOC), basic EmOC (BEmOC), or limited or substandard services. Multivariable multilevel logistic regression analyses were performed to investigate the influence of distance to care and level of care on place of delivery (facility or home) for 3,682 rural births, controlling for a wide range of confounders. Only a third of rural Zambian births occurred at a health facility, and half of all births were to mothers living more than 25 km from a facility of BEmOC standard or better. As distance to the closest health facility doubled, the odds of facility delivery decreased by 29% (95% CI, 14%–40%). Independently, each step increase in level of care led to 26% higher odds of facility delivery (95% CI, 7%–48%). The population impact of poor geographic access to EmOC was at least of similar magnitude as that of low maternal education, household poverty, or lack of female autonomy. Conclusions Lack of geographic access to emergency obstetric care is a key factor explaining why most rural deliveries in Zambia still occur at home without skilled care. Addressing geographic and quality barriers is crucial to increase service use and to lower maternal and perinatal mortality. Linking datasets using GIS has great potential for future research and can help overcome the neglect of health system factors in research and policy. Please see later in the article for the Editors' Summary PMID:21283606

Developing a community driven sustainable model of maternity waiting homes for rural Zambia.

PubMed

Lori, Jody R; Munro-Kramer, Michelle L; Mdluli, Eden Ahmed; Musonda Mrs, Gertrude K; Boyd, Carol J

2016-10-01

maternity waiting homes (MWHs) are residential dwellings located near health facilities where women in the late stages of pregnancy stay to await childbirth and receive immediate postpartum services. These shelters help overcome distance and transportation barriers that prevent women from receiving timely skilled obstetric care. the purpose of this study was to explore Zambian stakeholders' beliefs regarding the acceptability, feasibility, and sustainability of maternity waiting homes (MWHs) to inform a model for rural Zambia. a qualitative design using a semi-structured interview guide for data collection was used. two rural districts in the Eastern province of Zambia. individual interviews were conducted with community leaders (n=46). Focus groups were held with Safe Motherhood Action Groups, husbands, and women of childbearing age in two rural districts in Zambia (n=500). latent content analysis was used to analyze the data. participants were overwhelmingly in support of MWHs as a way to improve access to facility-based childbirth and address the barrier of distance. Data suggest that participants can describe features of high quality care, and the type of care they expect from a MWH. Stakeholders acknowledged the need to contribute to the maintenance of the MWH, and that community involvement was crucial to MWH sustainability. access to facility childbirth remains particularly challenging in rural Zambia and delays in seeking care exist. Maternity waiting homes offer a feasible and acceptable intervention to reduce delays in seeking care, thereby holding the potential to improve maternal outcomes. this study joins a growing literature on the acceptability, feasibility, and sustainability of MWHs. It is believed that MWHs, by addressing the distance and transportation barriers, will increase the use of skilled birth attendants, thereby reducing maternal and neonatal morbidity and mortality in rural, low resource areas of Zambia. We recommend that any initiative, such as MWHs, seeking to increase facility-based births with a skilled birth attendant also concurrently addresses any local deficiencies in quality of care. Copyright © 2016 Elsevier Ltd. All rights reserved.

Holding a country countdown to 2015 conference on Millennium Development Goals (MDGs) - the Zambian experience.

PubMed

Mukonka, Victor M; Malumo, Sarai; Kalesha, Penelope; Nambao, Mary; Mwale, Rodgers; Mwinga, Kasonde; Katepa-Bwalya, Mary; Babaniyi, Olusegan; Mason, Elizabeth; Phiri, Caroline; Wamulume, Pauline K

2014-01-21

Initiatives such as the Country Countdown to 2015 Conference on Millennium Development Goals (MDGs) have provided countries with high maternal and child deaths like Zambia a platform to assess progress, discuss challenges and share lessons learnt as a conduit for national commitment to reaching and attaining the MDGs four and five. This paper discusses and highlights the process of holding a successful country countdown conference and shares Zambia's experience with other countries planning to organise country countdown to 2015 Conferences on MDGs.

Age- and Sex-Specific Social Contact Patterns and Incidence of Mycobacterium tuberculosis Infection.

PubMed

Dodd, Peter J; Looker, Clare; Plumb, Ian D; Bond, Virginia; Schaap, Ab; Shanaube, Kwame; Muyoyeta, Monde; Vynnycky, Emilia; Godfrey-Faussett, Peter; Corbett, Elizabeth L; Beyers, Nulda; Ayles, Helen; White, Richard G

2016-01-15

We aimed to model the incidence of infection with Mycobacterium tuberculosis among adults using data on infection incidence in children, disease prevalence in adults, and social contact patterns. We conducted a cross-sectional face-to-face survey of adults in 2011, enumerating "close" (shared conversation) and "casual" (shared indoor space) social contacts in 16 Zambian communities and 8 South African communities. We modeled the incidence of M. tuberculosis infection in all age groups using these contact patterns, as well as the observed incidence of M. tuberculosis infection in children and the prevalence of tuberculosis disease in adults. A total of 3,528 adults participated in the study. The reported rates of close and casual contact were 4.9 per adult per day (95% confidence interval: 4.6, 5.2) and 10.4 per adult per day (95% confidence interval: 9.3, 11.6), respectively. Rates of close contact were higher for adults in larger households and rural areas. There was preferential mixing of close contacts within age groups and within sexes. The estimated incidence of M. tuberculosis infection in adults was 1.5-6 times higher (2.5%-10% per year) than that in children. More than 50% of infections in men, women, and children were estimated to be due to contact with adult men. We conclude that estimates of infection incidence based on surveys in children might underestimate incidence in adults. Most infections may be due to contact with adult men. Treatment and control of tuberculosis in men is critical to protecting men, women, and children from tuberculosis. © The Author 2015. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health.

Rabies, canine distemper, and canine parvovirus exposure in large carnivore communities from two Zambian ecosystems.

PubMed

Berentsen, Are R; Dunbar, Mike R; Becker, Matthew S; M'soka, Jassiel; Droge, Egil; Sakuya, Nicholas M; Matandiko, Wigganson; McRobb, Rachel; Hanlon, Cathleen A

2013-09-01

Disease transmission within and among wild and domestic carnivores can have significant impacts on populations, particularly for threatened and endangered species. We used serology to evaluate potential exposure to rabies virus, canine distemper virus (CDV), and canine parvovirus (CPV) for populations of African lions (Panthera leo), African wild dogs (Lycaon pictus), and spotted hyenas (Crocuta crocuta) in Zambia's South Luangwa National Park (SLNP) and Liuwa Plain National Park (LPNP) as well as community lands bordering these areas. In addition, domestic dogs in the study region were evaluated for exposure to CDV and rabies. We provide the first comprehensive disease exposure data for these species in these ecosystems. Twenty-one lions, 20 hyenas, 13 wild dogs, and 38 domestic dogs were sampled across both regions from 2009 to 2011. Laboratory results show 10.5% of domestic dogs, 5.0% of hyenas, and 7.7% of wild dogs sampled were positive for CDV exposure. All lions were negative. Exposure to CPV was 10.0% and 4.8% for hyenas and lions, respectively. All wild dogs were negative, and domestic dogs were not tested due to insufficient serum samples. All species sampled were negative for rabies virus neutralizing antibodies except lions. Forty percent of lions tested positive for rabies virus neutralizing antibodies. Because these lions appeared clinically healthy, this finding is consistent with seroconversion following exposure to rabies antigen. To our knowledge, this finding represents the first ever documentation of rabies virus neutralizing antibodies consistent with rabies exposure that did not lead to clinical disease in free-ranging African lions from this region. With ever-increasing human pressure on these ecosystems, understanding disease transmission dynamics is essential for proper management and conservation of these carnivore species.

Implications of the "My School" Website for Disadvantaged Communities: A Bourdieuian Analysis

ERIC Educational Resources Information Center

Mills, Carmen

2015-01-01

Drawing on the theoretical constructs of Pierre Bourdieu, this article explores implications of the Australian "My School" website for schools located in disadvantaged communities. These implications flow from the legitimisation of certain cultural practices through the hidden linkages between scholastic aptitude and cultural heritage…

Mitochondrial Haplotype Diversity in Zambian Lions: Bridging a Gap in the Biogeography of an Iconic Species

PubMed Central

Curry, Caitlin J.; White, Paula A.; Derr, James N.

2015-01-01

Analysis of DNA sequence diversity at the 12S to 16S mitochondrial genes of 165 African lions (Panthera leo) from five main areas in Zambia has uncovered haplotypes which link Southern Africa with East Africa. Phylogenetic analysis suggests Zambia may serve as a bridge connecting the lion populations in southern Africa to eastern Africa, supporting earlier hypotheses that eastern-southern Africa may represent the evolutionary cradle for the species. Overall gene diversity throughout the Zambian lion population was 0.7319 +/- 0.0174 with eight haplotypes found; three haplotypes previously described and the remaining five novel. The addition of these five novel haplotypes, so far only found within Zambia, nearly doubles the number of haplotypes previously reported for any given geographic location of wild lions. However, based on an AMOVA analysis of these haplotypes, there is little to no matrilineal gene flow (Fst = 0.47) when the eastern and western regions of Zambia are considered as two regional sub-populations. Crossover haplotypes (H9, H11, and Z1) appear in both populations as rare in one but common in the other. This pattern is a possible result of the lion mating system in which predominately males disperse, as all individuals with crossover haplotypes were male. The determination and characterization of lion sub-populations, such as done in this study for Zambia, represent a higher-resolution of knowledge regarding both the genetic health and connectivity of lion populations, which can serve to inform conservation and management of this iconic species. PMID:26674533

Physical growth and nonverbal intelligence: associations in Zambia.

PubMed

Hein, Sascha; Reich, Jodi; Thuma, Philip E; Grigorenko, Elena L

2014-11-01

To investigate normative developmental body mass index (BMI) trajectories and associations of physical growth indicators--height, weight, head circumference (HC), and BMI--with nonverbal intelligence in an understudied population of children from sub-Saharan Africa. A sample of 3981 students (50.8% male), grades 3-7, with a mean age of 12.75 years was recruited from 34 rural Zambian schools. Children with low scores on vision and hearing screenings were excluded. Height, weight, and HC were measured, and nonverbal intelligence was assessed using the Universal Nonverbal Intelligence Test, Symbolic Memory subtest and Kaufman Assessment Battery for Children, Second Edition, Triangles subtest. Students in higher grades had a higher BMI over and above the effect of age. Girls had a marginally higher BMI, although that for both boys and girls was approximately 1 SD below the international Centers for Disease Control and Prevention and World Health Organization norms. When controlling for the effect of age, nonverbal intelligence showed small but significant positive relationships with HC (r = 0.17) and BMI (r = 0.11). HC and BMI accounted for 1.9% of the variance in nonverbal intelligence, over and above the contribution of grade and sex. BMI-for-age growth curves of Zambian children follow observed worldwide developmental trajectories. The positive relationships between BMI and intelligence underscore the importance of providing adequate nutritional and physical growth opportunities for children worldwide and in sub-Saharan Africa in particular. Directions for future studies are discussed with regard to maximizing the cognitive potential of all rural African children. Copyright © 2014 Elsevier Inc. All rights reserved.

Mitochondrial Haplotype Diversity in Zambian Lions: Bridging a Gap in the Biogeography of an Iconic Species.

PubMed

Curry, Caitlin J; White, Paula A; Derr, James N

2015-01-01

Analysis of DNA sequence diversity at the 12S to 16S mitochondrial genes of 165 African lions (Panthera leo) from five main areas in Zambia has uncovered haplotypes which link Southern Africa with East Africa. Phylogenetic analysis suggests Zambia may serve as a bridge connecting the lion populations in southern Africa to eastern Africa, supporting earlier hypotheses that eastern-southern Africa may represent the evolutionary cradle for the species. Overall gene diversity throughout the Zambian lion population was 0.7319 +/- 0.0174 with eight haplotypes found; three haplotypes previously described and the remaining five novel. The addition of these five novel haplotypes, so far only found within Zambia, nearly doubles the number of haplotypes previously reported for any given geographic location of wild lions. However, based on an AMOVA analysis of these haplotypes, there is little to no matrilineal gene flow (Fst = 0.47) when the eastern and western regions of Zambia are considered as two regional sub-populations. Crossover haplotypes (H9, H11, and Z1) appear in both populations as rare in one but common in the other. This pattern is a possible result of the lion mating system in which predominately males disperse, as all individuals with crossover haplotypes were male. The determination and characterization of lion sub-populations, such as done in this study for Zambia, represent a higher-resolution of knowledge regarding both the genetic health and connectivity of lion populations, which can serve to inform conservation and management of this iconic species.

Health systems analysis of eye care services in Zambia: evaluating progress towards VISION 2020 goals

PubMed Central

2014-01-01

Background VISION 2020 is a global initiative launched in 1999 to eliminate avoidable blindness by 2020. The objective of this study was to undertake a situation analysis of the Zambian eye health system and assess VISION 2020 process indicators on human resources, equipment and infrastructure. Methods All eye health care providers were surveyed to determine location, financing sources, human resources and equipment. Key informants were interviewed regarding levels of service provision, management and leadership in the sector. Policy papers were reviewed. A health system dynamics framework was used to analyse findings. Results During 2011, 74 facilities provided eye care in Zambia; 39% were public, 37% private for-profit and 24% owned by Non-Governmental Organizations. Private facilities were solely located in major cities. A total of 191 people worked in eye care; 18 of these were ophthalmologists and eight cataract surgeons, equivalent to 0.34 and 0.15 per 250,000 population, respectively. VISION 2020 targets for inpatient beds and surgical theatres were met in six out of nine provinces, but human resources and spectacles manufacturing workshops were below target in every province. Inequalities in service provision between urban and rural areas were substantial. Conclusion Shortage and maldistribution of human resources, lack of routine monitoring and inadequate financing mechanisms are the root causes of underperformance in the Zambian eye health system, which hinder the ability to achieve the VISION 2020 goals. We recommend that all VISION 2020 process indicators are evaluated simultaneously as these are not individually useful for monitoring progress. PMID:24575919

The sensitivity of the QuantiFERON®-TB Gold Plus assay in Zambian adults with active tuberculosis.

PubMed

Telisinghe, L; Amofa-Sekyi, M; Maluzi, K; Kaluba-Milimo, D; Cheeba-Lengwe, M; Chiwele, K; Kosloff, B; Floyd, S; Bailey, S-L; Ayles, H

2017-06-01

To investigate the sensitivity of the new interferon-gamma release assay (IGRA), QuantiFERON®-TB Gold Plus (QFT-Plus), for active TB (used as a surrogate for latent tuberculous infection) in a Zambian TB clinic. Consecutive smear or Xpert® MTB/RIF-positive adult (age 18 years) pulmonary TB patients were recruited between June 2015 and March 2016. Venous blood was tested using QFT-Plus. The sensitivity was defined as the number positive divided by the total number tested. Using logistic regression, factors associated with positive QFT-Plus results were explored. Of 108 patients (median age 32 years, interquartile range 27-38; 73% male; 63% human immunodeficiency virus [HIV] positive), 90 were QFT-Plus-positive, 11 were negative and seven had indeterminate results; sensitivity was 83% (95%CI 75-90). There was no difference in sensitivity by HIV status (HIV-positive 85%, 95%CI 75-93; n = 68 vs. HIV-negative 80%, 95%CI 64-91; n = 40; P = 0.59). In models adjusted for age alone, CD4 cell count <100 cells/μl (OR 0.15, 95%CI 0.02-0.96; P = 0.05) and body mass index <18.5 kg/m2 (OR 0.27, 95%CI 0.08-0.91; P = 0.02) were associated with decreased odds of positive QFT-Plus results. Overall, the sensitivity of QFT-Plus is similar to that of the tuberculin skin test and other IGRAs. While overall sensitivity is not affected by HIV status, QFT-Plus sensitivity was lower among people living with HIV/acquired immune-deficiency syndrome with severe immunosuppression.

Fukushima Daiichi: implications for carbon-free energy, nuclear nonproliferation, and community resilience.

PubMed

Hall, Howard L

2011-07-01

Implications of the nuclear power plant accidents at Fukushima Daiichi are explored in this commentary. In addition to questions of nuclear reactor regulatory standards, broader implications on noncarbon-emitting energy production, nuclear nonproliferation objectives, and community resilience and emergency response against catastrophic events are explored. Copyright © 2011 SETAC.

e-Government for Development Information Exchange (DIE): Zambia

NASA Astrophysics Data System (ADS)

Joseph, Bwalya Kelvin

In most parts of the world, political systems which utilize authoritative rule and mostly employ top-down decision-making processes are slowly transcending towards democratic norms. Information Technology Systems have been identified and adopted as one of the most efficient vehicles for appropriate, transparent and inclusive / participatory decision making. Zambia has shown a higher propensity to indigenous knowledge systems which are full of inefficiencies, a lot of red tape in public service delivery, and prone to corrupt practices. Despite that being the case, it is slowly trying to implement e-government. The adoption of e-government promises a sharp paradigm shift where public institutions will be more responsive and transparent, promote efficient PPP (Public Private Partnerships), and empower citizens by making knowledge and other resources more directly accessible. This paper examines three cases from Zambia where ICT in support of e-government has been implemented for Development Information Exchange (DIE) - knowledge-based decision making. The paper also assesses the challenges, opportunities, and issues together with e-government adoption criteria regarding successful encapsulation of e-government into the Zambian contextual environment. I propose a conceptual model which offers balanced e-government adoption criteria involving a combination of electronic and participatory services. This conceptual e-government adoption model can later be replicated to be used at the Southern African Development Community (SADC) level given the similarity in the contextual environment.

Resuscitating voter interest in Zambia: the Adult Education Association of Zambia's role in national elections.

PubMed

Chakanika, W W; Chuma, P C

1999-08-01

This paper examines the role of the Adult Education Association of Zambia (AEAZ) in the Zambian national elections. Outlined in this paper are workshop topics, challenges encountered, and outcomes of the education campaign by the AEAZ in its crusade to inform voters of their rights and obligations. The six interrelated topics presented at various civic awareness campaigns were leadership qualities; community participation in national development; responsible citizenship; electoral process and the management of elections; the role of a member parliament; and human rights. The primary problem of the AEAZ campaign was language. Although English is preferred in urban areas, most of the residents in the rural areas are illiterate, and the campaign had to be conducted in several local languages, where most of the people were unfamiliar to campaigners. Other challenges affecting the AEAZ outreach efforts were lack of reliable transportation and lack of funds. Despite these challenges, the campaign was successful in encouraging citizens to vote, lobbying, advocacy, and holding political representatives accountable for their actions. This was evident in the 1996 presidential and general elections, in which there was a significant increase in the number of voters who took part in the electoral process. This paper concludes that nongovernmental organizations involved in the sensitization campaigns should coordinate and collaborate in order to enhance their capacity.

Innovative Advances in Connectivity and Community Pharmacist Patient Care Services: Implications for Patient Safety.

PubMed

Bacci, Jennifer L; Berenbrok, Lucas A

2018-06-07

The scope of community pharmacy practice has expanded beyond the provision of drug product to include the provision of patient care services. Likewise, the community pharmacist's approach to patient safety must also expand beyond prevention of errors during medication dispensing to include optimization of medications and prevention of adverse events throughout the entire medication use process. Connectivity to patient data and other healthcare providers has been a longstanding challenge in community pharmacy with implications for the delivery and safety of patient care. Here, we describe three innovative advances in connectivity in community pharmacy practice that enhance patient safety in the provision of community pharmacist patient care services across the entire medication use process. Specifically, we discuss the growing use of immunization information systems, quality improvement platforms, and health information exchanges in community pharmacy practice and their implications for patient safety. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Food and survival in Lusaka's self-help townships.

PubMed

Ledogar, R J

1978-01-01

Zambia, formerly 1 of the more prosperous of developing nations, has fallen on hard times due to political problems of its neighbors and the depressed market price of copper, its main export product and largely the basis for its prosperity. The country is currently (1978) trying to shift its economic base to agriculture -- meaning that surplus crops go to export rather than to the crowded urban areas of Zambia itself (35 to 40% of the population). Zambian squatter settlements, traditionally self-reliant, are the target of a pilot project planned by UNICEF and The American Friends Service Committee, which hopes to encourage this self reliant tradition by expanding the practice of urban agriculture. The project hopes to develop ways to raise the productivity of urban agricultural areas by finding the most suitable crops and creating irrigation so that agriculture can be practised year round. This is the start of a planned "Urban Agriculture and Nutrition Service" to be funded by the above groups, with the Zambian government and, hopefully, other agencies, aimed at providing: 1) Kitchen gardens on residential plots. 2) Cultivation of road reserves, green belts, and other reserved areas throughout the city and on its outskirts. 3) Rainy season cultivation of all idle land in the urban area. 4) Raising of poultry, rabbits and other small livestock on residential and communal plots. 5) Cultivation of small holdings in the urban periphery by low income residents on a cooperative basis. 6) Eventual resettlement of some urban residents on farms in the urban periphery. There will be, in addition, a small-loan fund, 1st for individuals and later for cooperative ventures, and a program to improve technical skills. It is hoped that by 1980, when the pilot project is completed, the service will be self-supporting.

Discovery of African bat polyomaviruses and infrequent recombination in the large T antigen in the Polyomaviridae.

PubMed

Carr, Michael; Gonzalez, Gabriel; Sasaki, Michihito; Ito, Kimihito; Ishii, Akihiro; Hang'ombe, Bernard M; Mweene, Aaron S; Orba, Yasuko; Sawa, Hirofumi

2017-04-01

Bat species represent natural reservoirs for a number of high-consequence human pathogens. The present study investigated the diversity of polyomaviruses (PyVs) in Zambian insectivorous and fruit bat species. We describe the complete genomes from four newly proposed African bat PyV species employing the recently recommended criteria provided by the Polyomaviridae Study Group of the International Committee on Taxonomy of Viruses. A comprehensive phylogenetic and recombination analysis was performed to determine genetic relationships and the distribution of recombination events in PyV from mammalian and avian species. The novel species of PyV from Zambian bats segregated with members of the genera Alphapolyomavirus and Betapolyomavirus, forming monophyletic clades with bat and non-human primate PyVs. Miniopterus schreibersii polyomavirus 1 and 2 segregated in a clade with South American bat PyV species, Old World monkey and chimpanzee PyVs and Human polyomavirus 13 (New Jersey PyV). Interestingly, the newly described Egyptian fruit bat PyV, tentatively named Rousettus aegyptiacus polyomavirus 1, had the highest nucleotide sequence identity to species of PyV from Indonesian fruit bats, and Rhinolophus hildebrandtii polyomavirus 1 was most closely related to New World monkey PyVs. The distribution of recombination events in PyV genomes was non-random: recombination boundaries existed in the intergene region between VP1 and LTAg and also at the 3' end of VP2/3 in the structural genes, whereas infrequent recombination was present within the LTAg gene. These findings indicate that recombination within the LTAg gene has been negatively selected against during polyomaviral evolution and support the recent proposal for taxonomic classification based on LTAg to define novel PyV species.

Exploring SWAp's contribution to the efficient allocation and use of resources in the health sector in Zambia.

PubMed

Chansa, Collins; Sundewall, Jesper; McIntyre, Di; Tomson, Göran; Forsberg, Birger C

2008-07-01

Zambia introduced a sector-wide approach (SWAp) in the health sector in 1993. The goal was to improve efficiency in the use of domestic funds and externally sourced development assistance by integrating these into a joint sectoral framework. Over a decade into its existence, however, the SWAp remains largely unevaluated. This study explores whether the envisaged improvements have been achieved by studying developments in administrative, technical and allocative efficiency in the Zambian health sector from 1990-2006. A case study was conducted using interviews and analysis of secondary data. Respondents represented a cross-section of stakeholders in the Zambian health sector. Secondary data from 1990-2006 were collected for six indicators related to administrative, technical and allocative efficiency. The results showed small improvements in administrative efficiency. Transaction costs still appeared to be high despite the introduction of the SWAp. Indicators for technical efficiency showed a drop in hospital bed utilization rates and government share of funding for drugs. As for allocative efficiency, budget execution did not improve with the SWAp, although there were large variations between both donors and year. Funding levels had apparently improved at district level but declined for hospitals. Finally, the SWAp had not succeeded in bringing all external assistance together under a common framework. Despite strong commitment to implement the SWAp in Zambia, the envisaged efficiency improvements do not seem to have been attained. Possible explanations could be that the SWAp has not been fully developed or that not all parties have completely embraced it. SWAp is not ruled out as a coordination model, but the current setup in Zambia has not proved to be fully effective.

Assessing Zambia's industrial fortification options: getting beyond changes in prevalence and cost-effectiveness.

PubMed

Fiedler, John L; Lividini, Keith; Kabaghe, Gladys; Zulu, Rodah; Tehinse, John; Bermudez, Odilia I; Jallier, Vincent; Guyondet, Christophe

2013-12-01

Background. Since fortification of sugar with vitamin A was mandated in 1998, Zambia's fortification program has not changed, while the country remains plagued by high rates ofmicronutrient deficiencies. Objective. To provide evidence-based fortification options with the hope of reinvigorating the Zambian fortification program. Methods. Zambia's 2006 Living Conditions Monitoring Survey is used to estimate the apparent intakes of vitamin A, iron, and zinc, as well as the apparent consumption levels and coverage of four fortification vehicles. Fourteen alternativefoodfortification portfolios are modeled, and their costs, impacts, average cost-effectiveness, and incremental cost-effectiveness are calculated using three alternative impact measures. Results. Alternative impact measures result in different rank orderings of the portfolios. The most cost-effective portfolio is vegetable oil, which has a cost per disability-adjusted life-year (DALY) saved ranging from 12% to 25% of that of sugar, depending on the impact measure used. The public health impact of fortified vegetable oil, however, is relatively modest. Additional criteria beyond cost-effectiveness are introduced and used to rank order the portfolios. The size of the public health impact, the total cost, and the incremental cost-effectiveness of phasing in multiple vehicle portfolios over time are analyzed. Conclusions. Assessing fortification portfolios by measuring changes in the prevalence of inadequate intakes underestimates impact. A more sensitive measure, which also takes into account change in the Estimated Average Requirement (EAR) gap, is provided by a dose-response-based approach to estimating the number ofDALYs saved. There exist highly cost-effective fortification intervention portfolios with substantial public health impacts and variable price tags that could help improve Zambians' nutrition status.

HIV and Dyadic Intervention: An Interdependence and Communal Coping Analysis

PubMed Central

Montgomery, Catherine M.; Watts, Charlotte; Pool, Robert

2012-01-01

Background The most common form of HIV transmission in sub-Saharan Africa is heterosexual sex between two partners. While most HIV prevention interventions are aimed at the individual, there is mounting evidence of the feasibility, acceptability, and efficacy of dyadic interventions. However, the mechanisms through which dyadic-level interventions achieve success remain little explored. We address this gap by using Lewis et al’s interdependence model of couple communal coping and behaviour change to analyse data from partners participating in an HIV prevention trial in Uganda and Zambia. Methods and Findings We conducted a comparative qualitative study using in-depth interviews. Thirty-three interviews were conducted in total; ten with couples and twenty-three with staff members at the two sites. The Ugandan site recruited a sero-discordant couple cohort and the Zambian site recruited women alone. Spouses’ transformation of motivation is strong where couples are recruited and both partners stand to gain considerably by participating in the research; it is weaker where this is not the case. As such, coping mechanisms differ in the two sites; among sero-discordant couples in Uganda, communal coping is evidenced through joint consent to participate, regular couple counselling and workshops, sharing of HIV test results, and strong spousal support for adherence and retention. By contrast, coping at the Zambian site is predominantly left to the individual woman and occurs against a backdrop of mutual mistrust and male disenfranchisement. We discuss these findings in light of practical and ethical considerations of recruiting couples to HIV research. Conclusions We argue for the need to consider the broader context within which behaviour change occurs and propose that future dyadic research be situated within the framework of the ‘risk environment’. PMID:22808227

Intussusception incidence rates in 9 Zambian hospitals, 2007-2011: prerotavirus vaccine introduction.

PubMed

Mpabalwani, Evans M; Chitambala, Pearson; Chibumbya, Julia N; Matapo, Belem; Mutambo, Helen; Mwenda, Jason M; Babaniyi, Olusegun; Munkonge, Lupando

2014-01-01

Intussusception, a rare adverse event associated with rotavirus vaccines in some settings, is a common cause of intestinal obstruction in infants and toddlers globally with a peak age of 4-6 months. This age group may overlap with the extended age of administering rotavirus vaccine. A retrospective (January 2007 to June 2009) and prospective (July 2009 to June 2012) survey was conducted in 9 Zambian hospitals. Children between 0 and 24 months who were operated on for intestinal obstruction/intussusception were identified in theatre log books. In the latter part of the survey, patients were recruited prospectively. Demographic, clinical and surgical data from hospital files were collected for each patient. One-hundred and five children were identified to have undergone surgery for intussusceptions. Many were boys 57.6% (57/99). Of those with complete data, intussusception was common in infants 86.9% (86/99) and many children (68.0%) were between 3 and 8 months of age with a peak age of 5-6 months. Lusaka had the highest number of children with intussusception with an estimated annual incidence rate of 12/100,000 in children <2 years of age. The overall case fatality rate was very high 33.7% (31/92). Intussusception was common in infants with a peak age of 5-6 months, and of particular concern is the group of 2-4 months the age of rotavirus vaccination. The estimated incidence rate of 12/100,000 is an underestimate as many cases may not present for care. The high case fatality rate of 33.7% is due to both delayed presentation and diagnosis in hospital.

The sensitivity of the QuantiFERON®-TB Gold Plus assay in Zambian adults with active tuberculosis

PubMed Central

Amofa-Sekyi, M.; Maluzi, K.; Kaluba-Milimo, D.; Cheeba-Lengwe, M.; Chiwele, K.; Kosloff, B.; Floyd, S.; Bailey, S-L.; Ayles, H.

2017-01-01

SUMMARY SETTING AND OBJECTIVE: To investigate the sensitivity of the new interferon-gamma release assay (IGRA), QuantiFERON®-TB Gold Plus (QFT-Plus), for active TB (used as a surrogate for latent tuberculous infection) in a Zambian TB clinic. DESIGN: Consecutive smear or Xpert® MTB/RIF-positive adult (age ⩾18 years) pulmonary TB patients were recruited between June 2015 and March 2016. Venous blood was tested using QFT-Plus. The sensitivity was defined as the number positive divided by the total number tested. Using logistic regression, factors associated with positive QFT-Plus results were explored. RESULTS: Of 108 patients (median age 32 years, interquartile range 27–38; 73% male; 63% human immunodeficiency virus [HIV] positive), 90 were QFT-Plus-positive, 11 were negative and seven had indeterminate results; sensitivity was 83% (95%CI 75–90). There was no difference in sensitivity by HIV status (HIV-positive 85%, 95%CI 75–93; n = 68 vs. HIV-negative 80%, 95%CI 64–91; n = 40; P = 0.59). In models adjusted for age alone, CD4 cell count <100 cells/μl (OR 0.15, 95%CI 0.02–0.96; P=0.05) and body mass index <18.5 kg/m2 (OR 0.27, 95%CI 0.08–0.91; P = 0.02) were associated with decreased odds of positive QFT-Plus results. CONCLUSION: Overall, the sensitivity of QFT-Plus is similar to that of the tuberculin skin test and other IGRAs. While overall sensitivity is not affected by HIV status, QFT-Plus sensitivity was lower among people living with HIV/acquired immune-deficiency syndrome with severe immunosuppression. PMID:28482964

Zambian pre-service junior high school science teachers' chemical reasoning and ability

NASA Astrophysics Data System (ADS)

Banda, Asiana

The purpose of this study was two-fold: examine junior high school pre-service science teachers' chemical reasoning; and establish the extent to which the pre-service science teachers' chemical abilities explain their chemical reasoning. A sample comprised 165 junior high school pre-service science teachers at Mufulira College of Education in Zambia. There were 82 males and 83 females. Data were collected using a Chemical Concept Reasoning Test (CCRT). Pre-service science teachers' chemical reasoning was established through qualitative analysis of their responses to test items. The Rasch Model was used to determine the pre-service teachers' chemical abilities and item difficulty. Results show that most pre-service science teachers had incorrect chemical reasoning on chemical concepts assessed in this study. There was no significant difference in chemical understanding between the Full-Time and Distance Education pre-service science teachers, and between second and third year pre-service science teachers. However, there was a significant difference in chemical understanding between male and female pre-service science teachers. Male pre-service science teachers showed better chemical understanding than female pre-service science teachers. The Rasch model revealed that the pre-service science teachers had low chemical abilities, and the CCRT was very difficult for this group of pre-service science teachers. As such, their incorrect chemical reasoning was attributed to their low chemical abilities. These results have implications on science teacher education, chemistry teaching and learning, and chemical education research.

The implications of community responses to intimate partner violence in Rwanda

PubMed Central

Seyed-Raeisy, Iran; Burgess, Rochelle; Campbell, Catherine

2018-01-01

Intimate partner violence (IPV) has significant impacts on mental health. Community-focused interventions have shown promising results for addressing IPV in low-income countries, however, little is known about the implications of these interventions for women’s mental wellbeing. This paper analyses data from a community-focused policy intervention in Rwanda collected in 2013–14, including focus group discussions and in-depth interviews with community members (n = 59). Our findings point to three ways in which these community members responded to IPV: (1) reconciling couples experiencing violence, (2) engaging community support through raising cases of IPV during community discussions, (3) navigating resources for women experiencing IPV, including police, social services and legal support. These community responses support women experiencing violence by helping them access available resources and by engaging in community discussions. However, assistance is largely only offered to married women and responses tend to focus exclusively on physical rather than psychological or emotional forms of violence. Drawing on Campbell and Burgess’s (2012) framework for ‘community mental health competence’, we interrogate the potential implications of these responses for the mental wellbeing of women affected by violence. We conclude by drawing attention to the gendered nature of community responses to IPV and the potential impacts this may have for the mental health of women experiencing IPV. PMID:29718961

The implications of community responses to intimate partner violence in Rwanda.

PubMed

Mannell, Jenevieve; Seyed-Raeisy, Iran; Burgess, Rochelle; Campbell, Catherine

2018-01-01

Intimate partner violence (IPV) has significant impacts on mental health. Community-focused interventions have shown promising results for addressing IPV in low-income countries, however, little is known about the implications of these interventions for women's mental wellbeing. This paper analyses data from a community-focused policy intervention in Rwanda collected in 2013-14, including focus group discussions and in-depth interviews with community members (n = 59). Our findings point to three ways in which these community members responded to IPV: (1) reconciling couples experiencing violence, (2) engaging community support through raising cases of IPV during community discussions, (3) navigating resources for women experiencing IPV, including police, social services and legal support. These community responses support women experiencing violence by helping them access available resources and by engaging in community discussions. However, assistance is largely only offered to married women and responses tend to focus exclusively on physical rather than psychological or emotional forms of violence. Drawing on Campbell and Burgess's (2012) framework for 'community mental health competence', we interrogate the potential implications of these responses for the mental wellbeing of women affected by violence. We conclude by drawing attention to the gendered nature of community responses to IPV and the potential impacts this may have for the mental health of women experiencing IPV.

Power and action in critical theory across disciplines: implications for critical community psychology.

PubMed

Davidson, Heather; Evans, Scot; Ganote, Cynthia; Henrickson, Jorie; Jacobs-Priebe, Lynette; Jones, Diana L; Prilleltensky, Isaac; Riemer, Manuel

2006-09-01

Although critical scholarship and community psychology share similar aspirations, the links between them remain unexplored and under-theorized. In this article we explore the implications of critical scholarship in various specialties for the field of community psychology. To understand the contributions of critical scholarship to a theory of power and action for social change, we conducted a systematic analysis of a ten-year period of publications in seven journals associated with the critical scholarship tradition. We created precise criteria for the concepts of power and action and applied them to the publications. Results indicate an interesting paradox at play. Whereas community psychology is more action oriented than critical scholarship, its actions fall short of challenging institutionalized power structures and the status quo; and whereas critical scholarship is more challenging of the status quo than community psychology in theory, it has failed to produce viable actions that challenge the status quo. We discuss the implications of this state of affairs for the development of a more critical community psychology.

The relationship between secondhand smoke exposure, pro-tobacco social influences, and smoking susceptibility among nonsmoking Zambian adolescents.

PubMed

Agaku, Israel Terungwa; Maliselo, Tino; Ayo-Yusuf, Olalekan A

2015-02-01

We tested the hypothesis that the extent of secondhand smoke (SHS) exposure among nonsmoking adolescents would be associated with their overall exposure to pro-tobacco social influences. Data were analyzed using descriptive and multivariate methods from the 2011 Zambia Global Youth Tobacco Survey. The odds of SHS exposure increased with increasing exposure to pro-tobacco advertisements. About 39.5% of the gap in SHS exposure between nonsmokers with low versus high smoking susceptibility was attributable to differences in parental or peer smoking. Sustained efforts are needed to denormalize tobacco use in order to reduce youth susceptibility to tobacco use.

Monitoring, characterization and control of chronic, symptomatic malaria infections in rural Zambia through monthly household visits by paid community health workers

PubMed Central

2014-01-01

Background Active, population-wide mass screening and treatment (MSAT) for chronic Plasmodium falciparum carriage to eliminate infectious reservoirs of malaria transmission have proven difficult to apply on large national scales through trained clinicians from central health authorities. Methodology Fourteen population clusters of approximately 1,000 residents centred around health facilities (HF) in two rural Zambian districts were each provided with three modestly remunerated community health workers (CHWs) conducting active monthly household visits to screen and treat all consenting residents for malaria infection with rapid diagnostic tests (RDT). Both CHWs and HFs also conducted passive case detection among residents who self-reported for screening and treatment. Results Diagnostic positivity was higher among symptomatic patients self-reporting to CHWs (42.5%) and HFs (24%) than actively screened residents (20.3%), but spatial and temporal variations of diagnostic positivity were highly consistent across all three systems. However, most malaria infections (55.6%) were identified through active home visits by CHWs rather than self-reporting to CHWs or HFs. Most (62%) malaria infections detected actively by CHWs reported one or more symptoms of illness. Most reports of fever and vomiting, plus more than a quarter of history of fever, headache and diarrhoea, were attributable to malaria infection. The minority of residents who participated >12 times had lower rates of malaria infection and associated symptoms in later contacts but most residents were tested <4 times and high malaria diagnostic positivity (32%) in active surveys, as well as incidence (1.7 detected infections per person per year) persisted in the population. Per capita cost for active service delivery by CHWs was US$5.14 but this would rise to US$10.68 with full community compliance with monthly testing at current levels of transmission, and US$6.25 if pre-elimination transmission levels and negligible treatment costs were achieved. Conclusion Monthly active home visits by CHWs equipped with RDTs were insufficient to eliminate the human infection reservoir in this typical African setting, despite reasonably high LLIN/IRS coverage. However, dramatic impact upon infection and morbidity burden might be attainable and cost-effective if community participation in regular testing could be improved and the substantial, but not necessarily prohibitive, costs are affordable to national programmes. PMID:24678631

Electronically Distributed Work Communities: Implications for Research on Telework.

ERIC Educational Resources Information Center

Hesse, Bradford W.; Grantham, Charles E.

1991-01-01

Describes the concept of telework, or telecommuting, and its influence on the electronic community and organizational structures. The electronically distributed organization is discussed, and implications for research on telework are suggested in the areas of privacy regulation, self-efficacy, temporal aspects of employee behavior, communication…

An outline of the need for psychology knowledge in health professionals: implications for community development and breast cancer prevention.

PubMed

Ahmadian, Maryam; Samah, Asnarulkhadi Abu; Saidu, Mohammed Bashir

2014-01-01

Knowledge of health and community psychology in health professionals influences psychosocial and community determinants of health and promoting participation in disease prevention at the community level. This paper appraises the potential of knowledge on psychology in health care professionals and its contribution to community empowerment through individual behavior change and health practice. The authors proposed a schematic model for the use of psychological knowledge in health professionals to promote participation in health interventions/disease prevention programs in developing countries. By implication, the paper provides a vision on policies towards supporting breast cancer secondary prevention efforts for community health development in Asian countries.

The Impact of Community Violence on School-Based Research.

PubMed

Velsor-Friedrich, Barbara; Richards, Maryse; Militello, Lisa K; Dean, Kyle C; Scott, Darrick; Gross, Israel M; Romeo, Edna

2015-12-01

Research conducted on youth exposure to violence has generally focused on documenting the prevalence of community violence and its emotional and behavioral implications. However, there is a dearth of information related to the impact of violence on the implementation and evaluation of community and school-based programs. This commentary examines the impact of community violence on a school-based research program. It is also a brief summary of the detrimental effects of exposure to community violence on psychological and academic functioning and health outcomes. An example of the impact of community violence on the implementation of a school-based asthma program will be addressed. Implications for school nurses will be discussed. © The Author(s) 2015.

Psychological and behavioral implications of connectedness to communities with opposing values and beliefs

PubMed Central

Mashek, Debra; Stuewig, Jeffrey; Furukawa, Emi; Tangney, June

2011-01-01

Without a doubt, people can feel simultaneously connected to multiple communities (e.g., Deaux, 1993; Roccas & Brewer, 2002). But, to what degree can people feel simultaneously connected to communities with opposing beliefs and values? And, more importantly, what are the psychological implications of being dually connected to these communities? Capitalizing on a sample of individuals positioned to potentially feel connected to two very distinct communities, we examined jail inmates’ (N = 256) sense of connectedness to the criminal community and to the community at large. Results indicated that (a) connectedness to the community at large is orthogonal to connectedness to the criminal community, supporting the supposition that it is possible to be dually connected to opposing communities; and (b) connectedness to the community at large moderated the relationship between criminal connectedness and indicators of psychological distress, suggesting that connectedness to the criminal community is especially problematic when it occurs in tandem with connectedness to the community at large. These findings are consistent with predictions from the self-expansion model. PMID:21532983

Issues in the design of a clinical trial with a behavioral intervention--the Zambia exclusive breast-feeding study.

PubMed

Thea, Donald M; Vwalika, Cheswa; Kasonde, Prisca; Kankasa, Chipepo; Sinkala, Moses; Semrau, Katherine; Shutes, Erin; Ayash, Christine; Tsai, Wei-Yann; Aldrovandi, Grace; Kuhn, Louise

2004-08-01

We present the rationale and design of the Zambian Exclusive Breast-feeding Study (ZEBS), a randomized trial evaluating the efficacy of short-duration exclusive breast-feeding (EBF) as a strategy to reduce postnatal human immunodeficiency virus (HIV) transmission while preserving the other health benefits of this important mode of infant feeding. One thousand two hundred HIV-positive pregnant women were recruited in Lusaka, Zambia, and followed with their infants for 24 months. In addition to Nevirapine (NVP), all women received intensive and frequent clinic- and home-based counseling to support exclusive breast-feeding. When the infant was 1 week of age, half of the women were randomly assigned to a group encouraged to abruptly (<24 h) cease all breast-feeding at 4 months. The primary outcome of the experimental (randomized) comparison is HIV-free survival at 24 months. The design is also observational and will compare HIV transmission rates between those who do and do not adhere to the counseling intervention promoting exclusive breast-feeding. Our study aims to quantify the benefit-risk ratio of early cessation of exclusive breast-feeding to interrupt mother-to-child transmission of HIV with an intensive behavioral intervention and has both observational and experimental analytic approaches. Our study design assesses efficacy and also has a prominent applied component that if the intervention is effective, it will permit rapid and sustainable adoption within low-resource communities.

Stages of Change for Voluntary Medical Male Circumcision and Sexual Risk Behavior in Uncircumcised Zambian Men: The Spear and Shield Project.

PubMed

Redding, Colleen A; Jones, Deborah; Zulu, Robert; Chitalu, Ndashi; Cook, Ryan; Weiss, Stephen M

2015-12-01

Dissemination and scale up of voluntary medical male circumcision (VMMC) programs is well supported by evidence that VMMC reduces HIV risk in populations with high HIV prevalence and low rates of circumcision, as is the case in Zambia. At both individual and population levels, it is important to understand what stages of change for VMMC are associated with, especially across cultures. This study evaluated VMMC knowledge, misinformation, and stages of change for VMMC of uncircumcised men and boys (over 18 years), as well as the concurrent relationship between VMMC stages of change and sexual risk behaviors. Uncircumcised (N = 800) adult men and boys (over 18) were screened and recruited from urban community health centers in Lusaka, Zambia, where they then completed baseline surveys assessing knowledge, attitudes, HIV risk behaviors, and stages of change for VMMC. A series of analyses explored cross-sectional relationships among these variables. VMMC was culturally acceptable in half of the sample; younger, unmarried, and more educated men were more ready to undergo VMMC. Stage of change for VMMC was also related to knowledge, and those at greater HIV risk reported greater readiness to undergo VMMC. Efforts to increase VMMC uptake should address the role of perceived HIV risk, risk behaviors, readiness, accurate knowledge, cultural acceptance, and understanding of the significant degree of HIV protection conferred as part of the VMMC decision making process. These results support incorporating comprehensive HIV risk reduction in VMMC promotion programs.

Mental illness--stigma and discrimination in Zambia.

PubMed

Kapungwe, A; Cooper, S; Mwanza, J; Mwape, L; Sikwese, A; Kakuma, R; Lund, C; Flisher, A J

2010-07-01

The aim of this qualitative study was to explore the presence, causes and means of addressing individual and systemic stigma and discrimination against people with mental illness in Zambia. This is to facilitate the development of tailor-made antistigma initiatives that are culturally sensitive for Zambia and other low-income African countries. This is the first in-depth study on mental illness stigma in Zambia. Fifty semi-structured interviews and 6 focus group discussions were conducted with key stakeholders drawn from 3 districts in Zambia (Lusaka, Kabwe and Sinazongwe). Transcripts were analyzed using a grounded theory approach. Mental illness stigma and discrimination is pervasive across Zambian society, prevailing within the general community, amongst family members, amid general and mental health care providers, and at the level of government. Such stigma appears to be fuelled by misunderstandings of mental illness aetiology; fears of contagion and the perceived dangerousness of people with mental illness; and associations between HIV/AIDS and mental illness. Strategies suggested for reducing stigma and discrimination in Zambia included education campaigns, the transformation of mental health policy and legislation and expanding the social and economic opportunities of the mentally ill. In Zambia, as in many other low-income African countries, very little attention is devoted to addressing the negative beliefs and behaviours surrounding mental illness, despite the devastating costs that ensue. The results from this study underscore the need for greater commitment from governments and policy-makers in African countries to start prioritizing mental illness stigma as a major public health and development issue.

Ideology and community social psychology: theoretical considerations and practical implications.

PubMed

Montenegro, Marisela

2002-08-01

This paper addresses the importance of the concept of ideology in community work. The implications of a Marxist approach to ideology in community practice are analyzed in terms of the concepts of problematization (P. Freire, 1979) and consciousness-raising (J. Barreiro, 1976), illustrating the point with some examples. The traditional Marxist perspective is also examined in relation to the perspectives of social constructionism (I. Ibáñez, 1996), cultural studies (A. McRobbie, 1992), post-Marxism (E. Laclau & C. Mouffe, 1985), and feminism (D. Haraway, 1991). It is argued that the concepts of hegemony and habitus (P. Bourdieu, 1985) can be useful to community social psychology theory and practice. A "situated perspective"--in which it is possible to dialogue from different "subject positions," and articulate transformation and political action--is argued. The implications of this shifting in the concept of ideology by means of theoretical developments outside social communitypsychology can help to define the external (outside) agent's position in community practice.

Successful Community Development Strategies.

ERIC Educational Resources Information Center

Johnson, Thomas G.

This paper sketches several successful community economic development programs that have implications for rural education. Case studies are used to discuss community characteristics that contribute to development success. In Virginia, a Community Certification Program offers statewide business recruitment services to communities that meet program…

The Dual Labor Market Theory: Implications for the Community College.

ERIC Educational Resources Information Center

Nation, William C.

This paper reviews existing manpower training programs in light of the dual labor market theory, and discusses the implications for community colleges in addressing the needs of the unemployed within their service areas. The dual labor market theory postulates that there are two distinct spheres of employment: a primary labor market in which…

Sexual Satisfaction, Performance, and Partner Response Following Voluntary Medical Male Circumcision in Zambia: The Spear and Shield Project.

PubMed

Zulu, Robert; Jones, Deborah; Chitalu, Ndashi; Cook, Ryan; Weiss, Stephen

2015-12-01

Voluntary medical male circumcision (VMMC) is an important HIV prevention strategy, particularly in regions with high HIV incidence and low rates of male circumcision. However, 88% of the Zambian male population remain uncircumcised, and of these 80% of men surveyed expressed little interest in undergoing VMMC. The Spear and Shield study (consisting of 4 weekly, 90-minute sexual risk reduction/VMMC promotion sessions) recruited and enrolled men (N = 800) who self-identified as at risk of HIV by seeking HIV testing and counseling at community health centers. Eligible men tested HIV-negative, were uncircumcised, and expressed no interest in VMMC. Participants were encouraged (but not required) to invite their female partners (N = 668) to participate in the program in a gender-concordant intervention matched to their partners'. Men completed assessments at baseline, post-intervention (about 2 months after baseline), and 6 and 12 months post-intervention; women completed assessments at baseline and post-intervention. For those men who underwent VMMC and for their partners, an additional assessment was conducted 3 months following the VMMC. The ancillary analysis in this article compared the pre- and post-VMMC responses of the 257 Zambian men who underwent circumcision during or following study participation, using growth curve analyses, as well as of the 159 female partners. Men were satisfied overall with the procedure (mean satisfaction score, 8.4 out of 10), and nearly all men (96%) and women (94%) stated they would recommend VMMC to others. Approximately half of the men reported an increase or no change in erections, orgasms, and time to achieve orgasms from pre-VMMC, while one-third indicated fewer erections and orgasms and decreased time to achieve orgasms post-VMMC. Nearly half (42%) of the men, and a greater proportion (63%) of the female partners, said their sexual pleasure increased while 22% of the men reported less sexual pleasure post-VMMC. Growth curve analysis of changes in sexual functioning and satisfaction over time revealed no changes in erectile functioning or intercourse satisfaction, but there were increases in orgasm functioning, overall sexual satisfaction, and sexual desire. The majority (61% to 70%) of men and women thought penile cleanliness and appearance had improved post-VMMC. Of the 69% of men who reported having sexual intercourse at least once between having the procedure and their 3-month post-VMMC assessment, the large majority (76%) waited at least 6 weeks before resuming sex. Sexual intercourse prior to the 6-week healing period was associated with adverse events and lower levels of post-VMMC sexual satisfaction. Both men and their partners can generally expect equal or improved sexual satisfaction and penile hygiene following VMMC. Future studies should consider innovative strategies to assist men in their efforts to abstain from sexual activities prior to complete healing. © Zulu et al.

Sexual Satisfaction, Performance, and Partner Response Following Voluntary Medical Male Circumcision in Zambia: The Spear and Shield Project

PubMed Central

Zulu, Robert; Jones, Deborah; Chitalu, Ndashi; Cook, Ryan; Weiss, Stephen

2015-01-01

Background: Voluntary medical male circumcision (VMMC) is an important HIV prevention strategy, particularly in regions with high HIV incidence and low rates of male circumcision. However, 88% of the Zambian male population remain uncircumcised, and of these 80% of men surveyed expressed little interest in undergoing VMMC. Methods: The Spear and Shield study (consisting of 4 weekly, 90-minute sexual risk reduction/VMMC promotion sessions) recruited and enrolled men (N = 800) who self-identified as at risk of HIV by seeking HIV testing and counseling at community health centers. Eligible men tested HIV-negative, were uncircumcised, and expressed no interest in VMMC. Participants were encouraged (but not required) to invite their female partners (N = 668) to participate in the program in a gender-concordant intervention matched to their partners’. Men completed assessments at baseline, post-intervention (about 2 months after baseline), and 6 and 12 months post-intervention; women completed assessments at baseline and post-intervention. For those men who underwent VMMC and for their partners, an additional assessment was conducted 3 months following the VMMC. The ancillary analysis in this article compared the pre- and post-VMMC responses of the 257 Zambian men who underwent circumcision during or following study participation, using growth curve analyses, as well as of the 159 female partners. Results: Men were satisfied overall with the procedure (mean satisfaction score, 8.4 out of 10), and nearly all men (96%) and women (94%) stated they would recommend VMMC to others. Approximately half of the men reported an increase or no change in erections, orgasms, and time to achieve orgasms from pre-VMMC, while one-third indicated fewer erections and orgasms and decreased time to achieve orgasms post-VMMC. Nearly half (42%) of the men, and a greater proportion (63%) of the female partners, said their sexual pleasure increased while 22% of the men reported less sexual pleasure post-VMMC. Growth curve analysis of changes in sexual functioning and satisfaction over time revealed no changes in erectile functioning or intercourse satisfaction, but there were increases in orgasm functioning, overall sexual satisfaction, and sexual desire. The majority (61% to 70%) of men and women thought penile cleanliness and appearance had improved post-VMMC. Of the 69% of men who reported having sexual intercourse at least once between having the procedure and their 3-month post-VMMC assessment, the large majority (76%) waited at least 6 weeks before resuming sex. Sexual intercourse prior to the 6-week healing period was associated with adverse events and lower levels of post-VMMC sexual satisfaction. Conclusion: Both men and their partners can generally expect equal or improved sexual satisfaction and penile hygiene following VMMC. Future studies should consider innovative strategies to assist men in their efforts to abstain from sexual activities prior to complete healing. PMID:26681707

Conceptualising the 'community' as a recipient of money--A critical literature review, and implications for health and inequalities.

PubMed

Reynolds, Joanna; Egan, Matt; Renedo, Alicia; Petticrew, Mark

2015-10-01

There is increasing attention on how money may bring about positive changes to health, and money-based development approaches are becoming more commonplace at the 'community' level, including in high-income countries. However, little attention has been paid to how the 'community' might be varyingly conceptualised in these scenarios, or to the potential implications of this for interpreting the impacts of such health improvement approaches. This paper presents a critical interpretive review of literature presenting different scenarios from high-income countries in which the 'community' receives money, to explore how 'community' is conceptualised in relation to this process. Some texts gave explicit definitions of 'community', but multiple other conceptualisations were interpreted across all texts, conveyed through the construction of 'problematics', and descriptions of how and why money was given. The findings indicate that the flow of money shapes how conceptualisations of 'community' are produced, and that the implicit power relations and inequalities can construct and privilege particular sets of identities and relationships throughout the process. This highlights implications for approaching public health evaluations of giving money to 'communities', and for better understanding how it might bring about change to health and inequalities, where the 'community' cannot be interpreted merely as a setting or recipient of such an intervention, but something constructed and negotiated through the flow of money itself. Copyright © 2015 Elsevier Ltd. All rights reserved.

Paradigm Shifters, Professionals and Community Sentinels: Immigrant Community Institutions’ Roles in Shaping Places and Implications for Stigmatized Public Health Initiatives

PubMed Central

Chin, John J.; Neilands, Torsten B.; Weiss, Linda; Mantell, Joanne E.

2008-01-01

Immigrant community institutions are strategically positioned to facilitate or impede public health efforts in their neighborhoods and communities because of their influence over discourse regarding values and tradition. Their authority may be particularly relevant when stigmatized or sensitive issues, such as HIV or reproductive health, are addressed. Using qualitative and quantitative methods to analyze data collected from 22 Chinese and South Asian immigrant institutions in New York City, we examine attitudes about HIV, social change and tradition to delineate the different structural roles that Asian immigrant community institutions play in relation to the preservation of traditional values and culture in their neighborhoods and communities. Implications are explored for working with immigrant community institutions to conduct HIV-related work and other stigmatized public health initiatives in immigrant neighborhoods. PMID:18321761

The economic value of an improved malaria treatment programme in Zambia: results from a contingent valuation survey.

PubMed

Masiye, Felix; Rehnberg, Clas

2005-12-15

Zambia is facing a double crisis of increasing malaria burden and dwindling capacity to deal with the endemic malaria burden. The pursuit of sustainable but equity mechanisms for financing malaria programmes is a subject of crucial policy discussion. This requires that comprehensive accounting of the economic impact of the various malaria programmes. Information on the economic value of programmes is essential in soliciting appropriate funding allocations for malaria control. This paper specifically seeks to elicit a measure of the economic benefits of an improved malaria treatment programme in Zambia. The paper also studies the equity implications in malaria treatment given that demand or malaria treatment is determined by household socio-economic status. A contingent valuation survey of about 300 Zambian households was conducted in four districts. Willingness-to-pay (WTP) was elicited for an improved treatment programme for malaria in order to generate a measure of the economic benefits of the programme. The payment card method was used in eliciting WTP bids. The study reports that malaria treatment has significant economic benefits to society. The total economic benefits of an improved treatment programme were estimated at an equivalent of USD 77 million per annum, representing about 1.8% of Zambia's GDP. The study also reports the theoretically anticipated association between WTP and several socio-economic factors. Our income elasticity of demand is positive and similar in magnitude to estimates reported in similar studies. Finally, from an equity standpoint, the constraints imposed by income and socio-economic status are discussed.

The economic value of an improved malaria treatment programme in Zambia: results from a contingent valuation survey

PubMed Central

Masiye, Felix; Rehnberg, Clas

2005-01-01

Background Zambia is facing a double crisis of increasing malaria burden and dwindling capacity to deal with the endemic malaria burden. The pursuit of sustainable but equity mechanisms for financing malaria programmes is a subject of crucial policy discussion. This requires that comprehensive accounting of the economic impact of the various malaria programmes. Information on the economic value of programmes is essential in soliciting appropriate funding allocations for malaria control. Aims and objectives This paper specifically seeks to elicit a measure of the economic benefits of an improved malaria treatment programme in Zambia. The paper also studies the equity implications in malaria treatment given that demand or malaria treatment is determined by household socio-economic status. Methods A contingent valuation survey of about 300 Zambian households was conducted in four districts. Willingness-to-pay (WTP) was elicited for an improved treatment programme for malaria in order to generate a measure of the economic benefits of the programme. The payment card method was used in eliciting WTP bids. Findings The study reports that malaria treatment has significant economic benefits to society. The total economic benefits of an improved treatment programme were estimated at an equivalent of US$ 77 million per annum, representing about 1.8% of Zambia's GDP. The study also reports the theoretically anticipated association between WTP and several socio-economic factors. Our income elasticity of demand is positive and similar in magnitude to estimates reported in similar studies. Finally, from an equity standpoint, the constraints imposed by income and socio-economic status are discussed. PMID:16356176

Human milk galectin-3 binding protein and breast-feeding-associated HIV transmission.

PubMed

Chan, Christina S; Kim, Hae-Young; Autran, Chloe; Kim, Jae H; Sinkala, Moses; Kankasa, Chipepo; Mwiya, Mwiya; Thea, Donald M; Aldrovandi, Grace M; Kuhn, Louise; Bode, Lars

2013-12-01

Analysis of milk from 247 HIV-infected Zambian mothers showed that galectin-3 binding protein concentrations were significantly higher among HIV-infected mothers who transmitted HIV through breast-feeding (6.51 ± 2.12 μg/mL) than among nontransmitters but were also correlated with higher milk and plasma HIV RNA copies/mL and lower CD4+ cell counts. The association between galectin-3 binding protein and postnatal transmission was attenuated after adjustment for milk and plasma HIV load and CD4+ cell counts. This suggests that although milk galectin-3 binding protein is a marker of advanced maternal disease, it does not independently modify transmission risk.

Volunteering for College? Potential Implications of Financial Aid Tax Credits Rewarding Community Service

ERIC Educational Resources Information Center

Wells, Ryan S.; Lynch, Cassie M.

2014-01-01

President Obama has proposed a financial aid policy whereby students who complete 100 hours of community service would receive a tax credit of US$4,000 for college. After lawmakers cut this proposal from previous legislation, the administration was tasked with studying the feasibility of implementation. However, the implications of the policy for…

Los Angeles in an Era of Welfare Reform: Implications for Poor People and Community Well-being.

ERIC Educational Resources Information Center

Wolch, Jennifer; Sommer, Heidi

This report, framed by the region's foremost experts on poverty, is the first comprehensive and scientifically rigorous analysis of the implications of welfare reform for the people and communities of Los Angeles (California). Direct and indirect impacts are considered. It is concluded that the number of welfare recipients in Los Angeles likely to…

An Investigation Examining the Perceived Implications of Principal Leadership Changing a Large Comprehensive High School into Smaller Learning Communities

ERIC Educational Resources Information Center

Miller, Raymond J.

2012-01-01

The purpose of this qualitative case study was to examine the perceived implications that principal leadership has on transforming a large comprehensive high school into smaller learning communities (SLCs); and to speculate on possible factors that contribute to the change process after the implementation of SLCs. The study explores the roles,…

Unravelling the quality of HIV counselling and testing services in the private and public sectors in Zambia

PubMed Central

Ron Levey, Ilana; Wang, Wenjuan

2014-01-01

Background Despite the substantial investment for providing HIV counselling and testing (VCT) services in Zambia, there has been little effort to systematically evaluate the quality of VCT services provided by various types of health providers. This study, conducted in 2009, examines VCT in the public and private sectors including private for-profit and NGO/faith-based sectors in Copperbelt and Luapula. Methods The study used five primary data collection methods to gauge quality of VCT services: closed-ended client interviews with clients exiting VCT sites; open-ended client interviews; interviews with facility managers; review of service statistics; and an observation of the physical environment for VCT by site. Over 400 clients and 87 facility managers were interviewed from almost 90 facilities. Sites were randomly selected and results are generalizable at the provincial level. Results The study shows concerning levels of underperformance in VCT services across the sectors. It reveals serious underperformance in counselling about key risk-reduction methods. Less than one-third of clients received counselling on reducing number of sexual partners and only approximately 5% of clients received counselling about disclosing test results to partners. In terms of client profiles, the NGO sector attracts the most educated clients and less educated Zambians seek VCT services at very low rates (7%). The private for-profit performs equally or sometimes better than other sectors even though this sector is not adequately integrated into the Zambian national response to HIV. Conclusion The private for-profit sector provides VCT services on par in quality with the other sectors. Most clients did not receive counselling on partner reduction or disclosure of HIV test results to partners. In a generalized HIV epidemic where multiple concurrent sexual partners are a significant problem for transmitting the disease, risk-reduction methods and discussion should be a main focus of pre-test and post-test counselling. PMID:25012796

Unravelling the quality of HIV counselling and testing services in the private and public sectors in Zambia.

PubMed

Ron Levey, Ilana; Wang, Wenjuan

2014-07-01

Despite the substantial investment for providing HIV counselling and testing (VCT) services in Zambia, there has been little effort to systematically evaluate the quality of VCT services provided by various types of health providers. This study, conducted in 2009, examines VCT in the public and private sectors including private for-profit and NGO/faith-based sectors in Copperbelt and Luapula. The study used five primary data collection methods to gauge quality of VCT services: closed-ended client interviews with clients exiting VCT sites; open-ended client interviews; interviews with facility managers; review of service statistics; and an observation of the physical environment for VCT by site. Over 400 clients and 87 facility managers were interviewed from almost 90 facilities. Sites were randomly selected and results are generalizable at the provincial level. The study shows concerning levels of underperformance in VCT services across the sectors. It reveals serious underperformance in counselling about key risk-reduction methods. Less than one-third of clients received counselling on reducing number of sexual partners and only approximately 5% of clients received counselling about disclosing test results to partners. In terms of client profiles, the NGO sector attracts the most educated clients and less educated Zambians seek VCT services at very low rates (7%). The private for-profit performs equally or sometimes better than other sectors even though this sector is not adequately integrated into the Zambian national response to HIV. The private for-profit sector provides VCT services on par in quality with the other sectors. Most clients did not receive counselling on partner reduction or disclosure of HIV test results to partners. In a generalized HIV epidemic where multiple concurrent sexual partners are a significant problem for transmitting the disease, risk-reduction methods and discussion should be a main focus of pre-test and post-test counselling. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

Understanding the dynamic interactions driving Zambian health centre performance: a case-based health systems analysis

PubMed Central

Topp, Stephanie M; Chipukuma, Julien M; Hanefeld, Johanna

2015-01-01

Background Despite being central to achieving improved population health outcomes, primary health centres in low- and middle-income settings continue to underperform. Little research exists to adequately explain how and why this is the case. This study aimed to test the relevance and usefulness of an adapted conceptual framework for improving our understanding of the mechanisms and causal pathways influencing primary health centre performance. Methods A theory-driven, case-study approach was adopted. Four Zambian health centres were purposefully selected with case data including health-care worker interviews (n = 60); patient interviews (n = 180); direct observation of facility operations (2 weeks/centre) and key informant interviews (n = 14). Data were analysed to understand how the performance of each site was influenced by the dynamic interactions between system ‘hardware’ and ‘software’ acting on mechanisms of accountability. Findings Structural constraints including limited resources created challenging service environments in which work overload and stockouts were common. Health workers’ frustration with such conditions interacted with dissatisfaction with salary levels eroding service values and acting as a catalyst for different forms of absenteeism. Such behaviours exacerbated patient–provider ratios and increased the frequency of clinical and administrative shortcuts. Weak health information systems and lack of performance data undermined providers’ answerability to their employer and clients, and a lack of effective sanctions undermined supervisors’ ability to hold providers accountable for these transgressions. Weak answerability and enforceability contributed to a culture of impunity that masked and condoned weak service performance in all four sites. Conclusions Health centre performance is influenced by mechanisms of accountability, which are in turn shaped by dynamic interactions between system hardware and system software. Our findings confirm the usefulness of combining Sheikh et al.’s (2011) hardware–software model with Brinkerhoff’s (2004) typology of accountability to better understand how and why health centre micro-systems perform (or under-perform) under certain conditions. PMID:24829316

Surviving the impact of HIV-related illness in the Zambian business sector.

PubMed

Guinness, Lorna; Walker, Damian; Ndubani, Phillimon; Jama, John; Kelly, Paul

2003-07-01

The HIV epidemic in sub-Saharan Africa represents an obstacle to productive employment and economic development. Employers in the region are experiencing severe staff shortages, reduced productivity, and increased costs because of protracted ill health and death among their workforce. The scale of the problem has not been fully estimated and the extent to which it could be ameliorated by control measures including effective treatment of opportunistic infections is not well known. Employers and employees (n = 108) in seven Zambian firms were interviewed to assess direct and indirect costs of illness to the firms. Information was collected on diagnosis and treatment received, duration of illness, time off, and strategies adopted to compensate for absent workers using a combination of questionnaires, structured interviews and focus group discussions. The main causes of ill health were tuberculosis (TB) (46.8%), diarrhea (12.9%), and sexually transmitted diseases (STDs; 5.8%). Annual treatment costs to the firm ranged from Zambia Kwacha (K) 60,000 to 405,000 per person treated. Other firm costs included productivity losses because of ill health, paid sick leave, the cost of employee replacement, and funerals. Employees incurred K 67,773 on average per illness episode. The most common causes of ill health were those most frequently associated with HIV. They can be easily but were often ineffectively treated. Improving disease management would thus reduce wastage and costs both to employer and employee. The extent of the impact in these firms shows the need for the private sector to adopt a stronger role in prevention and care. Further research is required to assess what recommended treatment options might be, how they could be financed, and the extent of the economic impact of HIV on firms. This would foster the development of more appropriate responses to the epidemic in Zambia and the region as a whole.

Impact of a school-based peer sexual health intervention on normative beliefs, risk perceptions, and sexual behavior of Zambian adolescents.

PubMed

Agha, Sohail; Van Rossem, Ronan

2004-05-01

To determine whether adolescents' normative beliefs about abstinence and condoms, their personal risk perception, and safer sex practices changed after the implementation of a peer sexual health education intervention implemented in Zambian secondary schools. The peer intervention was implemented during the first week of September 2000 in Lusaka, Zambia. A quasi-experimental, longitudinal panel design was used to evaluate its impact. Three schools were randomly assigned to the intervention condition and two to the control condition. Three rounds of data from male and female adolescents in grades 10 and 11 were collected at baseline in July 2000, at first follow-up in the second half of September 2000, and at second follow-up in early April 2001. A total of 416 respondents aged 14-23 (at baseline) were interviewed in all three survey rounds. A mixed-effects logistic regression growth curve analysis was used to calculate adjusted odds ratios to compare intervention and control groups on the outcome variables. Student self-reports showed positive changes in normative beliefs about abstinence immediately after the intervention, and these improvements were largely sustained until 6 months after the intervention. Students became more likely to approve of condom use and to intend using condoms immediately after the intervention, but these positive outcomes could not be sustained during the 6 months that followed the intervention. Normative beliefs regarding condom use took longer to develop: these were only observed at 6 months follow-up. Students reported reductions in multiple regular partnerships. There was no change in condom use. A single session school-based peer sexual health intervention resulted in the development of normative beliefs about abstinence that were sustained over a 6-month period. Normative beliefs about condoms took longer to develop. More regular efforts may be required to sustain the approval of, and the intention to use, condoms. The intervention was successful in reducing multiple regular partnerships.

Understanding the dynamic interactions driving Zambian health centre performance: a case-based health systems analysis.

PubMed

Topp, Stephanie M; Chipukuma, Julien M; Hanefeld, Johanna

2015-05-01

Despite being central to achieving improved population health outcomes, primary health centres in low- and middle-income settings continue to underperform. Little research exists to adequately explain how and why this is the case. This study aimed to test the relevance and usefulness of an adapted conceptual framework for improving our understanding of the mechanisms and causal pathways influencing primary health centre performance. A theory-driven, case-study approach was adopted. Four Zambian health centres were purposefully selected with case data including health-care worker interviews (n = 60); patient interviews (n = 180); direct observation of facility operations (2 weeks/centre) and key informant interviews (n = 14). Data were analysed to understand how the performance of each site was influenced by the dynamic interactions between system 'hardware' and 'software' acting on mechanisms of accountability. Structural constraints including limited resources created challenging service environments in which work overload and stockouts were common. Health workers' frustration with such conditions interacted with dissatisfaction with salary levels eroding service values and acting as a catalyst for different forms of absenteeism. Such behaviours exacerbated patient-provider ratios and increased the frequency of clinical and administrative shortcuts. Weak health information systems and lack of performance data undermined providers' answerability to their employer and clients, and a lack of effective sanctions undermined supervisors' ability to hold providers accountable for these transgressions. Weak answerability and enforceability contributed to a culture of impunity that masked and condoned weak service performance in all four sites. Health centre performance is influenced by mechanisms of accountability, which are in turn shaped by dynamic interactions between system hardware and system software. Our findings confirm the usefulness of combining Sheikh et al.'s (2011) hardware-software model with Brinkerhoff's (2004) typology of accountability to better understand how and why health centre micro-systems perform (or under-perform) under certain conditions. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014.

Demonstration of an algorithm to overcome health system-related barriers to timely diagnosis of breast diseases in rural Zambia

PubMed Central

Nzayisenga, Jean-Baptiste; Shibemba, Aaron; Kusweje, Victor; Chiboola, Hector; Amuyunzu-Nyamongo, Mary; Kapambwe, Sharon; Mwaba, Catherine; Lermontov, Pavlo; Mumba, Chibamba; Henry-Tillman, Ronda; Parham, Groesbeck P.

2018-01-01

Background Long delays to diagnosis is a major cause of late presentation of breast diseases in sub-Saharan Africa. Aims We designed and implemented a single-visit breast care algorithm that overcomes health system-related barriers to timely diagnosis of breast diseases. Methods A multidisciplinary team of Zambian healthcare experts trained a team of mid- and high-level Zambian healthcare practitioners how to evaluate women for breast diseases, and train trainers to do likewise. Working collaboratively, the two teams then designed a clinical platform that provides multiple breast care services within a single visit. The service platform was implemented using a breast outreach camp format, during which breast self-awareness, psychosocial counseling, clinical breast examination, breast ultrasound, ultrasound-guided biopsy, imprint cytology of biopsy specimens and surgical treatment or referral, were offered within a single visit. Results Eleven hundred and twenty-nine (1129) women attended the camps for breast care. Mean age was 35.9 years. The majority were multiparous (79.4%), breast-fed (76.0%), and reported hormone use (50.4%). Abnormalities were detected on clinical breast examination in 122 (10.8%) women, 114 of whom required ultrasound. Of the 114 who underwent ultrasound, 48 had identifiable lesions and were evaluated with ultrasound-guided core needle biopsy (39) or fine-needle aspiration (9). The concordance between imprint cytology and histopathology was 100%, when breast specimens were classified as either benign or malignant. However, when specimens were classified by histopathologic subtype, the concordance between imprint cytology and histology was 85.7% for benign and 100% for malignant lesions. Six (6) women were diagnosed with invasive cancer. Eighteen (18) women with symptomatic breast lesions had next-day surgery. Significance Similar to its impact on cervical cancer prevention services, a single visit breast care algorithm has the potential to overcome health system-related barriers to timely diagnosis of breast diseases, including cancer, in rural African settings. PMID:29746541

Threat Assessment and Targeted Violence at Institutions of Higher Education: Implications for Policy and Practice Including Unique Considerations for Community Colleges

ERIC Educational Resources Information Center

Bennett, Laura; Bates, Michael

2015-01-01

This article provides an overview of the research on targeted violence, including campus violence, and the implications for policy and practice at institutions of higher education. Unique challenges of threat assessment in the community college setting are explored, and an overview of an effective threat assessment policy and team at William…

A "Fine Balance" in Truth and Fiction: Exploring Globalization's Impacts on Community and Implications for Adult Learning in Rohinton Mistry's Novel and Related Literature

ERIC Educational Resources Information Center

Jubas, Kaela

2005-01-01

Globalization continues to interest researchers and practitioners as it unfolds around us. This article contributes to the analysis of globalization's discourse, objectives and outcomes, by exploring the impact of globalization on community and its implications for adult learning. Using selected themes from a work of fiction to frame this…

Out-of-hours medical cover in community hospitals: implications for palliative care.

PubMed

Kerr, Chris; Hawker, Sheila; Payne, Sheila; Lloyd-Williams, Mari; Seamark, David

2006-02-01

The new General Medical Services contract in England means many GPs have transferred out-of hours work to their primary care organization, with implications for continuity of palliative care in community hospitals. To examine existing arrangements for out-of-hours medical cover in community hospitals, focusing on palliative care. Telephone survey of community hospital managers/senior nurses across England and Wales. Interviews (n = 62) revealed nursing staff were satisfied with existing out-of-hours care. Concern was expressed about the future of out-of-hours medical care from GPs as new services will cover larger areas, meaning unknown doctors may attend, taking longer to arrive. Arrangements for out-of-hours medical cover in community hospitals are in transition, threatening the continuity of care for dying patients.

Cultural diversity and the mistreatment of older people in black and minority ethnic communities: some implications for service provision.

PubMed

Bowes, Alison; Avan, Ghizala; Macintosh, Sherry Bien

2012-07-01

Previous research on mistreatment of older people in black and minority ethnic communities has identified limited service responses and the need to consider mistreatment as an issue not only for individuals but also for families, communities, and institutions. The impact of cultural factors on understandings, experiences, and remedies for mistreatment has been debated. Drawing on empirical research in the United Kingdom involving service providers and ethnically-diverse community members, the article explores implications of cultural variation for service provision. Clear gaps exist between service provision and people experiencing mistreatment due to structural and contextual factors; cultural factors have a relatively minor impact.

Nanotechnology Environmental and Health Implications (NEHI) | Nano

Science.gov Websites

Communities Environmental, Health, and Safety Issues Ethical, Legal, and Societal Issues Federal Legislation Event Past Events Nanotechnology Environmental and Health Implications (NEHI) Related Resources Visit Health Implications working group of the Nanoscale Science, Engineering, and Technology (NSET

Community rating in the absence of risk equalisation: lessons from the Irish private health insurance market.

PubMed

Turner, Brian; Shinnick, Edward

2013-04-01

Ireland's private health insurance market operates on the basis of community rating, alongside open enrolment and lifetime cover. A risk equalisation scheme was introduced in 2003 to bolster community rating. However, in July 2008 the Irish Supreme Court set aside this scheme, on the basis of the interpretation of community rating in Irish legislation. This decision has significant implications for the Irish private health insurance market. This paper reviews the development of the market, focusing in particular on community rating. The breakdown of community rating in a market with multiple insurers with differing risk profiles is discussed. Applying this to the Irish market, it can be seen that the Irish Supreme Court judgment has significant implications for the application of community rating. Specifically, while community rating operates within plans, it no longer operates across the market, leading to high-risk lives paying more, on average, than low-risk lives. It has also led to greater opportunities for insurers to engage in market segmentation. This may have relevance for the design and operation of other community rated markets.

Community and individual effects on SOD intensification in California redwood forests: implications for tanoak persistence

Treesearch

Richard C. Cobb; Joao A. N. Filipe; Ross K. Meentemeyer; Chris A. Gilligan; Shannon C. Lynch; David M. Rizzo

2010-01-01

Processes operating across different spatial scales (for example, individual, community, landscape) influence disease dynamics. Understanding these processes and their interactions can yield general insights into disease control, disease dynamics within communities, and community response to disease. For Phytophthora ramorum, pathogen establishment...

Participation Levels in 25 Community-Based Participatory Research Projects

ERIC Educational Resources Information Center

Spears Johnson, C. R.; Kraemer Diaz, A. E.; Arcury, T. A.

2016-01-01

This analysis describes the nature of community participation in National Institutes of Health and Centers for Disease Control and Prevention funded community-based participatory research (CBPR) projects, and explores the scientific and social implications of variation in community participation. We conducted in-depth interviews in 2012 with…

Research Foundations and Problems Regarding Counseling in the Community.

ERIC Educational Resources Information Center

Campbell, Robert E.

Research foundations and problems for counseling in the community are discussed. Research implications are outlined around Sarason's three challenges to community health; (1) extending therapeutic outreach, (2) studying those situations, settings, or forces in the community that set the stage for problems; and (3) efforts toward prevention.…

Social Networks as a Political Resource: Some Insights Drawn from the Community Organizational and Community Action Experiences.

ERIC Educational Resources Information Center

Rosenbaum, Allan

The development and functioning of urban social networks in highly politicized environments--particularly, the neighborhood based community organization, political coalition building of urban mayors, and community action programs--suggest implications for building locally based educational reform capacity through network development. Community…

Faculty Perspectives on Creating Community in Residence Halls

ERIC Educational Resources Information Center

Ellett, Tom; Schmidt, Anna

2011-01-01

This study sought to explore and understand the perceptions that faculty members have of community development in living-learning communities at a large, private research institution in the Northeast. Boyer's (1990) tenets of community development provided a theoretical lens for the study. The article concludes with implications for practice and…

Listening: Implications for Qualitative Research.

ERIC Educational Resources Information Center

Enos, Anya Dozier

Pueblo communities want local research to be linked to community needs. To address this requirement, university research must shift from a set agenda that addresses personal or professional goals to a flexible design that moves toward a community-based goal. This can be achieved through collaboration with the Pueblo community. Key to developing…

Texas Community College Fundraising: Strategies for Meeting Future Financial Needs

ERIC Educational Resources Information Center

Garcia, Esmeralda

2009-01-01

While the entire weakened economy has had serious implications for higher education and the public investment in the mission of community college, the literature reveals a limited amount of research regarding the types, prevalence, and accountability of more sophisticated fundraising efforts in community colleges. Community colleges are seeking to…

Stages of Change for Voluntary Medical Male Circumcision and Sexual Risk Behavior in Uncircumcised Zambian Men: The Spear and Shield Project

PubMed Central

Redding, Colleen A.; Jones, Deborah; Zulu, Robert; Chitalu, Ndashi; Cook, Ryan; Weiss, Stephen M

2015-01-01

Background Dissemination and scale up of voluntary medical male circumcision (VMMC) programs is well supported by evidence that VMMC reduces HIV risk in populations with high HIV prevalence and low rates of circumcision, as is the case in Zambia. Purpose At both individual and population levels, it is important to understand what stages of change for VMMC are associated with, especially across cultures. This study evaluated VMMC knowledge, misinformation and stages of change for VMMC of uncircumcised men and boys (over 18 years), as well as the concurrent relationship between VMMC stages of change and sexual risk behaviors. Method Uncircumcised (N = 800) adult men and boys (over 18) were screened and recruited from urban community health centers in Lusaka, Zambia, where they then completed baseline surveys assessing knowledge, attitudes, HIV risk behaviors and stages of change for VMMC. A series of analyses explored cross-sectional relationships among these variables. Results VMMC was culturally acceptable in half of the sample; younger, unmarried, and more educated men were more ready to undergo VMMC. Stage of change for VMMC was also related to knowledge, and those at greater HIV risk reported greater readiness to undergo VMMC. Conclusions Efforts to increase VMMC uptake should address the role of perceived HIV risk, risk behaviors, readiness, accurate knowledge, cultural acceptance and understanding of the significant degree of HIV protection conferred as part of the VMMC decision making process. These results support incorporating comprehensive HIV risk reduction in VMMC promotion programs. PMID:25896876

Theater dramatizes ORT message.

PubMed

White, K

1990-04-01

The Zambian Control of Diarrheal Diseases (CDD) Program sought the assistance of 2 popular theater groups to develop a play on diarrhea including messages on using oral rehydration therapy (ORT), breast feeding, continued feeding, and using fluids. This was a more appropriate channel for promoting ORT because only 30% of the population had access to a radio and even less to a television set. The groups performed their 35-40 minute plays, complete with dancing and singing, in the local language for 40 different high density communities in Lusaka 6 times/week for 3 months. Before each play, 1 group went door to door telling the occupants that they were going to perform a play about diarrhea management, specifically ORT. If no one could come, the group described ORT for the occupants. The other group held discussions after each performance to determine what learned and to correct any misconceptions about ORT. 1 group concentrated on bottle feeding as the cause of diarrhea while the other group concentrated on poor sanitation and personal hygiene. The groups always performed in locations convenient to mothers, such as markets, outside clinics, and schools, thereby reaching an estimated 10,000 people. Men also attended the plays which was good because fathers often decide whether or not to use ORT for a sick child. Several performances were recorded and aired on local language radio programs to increase awareness of ORT. The entire 1989 campaign of the CDD Program cost $3000 while radio spots for the same period cost the program $8000-10,000. Popular theater is now being used to publicize many other health messages, such as AIDS-prevention.

Voluntary counselling and testing for HIV in a Zambian mining community: serial interviews with people testing negative.

PubMed

Sikasote, Janet; Grant, Liz; Chinn, David J; Macwang'i, Mubiana; Murray, Scott A

2011-08-01

To understand the influence of voluntary counselling and testing (VCT) and an HIV-negative result on subsequent sexual behaviour; and to identify the specific felt needs of those testing negative. Serial interviews, 6 months apart, with people who had tested negative, and three one-off focus group discussions with counsellors. Interviews were transcribed verbatim and analysed thematically. Paired transcripts were analysed longitudinally. Purposively sampled from first attenders for VCT who had tested negative. Four health-facility affiliated VCT centres in two mining towns in the Copperbelt Province of Zambia. Participants in the 42 initial and 31 follow-up interviews understood VCT as 'testing for HIV'. Most participants reported having adopted safer sexual behaviour months before attending VCT. They had already recognised personal susceptibility to HIV infection and reported engaging both emotionally and cognitively with the issues of testing. Ultimately attendance at testing was to know their status in order to regain control of their lives. Unmet post-test support needs were common and included additional information, supportive networks, life-skills training and access to recreational activities. In this population who tested HIV negative the majority said they had made life changes months before attending VCT. Counselling served to consolidate pre-test decisions about risk behaviour. Those testing HIV negative are underserved compared with those testing positive. We recommend that counselling for HIV should be de-linked from testing to encourage earlier attendance for counselling and that clients testing negative should receive more post-test support to help them remain HIV negative.

A Rural School/Community: A Case Study of a Dramatic Turnaround & Its Implications for School Improvement.

ERIC Educational Resources Information Center

Carlson, Robert V.

This paper presents a case study of a rural community exhibiting a dramatic turnaround in community support for a new school bond issue. Demographic change was partly responsible for the change in community attitudes, with two waves of immigration altering the long-term conservative orientation of this community. After a series of failed…

Community-Building Principles: Implications for Professional Development

ERIC Educational Resources Information Center

Austin, Sandra

2005-01-01

This article reviews a Think Tank meeting among child welfare practitioners at the 2003 Building Communities for 21st-Century Child Welfare Symposium. The Child Welfare League of America's focus on community building is recognition of the vital importance of promoting and fostering collaboration with community members to enhance the well-being of…

King John's Christmas: Developing Leadership Communities On-Line.

ERIC Educational Resources Information Center

Crawford, Megan

This paper examines how online communities provide space for educational leaders to reflect on and share the affective side of leadership, discussing implications of online communities in leadership and relating it to Wenger's concept of a community of practice. Using research conducted at the United Kingdom's Open University, the paper argues for…

The Impact of Resort Development on an Hawaiian Island: Implications for Community Preservation.

ERIC Educational Resources Information Center

Matsuoka, Jon K.; Shera, Wes J.

1991-01-01

The impact of resort development on Lana'i island (Hawaii) was investigated through community and island assessments, surveys of households and high school students, and focus groups. Assessment results relate to economic impacts, community services, community satisfaction, quality of life, and social impacts. Recommendations are included for…

Rifaximin Reduces Markers of Inflammation and Bacterial 16S rRNA in Zambian Adults with Hepatosplenic Schistosomiasis: A Randomized Control Trial.

PubMed

Sinkala, Edford; Zyambo, Kanekwa; Besa, Ellen; Kaonga, Patrick; Nsokolo, Bright; Kayamba, Violet; Vinikoor, Michael; Zulu, Rabison; Bwalya, Martin; Foster, Graham R; Kelly, Paul

2018-04-01

Cirrhosis is the dominant cause of portal hypertension globally but may be overshadowed by hepatosplenic schistosomiasis (HSS) in the tropics. In Zambia, schistosomiasis seroprevalence can reach 88% in endemic areas. Bacterial translocation (BT) drives portal hypertension in cirrhosis contributing to mortality but remains unexplored in HSS. Rifaximin, a non-absorbable antibiotic may reduce BT. We aimed to explore the influence of rifaximin on BT, inflammation, and fibrosis in HSS. In this phase II open-label trial (ISRCTN67590499), 186 patients with HSS in Zambia were evaluated and 85 were randomized to standard care with or without rifaximin for 42 days. Changes in markers of inflammation, BT, and fibrosis were the primary outcomes. BT was measured using plasma 16S rRNA, lipopolysaccharide-binding protein, and lipopolysaccharide, whereas hyaluronan was used to measure fibrosis. Tumor necrosis factor receptor 1 (TNFR1) and soluble cluster of differentiation 14 (sCD14) assessed inflammation. 16S rRNA reduced from baseline (median 146 copies/µL, interquartile range [IQR] 9, 537) to day 42 in the rifaximin group (median 63 copies/µL, IQR 12, 196), P < 0.01. The rise in sCD14 was lower ( P < 0.01) in the rifaximin group (median rise 122 ng/mL, IQR-184, 783) than in the non-rifaximin group (median rise 832 ng/mL, IQR 530, 967). TNFR1 decreased ( P < 0.01) in the rifaximin group (median -39 ng/mL IQR-306, 563) but increased in the non-rifaximin group (median 166 ng/mL, IQR 3, 337). Other markers remained unaffected. Rifaximin led to a reduction of inflammatory markers and bacterial 16S rRNA which may implicate BT in the inflammation in HSS.

Rifaximin Reduces Markers of Inflammation and Bacterial 16S rRNA in Zambian Adults with Hepatosplenic Schistosomiasis: A Randomized Control Trial

PubMed Central

Sinkala, Edford; Zyambo, Kanekwa; Besa, Ellen; Kaonga, Patrick; Nsokolo, Bright; Kayamba, Violet; Vinikoor, Michael; Zulu, Rabison; Bwalya, Martin; Foster, Graham R.; Kelly, Paul

2018-01-01

Abstract. Cirrhosis is the dominant cause of portal hypertension globally but may be overshadowed by hepatosplenic schistosomiasis (HSS) in the tropics. In Zambia, schistosomiasis seroprevalence can reach 88% in endemic areas. Bacterial translocation (BT) drives portal hypertension in cirrhosis contributing to mortality but remains unexplored in HSS. Rifaximin, a non-absorbable antibiotic may reduce BT. We aimed to explore the influence of rifaximin on BT, inflammation, and fibrosis in HSS. In this phase II open-label trial (ISRCTN67590499), 186 patients with HSS in Zambia were evaluated and 85 were randomized to standard care with or without rifaximin for 42 days. Changes in markers of inflammation, BT, and fibrosis were the primary outcomes. BT was measured using plasma 16S rRNA, lipopolysaccharide-binding protein, and lipopolysaccharide, whereas hyaluronan was used to measure fibrosis. Tumor necrosis factor receptor 1 (TNFR1) and soluble cluster of differentiation 14 (sCD14) assessed inflammation. 16S rRNA reduced from baseline (median 146 copies/µL, interquartile range [IQR] 9, 537) to day 42 in the rifaximin group (median 63 copies/µL, IQR 12, 196), P < 0.01. The rise in sCD14 was lower (P < 0.01) in the rifaximin group (median rise 122 ng/mL, IQR-184, 783) than in the non-rifaximin group (median rise 832 ng/mL, IQR 530, 967). TNFR1 decreased (P < 0.01) in the rifaximin group (median -39 ng/mL IQR-306, 563) but increased in the non-rifaximin group (median 166 ng/mL, IQR 3, 337). Other markers remained unaffected. Rifaximin led to a reduction of inflammatory markers and bacterial 16S rRNA which may implicate BT in the inflammation in HSS. PMID:29436337

Community Information Systems.

ERIC Educational Resources Information Center

Freeman, Andrew

Information is provided on technological and social trends as background for a workshop designed to heighten the consciousness of workers in community information systems. Initially, the basic terminology is considered in its implications for an integrated perspective of community information systems, with particular attention given to the meaning…

Environmental implications of herbicide resistance: soil biology and ecology

USDA-ARS?s Scientific Manuscript database

Soil microbial community structure and activity are clearly linked to plant communities established in natural and agricultural ecosystems. A limited number of studies confirm that weeds alter their soil environment and select for specific microbial communities in the rhizosphere. Such rhizosphere m...

Community Businesses--Lessons from Liverpool, UK.

ERIC Educational Resources Information Center

Leeming, Karen

2002-01-01

Comparison of community business development in two neighborhoods in Liverpool, England, resulted in the following implications for economic development strategy: (1) social entrepreneurs do not access the same infrastructure as business entrepreneurs; (2) community businesses differ from private enterprise; (3) displacement effects must be…

Adapting to the impacts of climate change on food security among Inuit in the Western Canadian Arctic.

PubMed

Wesche, Sonia D; Chan, Hing Man

2010-09-01

This study examined critical impacts of climate change on Inuit diet and nutritional health in four Inuit communities in the Inuvialuit Settlement Region, Western Arctic, Canada. The first objective was to combine data from community observation studies and dietary interview studies to determine potential climate change impacts on nutritional quality. The second objective was to address the scale of data collection and/or availability to compare local versus regional trends, and identify implications for adaptation planning. Information was compiled from 5 reports (4 community reports and 1 synthesis report) of climate change observations, impacts and adaptations in 12 Inuit communities (2005-2006), and from a dietary report of food use from 18 Inuit communities (1997-2000). Changing access to, availability of, quality of, and ability to use traditional food resources has implications for quality of diet. Nutritional implications of lower traditional food use include likely reductions in iron, zinc, protein, vitamin D, and omega-3 fatty acids, among others. The vulnerability of each community to changing food security is differentially influenced by a range of factors, including current harvesting trends, levels of reliance on individual species, opportunities for access to other traditional food species, and exposure to climate change hazards. Understanding linkages between climate change and traditional food security provides a basis for strengthening adaptive capacity and determining effective adaptation options to respond to future change.

Internationalizing the Community College: Examples of Success. ERIC Digest.

ERIC Educational Resources Information Center

Quimbita, Grace

With the growing technological, economic and political interdependence between nations, the word "community" has come to have international implications. In order to alleviate American ignorance about other nations and global issues, community colleges must institutionalize international perspectives into their curricula. More than 50%…

An Analysis of the Emerging Roles of the Paraprofessional School-Community Aide with Implications for Strategies of Social Change in Disadvantaged Areas.

ERIC Educational Resources Information Center

Hadden, Marise Alvena Tabor Bell

This study analyzed the use of paraprofessionals as school-community workers (Community Counselors) by the Flint (Michigan) Community Schools. The purpose was to examine perceptions and expectations of this position in order to: organize a framework for the emerging role of the indigenous school-community worker in urban disadvantaged areas; make…

Community Fragmentation: Implications for Future Wild Fire Management

Treesearch

Robert G. Lee

1987-01-01

Two meanings of human community compete for public attention: (1) community as a sense of belonging to a particular social group within a society, and (2) community as a global ideal consisting of political expression, religious fulfillment, and/or harmony with the world at large. The latter meaning has become increasingly prevalent as we approach the year2000. This...

Community College Non-Liberal Arts: Implications for Transferability.

ERIC Educational Resources Information Center

Ignash, Jan

To gain a more complete understanding of the community college curriculum, the Center for the Study of Community Colleges (CSCC), in Los Angeles, California, augmented its 1991 national study of liberal arts courses, with a 1992 study of non-liberal arts courses. Data were drawn from the same 164 community colleges that responded to the 1991…

Community violence and youth: affect, behavior, substance use, and academics.

PubMed

Cooley-Strickland, Michele; Quille, Tanya J; Griffin, Robert S; Stuart, Elizabeth A; Bradshaw, Catherine P; Furr-Holden, Debra

2009-06-01

Community violence is recognized as a major public health problem (WHO, World Report on Violence and Health, 2002) that Americans increasingly understand has adverse implications beyond inner-cities. However, the majority of research on chronic community violence exposure focuses on ethnic minority, impoverished, and/or crime-ridden communities while treatment and prevention focuses on the perpetrators of the violence, not on the youth who are its direct or indirect victims. School-based treatment and preventive interventions are needed for children at elevated risk for exposure to community violence. In preparation, a longitudinal, community epidemiological study, The Multiple Opportunities to Reach Excellence (MORE) Project, is being fielded to address some of the methodological weaknesses presented in previous studies. This study was designed to better understand the impact of children's chronic exposure to community violence on their emotional, behavioral, substance use, and academic functioning with an overarching goal to identify malleable risk and protective factors which can be targeted in preventive and intervention programs. This paper describes the MORE Project, its conceptual underpinnings, goals, and methodology, as well as implications for treatment and preventive interventions and future research.

Deregulation: Implications for Community College Leaders.

ERIC Educational Resources Information Center

Bender, Louis W.

1986-01-01

Looks at the ways in which the deregulation of business and industry may affect community colleges in the years ahead, using the banking industry as an illustration. Argues that the deregulation of higher education requires that community college leadership programs examine past assumptions and develop new strategies. (LAL)

Community Research Mythology

ERIC Educational Resources Information Center

Waldern, Barbara

2006-01-01

This article is dedicated to an in-depth discussion of the theme community and the implications the multiple meanings of community hold for the field of qualitative research. This theme surfaced from Walderns 2003 study entitled Resistance to Research in Vancouvers Downtown Eastside, which dealt with participant resistance to joining research…

Effect of holding office on the behavior of politicians

PubMed Central

Enemark, Daniel; Gibson, Clark C.; McCubbins, Mathew D.; Seim, Brigitte

2016-01-01

Reciprocity is central to our understanding of politics. Most political exchanges—whether they involve legislative vote trading, interbranch bargaining, constituent service, or even the corrupt exchange of public resources for private wealth—require reciprocity. But how does reciprocity arise? Do government officials learn reciprocity while holding office, or do recruitment and selection practices favor those who already adhere to a norm of reciprocity? We recruit Zambian politicians who narrowly won or lost a previous election to play behavioral games that provide a measure of reciprocity. This combination of regression discontinuity and experimental designs allows us to estimate the effect of holding office on behavior. We find that holding office increases adherence to the norm of reciprocity. This study identifies causal effects of holding office on politicians’ behavior. PMID:27856736

High-tech and low-tech orthopaedic surgery in Sub-Saharan Africa.

PubMed

Kluge, Wolfram H; Bauer, Heike I

2002-01-01

BACKGROUND: Zambia's governmental health system suffers from shortage of surgical supplies and poor management skills for the sparse resources at hand. The situation has been worsened by the dual epidemics of HIV disease and tuberculosis. On the other hand the private medical sector has benefited greatly from less bureaucracy under the goverment of the Movement for Multi-party Democracy. DISCUSSION: The Zambian-Italian Orthopaedic Hospital in Lusaka is a well organized small unit providing free treatment of physically disabled children. The running costs are met from the fees charged for private consultations, supplemented by donations. State of the art surgical techniques are being used for congenital and acquired musculo-skeletal abnormalities. Last year 513 patients were operated upon free of charge and 320 operations were performed on private patients.

Effect of holding office on the behavior of politicians.

PubMed

Enemark, Daniel; Gibson, Clark C; McCubbins, Mathew D; Seim, Brigitte

2016-11-29

Reciprocity is central to our understanding of politics. Most political exchanges-whether they involve legislative vote trading, interbranch bargaining, constituent service, or even the corrupt exchange of public resources for private wealth-require reciprocity. But how does reciprocity arise? Do government officials learn reciprocity while holding office, or do recruitment and selection practices favor those who already adhere to a norm of reciprocity? We recruit Zambian politicians who narrowly won or lost a previous election to play behavioral games that provide a measure of reciprocity. This combination of regression discontinuity and experimental designs allows us to estimate the effect of holding office on behavior. We find that holding office increases adherence to the norm of reciprocity. This study identifies causal effects of holding office on politicians' behavior.

Community resilience elements and community preparedness at Bukit Antarabangsa

NASA Astrophysics Data System (ADS)

Ridzuan, Ahmad Azan; Kadir, Mohd Juraimy Hj; Yaacob, Safar; Oktari, Rina Suryani; Zainol, Noor Azmi Mohd; Zain, Mazura Mat

2017-07-01

This study was conducted to measure the relationship between community resilience elements (community education, community engagement, community leadership) and community preparedness using questionnaires gathered from 318 samples of the Bukit Antarabangsa community at Ampang Jaya Municipal in Malaysia. The outcomes of SmartPLS path model showed three important findings: firstly, community education significantly correlated with community preparedness. Second, community engagement significantly correlated with community preparedness. Third, community leadership significantly correlated with community preparedness. Statistically, this result confirms that the implementation of community resilience elements such as community education, community engagement, and community leadership act as an important determinant of community preparedness towards disasters in the studied community area sample. In addition, discussion, implications and conclusion are elaborated.

Community and Contribution: Factors Motivating Students to Participate in an Extra-Curricular Online Activity and Implications for Learning

ERIC Educational Resources Information Center

Reeves, Tony; Gomm, Phil

2015-01-01

The human desire to join and participate in communities can be seen as an attempt to satisfy some of our universal human needs. The theory of communities of practice has been widely used to explain how and why humans participate in multiple communities, and a key requirement of a community of practice (CoP) is that members engage in "joint…

Food beliefs and practices in urban poor communities in Accra: implications for health interventions.

PubMed

Boatemaa, Sandra; Badasu, Delali Margaret; de-Graft Aikins, Ama

2018-04-02

Poor communities in low and middle income countries are reported to experience a higher burden of chronic non-communicable diseases (NCDs) and nutrition-related NCDs. Interventions that build on lay perspectives of risk are recommended. The objective of this study was to examine lay understanding of healthy and unhealthy food practices, factors that influence food choices and the implications for developing population health interventions in three urban poor communities in Accra, Ghana. Thirty lay adults were recruited and interviewed in two poor urban communities in Accra. The interviews were audio-taped, transcribed and analysed thematically. The analysis was guided by the socio-ecological model which focuses on the intrapersonal, interpersonal, community, structural and policy levels of social organisation. Food was perceived as an edible natural resource, and healthy in its raw state. A food item retained its natural, healthy properties or became unhealthy depending on how it was prepared (e.g. frying vs boiling) and consumed (e.g. early or late in the day). These food beliefs reflected broader social food norms in the community and incorporated ideas aligned with standard expert dietary guidelines. Healthy cooking was perceived as the ability to select good ingredients, use appropriate cooking methods, and maintain food hygiene. Healthy eating was defined in three ways: 1) eating the right meals; 2) eating the right quantity; and 3) eating at the right time. Factors that influenced food choice included finances, physical and psychological state, significant others and community resources. The findings suggest that beliefs about healthy and unhealthy food practices are rooted in multi-level factors, including individual experience, family dynamics and community factors. The factors influencing food choices are also multilevel. The implications of the findings for the design and content of dietary and health interventions are discussed.

Travel and environmental implications of school siting.

DOT National Transportation Integrated Search

2003-10-01

Over the next few decades, thousands of schools will be built : or renovated. : The planning decisions : around that construction and renovation will have important implications for education and community quality of : life. : Recent trends in travel...

Community Control of Schools. Studies in Social Economics.

ERIC Educational Resources Information Center

Levin, Henry M., Ed.

The conference proceedings which comprise this book focus on three problem areas: (1) Objectives and social implications of community governance of city schools, covered as follows: Harold Pfautz discusses the long-run impact of community-governed schools on goals of racial equality and harmony, Mario Fantini suggests the curriculum and other…

Transcultural oral health care and the Chinese--an invisible community.

PubMed

Kwan, S Y; Bedi, R

2000-01-01

The Chinese, a 'silent minority', are the most scattered, but neglected, community in the UK. Most dentists will have at least a few Chinese people in their community. This paper describes the health beliefs, dental knowledge, attitudes and behaviours of the Chinese. Implications for general dental practitioners are discussed.

The Impact of Community Violence on School-Based Research

ERIC Educational Resources Information Center

Velsor-Friedrich, Barbara; Richards, Maryse; Militello, Lisa K.; Dean, Kyle C.; Scott, Darrick; Gross, Israel M.; Romeo, Edna

2015-01-01

Research conducted on youth exposure to violence has generally focused on documenting the prevalence of community violence and its emotional and behavioral implications. However, there is a dearth of information related to the impact of violence on the implementation and evaluation of community and school-based programs. This commentary examines…

Imagining Literacy Equity: Theorizing Flows of Community Practices

ERIC Educational Resources Information Center

González, Norma

2016-01-01

Theorizing flows of community practices implicates three interrelated themes: (1) theorizing practices rather than practicing theories, (2) theorizing our stories, and (3) research as responsibility to the communities in which we work. One way to claim literacy research as a principled epistemological stance is to confront the real-life effects of…

Engaging in School-Led Multisectoral Collaboration: Implications to Agroforestry Promotion in the Philippine Uplands

ERIC Educational Resources Information Center

Landicho, Leila D.; Cabahug, Rowena D.; De Luna, Catherine C.

2009-01-01

The Agroforestry Support Program for Empowering Communities Towards Self-Reliance (ASPECTS) was conceived to develop a model of two-stage approach in agroforestry promotion by capacitating the upland communities to establish community-managed agroforestry extension services, while strengthening the agroforestry education programs of the three…

Religious Communities, Immigration, and Social Cohesion in Rural Areas: Evidence from England

ERIC Educational Resources Information Center

Andrews, Rhys

2011-01-01

Religious communities are important sources of bridging and bonding social capital that have varying implications for perceptions of social cohesion in rural areas. In particular, as well as cultivating cohesiveness more broadly, the bridging social capital associated within mainline religious communities may represent an especially important…

Community Violence and Youth: Affect, Behavior, Substance Use, and Academics

ERIC Educational Resources Information Center

Cooley-Strickland, Michele; Quille, Tanya J.; Griffin, Robert S.; Stuart, Elizabeth A.; Bradshaw, Catherine P.; Furr-Holden, Debra

2009-01-01

Community violence is recognized as a major public health problem (WHO, "World Report on Violence and Health," 2002) that Americans increasingly understand has adverse implications beyond inner-cities. However, the majority of research on chronic community violence exposure focuses on ethnic minority, impoverished, and/or crime-ridden communities…

Communities of Difference Culture, Language, Technology

ERIC Educational Resources Information Center

Trifonas, Peter

2005-01-01

This book looks at the implications of educational practices in communities that are differentiated by issues of language, culture, and technology. Trifonas argues that a "community" is at once a gathering of like-minded individuals in solidarity of purpose and conviction, and also a gathering that excludes others. The chapters in this…

Community Environmental Education as a Model for Effective Environmental Programmes

ERIC Educational Resources Information Center

Blair, Morag

2008-01-01

The benefits of community environmental education outlined in environmental education literature are supported by the findings and implications of a research study undertaken in New Zealand. Evidence from a two-case case study suggests that environmental programmes guided by the key principles and practices of community environmental education,…

Ecological Dynamics of the Inner City: Implications for Community Psychology.

ERIC Educational Resources Information Center

Myers, Ernest R.

If community psychology is a discipline of principles, methods, and techniques designed to adapt tomorrow's psychologists to a community orientation and commitment, then ecological parameters necessarily become fundamental concerns. It is no revelation that urban America, particularly the central city, is characteristically the home site of "Black…

Satisfaction with Rural Services: The Policy Preferences of Leaders and Community Residents.

ERIC Educational Resources Information Center

Molnar, Joseph J.; Smith, John P.

To examine ratings of satisfaction with selected community services in relation to spending preferences and to ascertain policy-relevant implications of citizen evaluations in planning and delivering rural services), a study focused on perceptions of community leaders and household respondents in eight rural Alabama counties. Research literature…

Community: The Missing Piece in Preparing Teacher Candidates for Future Urban Classrooms

ERIC Educational Resources Information Center

Marx, Dea; Pecina, Uzziel

2016-01-01

Preparing successful teacher candidates in urban schools requires educator preparation programs to integrate the exploration of community and cultures into the curriculum. Understanding the importance of community, interpreting and analyzing cultural implications, and creating new perceptions and understandings of urban students are essential for…

Feels Like the Third Wave: The Rise of Fundraising in the Community College

ERIC Educational Resources Information Center

Milliron, Mark David; de los Santos, Gerardo E.; Browning, Boo

2003-01-01

Not so long ago, the word "fundraising" scarcely made an appearance in the community college lexicon. Now, as our society moves from the industrial age to the information age, it can be considered part of a wave of change flooding across the community college movement, with clear implications for how community colleges teach, reach, and lead. In…

An Arts Advocacy Group Performs Community Arts Education: Community Development with Implications for K-12 Arts Education Policymaking

ERIC Educational Resources Information Center

Rademaker, Linnea L.

2007-01-01

In this article, the author revisits a case study presented in "Arts Education Policy Review" 105(1) in September/October 2003. The author discusses Arts Collaborator's Incorporated's (ACI) efforts to educate the community about art and about arts opportunities in River City. Themes visited in the discussion are community development through the…

An Exploratory Assessment of the Validity of the Community College Survey of Men (CCSM): Implications for Serving Veteran Men

ERIC Educational Resources Information Center

De La Garza, Thomas; Wood, J. Luke; Harris, Frank, III

2015-01-01

The Community College Survey of Men (CCSM) assesses predictors of student success for historically underrepresented and underserved men in community colleges. The instrument is designed to inform programming and service-delivery for male students (Wood & Harris, 2013). While the instrument was designed for community college men in general,…

Sources of Inequities in Rural America: Implications for Rural Community Development and Research. Community Development Research Series.

ERIC Educational Resources Information Center

Fujimoto, Isao; Zone, Martin

As part of a series prepared to acquaint small community officials with information on the latest community related research findings at the University of California at Davis, this monograph explicates the way in which tax structure, rural development assumptions, and even rural development policies and subsidies contribute to the inequities found…

Gendered negotiations for research participation in community-based studies: implications for health research policy and practice

PubMed Central

Kamuya, Dorcas M; Molyneux, Catherine, S; Theobald, Sally

2017-01-01

There is a growing literature documenting the complex realities of consent processes in the field, and the negotiations and ethical dilemmas involved. Much has also been written about how gender and power shape household decision-making processes. However, these bodies of literature have rarely been brought together to inform research theory and practice in low-income settings. In this paper, qualitative research (observation, focus group discussions and interviews) were used alongside large clinical community-based studies conducted on the Kenyan Coast to explore how gender and power relations within households and communities and between fieldworkers and communities shape consent processes and interactions. This exploration is embedded in relevant literature and the implications for community-based health research policy and practice are considered. Across diverse forms of households, we observed significant consultation on whether or not to participate in research. Although men are typically described as household decision-makers, in practice, decision-making processes are often far more nuanced, with many women using their agency to control, sometimes subtly, the decisions made. Where decisions are made without adequately consulting women, many find strategies to exercise their choice, in ways that safeguard important relationships within households in the longer term. We also found that the gender of field staff who typically conduct research activities in the field, including consent processes, can influence household dynamics and decision-making processes with important implications for the science and ethics of research. It is essential that frontline field staff and their supervisors are aware of the complex and gendered realities of consent processes at household level, and their implications, and that they develop appropriate context-informed approaches that support ethical practice. PMID:29225935

Assessing health in an urban neighborhood: community process, data results and implications for practice.

PubMed

Idali Torres, M

1998-06-01

This article examines the community process and data results of a health assessment conducted in an urban neighborhood of a middle-size city in Western Massachusetts. It describes the four-stage development process of the Health Assessment Project (HAP), a collaboration of the UMASS School of Public Health faculty and students, community based organizations and youth residents: (1) planning with a contemporary participatory approach, (2) implementing the data collection with traditional survey methodology, (3) tailoring the data analysis for a presentation at a community forum and report, and (4) incorporating the community's reaction to data results. In addition, it presents selected data results on health conditions of individual household members and perceived community health concerns and resources. Salient data results include high rates of chronic health conditions such as asthma and other respiratory problems among residents 0-18, back pain and other musculoskeletal among younger adults 19-54, and high blood pressure and other cardi-circulatory problems among older adults age 55 and older. The three most prevalent perceived community concerns are substance abuse, gangs and drug dealing. Identified community resources include sources of (1) providers of primary care, (2) health information as family/friends and Spanish media, (3) social activity such as churches and schools. Finally, this paper concludes by discussing implications for community health practice.

"Don't Look Now, Beauregard, But Isn't That A Camel Looking Under Our Tent?"

ERIC Educational Resources Information Center

Keim, William

1973-01-01

The immediate past president of the National Council for Community Services dercribes the developmant of the "continuing education unit", and its implications for community services practitioners. (Editor)

Decentralization in Zambia: resource allocation and district performance.

PubMed

Bossert, Thomas; Chitah, Mukosha Bona; Bowser, Diana

2003-12-01

Zambia implemented an ambitious process of health sector decentralization in the mid 1990s. This article presents an assessment of the degree of decentralization, called 'decision space', that was allowed to districts in Zambia, and an analysis of data on districts available at the national level to assess allocation choices made by local authorities and some indicators of the performance of the health systems under decentralization. The Zambian officials in health districts had a moderate range of choice over expenditures, user fees, contracting, targeting and governance. Their choices were quite limited over salaries and allowances and they did not have control over additional major sources of revenue, like local taxes. The study found that the formula for allocation of government funding which was based on population size and hospital beds resulted in relatively equal per capita expenditures among districts. Decentralization allowed the districts to make decisions on internal allocation of resources and on user fee levels and expenditures. General guidelines for the allocation of resources established a maximum and minimum percentage to be allocated to district offices, hospitals, health centres and communities. Districts tended to exceed the maximum for district offices, but the large urban districts and those without public district hospitals were not even reaching the minimum for hospital allocations. Wealthier and urban districts were more successful in raising revenue through user fees, although the proportion of total expenditures that came from user fees was low. An analysis of available indicators of performance, such as the utilization of health services, immunization coverage and family planning activities, found little variation during the period 1995-98 except for a decline in immunization coverage, which may have also been affected by changes in donor funding. These findings suggest that decentralization may not have had either a positive or negative impact on services.

Compensation patterns following occupational injuries in Zambia: results from the 2009 Labour Survey

PubMed Central

2010-01-01

Background Occupational injuries have received limited research attention in the Southern African Development Community. Much of the published data come from South Africa and little has been reported elsewhere within the region. The present study was conducted to estimate the prevalence rates of occupational injuries and compensation; and to determine factors associated with occupational injuries and compensation. Methods Data were obtained from occupational health and injury questions added to the Zambian Labour Force Survey of 2009 by the Work and Health in Southern Africa programme. Logistic regression analyses were conducted to determine the degree of association between demographic, social and economic factors on one hand and injury and compensation on the other. Results Data on 61871 study participants were available for analysis, of whom 4998 (8.1%) reported having been injured (10.0% of males, and 6.2% of females) due to work in the previous 12 months to the survey. Of those injured, 60.5% reported having stayed away from work as a result. The commonest type of injury was "open wound" (81.6%). Male gender, being married or married before, being a paid employee, working for a private company and household were positively associated with serious injuries. Injuries also varied by geographical area. Factors positively associated with receiving compensation for work-related injuries were: male gender, Copperbelt and North-Western provinces, and unpaid family worker. Employer/self employed and having less than 5 employees in a workplace were negatively associated with compensation. Conclusion The prevalence of reported injury and its association with a significant level of absence from work, indicate that occupational hazards in Zambia have significant health and economic effects. Female workers should equally be compensated for injuries suffered as their male counterparts. PMID:20825646

Assessing the impact of a food supplement on the nutritional status and body composition of HIV-infected Zambian women on ARVs.

PubMed

Zulu, Rodah M; Byrne, Nuala M; Munthali, Grace K; Chipeta, James; Handema, Ray; Musonda, Mofu; Hills, Andrew P

2011-09-21

Zambia is a sub-Saharan country with one of the highest prevalence rates of HIV, currently estimated at 14%. Poor nutritional status due to both protein-energy and micronutrient malnutrition has worsened this situation. In an attempt to address this combined problem, the government has instigated a number of strategies, including the provision of antiretroviral (ARV) treatment coupled with the promotion of good nutrition. High-energy protein supplement (HEPS) is particularly promoted; however, the impact of this food supplement on the nutritional status of people living with HIV/AIDS (PLHA) beyond weight gain has not been assessed. Techniques for the assessment of nutritional status utilising objective measures of body composition are not commonly available in Zambia. The aim of this study is therefore to assess the impact of a food supplement on nutritional status using a comprehensive anthropometric protocol including measures of skinfold thickness and circumferences, plus the criterion deuterium dilution technique to assess total body water (TBW) and derive fat-free mass (FFM) and fat mass (FM). This community-based controlled and longitudinal study aims to recruit 200 HIV-infected females commencing ARV treatment at two clinics in Lusaka, Zambia. Data will be collected at four time points: baseline, 4-month, 8-month and 12-month follow-up visits. Outcome measures to be assessed include body height and weight, body mass index (BMI), body composition, CD4, viral load and micronutrient status. This protocol describes a study that will provide a longitudinal assessment of the impact of a food supplement on the nutritional status of HIV-infected females initiating ARVs using a range of anthropometric and body composition assessment techniques. Pan African Clinical Trial Registry PACTR201108000303396.

Assessing the impact of a food supplement on the nutritional status and body composition of HIV-infected Zambian women on ARVs

PubMed Central

2011-01-01

Background Zambia is a sub-Saharan country with one of the highest prevalence rates of HIV, currently estimated at 14%. Poor nutritional status due to both protein-energy and micronutrient malnutrition has worsened this situation. In an attempt to address this combined problem, the government has instigated a number of strategies, including the provision of antiretroviral (ARV) treatment coupled with the promotion of good nutrition. High-energy protein supplement (HEPS) is particularly promoted; however, the impact of this food supplement on the nutritional status of people living with HIV/AIDS (PLHA) beyond weight gain has not been assessed. Techniques for the assessment of nutritional status utilising objective measures of body composition are not commonly available in Zambia. The aim of this study is therefore to assess the impact of a food supplement on nutritional status using a comprehensive anthropometric protocol including measures of skinfold thickness and circumferences, plus the criterion deuterium dilution technique to assess total body water (TBW) and derive fat-free mass (FFM) and fat mass (FM). Methods/Design This community-based controlled and longitudinal study aims to recruit 200 HIV-infected females commencing ARV treatment at two clinics in Lusaka, Zambia. Data will be collected at four time points: baseline, 4-month, 8-month and 12-month follow-up visits. Outcome measures to be assessed include body height and weight, body mass index (BMI), body composition, CD4, viral load and micronutrient status. Discussion This protocol describes a study that will provide a longitudinal assessment of the impact of a food supplement on the nutritional status of HIV-infected females initiating ARVs using a range of anthropometric and body composition assessment techniques. Trial Registration Pan African Clinical Trial Registry PACTR201108000303396. PMID:21936938

Community interaction and child maltreatment.

PubMed

Kim, Bomi; Maguire-Jack, Kathryn

2015-03-01

The way in which parents interact with their environment may have implications for their likelihood of abuse and neglect. This study examines the parent-environment relationship through community involvement and perception, using social disorganization theory. We hypothesize mothers who participate in their communities and have positive perceptions of them may be less likely to maltreat their children because of the potential protective capacity of neighborhood supports. Using information from the 5 year Fragile Families and Child Wellbeing Study (n=2991), the mother's self-reported acts of psychological and physical maltreatment and neglect are measured. A mother's community involvement index is the number of community activities a mother was involved in, and community perception is measured by two five-item Likert scales assessing perception of community collective efficacy. We analyze the relationship between community variables and each of mother's maltreatment behaviors as well as the interaction between community factors using a series of nested logistic regressions. Higher levels of community involvement are associated with lower levels of psychological aggression. More positive perception of community social control is associated with lower levels of physical assault. A moderation effect of community perception suggests that a mother's perception of her community changes the relationship between community involvement and psychological child abuse. The results provide important policy and empirical implications to build positive and supportive communities as a protective factor in child maltreatment. Getting parents involved in their communities can improve the environment in which children and families develop, and decrease the likelihood that maltreatment will occur. Copyright © 2013 Elsevier Ltd. All rights reserved.

Identifying the Organizational Changes Taking Place in Somali Community-Based Organization (CBO) in Response to New Patterns of Immigration: Implications for Adult Community Education

ERIC Educational Resources Information Center

Osman, Sirad Warfa

2009-01-01

This dissertation focuses on changes in the organizational development of community-based organizations (CBOs) within the context of new patterns of immigration, in the United States. Organizational development is considered within the context of dialects of growth, change and transformation of communities in transition. The primary goal of this…

Community health clinical education in Canada: part 2--developing competencies to address social justice, equity, and the social determinants of health.

PubMed

Cohen, Benita E; Gregory, David

2009-01-01

Recently, several Canadian professional nursing associations have highlighted the expectations that community health nurses (CHNs) should address the social determinants of health and promote social justice and equity. These developments have important implications for (pre-licensure) CHN clinical education. This article reports the findings of a qualitative descriptive study that explored how baccalaureate nursing programs in Canada address the development of competencies related to social justice, equity, and the social determinants of health in their community health clinical courses. Focus group interviews were held with community health clinical course leaders in selected Canadian baccalaureate nursing programs. The findings foster understanding of key enablers and challenges when providing students with clinical opportunities to develop the CHN role related to social injustice, inequity, and the social determinants of health. The findings may also have implications for nursing programs internationally that are addressing these concepts in their community health clinical courses.

The AACC Competencies and the PhD Completion Project: Practical Implications

ERIC Educational Resources Information Center

Sinady, Chantal; Floyd, Deborah L.; Mulder, Anne E.

2010-01-01

The American Association of Community Colleges (AACC) has identified a set of six competencies essential to effective community college leadership. Studies have been conducted to test the validity and usefulness of these competencies in such ways as by surveying community college professionals and to examine the effectiveness of graduate programs…

Schools and Religious Communities' Contributions to the Religious Formation of Christian Youth

ERIC Educational Resources Information Center

de Kock, A.

2015-01-01

This article questions the implications of tribal forms of religious socialization for (religious) schools' and communities' contributions to the religious formation of Christian youth. It clarifies that the religious education of a new generation of young Christians requires authorities and communities to connect in a worldwide pedagogical space…

The Parallels between Philosophical Inquiry and Scientific Inquiry: Implications for Science Education

ERIC Educational Resources Information Center

Burgh, Gilbert; Nichols, Kim

2012-01-01

The "community of inquiry" as formulated by C. S. Peirce is grounded in the notion of communities of discipline-based inquiry engaged in the construction of knowledge. The phrase "transforming the classroom into a community of inquiry" is commonly understood as a pedagogical activity with a philosophical focus to guide…

Electronic Monitoring of Sex Offenders: Identifying Unanticipated Consequences and Implications

ERIC Educational Resources Information Center

Demichele, Matthew; Payne, Brian K.; Button, Deeanna M.

2008-01-01

In recent years, increased legislative attention has been given to strategies to supervise sex offenders in the community. Among other policies, several states have passed laws calling for the use of electronic monitoring technologies to supervise sex offenders in the community. When initially developed, this community-based sanction was designed…

Community Reinforcement and the Dissemination of Evidence-Based Practice: Implications for Public Policy

ERIC Educational Resources Information Center

Milford, Jaime L.; Austin, Julia L.; Smith, Jane Ellen

2007-01-01

The Community Reinforcement Approach (CRA) and Community Reinforcement and Family Training (CRAFT) are both highly effective and empirically validated psychosocial approaches to the treatment of addictions whose unique designs may help achieve certain public health objectives. Literature will be reviewed to examine the potential impact of CRA and…

The Community College and a Rising Global Imaginary: An Analysis of Practical Reasoning, 1950-2013

ERIC Educational Resources Information Center

Ayers, David F.; Palmadessa, Allison L.

2015-01-01

Through an analysis of 245 issues of the "Community College Journal" published between 1950 and 2013, we show how three discourses--international understanding and geopolitics, economic competitiveness, and global citizenship--informed practical reasoning about a rising global imaginary and its implications for the community college. By…

Do College Youth Serve Others? How and under Which Circumstances? Implications for Promoting Community Service

ERIC Educational Resources Information Center

Griffith, James; Thomas, Todd

2014-01-01

This chapter describes how data on the extent of community service among a national representative sample of young college students were associated with "supports," including human, social, and cultural capital. This chapter helps fill missing information on estimates of the occurrence and persistence of community service, types of…

Theme with Variations: Social Policy, Community Care and Adult Education.

ERIC Educational Resources Information Center

Lavender, Peter

1990-01-01

Changes in British social policy regarding community health care has implications for local education agency (LEA) providers of adult continuing education. LEAs will either have a role in providing staff training and other learning opportunities, will be forced to provide cheaper forms of community care, or will be ignored altogether. (SK)

Living with Crime: The Implications of Racial/Ethnic Differences in Suburban Location.

ERIC Educational Resources Information Center

Alba, Richard D.; And Others

1994-01-01

In New Jersey suburban communities, blacks were most exposed to property and violent crime and whites and Asians were least exposed. Individual characteristics such as home ownership, income, and education did predict crime level of an individual's community, but contextual factors (community racial composition, poverty, and population size)…

Promoting Knowledge of Climate Change (CC) amongst Nigerians: Implications for Education Managers

ERIC Educational Resources Information Center

Akpomi, Margaret E.; Vipene, Joseph

2016-01-01

Rising sea levels, due to thermal expansion of the ocean, and higher frequency and intensity of coastal and inland storms threaten coastal communities worldwide. The implementation of pro-active, planned adaptation to reduce community vulnerability is strongly dependent upon people's awareness of the threat posed to their communities at the local…

The Law, Policy, and Politics of Formal Hypnosis in the Public Community College Classroom.

ERIC Educational Resources Information Center

Sachs, Steven Mark

Information from printed sources, legal documents, and interviews with community college administrators formed the basis of an investigation of the legal, policy, and political implications of the use of formal hypnosis as an instructional augmentation in the community college classroom. Study findings included the following: (1) no formal policy…

Community College Programs for Older Adults: A Status Report.

ERIC Educational Resources Information Center

Doucette, Don; Ventura-Merkel, Catherine

Part of an effort to expand and improve community college programs and services for older adults, this two-part report summarizes results from a national survey of older adult programs and provides an overview of current trends and their implications for action in community colleges. Following introductory sections, the report discusses a fall…

A Healthy Harvest: Adolescents Grow Food and Well-Being with Policy Implications for Education, Health and Community Planning

ERIC Educational Resources Information Center

Pevec, Illene Susan

2011-01-01

The severe youth health crisis involving overweight and obesity requires a complex policy response involving multiple domains: education, agriculture, health services, and community planning. This research examines gardening's affective benefits for adolescents and the potential school and youth gardens have to support healthy communities.…

As Your Community Grows... Some Economic Considerations.

ERIC Educational Resources Information Center

Gordon, John; Nelson, Glenn

Economic growth and development have many implications that need to be considered so that informed decisions regarding the community can be made. Although expansion of an existing establishment or a newly located plant or business are the primary means by which communities seek economic growth, growth can also occur when the new industry is…

Critical Pedagogy in HIV-AIDS Education for a Maya Immigrant Community

ERIC Educational Resources Information Center

Schoorman, Dilys; Acosta, Maria Cristina; Sena, Rachel; Baxley, Traci

2012-01-01

In this article the authors discuss how the perspectives of Paulo Freire were instructive in addressing the challenges of HIV-AIDS education in Guatemalan Maya immigrant communities with minimal formal education and literacy. The forging of a community-based, collaborative, educational program offers several implications for effective teaching and…

Community College Study Abroad: Implications for Student Success

ERIC Educational Resources Information Center

Raby, Rosalind Latiner; Rhodes, Gary M.; Biscarra, Albert

2014-01-01

The aim of this research is to explore whether participation in study abroad by community college students impacts levels of engagement and if there is a connection between studying abroad and academic achievement. While university-level studies have a history in exploring these questions, the same is not true for community colleges. The…

An information and dialogue conference on the human genome project (HGP) for the minority communities in the state of Louisiana

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

1999-06-01

Zeta Phi Beta Sorority National Educational Foundation, in cooperation with Xavier University of New Orleans, and the New Orleans District Office of the United States Equal Employment Opportunity Commission, held the Information and Dialogue Conference on the Human Genome Project for the Minority Communities in the State of Louisiana on April 16-17, 1999. The Conference was held on the campus of Xavier University in New Orleans. Community leaders, government officials, minority professional and social organizations leaders, religious leaders, persons from the educational and academic community, and students were invited. Conference objectives included bringing HGP information and a focus in themore » minority community on the project, in clear and understandable terms, to spread the work in the minority community about the project; to explore the likely positive implications with respect to health care and related matters; to explore possible negative results and strategies to meet them; to discuss the social, legal, and ethical implications; and to facilitate minority input into the HGP as it develops.« less

How community members and health professionals conceptualize medical emergencies: implications for primary care promotion.

PubMed

Wilkin, Holley A; Tannebaum, Michael A; Cohen, Elizabeth L; Leslie, Travie; Williams, Nora; Haley, Leon L

2012-12-01

Access to continuous care through a primary care provider is associated with improved health outcomes, but many communities rely on emergency departments (EDs) for both emergent and non-emergent health problems. This article describes one portion of a community-based participatory research project and investigates the type of education that might be needed as part of a larger intervention to encourage use of a local primary care clinic. In this article we examine how people who live in a low-income urban community and the healthcare workers who serve them conceptualize 'emergency medical condition'. We conducted forum and focus group discussions with 52 community members and individual interviews with 32 healthcare workers. Our findings indicate that while community members share a common general definition of what constitutes a medical emergency, they also desire better guidelines for how to assess health problems as requiring emergency versus primary care. Pain, uncertainty and anxiety tend to influence their choice to use EDs rather than availability of primary care. Implications for increasing primary care use are discussed.

The future of community pharmacy practice in South Africa in the light of the proposed new qualification for pharmacists: implications and challenges.

PubMed

Malangu, Ntambwe

2014-08-15

Community or retail pharmacies are regarded as one of the most common sources of health services throughout the world. In South Africa, community pharmacies have been providing some primary health care services to clients who could afford to pay. These services included screening, family planning, and emergency care for minor ailments. With the introduction of the new qualification, community pharmacies are poised to become providers of expanded services.  This paper describes the contents, the implications and challenges of the new qualification in light with future directions for community pharmacy practice in South Africa. Its purpose is to inform relevant stakeholders in South Africa and those outside South Africa that may pursue similar offerings. Published papers were identified through searches in MEDLINE and Google Scholar using a combination of search terms, namely: 'community, retail pharmacy, pharmacist/non-medical prescribing, South Africa'. Only articles published in English were considered. In addition, documents from the Ministry of Health of South Africa, the South African Pharmacy Council and curricula materials from schools of pharmacy were also reviewed. Laureates of the new qualification will essentially have the right to examine, diagnose, prescribe and monitor the treatment of their clients or patients. In doing so, this expanded function of prescribing for primary healthcare will imply several practice and infrastructural adjustments; and with many challenges laying ahead in need to be addressed. In conclusion, the authorized pharmacist prescriber qualification augurs a new era for community pharmacy practice in South Africa. This has many implications and some challenges that need to be managed. The pharmacy profession, academia, legislators and political decision-makers need to work together to resolve outstanding issues in a constructive manner.

Executive summary: Climate change in the northwest: Implications for our landscapes, waters, and communities

USGS Publications Warehouse

Dalton, Meghan M.; Bethel, Jeffrey; Capalbo, Susan M.; Cuhaciyan, J.E.; Eigenbrode, Sanford D.; Glick, Patty; Houston, Laurie L.; Littell, Jeremy S.; Lynn, Kathy; Mote, Philip W.; Raymondi, Rick R.; Reeder, W. Spencer; Shafer, Sarah L.; Snover, Amy K.

2013-01-01

Climate Change in the Northwest: Implications for Our Landscapes, Waters, and Communities is aimed at assessing the state of knowledge about key climate impacts and consequences to various sectors and communities in the northwest United States. It draws on a wealth of peer-reviewed literature, earlier state-level assessment reports conducted for Washington (2009) and Oregon (2010), as well as a risk-framing workshop. As an assessment, it aims to be representative (though not exhaustive) of the key climate change issues as reflected in the growing body of Northwest climate change science, impacts, and adaptation literature now available. This report will serve as an updated resource for scientists, stakeholders, decision makers, students, and community members interested in understanding and preparing for climate change impacts on Oregon, Washington, and Idaho. This more detailed, foundational report is intended to support the key findings presented in the Northwest chapter of the Third National Climate Assessment.

The ADA Mandate for Social Change.

ERIC Educational Resources Information Center

Wehman, Paul, Ed.

This book analyzes the effectiveness and implications for social change of the Americans with Disabilities Act (ADA). It outlines several issues--legal implications, physical accessibility, transportation options, employment opportunities, and recreation--that stimulate community action for full inclusion. Part I, titled "Definitions and…

Who Guards the Guardians? National Implications of Accreditation at City College of San Francisco

ERIC Educational Resources Information Center

Barber, Bob; McNair, Delores E.

2017-01-01

Purpose: This article addresses the broad context of community college accreditation which surrounds a controversy involving one of the largest community colleges in the United States, City College of San Francisco (CCSF), and its regional accrediting agency, the Accrediting Commission for Community and Junior Colleges (ACCJC). Its purposes are to…

Understanding Contexts of Family Violence in Rural, Farming Communities: Implications for Rural Women's Health

ERIC Educational Resources Information Center

Wendt, Sarah; Hornosty, Jennie

2010-01-01

Research on family violence in rural communities in Australia and Canada has shown that women's experience of family violence is shaped by social and cultural factors. Concern for economic security and inheritance for children, closeness and belonging, and values of family unity and traditional gender roles are factors in rural communities that…

Guidelines For Implementation of Industrial Programs For Proposed Community Colleges in Venezuela.

ERIC Educational Resources Information Center

Sada, Pablo Maria

The purpose of this study was to examine selected industrial education departments and programs of the community colleges in the United States, and to draw some beneficial implications for the establishment of the proposed community colleges in Venezuela. The procedure involved a review of the literature, the construction of a questionnaire, and…

Dimensions of Leadership among Community College Health Career Program Department Chairs and Implications for Leadership Development

ERIC Educational Resources Information Center

Platz-Wiechert, Lynn Marie

2010-01-01

Given the growth in community colleges, the projected need for health career workers, and the central position of the department chair in higher education, this study explored dimensions of leadership as identified by health career department chairs in five Illinois community colleges. Areas of study included: (a) professional profiles of health…

State Higher Education Performance Funding for Community Colleges: Diverse Effects and Policy Implications

ERIC Educational Resources Information Center

Tandberg, David A.; Hillman, Nichola; Barakat, Mohamed

2014-01-01

Background/Context: Community colleges are central to the United States' college completion goals. A popular strategy pushed by a number of influential policy organizations and foundations is a policy of tying state funding to community college completions, otherwise known simply as performance funding. This is happening despite little to no…

Teacher Use of Community Resources in the Development of Business, Industry, and Education Partnerships.

ERIC Educational Resources Information Center

Flick, Lawrence B.; Fekete, Donald; Hawkins, Bruce H.; Stone, Richard H.

1995-01-01

Reports the results of a study on teacher use of community resources to provide background for program development. Focuses on the Hanford Education Consortium in Washington. Discusses the implications that the results of the study have for the ongoing design of a program for sharing community expertise with schools. (DDR)

Community Satisfaction: Implications for Army Communities

DTIC Science & Technology

1990-08-01

1954) hierarchical theory of motivation, hypothesize that a hierarchy of community services exists, such that basic human needs must be provided for...help in an emergency (Ahlbrandt, 1984). Neighbors 13 may provide socioemotional support, which is positively associated with neighborhood satisfaction...Saroson & B. R. Sarason (Eds.), Social .support: Theory , research and applications. Boston: Martinus Nijhoff. Baldassare, M. (1979). Residential crowding

A Needs Assessment for a Community College Outreach Program: Implications for Curriculum Development.

ERIC Educational Resources Information Center

Smith, Jack E.

An educational needs assessment of the seven-community service area of Los Angeles Harbor College (California) was conducted to identify sources of demographic information, and to analyze and compile this information to provide a resource for both college and community committees in drafting plans for an expanded outreach program. A four-point…

Internet Use among Community College Students: Implications in Designing Healthcare Interventions.

ERIC Educational Resources Information Center

Hanauer, David; Dibble, Emily; Fortin, Jennifer; Col, Nananda F.

2004-01-01

The Internet has become a commonly used venue for seeking healthcare information. Young adults search the Internet for health information more than any other group, yet little is known about use patterns among community college students. The authors surveyed a diverse community college to assess students' use of the Internet for health-related…

Community Capacity for Environmental Health Promotion: Determinants and Implications for Practice

ERIC Educational Resources Information Center

Freudenberg, Nicholas

2004-01-01

The human response to an environmental hazard can either reduce or exacerbate its impact on health. This article reviews determinants of community-level responses to environmental health hazards. The aim is to identify factors that can enhance a community's capacity to protect itself and to suggest public health strategies that can increase such…

Service-Learning: Implications for Empathy and Community Engagement in Elementary School Children

ERIC Educational Resources Information Center

Scott, Katharine E.; Graham, James A.

2015-01-01

The literature on service-learning outcomes in pre-adolescent children is relatively sparse. Empathy (i.e., overall, cognitive, affective) and community engagement (i.e., connection to the community, civic awareness, civic efficacy) were assessed in 155 first, second, and fifth graders (n = 79 males; n = 76 females) using a pre/post design for a…

Community Connections: Integrating Community-Based Field Experiences to Support Teacher Education for Diversity

ERIC Educational Resources Information Center

Beaudry, Christine

2015-01-01

In the United States, preservice teachers often graduate and go on to work with students whose backgrounds are different from their own and in communities in which they have limited lived experience (Sleeter 2000). This holds significant implications for teacher education programs given the importance of life and educational experiences in…

Microbial community variation and its relationship with nitrogen mineralization in historically altered forests

Treesearch

Jennifer M. Fraterrigo; Teri C. Balser; Monica g. Turner

2006-01-01

Past land use can impart soil legacies that have important implications for ecosystem function. Although these legacies have been linked with microbially mediated processes, little is known about the long-term influence of land use on soil microbial communities themselves. We examined whether historical land use affected soil microbial community composition (lipid...

Connectedness to the criminal community and the community at large predicts 1-year post-release outcomes among felony offenders

PubMed Central

Folk, Johanna B.; Mashek, Debra; Tangney, June; Stuewig, Jeffrey; Moore, Kelly E.

2016-01-01

Connectedness to one's community relates to positive psychological and behavioral outcomes. But what implications do connectedness to distinct communities—the criminal community and the community at large—have for inmates about to be released from jail? This study (N = 383) prospectively examined connectedness to the criminal community and community at large prior to release from jail, and functioning at one-year post-release. Connectedness to the community at large positively predicted community adjustment whereas connectedness to the criminal community positively predicted recidivism. Targeting both types of community connectedness may enhance interventions intended to undermine recidivism and increase positive outcomes for inmates. PMID:27524842

The Male Role in Contraception: Implications for Health Education.

ERIC Educational Resources Information Center

Chng, Chwee Lye

1983-01-01

Many males still perceive contraception as a woman's responsibility. This paper describes male contraceptives and their effectiveness and draws implications for school and community health education professionals. More equitable sharing of the responsibility for contraception might result in more effective contraception. (PP)

A Constructive Reframing of Student Roles and Systems Learning in Medical Education Using a Communities of Practice Lens.

PubMed

Gonzalo, Jed D; Thompson, Britta M; Haidet, Paul; Mann, Karen; Wolpaw, Daniel R

2017-12-01

Health systems are in the midst of a transformation that is being driven by a variety of forces. This has important implications for medical educators because clinical practice environments play a key role in learning and professional development, and evolving health systems are beginning to demand that providers have "systems-ready" knowledge, attitudes, and skills. Such implications provide a clear mandate for medical schools to modify their goals and prepare physicians to practice flexibly within teams and effectively contribute to the improvement of health care delivery. In this context, the concepts of value-added medical education, authentic student roles, and health systems science are emerging as increasingly important. In this Article, the authors use a lens informed by communities of practice theory to explore these three concepts, examining the implications that the communities of practice theory has in the constructive reframing of educational practices-particularly common student roles and experiences-and charting future directions for medical education that better align with the needs of the health care system. The authors apply several key features of the communities of practice theory to current experiential roles for students, then propose a new approach to students' clinical experiences-value-added clinical systems learning roles-that provides students with opportunities to make meaningful contributions to patient care while learning health systems science at the patient and population level. Finally, the authors discuss implications for professional role formation and anticipated challenges to the design and implementation of value-added clinical systems learning roles.

THE NEIGHBORHOOD YOUTH CORPS AND THE COMMUNITY, AN EXPLORATORY STUDY OF THE IMPLICATIONS OF A FEDERAL ANTI-POVERTY PROGRAM FOR MILWAUKEE, WISCONSIN.

ERIC Educational Resources Information Center

CARO, FRANCIS G.

TWO APPROACHES WERE USED IN STUDYING THE EFFECTS OF THE NEIGHBORHOOD YOUTH CORPS (NYC) ON MILWAUKEE, WISCONSIN -- (1) IMPLICATIONS FOR THE INTERNAL AND EXTERNAL OPERATIONS OF ORGANIZATIONS INVOLVED IN ITS WORK FLOW, AND (2) IMPLICATIONS FOR SPECIFIC PROBLEMS IN THE YOUTH AND POVERTY AREAS (SCHOOL ATTENDANCE AND ACHIEVEMENT, JUVENILE DELINQUENCY,…

Stem cell terminology: practical, theological and ethical implications.

PubMed

Shanner, Laura

2002-01-01

Stem cell policy discussions frequently confuse embryonic and fetal sources of stem cells, and label untested, non-reproductive cloning as "therapeutic." Such misnomers distract attention from significant practical and ethical implications: accelerated research agendas tend to be supported at the expense of physical risks to women, theological implications in a multi-faith community, informed consent for participation in research, and treatment decisions altered by unrealistic expectations.

Responding to Past and Present Needs

ERIC Educational Resources Information Center

Morris, J. W.

1975-01-01

The Director of Civil Works, U. S. Corps of Engineers, presents thoughts to aid in answering questions related to the relationship between community action and great works, between community action and civilization, and the implications of these relationships for those we train. (GS)

Molecular Survey of Concrete Sewer Biofilm Microbial Communities

EPA Science Inventory

Although bacteria are implicated in deteriorating concrete structures, there is very little information on the composition of concrete microbial communities. To this end, we studied different concrete biofilms by performing sequence analysis of 16S rDNA concrete clone libraries. ...

Learning from Decoding across Disciplines and within Communities of Practice

ERIC Educational Resources Information Center

Miller-Young, Janice; Boman, Jennifer

2017-01-01

This final chapter synthesizes the findings and implications derived from applying the Decoding the Disciplines model across disciplines and within communities of practice. We make practical suggestions for teachers and researchers who wish to apply and extend this work.

The health implications of deportation policy.

PubMed

Morris, Juliana E; Palazuelos, Daniel

2015-05-01

The United States detains and deports over 400,000 people annually. This large-scale effort has important consequences for the health of affected individuals and communities. A growing body of research suggests that deportation increases stress and mental illness, economic deprivation, and individual exposure to violence, while also contributing to destabilization and crime at the community level. The challenges to reintegration experienced by deportees are additional push factors that increase their desire to re-emigrate. Furthermore, the related destabilization of local communities also contributes to the push, not just for deportees, but for all affected people in the region. This phenomenon has important implications for the long-term effectiveness of current U.S. deportation policies, which may be contributing to destabilization in home countries and thus potentiating further unauthorized emigration to the U.S.

An Early History of the Rural Community College Initiative: Reflections on the Past and Implications for the Future

ERIC Educational Resources Information Center

Kennamer, Mike; Katsinas, Stephen G.

2011-01-01

The $17.2 million Rural Community College Initiative (RCCI) demonstration grant program funded by the Ford Foundation which ran from 1994 to 2001 represents the largest philanthropic project specifically aimed at rural community colleges in United States history. While a good deal of literature has been published about this initiative, much was…

Effects of land-cover change on spatial pattern of forest communities in the Southern Appalachian Mountains (USA)

Treesearch

Monica G. Turner; Scott M. Pearson; Paul Bolstad; David N. Wear

2003-01-01

Understanding the implications of past. present and future patterns of human land use for biodiversity and ecosystem function is increasingly important in landscape ecology. We examined effects of land-use change on four major forest communities of the Southern Appalachian Mountains (USA), addressed two questions: (1) Are and forest communities differentially...

Attitudes and Perceptions about Private Philanthropic Giving to Arizona Community Colleges and Universities: Implications for Practice

ERIC Educational Resources Information Center

Martinez, George Andrew

2009-01-01

Wide disparity exists in philanthropic giving to public, two-year community colleges as compared to public, four-year universities. Recent estimates indicate that 0.5 to 5% of all private philanthropic giving to U.S. higher education annually goes to public, two-year community colleges, with the remainder going to public and private four-year…

Implications of Community Activism among Urban Minority Young People for Education for Engaged and Critical Citizenship

ERIC Educational Resources Information Center

Nam, Chaebong

2012-01-01

Citizenship is fundamentally defined by praxis--i.e., engagement in local and diverse forms of civic practices--rather than by a legal status tied to the nation-state (Tully, 2008). This study examined the participatory democracy practices of a community activist group that was organizing to resist gentrification in a Puerto Rican community in…

Levels of Community Cohesion: Theorizing the UK Agenda and the Implications for Policy and Practice in Schools

ERIC Educational Resources Information Center

Parker-Jenkins, Marie; Glenn, Meli

2011-01-01

This paper explores the concept of "community engagement," a central theme within a British research project examining the issues of cultural sustainability among faith-based schools. Discussion is informed by the views of Muslim and Jewish school community stakeholders at the time when the policy of social cohesion was being legally…

Policy, Leadership, and Student Achievement: Implications for Urban Communities. The Achievement Gap, Research, Practice, and Policy

ERIC Educational Resources Information Center

McGuire, C. Kent, Ed.; Ikpa, Vivian W., Ed.

2008-01-01

This is the second book in the series examining student achievement. The chapters in this book reflect the scholarly papers presented at the July 2006 Education Policy, Leadership Summer Institute (EPLSI) by K-16 educators, researchers, community advocates, and policymakers who work in urban communities. The Institute serves as a place where…

Community College Student Alcohol Use: Developing Context-Specific Evidence and Prevention Approaches

ERIC Educational Resources Information Center

Wall, Andrew F.; BaileyShea, Chelsea; McIntosh, Scott

2012-01-01

The objective of this study was to examine the prevalence of heavy alcohol use, related harm, and implications for prevention among community college students. We used data from 7,965 students at 19 community colleges who responded to the Core Alcohol and Other Drug Survey. This secondary analysis of the survey data found heavy consumption among…

Gender-specific behavioral health and community release patterns among New Jersey prison inmates: implications for treatment and community reentry.

PubMed

Blitz, Cynthia L; Wolff, Nancy; Pan, Ko-Yu; Pogorzelski, Wendy

2005-10-01

We describe behavioral health diagnoses and community release patterns among adult male and female inmates in New Jersey prisons and assess their implications for correctional health care and community reentry. We used clinical and classification data on a census of "special needs" inmates (those with behavioral health disorders) in New Jersey (n=3189) and a census of all special needs inmates released to New Jersey communities over a 12-month period (n=974). Virtually all adult inmates with special needs had at least 1 Axis I mental disorder, and 68% of these had at least 1 additional Axis I mental disorder, a personality disorder, or addiction problem (67% of all male and 75% of all female special needs inmates). Of those special needs inmates released, 25% returned to the most disadvantaged counties in New Jersey (27% of all male and 18% of all female special needs inmates). Two types of clustering were found: gender-specific clustering of disorders among inmates and spatial clustering of ex-offenders in impoverished communities. These findings suggest a need for gendered treatment strategies within correctional settings and need for successful reentry strategies.

Factors associated with self-reported health: implications for screening level community-based health and environmental studies

EPA Science Inventory

BACKGROUND: Advocates for environmental justice, local, state, and national public health officials, exposure scientists, need broad-based heath indices to identify vulnerable communities. Longitudinal studies show that perception of current health status predicts subsequent mort...

SPATIAL AGGREGATION IN A FOREST FLOOR INSECT DEPENDS ON SEASONAL CONGREGATION AND SCATTERING EFFECTS OF PREDATORS

EPA Science Inventory

Spatial aggregations arising from gregarious behavior are common in nature and have important implications for population dynamics, community stability, and conservation. However, the translation of aggregation behaviors into emergent properties of populations and communities de...

Identifying Automotive Changes in Facilities and Capital Equipment and Assessing Community and Employment Impacts

DOT National Transportation Integrated Search

1981-05-01

The paper presents a brief overview of the many forces impacting the automotive and related industries, and the resultant implications of these forces on facilities, employment and communities. It focuses on the facility planning and capital investme...

Methodological issues in medical workforce analysis: implications for regional Australia.

PubMed

Hays, R B; Veitch, P C; Franklin, L; Crossland, L

1998-02-01

Medical workforce data have a profound impact on health policy formulation, but derived doctor population ratios (DPR) are often more relevant to plotting national trends than providing a detailed regional or local workforce perspective. Regional workforce data may be more useful if national approaches are augmented by local information. In developing a detailed workforce analysis for one region of Australia, the authors encountered several challenging methodological issues, including the accuracy of medical workforce databases, clarity of definition of community boundaries, interpretation of workforce definitions and the difficulty accounting for local community needs. This paper discusses the implications for regional workforce research.

Low Income Life-Styles and the Consumption of Durable Goods: Implications for Consumer Educators

ERIC Educational Resources Information Center

Jolly, Desmond A.

1978-01-01

Low-income consumers badly need special purchasing skills, due to merchandising practices and greater markups for durable goods in low-income communities. The author discusses some of the ways in which these people are victimized, with implications for consumer education. (MF)

Genetic Counseling: Implications for Community Counselors.

ERIC Educational Resources Information Center

Bodenhorn, Nancy; Lawson, Gerard

2003-01-01

Special issue of the "Journal of Health Psychology" (Vol. 7, No. 2, 2002) was reviewed. Articles covered a variety of qualitative studies conducted using an interpretive phenomenological analysis method to examine the interviews with people who had received genetic testing and counseling. Implications for the broader counseling field…

ANTHROPOGENIC NUTRIENT INPUT AND ITS INFLUENCE ON PLANT COMPETITIVE OUTCOMES: IMPLICATIONS FOR HABITAT DEGRADATION AND COMMUNITY SHIFTS

EPA Science Inventory

By taking a multifactorial approach, the study will document complex aquatic plant responses to NPS nutrient contamination, providing fundamental insight into the broader impacts of environmental degradation, its impacts on plant function, and implications for ecosystem ser...

Forensic community mental health nurses' perceptions of statutory community aftercare: implications for practice.

PubMed

Riordan, Sharon; Wix, Stuart; Humphreys, Martin

2005-01-01

The key role played by forensic community mental health nurses in statutory community aftercare for mentally disordered offenders in England and Wales has been successful. The nurses often have the most contact with this patient population, yet paradoxically, have not been asked to express their views about the process. The pivotal role undertaken by this professional group appears to be fundamental to the success of statutory aftercare for this patient group.

A trait-based approach for examining microbial community assembly

NASA Astrophysics Data System (ADS)

Prest, T. L.; Nemergut, D.

2015-12-01

Microorganisms regulate all of Earth's major biogeochemical cycles and an understanding of how microbial communities assemble is a key part in evaluating controls over many types of ecosystem processes. Rapid advances in technology and bioinformatics have led to a better appreciation for the variation in microbial community structure in time and space. Yet, advances in theory are necessary to make sense of these data and allow us to generate unifying hypotheses about the causes and consequences of patterns in microbial biodiversity and what they mean for ecosystem function. Here, I will present a metaanalysis of microbial community assembly from a variety of successional and post-disturbance systems. Our analysis shows various distinct patterns in community assembly, and the potential importance of nutrients and dispersal in shaping microbial community beta diversity in these systems. We also used a trait-based approach to generate hypotheses about the mechanisms driving patterns of microbial community assembly and the implications for function. Our work reveals the importance of rRNA operon copy number as a community aggregated trait in helping to reconcile differences in community dynamics between distinct types of successional and disturbed systems. Specifically, our results demonstrate that decreases in average copy number can be a common feature of communities across various drivers of ecological succession, supporting a transition from an r-selected to a K-selected community. Importantly, our work supports the scaling of the copy number trait over multiple levels of biological organization, from cells to populations and communities, and has implications for both ecology and evolution. Trait-based approaches are an important next step to generate and test hypotheses about the forces structuring microbial communities and the subsequent consequences for ecosystem function.

Peer Outreach Work as Economic Activity: Implications for HIV Prevention Interventions among Female Sex Workers

PubMed Central

George, Annie; Blankenship, Kim M.

2015-01-01

Female sex workers (FSWs) who work as peer outreach workers in HIV prevention programs are drawn from poor socio-economic groups and consider outreach work, among other things, as an economic activity. Yet, while successful HIV prevention outcomes by such programs are attributed in part to the work of peers who have dense relations with FSW communities, there is scant discussion of the economic implications for FSWs of their work as peers. Using observational data obtained from an HIV prevention intervention for FSWs in south India, we examined the economic benefits and costs to peers of doing outreach work and their implications for sex workers’ economic security. We found that peers considered their payment incommensurate with their workload, experienced long delays receiving compensation, and at times had to advance money from their pockets to do their assigned peer outreach work. For the intervention these conditions resulted in peer attrition and difficulties in recruitment of new peer workers. We discuss the implications of these findings for uptake of services, and the possibility of reaching desired HIV outcomes. Inadequate and irregular compensation to peers and inadequate budgetary outlays to perform their community-based outreach work could weaken peers’ relationships with FSW community members, undermine the effectiveness of peer-mediated HIV prevention programs and invalidate arguments for the use of peers. PMID:25775122

Peer outreach work as economic activity: implications for HIV prevention interventions among female sex workers.

PubMed

George, Annie; Blankenship, Kim M

2015-01-01

Female sex workers (FSWs) who work as peer outreach workers in HIV prevention programs are drawn from poor socio-economic groups and consider outreach work, among other things, as an economic activity. Yet, while successful HIV prevention outcomes by such programs are attributed in part to the work of peers who have dense relations with FSW communities, there is scant discussion of the economic implications for FSWs of their work as peers. Using observational data obtained from an HIV prevention intervention for FSWs in south India, we examined the economic benefits and costs to peers of doing outreach work and their implications for sex workers' economic security. We found that peers considered their payment incommensurate with their workload, experienced long delays receiving compensation, and at times had to advance money from their pockets to do their assigned peer outreach work. For the intervention these conditions resulted in peer attrition and difficulties in recruitment of new peer workers. We discuss the implications of these findings for uptake of services, and the possibility of reaching desired HIV outcomes. Inadequate and irregular compensation to peers and inadequate budgetary outlays to perform their community-based outreach work could weaken peers' relationships with FSW community members, undermine the effectiveness of peer-mediated HIV prevention programs and invalidate arguments for the use of peers.

Adjusting to Community College as an International Student in Appalachia

ERIC Educational Resources Information Center

Guyton, Deirdre T.

2017-01-01

The study examines the primary aspects of academic, cultural, and social challenges affecting international students attending community colleges in rural Appalachia. Through qualitative interviews with international students, this study explores academic, cultural, and social challenges. Implications for programs to assist international students…

Service Learning in Light of Emmanuel Levinas

ERIC Educational Resources Information Center

Sherman, Glen L.

2016-01-01

Emmanuel Levinas, a twentieth century French Continental philosopher, proposed an original understanding of ethics which has serious implications for the particular activities within higher education designated as service learning and community service. First I will define service learning and community service and briefly review the theoretical…

Community leadership competencies in the Northeast US: implications for training public health educators.

PubMed Central

Strand, G A

1981-01-01

A survey was conducted to determine leadership competencies as perceived by 679 community residents (urban/rural) in six states of the Northeast United States. Respondents were asked to rate the extent to which it is important for a community leader to use each competency listed in the instrument. A factor analysis reduced the list of 39 competency items examined into nine distinct factors. Alpha internal consistency estimates revealed the strength of correlation among items in each factor. A series of one-way analyses of variance failed to show a significant difference between urban/rural community respondents' scores for each factor. The findings suggest specific leadership competencies which should be emphasized in training experiences. Conceptual competencies were identified as most important (problem delineation, organization, management of change, etc.), followed by human competencies (demeanor, empathy, attitudes) and technical competencies (budgeting, supervision, needs assessment) respectively. Items within each factor have implications for development of specific content areas in a leadership training curriculum for public health educators. PMID:7468880

Insights into the Shifting Perspectives of Members of the Gypsy and Traveller Community on Schooling, and Implications for School Leaders

ERIC Educational Resources Information Center

Smith, Anna R. T.

2017-01-01

This article focuses on the perceptions and experiences of education of two female adult members of the Gypsy and Traveller community and one female adult member of the settled community who works closely with Travellers. Narrative interviews were conducted in England in 2016, to gain some understanding of the factors contributing to the…

Tribal Militias: An Effective Tool to Counter Al-Qaida and Its Affiliates?

DTIC Science & Technology

2014-11-01

Army issues affecting the national security community . The Peacekeeping and Stability Operations Institute provides subject matter expertise...implications for the Army, the Department of Defense, and the larger national security community . In addition to its studies, SSI publishes special reports on...newsletter to update the national security community on the research of our analysts, recent and forthcoming publications, and upcoming confer- ences

Bruce's Magnificent Quartet: Inquiry, Community, Technology and Literacy--Implications for Renewing Qualitative Research in the Twenty-First Century

ERIC Educational Resources Information Center

Davidson, Judith

2014-01-01

Bruce and Bishop's community informatics work brings forward four critical concepts: inquiry, community, technology, and literacy. These four terms serve as the basis for a discussion of qualitative research in the twenty-first century--what is lacking and what is needed. The author suggests that to resolve the tensions or challenges…

User-Generated Content, YouTube and Participatory Culture on the Web: Music Learning and Teaching in Two Contrasting Online Communities

ERIC Educational Resources Information Center

Waldron, Janice

2013-01-01

In this paper, I draw on seminal literature from new media researchers to frame the broader implications that user-generated content (UGC), YouTube, and participatory culture have for music learning and teaching in online communities; to illustrate, I use examples from two contrasting online music communities, the Online Academy of Irish…

Adult Motivations in Community Orchestra Participation: A Pilot Case Study of the Bergen Philharmonic Orchestra (New Jersey)

ERIC Educational Resources Information Center

Shansky, Carol

2010-01-01

The purpose of this study was to explore the motivations of adults in choosing to participate in community orchestras. This paper identifies many of those motivations and examines the reasons and implications of why the adults in the study chose to continue to play in community orchestras. The investigation was conducted in 2007 via a case study…

Mental Illness in Offender Populations: Prevalence, Duty and Implications

ERIC Educational Resources Information Center

Soderstrom, Irina R.

2007-01-01

Prisons are increasingly being filled with inmates who suffer from mental illness. This paper examines the prevalence of mental illness in American jails and prisons, the duty government and society has to provide appropriate mental health treatment, and the implications for inmate safety, costs, recidivism, and community reintegration if…

Tax Reform Implications for Rural Communities and Farmers.

ERIC Educational Resources Information Center

Durst, Ron L.; Reeder, Richard J.

1987-01-01

Discusses indirect and long-term rural implications of tax reform: elimination of local sales tax deduction, limits on local bond issues. Summarizes major tax changes affecting agriculture: individual income taxes, corporate tax rates, tax treatment of capital, capital gains, land deductions, cash accounting, development costs, passive losses and…

Eastern Kentuckians View Their Quality of Life: Implications for Development.

ERIC Educational Resources Information Center

Coughenour, C. Milton; Coleman, A. Lee

Data from 1961, 1971, and 1973 surveys of households and community "knowledgeables" focused on the subjective assesssments of the quality of life (QOL) of residents of Harlan, Perry, Whitley, and Wolfe counties in Eastern Kentucky, and assessed policy implications. Overall, residents assessed their counties favorably. They rated wages…

AIDS: Implications for Homosexual Self-Help and Support Efforts.

ERIC Educational Resources Information Center

Toro-Alfonso, Jose

The Colectivo de Concientizacion Gay, a homosexual and lesbian organization in Puerto Rico, developed a brief analysis of what has happened since symptoms associated with acquired immunodeficiency syndrome (AIDS) were first reported by the Centers for Disease Control in 1981; the analysis also included implications for the gay community. Since…

CATV and Its Implications for Libraries.

ERIC Educational Resources Information Center

Thomassen, Cora E., Ed.

The theme of the nineteenth Allerton Park Institute, held in November, 1973, centered on the implications of cable television for libraries. Nine of the oral presentations were edited for inclusion in this collection. The subjects covered are: the relationship between libraries and cable TV; the possibilities of a community network; franchising…

Moving Beyond “China in Africa”: Insights from Zambian Immigration Data

PubMed Central

Postel, Hannah

2017-01-01

China’s growing presence in Africa is not news: the expansion of bilateral trade and investment ties has garnered intense media and political focus over the past decade. However, less is known about the people accompanying these increasingly intensive flows of goods and capital. This paper focuses on Zambia, drawing on multiple primary datasets to shed light on both the scale and nature of Chinese migration to the continent. Two years of Department of Immigration employment-permit data serve as the basis for the first quantitative analysis of the “Chinese” in “Africa,” illuminating the increasing diversity of this population flow. While the growing Chinese presence in Africa is often viewed as a coherent neocolonialist strategy planned and implemented by the Chinese state, this paper demonstrates that it is in fact typified by a multitude of both public and private actors with independent motives. PMID:29151983

Vulnerability and sexual and reproductive health among Zambian secondary school students.

PubMed

Warenius, Linnéa; Pettersson, Karen O; Nissen, Eva; Höjer, Bengt; Chishimba, Petronella; Faxelid, Elisabeth

2007-01-01

The present study aimed to explore secondary school students' needs in relation to sexual and reproductive health in order to inform efforts to improve the quality of health services available to young people. The study involved data collection from 716 11-22-year-old students in four secondary schools in an urban area in Zambia. Students completed a questionnaire and were invited to write down any inquiries they had regarding sexuality and reproduction. Findings revealed that boys and girls lack adequate information about human reproduction and STIs, including HIV. To avoid misconceptions and myths, they also need clear information on contraceptives and masturbation. Responses indicate that young people would welcome guidance and support related to contraception, pregnancy, abortion and STIs/HIV, but also on love and relationships. Culture, religion and gender are important factors influencing sexuality and sexual abuse. These issues need to be taken into consideration when developing youth-friendly programmes for young people.

Identifying Factors for Worker Motivation in Zambia's Rural Health Facilities.

PubMed

Cross, Samuel S; Baernholdt, Dr Marianne

2017-01-01

Within Zambia there is a shortage of health workers in rural areas. This study aims to identify motivating factors for retaining rural health workers. Sixty rural health workers completed surveys and 46 were interviewed. They rated the importance of six motivating factors and discussed these and other factors in interviews. An interview was conducted with a Government Human Resources Manager (HR Manager) to elicit contextual information. All six factors were identified as being very important motivators, as were two additional factors. Additional career training was identified by many as the most important factor. Comparison of results and the HR Manager interview revealed that workers lacked knowledge about opportunities and that the HR manager was aware of barriers to career development. The Zambian government might better motivate and retain rural health workers by offering them any combination of identified factors, and by addressing the barriers to career development.

Cost-effectiveness of three different vaccination strategies against measles in Zambian children.

PubMed

Dayan, Gustavo H; Cairns, Lisa; Sangrujee, Nalinee; Mtonga, Anne; Nguyen, Van; Strebel, Peter

2004-01-02

The vaccination program in Zambia includes one dose of measles vaccine at 9 months of age. The objective of this study was to compare the cost-effectiveness of the current one-dose measles vaccination program with an immunization schedule in which a second dose is provided either through routine health services or through supplemental immunization activities (SIAs). We simulated the expected cost and impact of the vaccination strategies for an annual cohort of 400,000 children, assuming 80% vaccination coverage in both routine and SIAs and an analytic horizon of 15 years. A vaccination program which includes SIAs reaching children not previously vaccinated would prevent on additional 29,242 measles cases and 1462 deaths for each vaccinated birth cohort when compared with a one-dose program. Given the parameters established for this analysis, such a program would be cost-saving and the most cost-effective vaccination strategy for Zambia.

Climate Change and Thawing Permafrost in Two Iñupiaq Communities of Alaska's Arctic: Observations, Implications, and Resilience

NASA Astrophysics Data System (ADS)

Woodward, A.; Kofinas, G.

2013-12-01

For thousands of years the Iñupiat of northern Alaska have relied on ecosystems underlain by permafrost for material and cultural resources. As permafrost thaws across the Arctic, these social-ecological systems are changing rapidly. Community-based research and extensive local knowledge of Iñupiaq villagers offer unique and valuable contributions to understanding permafrost change and its implications for humans. We partnered with two Iñupiaq communities in Alaska's Arctic to investigate current and potential effects of thawing permafrost on social-ecological systems. Anaktuvuk Pass is situated on thaw-stable consolidated gravel in the Brooks Range, while Selawik rests on ice-rich permafrost in Beringia lowland tundra. Using the transdisciplinary approach of resilience theory and mixed geophysical and ethnographic methods, we measured active layer thaw depths and documented local knowledge about climate and permafrost change. Thaw depths were greater overall in Selawik. Residents of both communities reported a variety of changes in surface features, hydrology, weather, flora, and fauna that they attribute to thawing permafrost and / or climate change. Overall, Selawik residents described more numerous and extreme examples of such changes, expressed higher degrees of certainty that change is occurring, and anticipated more significant and negative implications for their way of life than did residents of Anaktuvuk Pass. Of the two villages, Selawik faces greater and more immediate challenges to the resilience of its social-ecological system as permafrost thaws.

On Becoming Scholars and Activists for Disability Rights.

PubMed

Balcazar, Fabricio E; Suarez-Balcazar, Yolanda

2016-12-01

In this paper, the authors discussed the nexus between the Americans with Disabilities Act and the founding of the field of Community Psychology. Contributions of the latter and future areas of research are reviewed here in three areas of importance to both fields: Community living and participation, employment, and transition from high school. Community psychology can make potential contributions to advancing research in these three areas. Implications for future research are discussed. © Society for Community Research and Action 2016.

Contextualizing Community in Teacher Bible Talk

ERIC Educational Resources Information Center

Avni, Sharon

2013-01-01

This paper explores the interactions surrounding Bible teaching as a means of understanding how Jewish youth are discursively implicated within ideologies of community. Drawing on theoretical frameworks from linguistic anthropology and interactional sociolinguistics, I present a micro-analysis of a classroom lesson on the book of Leviticus to…

Management by Objectives: Advantages, Problems, Implications for Community Colleges.

ERIC Educational Resources Information Center

Collins, Robert W.

Not new in principle, management by objectives (MBO) focuses on the goals of an institution stated as end accomplishments. Community college administrators have been attracted by the reputed benefits of MBO: increased productivity, improved planning, maximized profits, objective managerial evaluation, and improved participant morale. This paper…

Updating sea spray aerosol emissions in the Community Multiscale Air Quality (CMAQ) model

EPA Science Inventory

Sea spray aerosols (SSA) impact the particle mass concentration and gas-particle partitioning in coastal environments, with implications for human and ecosystem health. In this study, the Community Multiscale Air Quality (CMAQ) model is updated to enhance fine mode SSA emissions,...

Quantifying long-term trajectories of plant community change with movement models: implication for ecological resilience

USDA-ARS?s Scientific Manuscript database

Quantification of rates and patterns of community dynamics is central for understanding the organization and function of ecosystems. These insights may support a greater empirical understanding of ecological resilience, and the application of resilience concepts toward ecosystem management. Distinct...

Recontextualization of Science from Lab to School: Implications for Science Literacy

ERIC Educational Resources Information Center

Sharma, Ajay; Anderson, Charles W.

2009-01-01

Scientists' science differs remarkably from school science. In order to be taught to students, science is recontextualized from scientific research communities to science classrooms. This paper examines scientific discourse in scientific research communities, and discusses its transformation from an internally-persuasive and authoritative…

pCO2 effects on species composition and growth of an estuarine phytoplankton community.

EPA Science Inventory

The effects of ongoing changes in ocean carbonate chemistry on plankton ecology have important implications for food webs and biogeochemical cycling. However, conflicting results have emerged regarding species-specific responses to pCO2 enrichment and thus community responses hav...

Coevolution between Native and Invasive Plant Competitors: Implications for Invasive Species Management

USDA-ARS?s Scientific Manuscript database

Invasive species may establish in communities because they are better competitors than natives, but in order to remain community dominants, the competitive advantage of invasive species must be persistent. Native species that are not extirpated when highly invasive species are introduced are likely...

Learning Global Citizenship?: Exploring Connections between the Local and the Global

ERIC Educational Resources Information Center

Mayo, Marjorie; Gaventa, John; Rooke, Alison

2009-01-01

This article identifies historical connections between adult learning, popular education and the emergence of the public sphere in Europe, exploring potential implications for adult learning and community development, drawing upon research evaluating programmes to promote community-based learning "for" active citizenship in UK. The…

Lincoln County Primary Care Center Is a Model for Good Health.

ERIC Educational Resources Information Center

Casto, James E.

1992-01-01

Describes a rural West Virginia health-care center as a successful model program for integration between the clinic and community. Describes center facilities, funding sources, community cooperation, and cooperative residency program with regional medical school. Discusses implications for other medical-education programs. Describes differences…

Maker Culture and "Minecraft": Implications for the Future of Learning

ERIC Educational Resources Information Center

Niemeyer, Dodie J.; Gerber, Hannah R.

2015-01-01

Collaborative learning environments found with gaming communities can provide excellent structures to study the way that learners act within informal learning environments. For example, many of these gaming communities encourage gamers to create videogames and virtual world walkthroughs and commentaries. Walkthroughs and commentaries provide…

Reduced Gas Cycling in Microbial Mats: Implications for Early Earth

NASA Technical Reports Server (NTRS)

Hoehler, Tori M.; Bebout, Brad M.; DesMarais, David J.; DeVincenzi, Donald L. (Technical Monitor)

2000-01-01

For more than half the history of life on Earth, biological productivity was dominated by photosynthetic microbial mats. During this time, mats served as the preeminent biological influence on earth's surface and atmospheric chemistry and also as the primary crucible for microbial evolution. We find that modern analogs of these ancient mat communities generate substantial quantities of hydrogen, carbon monoxide, and methane. Escape of these gases from the biosphere would contribute strongly to atmospheric evolution and potentially to the net oxidation of earth's surface; sequestration within the biosphere carries equally important implications for the structure, function, and evolution of anaerobic microbial communities within the context of mat biology.

The Role of the Family in Disability Concerned Policies and Services: Challenges for Community Based Rehabilitation in the Asian and Pacific Decade of Disabled Persons, 1993-2002.

ERIC Educational Resources Information Center

Kwok, J.

1995-01-01

This article addresses cultural influences on the family care and community-based rehabilitation of people with disabilities in Asia, especially Hong Kong. Considered are factors influencing the Hong Kong family, the caregiver role, the role of community development, and implications for policy and service delivery in newly industrialized cities…

Evaluation of Open Access Versus Selected Admission to the Nursing Program in a Community College. AIR 1983 Annual Forum Paper.

ERIC Educational Resources Information Center

Capoor, Madan

A procedure used to select students for a nursing program in a community college was evaluated, and attention was directed to the cost effectiveness of the program and the implications for the community of an open-door policy. The selection criteria were based on high school grades in chemistry and biology; scores on the Aptitude Test for Allied…

Arab Threat Perceptions and the Future of the U.S. Military Presence in the Middle East

DTIC Science & Technology

2015-10-01

knowledge, and provides solutions to strategic Army issues affecting the national security community . The Peacekeeping and Stability Operations...analysts concern topics having strategic implications for the Army, the Department of Defense, and the larger national security community . In addition...update the national security community on the research of our analysts, recent and forthcoming publications, and upcoming confer- ences sponsored by

Professional Learning Communities in Singapore and Shanghai: Implications for Teacher Collaboration

ERIC Educational Resources Information Center

Hairon, Salleh; Tan, Charlene

2017-01-01

Professional learning communities (PLCs) have been recognised as having the potential to raise the quality of teachers, teaching and student learning through structured teacher collaboration, and have been featured prominently in Singapore and Shanghai--both considered top-performing Asian societies in the Program for International Student…

AIDS, Alcohol & Health Care. Chapter 4.

ERIC Educational Resources Information Center

Acampora, Alfonso P., Ed.; Nebelkopf, Ethan, Ed.

This document contains 10 papers from the ninth World Conference of Therapeutic Communities (TC) that deal with a variety of health-related subjects. Papers include: (1) "AIDS among IV Drug Users: Epidemiology, Natural History & TC Experiences" (Don C. Des Jarlais, et al.); (2) "AIDS and Therapeutic Communities: Policy Implications" (Don C. Des…

A Decade of Community Engagement Literature: Exploring Past Trends and Future Implications

ERIC Educational Resources Information Center

Jones, Diann Olszowy; Lee, Joonghee

2017-01-01

Academic journals play a lead role in disseminating community-campus engagement scholarship. However, assessment of the content, methodologies, and authorship of this published body of works is lacking. This study was performed to review publication trends in the "Journal of Higher Education Outreach and Engagement" ("JHEOE"),…

The Role of Nutrition-Related Initiatives in Addressing Community Health Needs Assessments

ERIC Educational Resources Information Center

George, Daniel R.; Rovniak, Liza S.; Dillon, Judy; Snyder, Gail

2017-01-01

Academic Health Centers and nonprofit hospitals are exploring strategies to meet Affordable Care Act mandates requiring tax-exempt institutions to address community health needs, which commonly include major chronic illnesses. We explore the implications of this regulatory landscape, describing methods that nonprofit health care institutions are…

Cutting Edge Technologies in Community Colleges.

ERIC Educational Resources Information Center

Harlacher, Ervin L., Ed.

This collection of essays provides case studies of current uses of technology in community colleges and projections for the future. The collection includes: (1) "Education and Curriculum Futures: Impacts from Technological Advances and Global Trends," by Earl C. Joseph; (2) "The Sociological Implications of the New Technology," by Bernard G.…

Community Dissemination of the Early Start Denver Model: Implications for Science and Practice

ERIC Educational Resources Information Center

Vismara, Laurie A.; Young, Gregory S.; Rogers, Sally J.

2013-01-01

The growing number of Autism Spectrum Disorder cases exceeds the services available for these children. This increase challenges both researchers and service providers to develop systematic, effective dissemination strategies for transporting university research models to community early intervention (EI) programs. The current study developed an…

High School Journalism Research: Community College Program Implications.

ERIC Educational Resources Information Center

Dvorak, Jack

1987-01-01

Reviews findings from a Journalism Education Association study comparing the American College Testing (ACT) Program standardized scores, writing samples, and Language Arts Survey responses of students who were involved in high school journalism programs with students who were not. Urges community college journalism educators to support high school…

Educating Ecological Citizens of "The Blue Planet"

ERIC Educational Resources Information Center

MacPherson, Seonaigh

2005-01-01

This paper explores the implications of a renewed model of citizenship and citizenship education developed on the principles of ecology and ecological interdependence. By reframing our community from a human polity to a biotic community, the scope of our citizenship responsibilities shift. While expanding to encompass a global context, this new…

Cultural Awareness of Minority Groups: Some Implications for School-Community Interaction.

ERIC Educational Resources Information Center

Rodriguez, Jerry

Interaction between minority groups and local schools can be improved through increased cultural awareness by schools. School districts' responsiveness to the dominant social influences of the local community, coupled with minorities' reluctance to participate in school affairs, has helped deprive minority children of exposure to the unique…

Information Poverty and the Latino Community: Implications for Social Work Practice and Social Work Education.

ERIC Educational Resources Information Center

McNutt, John G.; Queiro-Tajalli, Irene; Boland, Katherine M.; Campbell, Craig

2001-01-01

Education level, computer ownership, and technology and information access determine one's status in the new information economy. Interventions such as community computer networks, telecommuting centers, grassroots electronic commerce, and volunteer technology corps can help Latinos and other marginalized groups overcome continued disadvantage.…

Toward a Model of Psychological Health Empowerment: Implications for Health Care in Multicultural Communities.

ERIC Educational Resources Information Center

Menon, Sanjay T.

2002-01-01

The context for health empowerment includes individuals, health providers, and the regulatory environment. Psychological health empowerment consists of perceived control, perceived competence, and goal internalization. In multicultural communities, barriers to empowerment include locus of control, access to health care, and language and cultural…

Locating Chicago's Charter Schools: A Socio-Spatial Analysis

ERIC Educational Resources Information Center

LaFleur, Jennifer C.

2016-01-01

This project contributes to the body of research examining the implications of the geographic location of charter schools for student access, especially in high-poverty communities. Using geographic information systems (GIS) software, this paper uses data from the U.S. Census American Community Survey to identify the socioeconomic characteristics…

The Futurist Perspective: Implications for Community College Planning.

ERIC Educational Resources Information Center

Nicholson, R. Stephen; Keyser, John S.

Community college managers would probably acknowledge the importance of planning, but might not accept the need to adopt a futuristic perspective on educational planning. One of the characteristics of futurists is a belief that the future is a created reality, not a consequence of random events. Futurists conceive possible paths, examine…

A Constructive Development Approach to Assessing Variations within a Community College Population

ERIC Educational Resources Information Center

Boyer, Timothy R.

2007-01-01

This study utilized a constructive-developmental approach to accomplish 3 purposes: to create a developmental stage profile for a population of students attending a single community college, to analyze variations within and between subpopulations, and to explore the implications for administrators and planners seeking to provide supportive…

Learning through Standard English: Cognitive Implications for Post-Pidgin/-Creole Speakers

ERIC Educational Resources Information Center

Malcolm, Ian G.

2011-01-01

Despite their (albeit limited) access to Standard Australian English through education, Australian Indigenous communities have maintained their own dialect (Aboriginal English) for intragroup communication and are increasingly using it as a medium of cultural expression in the wider community. Most linguists agree that the most significant early…

Biological control is more than just natural enemies

Treesearch

Dean E. Pearson

2005-01-01

The past decade has given rise to exciting new developments in the field of community ecology that have profound implications for biological control. The recognition that biological invasions offer unprecedented opportunities to investigate the nature of community assembly has swept invasive species studies to the forefront of popular ecology. Meanwhile,...

Recreating America's Community Colleges: Implications of the Substantive Issues in Their Future

ERIC Educational Resources Information Center

Eaton, Judith S.

2006-01-01

CHEA is an institutional membership organization of degree-granting colleges and universities, and serves as an institutional voice for accreditation. CHEA also recognizes 60 regional, national and specialized accrediting organizations. This paper (the text of a speech delivered via teleconference to the Community College Futures Assembly,…

Rural Rides in Queensland: Travels with Novice Teaching Principals

ERIC Educational Resources Information Center

Clarke, Simon; Stevens, Elizabeth; Wildy, Helen

2006-01-01

This article is concerned with the nature of novice teaching principals' interactions in Queensland rural communities. Stories selected from case accounts are used to provide insights into the teaching principals' interrelationship with the community. The article concludes with a discussion of some implications for practice suggested by these…

Instructional Computer Use in the Community College: A Discussion of the Research and Its Implications.

ERIC Educational Resources Information Center

Bower, Beverly L.

1998-01-01

Reviews research on the instructional benefits of computer technology. Discusses the computer readiness of students, faculty, and institutions, and suggests that despite mixed findings, political and organizational realities indicate computer-based instruction is a feasible alternative for community colleges. Therefore, educators should continue…

Perinatal AIDS: Permanency Planning for the African-American Community.

ERIC Educational Resources Information Center

Taylor-Brown, Susan; And Others

1992-01-01

Conducted a retrospective chart review utilizing Norwood's model on the families of the 83 infants whose cord blood was positive for maternal HIV antibodies or who were congenitally infected with HIV. Discusses implications for permanency planning in the context of their impact on the African-American community. (KS)

Building a Dynamic Online Learning Community among Adult Learners.

ERIC Educational Resources Information Center

Wang, Minjuan; Sierra, Christina; Folger, Terre

2003-01-01

Examines the nature of learning communities constructed among a diverse group of adult learners in an international online graduate-level course. Discusses independent work, team tasks, the variety of computer-mediated communication tools used, and implications for promoting adult learners' active participation in online learning and instructional…

Year-round metagenomes reveal remarkably stable microbial communities in agricultural soils and novel ammonia oxidizers responding to fertilization

USDA-ARS?s Scientific Manuscript database

Insight to what underlies the seasonal dynamics of indigenous soil microbial communities in agricultural soils, especially after major activities such as nitrogen fertilization, remain elusive. More detailed understanding of population dynamics will have important implications for modeling efforts a...

Criminal Division - Alaska Department of Law

Science.gov Websites

Criminal Division The Criminal Division works to assure safe and healthy communities by prosecuting and live in safe and healthy communities. The day-to-day prosecution services are carried out by the implicated in environmental crimes from further operations that damage the environment. The ECU is partially

Leaving a Community College Presidency: The Inevitable Career Transition

ERIC Educational Resources Information Center

Floyd, Deborah L.; Maslin-Ostrowski, Patricia

2013-01-01

This article provides a succinct synthesis of research about community college presidents who have experienced a crisis or dilemma as leaders and focuses on issues surrounding a sudden and unplanned departure. In addition to describing themes, the authors present implications for leaders and potential areas for future research.

Perceived Expectations for Acculturation: The Transitioning of Hispanics into Southern Communities

ERIC Educational Resources Information Center

Archuleta, Adrian J.

2011-01-01

Hispanics are a rapidly growing population that has sought resettlement in nontraditional locations across the United States. Movement in and out of cultural homogeneous communities has implications for an individual's perceived expectations for cultural change. Hispanics (N = 10) in two Southern states were asked questions using semi-structured…

Community Leadership Development: Implications for Extension.

ERIC Educational Resources Information Center

Northeast Regional Center for Rural Development, University Park, PA.

Designed for extension personnel who are involved in community leadership (CL) programs, this publication summarizes recent national efforts that could be useful in developing and conducting CL programs, and current leadership theory and literature. Part 1 reports the results of the national survey, initiated in April 1985, of extension staff…

Community-Referenced Math Activities for Moderately and Severely Handicapped Individuals.

ERIC Educational Resources Information Center

Schoen, Sharon F.

Community-referenced activities, which involve combinations of skills used in routine tasks of daily living, are critical for the independent functioning of moderately and severely handicapped persons. The paper examines the characteristics of these activities in order to extract implications for enhancing instruction. The tasks involved in such…

The Implications of State Fiscal Policies for Community Colleges

ERIC Educational Resources Information Center

Dowd, Alicia C.; Shieh, Linda Taing

2014-01-01

A variety of policies and practices, including those developed by local boards and administrations, as well as those mandated by state and federal governments, affect budgets and finances at community colleges. Examples include tuition policies, fee structures, performance-based funding, and personnel policies. This chapter explores some of the…

Leadership Stress in California Community Colleges

ERIC Educational Resources Information Center

Mattson, Carol

2012-01-01

Research indicates that stress is steadily increasing among college administrators. This has implications for the California Community College (CCC) system's ability to recruit and retain qualified leaders as the need to replace retiring baby boomers increases. For those working in leadership positions in CCCs, stress is compounded by the way that…

Insecticide resistance and role in malaria transmission of Anopheles funestus populations from Zambia and Zimbabwe.

PubMed

Choi, Kwang S; Christian, Riann; Nardini, Luisa; Wood, Oliver R; Agubuzo, Eunice; Muleba, Mbanga; Munyati, Shungu; Makuwaza, Aramu; Koekemoer, Lizette L; Brooke, Basil D; Hunt, Richard H; Coetzee, Maureen

2014-10-08

Two mitochondrial DNA clades have been described in Anopheles funestus populations from southern Africa. Clade I is common across the continent while clade II is known only from Mozambique and Madagascar. The specific biological status of these clades is at present unknown. We investigated the possible role that each clade might play in the transmission of Plasmodium falciparum and the insecticide resistance status of An. funestus from Zimbabwe and Zambia. Mosquitoes were collected inside houses from Nchelenge District, Zambia and Honde Valley, Zimbabwe in 2013 and 2014. WHO susceptibility tests, synergist assays and resistance intensity tests were conducted on wild females and progeny of wild females. ELISA was used to detect Plasmodium falciparum circumsporozoite protein. Specimens were identified to species and mtDNA clades using standard molecular methods. The Zimbabwean samples were all clade I while the Zambian population comprised 80% clade I and 20% clade II in both years of collection. ELISA tests gave an overall infection rate of 2.3% and 2.1% in 2013, and 3.5% and 9.2% in 2014 for Zimbabwe and Zambia respectively. No significant difference was observed between the clades. All populations were resistant to pyrethroids and carbamates but susceptible to organochlorines and organophosphates. Synergist assays indicated that pyrethroid resistance is mediated by cytochrome P450 mono-oxygenases. Resistance intensity tests showed high survival rates after 8-hrs continuous exposure to pyrethroids but exposure to bendiocarb gave the same results as the susceptible control. This is the first record of An. funestus mtDNA clade II occurring in Zambia. No evidence was found to suggest that the clades are markers of biologically separate populations. The ability of An. funestus to withstand prolonged exposure to pyrethroids has serious implications for the use of these insecticides, either through LLINs or IRS, in southern Africa in general and resistance management strategies should be urgently implemented.

Cost analysis of routine immunisation in Zambia.

PubMed

Schütte, Carl; Chansa, Collins; Marinda, Edmore; Guthrie, Teresa A; Banda, Stanley; Nombewu, Zipozihle; Motlogelwa, Katlego; Lervik, Marita; Brenzel, Logan; Kinghorn, Anthony

2015-05-07

This study aimed to inform planning and funding by providing updated, detailed information on total and unit costs of routine immunisation (RI) in Zambia, a GAVI-eligible lower middle-income country with a population of 13 million. The exercise was part of a multi-country study on costs and financing of routine immunisation (EPIC) that utilized a common, ingredients-based approach to costing. Data on inputs, prices and outputs were collected in a stratified, random sample of 51 facilities in nine districts between December 2012 and March 2013 using a pre-tested questionnaire. Shared inputs were allocated to RI costs on the basis of tracing factors developed for the study. A comprehensive set of costs were analysed to obtain total and unit costs, at facility and above-facility levels. The total annual economic cost of RI was $38.16 million, equivalent to approximately 10% of government health spending. Government contributed 83% of finances. Labour accounted for the lion's share (49%) of total costs followed by vaccines (16%) and travel allowances (12%). Analysis of specific activity costs showed that outreach and facility-based services accounted for half of total economic costs. Costs for managing the program at district, provincial and national levels (above-facility costs) represented 24% of total costs. Average unit costs were $7.18 per dose, $59.32 per infant and $65.89 per DPT3 immunised child, with markedly higher unit costs in rural facilities. Analyses suggest that greater efficiency is associated with higher utilisation levels and urban facility type. Total and unit costs, and government's contribution, were considerably higher than previous Zambian estimates and international benchmarks. These findings have substantial implications for planners, efficiency improvement and sustainable financing, particularly as new vaccines are introduced. Variations in immunisation costs at facility level warrant further statistical analyses. Copyright © 2015 Elsevier Ltd. All rights reserved.

Scaling Down to Scale Up: A Health Economic Analysis of Integrating Point-of-Care Syphilis Testing into Antenatal Care in Zambia during Pilot and National Rollout Implementation

PubMed Central

Ncube, Alexander Tshaka; Sweeney, Sedona; Fleischer, Colette; Mumba, Grace Tembo; Gill, Michelle M.; Strasser, Susan; Peeling, Rosanna W.; Terris-Prestholt, Fern

2015-01-01

Maternal syphilis results in an estimated 500,000 stillbirths and neonatal deaths annually in Sub-Saharan Africa. Despite the existence of national guidelines for antenatal syphilis screening, syphilis testing is often limited by inadequate laboratory and staff services. Recent availability of inexpensive rapid point-of-care syphilis tests (RST) can improve access to antenatal syphilis screening. A 2010 pilot in Zambia explored the feasibility of integrating RST within prevention of mother-to-child-transmission of HIV services. Following successful demonstration, the Zambian Ministry of Health adopted RSTs into national policy in 2011. Cost data from the pilot and 2012 preliminary national rollout were extracted from project records, antenatal registers, clinic staff interviews, and facility observations, with the aim of assessing the cost and quality implications of scaling up a successful pilot into a national rollout. Start-up, capital, and recurrent cost inputs were collected, including costs of extensive supervision and quality monitoring during the pilot. Costs were analysed from a provider’s perspective, incremental to existing antenatal services. Total and unit costs were calculated and a multivariate sensitivity analysis was performed. Our accompanying qualitative study by Ansbro et al. (2015) elucidated quality assurance and supervisory system challenges experienced during rollout, which helped explain key cost drivers. The average unit cost per woman screened during rollout ($11.16) was more than triple the pilot unit cost ($3.19). While quality assurance costs were much lower during rollout, the increased unit costs can be attributed to several factors, including higher RST prices and lower RST coverage during rollout, which reduced economies of scale. Pilot and rollout cost drivers differed due to implementation decisions related to training, supervision, and quality assurance. This study explored the cost of integrating RST into antenatal care in pilot and national rollout settings, and highlighted important differences in costs that may be observed when moving from pilot to scale-up. PMID:25970443

Scaling Down to Scale Up: A Health Economic Analysis of Integrating Point-of-Care Syphilis Testing into Antenatal Care in Zambia during Pilot and National Rollout Implementation.

PubMed

Shelley, Katharine D; Ansbro, Éimhín M; Ncube, Alexander Tshaka; Sweeney, Sedona; Fleischer, Colette; Tembo Mumba, Grace; Gill, Michelle M; Strasser, Susan; Peeling, Rosanna W; Terris-Prestholt, Fern

2015-01-01

Maternal syphilis results in an estimated 500,000 stillbirths and neonatal deaths annually in Sub-Saharan Africa. Despite the existence of national guidelines for antenatal syphilis screening, syphilis testing is often limited by inadequate laboratory and staff services. Recent availability of inexpensive rapid point-of-care syphilis tests (RST) can improve access to antenatal syphilis screening. A 2010 pilot in Zambia explored the feasibility of integrating RST within prevention of mother-to-child-transmission of HIV services. Following successful demonstration, the Zambian Ministry of Health adopted RSTs into national policy in 2011. Cost data from the pilot and 2012 preliminary national rollout were extracted from project records, antenatal registers, clinic staff interviews, and facility observations, with the aim of assessing the cost and quality implications of scaling up a successful pilot into a national rollout. Start-up, capital, and recurrent cost inputs were collected, including costs of extensive supervision and quality monitoring during the pilot. Costs were analysed from a provider's perspective, incremental to existing antenatal services. Total and unit costs were calculated and a multivariate sensitivity analysis was performed. Our accompanying qualitative study by Ansbro et al. (2015) elucidated quality assurance and supervisory system challenges experienced during rollout, which helped explain key cost drivers. The average unit cost per woman screened during rollout ($11.16) was more than triple the pilot unit cost ($3.19). While quality assurance costs were much lower during rollout, the increased unit costs can be attributed to several factors, including higher RST prices and lower RST coverage during rollout, which reduced economies of scale. Pilot and rollout cost drivers differed due to implementation decisions related to training, supervision, and quality assurance. This study explored the cost of integrating RST into antenatal care in pilot and national rollout settings, and highlighted important differences in costs that may be observed when moving from pilot to scale-up.

An emerging synthesis between community ecology and evolutionary biology.

PubMed

Johnson, Marc T J; Stinchcombe, John R

2007-05-01

A synthesis between community ecology and evolutionary biology is emerging that identifies how genetic variation and evolution within one species can shape the ecological properties of entire communities and, in turn, how community context can govern evolutionary processes and patterns. This synthesis incorporates research on the ecology and evolution within communities over short timescales (community genetics and diffuse coevolution), as well as macroevolutionary timescales (community phylogenetics and co-diversification of communities). As we discuss here, preliminary evidence supports the hypothesis that there is a dynamic interplay between ecology and evolution within communities, yet researchers have not yet demonstrated convincingly whether, and under what circumstances, it is important for biologists to bridge community ecology and evolutionary biology. Answering this question will have important implications for both basic and applied problems in biology.

Considering Shame and Its Implications for Student Learning

ERIC Educational Resources Information Center

Johnson, Diane Elizabeth

2012-01-01

Research evidence is accumulating to suggest that shame can be implicated in important ways in student adjustment to the learning environment. Student survey data spring-fall 2010 suggest that shame is associated with variables thought to be closely related to student learning--sense of community, burnout and achievement goals--and underline the…

Social Justice Advocacy in Rural Communities: Practical Issues and Implications

ERIC Educational Resources Information Center

Bradley, Joshua M.; Werth, James L., Jr.; Hastings, Sarah L.

2012-01-01

The professional literature related to social justice has increased, but there has been little discussion of the practical issues and implications associated with social advocacy. However, adding new roles will result in new considerations for counseling psychologists. The need to be attuned to how the practical aspects of advocacy intersect with…

Issues of Perception Post 9/11 and Implications for Antiterrorism Education

ERIC Educational Resources Information Center

Barner, Rayford E.

2015-01-01

This research study sought to determine a connection between antiterrorism education training and police officer's perception of the cultural communities implicated in the September 11, 2001 terrorist attacks. The study employs a mixed-methods research design using surveys and interviews. The sample is taken from 52 police officers of a police…

Mentoring Postsecondary Tenure-Track Faculty: A Theory-Building Case Study and Implications for Institutional Policy

ERIC Educational Resources Information Center

Davis, Dannielle Joy; Boyer, Patricia; Russell, Isela

2011-01-01

The featured research uses theory-building case study to understand the experiences of junior faculty in a mentoring program. Findings suggest the importance of professional interaction for faculty members' integration into their campus communities. An explanatory model illustrates the findings and supplements discussion of the implications for…

Inner City Providence: Implications for Education. Attachment 2.

ERIC Educational Resources Information Center

Blanchard, Walter J.

This is a collection of raw data and brief descriptions of the neighborhoods which compose the inner city of Providence. It was compiled so that staff, teachers, and the community leaders could think together about the implications of these data for the schools, education, and for the social studies project. Demographic data on the seven…

Viewing the Curriculum as a Product: Implications from a Marketing Research Study.

ERIC Educational Resources Information Center

Franzak, Frank J.; Cowles, Deborah L.

1993-01-01

From a marketing perspective, the curriculum is an important product of the college or university. A study using survey research and target marketing investigated what the business community wants this product to be. Implications for structuring the curriculum as preparation for employment of marketing graduates are examined. (Author/MSE)

Bring Back Our Girls, Social Mobilization: Implications for Cross-Cultural Research

ERIC Educational Resources Information Center

Olutokunbo, Adekalu Samuel; Suandi, Turiman; Cephas, Oluwaseyitan Rotimi; Abu-Samah, Irza Hanie

2015-01-01

Social mobilization is a proactive measure for community development that salvages the society from destruction and disaster. From sociological perspective, this paper discusses the concept of social mobilization and its implications for cross-cultural research. To do this, the study uses the "Bring Back Our Girls" Global Campaign, as…

Whole community planning: building resiliency at the local level.

PubMed

Grimm, Dee

2014-01-01

Business continuity planning often looks to preserving internal operations and focuses on customer retention as a marker for a successful outcome after a disaster. Building more resilient continuity plans also means planning for the survival of the community at large. As the national emphasis in the USA on 'whole community planning' becomes prominent guidance for emergency management planning, this paper examines the implications for businesses as members of the whole community and how they can increase their involvement in the whole community process. The paper will also discuss the impediments to and benefits of becoming a partner in planning for the community at large.

Concentrations of arsenic, copper, cobalt, lead and zinc in cassava (Manihot esculenta Crantz) growing on uncontaminated and contaminated soils of the Zambian Copperbelt

NASA Astrophysics Data System (ADS)

Kříbek, B.; Majer, V.; Knésl, I.; Nyambe, I.; Mihaljevič, M.; Ettler, V.; Sracek, O.

2014-11-01

The concentrations of arsenic (As), copper (Cu), cobalt (Co), lead (Pb) and zinc (Zn) in washed leaves and washed and peeled tubers of cassava (Manihot esculenta Crantz, Euphorbiaceae) growing on uncontaminated and contaminated soils of the Zambian Copperbelt mining district have been analyzed. An enrichment index (EI) was used to distinguish between contaminated and uncontaminated areas. This index is based on the average ratio of the actual and median concentration of the given contaminants (As, Co, Cu, mercury (Hg), Pb and Zn) in topsoil. The concentrations of copper in cassava leaves growing on contaminated soils reach as much as 612 mg kg-1 Cu (total dry weight [dw]). Concentrations of copper in leaves of cassava growing on uncontaminated soils are much lower (up to 252 mg kg-1 Cu dw). The concentrations of Co (up to 78 mg kg-1 dw), As (up to 8 mg kg-1 dw) and Zn (up to 231 mg kg-1 dw) in leaves of cassava growing on contaminated soils are higher compared with uncontaminated areas, while the concentrations of lead do not differ significantly. The concentrations of analyzed chemical elements in the tubers of cassava are much lower than in its leaves with the exception of As. Even in strongly contaminated areas, the concentrations of copper in the leaves and tubers of cassava do not exceed the daily maximum tolerance limit of 0.5 mg kg-1/human body weight (HBW) established by the Joint FAO/WHO Expert Committee on Food Additives (JECFA). The highest tolerable weekly ingestion of 0.025 mg kg-1/HBW for lead and the highest tolerable weekly ingestion of 0.015 mg kg-1/HBW for arsenic are exceeded predominantly in the vicinity of smelters. Therefore, the preliminary assessment of dietary exposure to metals through the consumption of uncooked cassava leaves and tubers has been identified as a moderate hazard to human health. Nevertheless, as the surfaces of leaves are strongly contaminated by metalliferous dust in the polluted areas, there is still a potential hazard of ingesting dangerous levels of copper, lead and arsenic if dishes are prepared with poorly washed foliage.

Can biomedical and traditional health care providers work together? Zambian practitioners' experiences and attitudes towards collaboration in relation to STIs and HIV/AIDS care: a cross-sectional study

PubMed Central

Kaboru, Berthollet Bwira; Falkenberg, Torkel; Ndubani, Phillimon; Höjer, Bengt; Vongo, Rodwell; Brugha, Ruairi; Faxelid, Elisabeth

2006-01-01

Background The World Health Organization's World health report 2006: Working together for health underscores the importance of human resources for health. The shortage of trained health professionals is among the main obstacles to strengthening low-income countries' health systems and to scaling up HIV/AIDS control efforts. Traditional health practitioners are increasingly depicted as key resources to HIV/AIDS prevention and care. An appropriate and effective response to the HIV/AIDS crisis requires reconsideration of the collaboration between traditional and biomedical health providers (THPs and BHPs). The aim of this paper is to explore biomedical and traditional health practitioners' experiences of and attitudes towards collaboration and to identify obstacles and potential opportunities for them to collaborate regarding care for patients with sexually transmitted infections (STIs) and HIV/AIDS. Methods We conducted a cross-sectional study in two Zambian urban sites, using structured questionnaires. We interviewed 152 biomedical health practitioners (BHPs) and 144 traditional health practitioners (THPs) who reported attending to patients with STIs and HIV/AIDS. Results The study showed a very low level of experience of collaboration, predominated by BHPs training THPs (mostly traditional birth attendants) on issues of safe delivery. Intersectoral contacts addressing STIs and HIV/AIDS care issues were less common. However, both groups of providers overwhelmingly acknowledged the potential role of THPs in the fight against HIV/AIDS. Obstacles to collaboration were identified at the policy level in terms of legislation and logistics. Lack of trust in THPs by individual BHPs was also found to inhibit collaboration. Nevertheless, as many as 40% of BHPs expressed an interest in working more closely with THPs. Conclusion There is indication that practitioners from both sectors seem willing to strengthen collaboration with each other. However, there are missed opportunities. The lack of collaborative framework integrating maternal health with STIs and HIV/AIDS care is at odds with the needed comprehensive approach to HIV/AIDS control. Also, considering the current human resources crisis in Zambia, substantial policy commitment is called for to address the legislative obstacles and the stigma reported by THPs and to provide an adequate distribution of roles between all partners, including traditional health practitioners, in the struggle against HIV/AIDS. PMID:16846497

Higher educational attainment associated with reduced likelihood of abnormal cervical lesions among Zambian women - a cross sectional study.

PubMed

Hamoonga, Twaambo Euphemia; Likwa, Rosemary Ndonyo; Musonda, Patrick; Michelo, Charles

2017-10-13

The high burden of cervical cancer in Zambia prompted the Ministry of Health and partners to develop the cervical cancer prevention program in Zambia (CCPPZ) in 2006. Despite this intervention more women continue to die from the disease and there is little understanding of factors that may be linked with abnormal cervical lesions in the general population. We therefore examined if educational attainment is associated with abnormal cervical lesions among Zambian women aged 15 to 49 years. This study used data from the cervical cancer prevention program in Zambia, where a total of 14,294 women aged 15 to 49 years were screened for cervical cancer at nine health facilities between October 2013 and September 2014. The data represents women from six provinces of Zambia, namely Southern, Central, Copperbelt, Luapula, North-western and Eastern provinces. Step-wise logistic regression analysis using the Statistical Package for the Social Sciences (SPSS) version 21 was used to estimate adjusted odds ratios (AOR) and 95% confidence intervals (CIs) for educational attainment with presence of abnormal cervical lesions as outcome. Multiple imputation was further used to obtain the imputed stabilized estimates for educational attainment. The prevalence of abnormal cervical lesions, using the Visual Inspection with Acetic-acid (VIA) test was 10.7% (n = 1523). Educational attainment was inversely associated with abnormal cervical lesions (AOR = 0.75; 95% CI:0.70-0.81, AOR = 0.74; 95% CI:0.68-0.81 and AOR = 0.46; 95% CI:0.41-0.51) among women with primary, secondary and tertiary education, respectively, compared to those with no formal education. We find reduced likelihood of abnormal cervical lesions in educated women, suggesting a differential imbalance with women who have no formal education. These findings may be a reflection of inequalities associated with access to cervical cancer screening, making the service inadequately accessible for lower educated groups. This might also indicate serious limitations in awareness efforts instituted in the formative phases of the program. These findings underline the prevailing need for urgent concerted efforts in repackaging cervical cancer awareness programs targeting women with low or no formal education in whom the risk may be even higher.

Effects of a performance and quality improvement intervention on the work environment in HIV-related care: a quasi-experimental evaluation in Zambia.

PubMed

Bazant, Eva; Sarkar, Supriya; Banda, Joseph; Kanjipite, Webby; Reinhardt, Stephanie; Shasulwe, Hildah; Mulilo, Joyce Monica Chongo; Kim, Young Mi

2014-12-20

Human resource shortages and reforms in HIV-related care make it challenging for frontline health care providers in southern Africa to deliver high-quality services. At health facilities of the Zambian Defence Forces, a performance and quality improvement approach was implemented to improve HIV-related care and was evaluated in 2010/2011. Changes in providers' work environment and perceived quality of HIV-related care were assessed to complement data of provider performance. The intervention involved on-site training, supportive supervision, and action planning focusing on detailed service delivery standards. The quasi-experimental evaluation collected pre- and post-intervention data from eight intervention and comparison facilities matched on defence force branch and baseline client volume. Overall, 101 providers responded to a 24-item questionnaire on the work environment, covering topics of drugs, supplies, and equipment; training, feedback, and supervision; compensation; staffing; safety; fulfilment; and HIV services quality. In bivariate analysis and multivariate analyses, we assessed changes within each study group and between the two groups. In the bivariate analysis, the intervention group providers reported improvements in the work environment on adequacy of equipment, feeling safe from harm, confidence in clinical skills, and reduced isolation, while the comparison group reported worsening of the work environment on supplies, training, safety, and departmental morale.In the multivariate analysis, the intervention group's improvement and the comparison group's decline were significant on perceived adequacy of drugs, supplies, and equipment; constructive feedback received from supervisor and co-workers; and feeling safe from physical harm (all P <0.01, except P <0.04 for equipment). Further, the item "provider lacks confidence in some clinical skills" declined in the intervention group but increased in the comparison group (P = -0.005). In multivariate analysis, changes in perceived quality of HIV care did not differ between study groups. Provider perceptions were congruent with observations of preparing drugs, supplies, equipment, and in service delivery of prevention of mother-to-child transmission of HIV and antiretroviral therapy follow-up care. The performance and quality improvement intervention implemented at Zambian Defence Forces' health facilities was associated with improvements in providers' perceptions of work environment consistent with the intervention's focus on commodities, skills acquisition, and receipt of constructive feedback.

Zambia.

PubMed

1988-08-01

Attention in this discussion of Zambia is directed to the following: geography; the people; history; government; the economy; foreign relations; defense; and relations between Zambia and the US. In 1986, the population totaled 7 million with an annual growth rate of 3.7%. The infant mortality rate is 87/1000 with a life expectancy of 51 years. Zambia, located in south-central Africa, is bordered by Zaire, Tanzania, Malawi, Mozambique, Zimbabwe, Botswana, Angola, and Namibia. The population is made up of over 70 Bantu-speaking tribes. Expatriates, mostly British (15,000 in 1986) or South African, live primarily in Lusaka where they are employed in mines and related activities. Some ancestors of present-day Zambians most likely arrived about 2000 years ago and eventually displaced or absorbed indigenous stone age hunters and gatherers. The major waves of Bantu-speaking immigrants began in the 15th century; the greatest influx occurred in the late 17th to the early 19th centuries. After the mid-19th century, the area was penetrated by Western explorers. In 1888, Northern and Southern Rhodesia (now Zambia and Zimbabwe) were proclaimed a British sphere of influence. Southern Rhodesia was annexed formally and granted self-government in 1923. Independence was realized on October 24, 1964. Zambia was the 1st British territory to become a republic immediately upon realizing independence. The constitution promulgated on August 25, 1973, abrogated the original 1964 constitution, and this new constitution and the national elections that followed in December 1973 were the final steps in achieving what is termed a "1-party participatory democracy." President Kenneth Kaunda is the major figure in the country's politics. He has wide popular support and traditionally has bridged the rivalries among the country's various regions and ethnic groups. The economy of Zambia is based primarily on its majority state-owned copper industry, which is the only significant source of foreign exchange. Copper production has dropped to less than 500,000 metric tons/year from a high of 720,000 in 1976. Beginning in late 1982, Zambian government leaders took several important steps to deal with the country's economic plight, including restricting public spending, reducing government subsidies, raising farm producer incentives, and devaluing the currency. The US maintains a substantial foreign assistance program in Zambia.

Cost-effectiveness of novel vaccines for tuberculosis control: a decision analysis study

PubMed Central

2011-01-01

Background The development of a successful new tuberculosis (TB) vaccine would circumvent many limitations of current diagnostic and treatment practices. However, vaccine development is complex and costly. We aimed to assess the potential cost effectiveness of novel vaccines for TB control in a sub-Saharan African country - Zambia - relative to the existing strategy of directly observed treatment, short course (DOTS) and current level of bacille Calmette-Guérin (BCG) vaccination coverage. Methods We conducted a decision analysis model-based simulation from the societal perspective, with a 3% discount rate and all costs expressed in 2007 US dollars. Health outcomes and costs were projected over a 30-year period, for persons born in Zambia (population 11,478,000 in 2005) in year 1. Initial development costs for single vaccination and prime-boost strategies were prorated to the Zambian share (0.398%) of global BCG vaccine coverage for newborns. Main outcome measures were TB-related morbidity, mortality, and costs over a range of potential scenarios for vaccine efficacy. Results Relative to the status quo strategy, a BCG replacement vaccine administered at birth, with 70% efficacy in preventing rapid progression to TB disease after initial infection, is estimated to avert 932 TB cases and 422 TB-related deaths (prevention of 199 cases/100,000 vaccinated, and 90 deaths/100,000 vaccinated). This would result in estimated net savings of $3.6 million over 30 years for 468,073 Zambians born in year 1 of the simulation. The addition of a booster at age 10 results in estimated savings of $5.6 million compared to the status quo, averting 1,863 TB cases and 1,011 TB-related deaths (prevention of 398 cases/100,000 vaccinated, and of 216 deaths/100,000 vaccinated). With vaccination at birth alone, net savings would be realized within 1 year, whereas the prime-boost strategy would require an additional 5 years to realize savings, reflecting a greater initial development cost. Conclusions Investment in an improved TB vaccine is predicted to result in considerable cost savings, as well as a reduction in TB morbidity and TB-related mortality, when added to existing control strategies. For a vaccine with waning efficacy, a prime-boost strategy is more cost-effective in the long term. PMID:21269503

Outbreaks by canopy-feeding geometrid moth cause state-dependent shifts in understorey plant communities.

PubMed

Karlsen, Stein Rune; Jepsen, Jane Uhd; Odland, Arvid; Ims, Rolf Anker; Elvebakk, Arve

2013-11-01

The increased spread of insect outbreaks is among the most severe impacts of climate warming predicted for northern boreal forest ecosystems. Compound disturbances by insect herbivores can cause sharp transitions between vegetation states with implications for ecosystem productivity and climate feedbacks. By analysing vegetation plots prior to and immediately after a severe and widespread outbreak by geometrid moths in the birch forest-tundra ecotone, we document a shift in forest understorey community composition in response to the moth outbreak. Prior to the moth outbreak, the plots divided into two oligotrophic and one eutrophic plant community. The moth outbreak caused a vegetation state shift in the two oligotrophic communities, but only minor changes in the eutrophic community. In the spatially most widespread communities, oligotrophic dwarf shrub birch forest, dominance by the allelopathic dwarf shrub Empetrum nigrum ssp. hermaphroditum, was effectively broken and replaced by a community dominated by the graminoid Avenella flexuosa, in a manner qualitatively similar to the effect of wild fires in E. nigrum communities in coniferous boreal forest further south. As dominance by E. nigrum is associated with retrogressive succession the observed vegetation state shift has widespread implications for ecosystem productivity on a regional scale. Our findings reveal that the impact of moth outbreaks on the northern boreal birch forest system is highly initial-state dependent, and that the widespread oligotrophic communities have a low resistance to such disturbances. This provides a case for the notion that climate impacts on arctic and northern boreal vegetation may take place most abruptly when conveyed by changed dynamics of irruptive herbivores.

Improving community health worker use of malaria rapid diagnostic tests in Zambia: package instructions, job aid and job aid-plus-training

PubMed Central

Harvey, Steven A; Jennings, Larissa; Chinyama, Masela; Masaninga, Fred; Mulholland, Kurt; Bell, David R

2008-01-01

Background Introduction of artemisinin combination therapy (ACT) has boosted interest in parasite-based malaria diagnosis, leading to increased use of rapid diagnostic tests (RDTs), particularly in rural settings where microscopy is limited. With donor support, national malaria control programmes are now procuring large quantities of RDTs. The scarcity of health facilities and trained personnel in many sub-Saharan African countries means that limiting RDT use to such facilities would exclude a significant proportion of febrile cases. RDT use by volunteer community health workers (CHWs) is one alternative, but most sub-Saharan African countries prohibit CHWs from handling blood, and little is known about CHW ability to use RDTs safely and effectively. This Zambia-based study was designed to determine: (i) whether Zambian CHWs could prepare and interpret RDTs accurately and safely using manufacturer's instructions alone; (ii) whether simple, mostly pictorial instructions (a "job aid") could raise performance to adequate levels; and (iii) whether a brief training programme would produce further improvement. Methods The job aid and training programme were based on formative research with 32 CHWs in Luangwa District. The study team then recruited three groups of CHWs in Chongwe and Chibombo districts. All had experience treating malaria based on clinical diagnosis, but only six had prior RDT experience. Trained observers used structured observation checklists to score each participant's preparation of three RDTs. Each also read 10 photographs showing different test results. The first group (n = 32) was guided only by manufacturer's instructions. The second (n = 21) used only the job aid. The last (n = 26) used the job aid after receiving a three-hour training. Results Mean scores, adjusted for education, age, gender and experience, were 57% of 16 RDT steps correctly completed for group 1, 80% for group 2, and 92% for group 3. Mean percentage of test results interpreted correctly were 54% (group 1), 80% (group 2), and 93% (group 3). All differences were statistically significant (p < 0.05). Conclusion Manufacturer's instructions like those provided with the RDTs used in this study are insufficient to ensure safe and accurate use by CHWs. However, well-designed instructions plus training can ensure high performance. More study is underway to determine how well this performance holds up over time. PMID:18718028

Improving community health worker use of malaria rapid diagnostic tests in Zambia: package instructions, job aid and job aid-plus-training.

PubMed

Harvey, Steven A; Jennings, Larissa; Chinyama, Masela; Masaninga, Fred; Mulholland, Kurt; Bell, David R

2008-08-22

Introduction of artemisinin combination therapy (ACT) has boosted interest in parasite-based malaria diagnosis, leading to increased use of rapid diagnostic tests (RDTs), particularly in rural settings where microscopy is limited. With donor support, national malaria control programmes are now procuring large quantities of RDTs. The scarcity of health facilities and trained personnel in many sub-Saharan African countries means that limiting RDT use to such facilities would exclude a significant proportion of febrile cases. RDT use by volunteer community health workers (CHWs) is one alternative, but most sub-Saharan African countries prohibit CHWs from handling blood, and little is known about CHW ability to use RDTs safely and effectively. This Zambia-based study was designed to determine: (i) whether Zambian CHWs could prepare and interpret RDTs accurately and safely using manufacturer's instructions alone; (ii) whether simple, mostly pictorial instructions (a "job aid") could raise performance to adequate levels; and (iii) whether a brief training programme would produce further improvement. The job aid and training programme were based on formative research with 32 CHWs in Luangwa District. The study team then recruited three groups of CHWs in Chongwe and Chibombo districts. All had experience treating malaria based on clinical diagnosis, but only six had prior RDT experience. Trained observers used structured observation checklists to score each participant's preparation of three RDTs. Each also read 10 photographs showing different test results. The first group (n = 32) was guided only by manufacturer's instructions. The second (n = 21) used only the job aid. The last (n = 26) used the job aid after receiving a three-hour training. Mean scores, adjusted for education, age, gender and experience, were 57% of 16 RDT steps correctly completed for group 1, 80% for group 2, and 92% for group 3. Mean percentage of test results interpreted correctly were 54% (group 1), 80% (group 2), and 93% (group 3). All differences were statistically significant (p < 0.05). Manufacturer's instructions like those provided with the RDTs used in this study are insufficient to ensure safe and accurate use by CHWs. However, well-designed instructions plus training can ensure high performance. More study is underway to determine how well this performance holds up over time.

Geography of community health information organization activity in the United States: Implications for the effectiveness of health information exchange.

PubMed

Vest, Joshua R

The United States has invested nearly a billion dollars in creating community health information organizations (HIOs) to foster health information exchange. Community HIOs provide exchange services to health care organizations within a distinct geographic area. While geography is a key organizing principle for community HIOs, it is unclear if geography is an effective method for organization or what challenges are created by a geography-based approach to health information exchange. This study describes the extent of reported community HIO coverage in the United States and explores the practical and policy implications of overlaps and gaps in HIO service areas. Furthermore, because self-reported service areas may not accurately reflect the true extent of HIOs activities, this study maps the actual markets for health services included in each HIO. An inventory of operational community HIOs that included self-reported geographic markets and participating organizations was face-validated using a crowd-sourcing approach. Aggregation of the participating hospitals' individual health care markets provided the total geographic market served by each community HIO. Mapping and overlay analyses using geographic information system methods described the extent of community HIO activity in the United States. Evidence suggests that community HIOs may be inefficiently distributed. Parts of the United States have multiple, overlapping HIOs, while others do not have any providing health information exchange services. In markets served by multiple community HIOs, 45% of hospitals were participants of only one HIO. The current geography of community HIO activity does not provide comprehensive patient information to providers, nor community-wide information for public health agencies. The discord between the self-reported and market geography of community HIOs raises concerns about the potential effectiveness of health information exchange, illustrates the limitations of geography as an organizing principle, and indicates operational challenges facing those leading and working with community HIOs.

Achieving a college education: The psychological experiences of Latina/o community college students

PubMed Central

Zell., Maristela C.

2011-01-01

This study examines the psychological and subjective experiences of Latina/o community college students. The impact of these experiences on their persistence toward achieving their education goals is also examined. Qualitative interviews with 15 community college students yielded eight themes: Overcoming personal and social challenges, maturation, self-discovery and college adjustment, self-efficacy, continuously strategizing, sense of purpose, perception of faculty, perception of advisors, and guided and groomed by family to succeed. Implications for practice and recommendations for community colleges are discussed. PMID:21544236

Student Perspectives on Transfer and Articulation: Implications for Teacher Education Pedagogy and Practice

ERIC Educational Resources Information Center

Kates, Laura R.

2010-01-01

This study introduces students' perspectives into the knowledge base on community college teacher education and transfer to the four-year college. There is currently widespread agreement that community colleges are an essential resource for diversifying the teaching force and improving teacher retention. While data on enrollment, alignment, and…

An Investigation into Factors Leading to the Longevity in Tenure of California Community College Presidents

ERIC Educational Resources Information Center

McDonald, Christopher

2012-01-01

Community colleges are experiencing many challenges that stem from political and fiscal uncertainties and these challenges are often exacerbated by high turnover in executive leadership positions (Floyd et al., 2010), which has implications for longterm strategic planning. The magnitude of the problems associated with high turnover rates for…

Listening to Their Lives: Learning through Narrative in an Undergraduate Practicum Course

ERIC Educational Resources Information Center

Cairney, Kristen; Breen, Andrea V.

2017-01-01

Experiential community-based learning is used for academic purposes, as well as to promote students' civic education, moral development, and the development of identity. Recent advancements in narrative identity theory may have important implications for enriching our understanding of how learning occurs in the context of community-based learning.…

Mentoring as a Formalized Learning Strategy with Community Sports Volunteers

ERIC Educational Resources Information Center

Griffiths, Mark; Armour, Kathleen

2012-01-01

The aim of our study was to examine formalized mentoring as a learning strategy for volunteer sports coaches and to consider implications for other volunteer groups in the community. Despite the increasingly popular use of mentoring as a learning and support strategy across professional domains, and the sheer scale of volunteer sports coach…

Century Three: Implications for Community and Junior College Research.

ERIC Educational Resources Information Center

Korim, Andrew S.

The past and present economic and social problems and cause-effect relationships are major factors in the development of education at the community and junior college levels. Internal redesign of public junior colleges during the 1960's and early 1970's transformed them from liberal arts institutions into administratively flexible institutions…

Speaking Habermas to Gramsci: Implications for the Vocational Preparation of Community Educators

ERIC Educational Resources Information Center

Bamber, John; Crowther, Jim

2012-01-01

Re-working the Gramscian idea of the "organic" intellectual from the cultural-political sphere to Higher Education (HE), suggests the need to develop critical and questioning "counter hegemonic" ideas and behaviour in community education students. Connecting this reworking to the Habermasian theory of communicative action, suggests that these…

Successional dynamics and restoration implications of a montane coniferous forest in the central Appalachians, USA

Treesearch

Thomas M. Schuler; Rachel J. Collins

2002-01-01

Central Appalachian montane red spruce (Picea rubens Sarg.) communities have been greatly reduced in extent and functional quality over the past century. This community decline has put several plant and animal species, such as the endangered Virginia northern flying squirrel (Glaucomys sabrinus fuscus Shaw), at risk from habitat...

Nitrogen availability is a primary determinant of conifer mycorrhizas across complex environmental gradients

Treesearch

Filipa Cox; Nadia Barsoum; Erik A. Lilleskov; Martin I. Bidartondo

2010-01-01

Global environmental change has serious implications for functional biodiversity in temperate and boreal forests. Trees depend on mycorrhizal fungi for nutrient uptake, but predicted increases in nitrogen availability may alter fungal communities. To address a knowledge gap regarding the effects of nitrogen availability on mycorrhizal communities at large scales, we...

A Framework for Rethinking Educational Leadership in the Margins: Implications for Social Justice Leadership Preparation

ERIC Educational Resources Information Center

Bertrand, Melanie; Rodela, Katherine C.

2018-01-01

This article reimagines the social justice educational leadership field, highlighting the leadership of youth, parents, and community. We examine widely cited social justice educational leadership publications, in addition to critical research on youth voice, parent engagement, and community organizing. Our analysis reveals that the field often…

Parent, Family, and Community Involvement in the Middle Grades. ERIC Digest.

ERIC Educational Resources Information Center

Rutherford, Barry; Billig, Shelley H.

From a synthesis of findings culled from a study that examined partnerships of families and communities with middle schools at multiple sites, researchers derived eight "lessons" that can help foster understanding of the nature of family-school partnerships in the middle grades. Researchers also elaborated implications of these lessons,…

Using Community Radio in a Rural Women's Post-Literacy Programme in Nepal

ERIC Educational Resources Information Center

Nagaoka, Chizuko; Karki, Manohar

2014-01-01

This paper examines the literacy and post-literacy needs of rural women in Nepal, describes a pilot study in using community radio to supplement a classroom-based post-literacy programme for these women, analyses the findings of this intervention and considers the implications for similar programmes in other settings.

Coping Styles and Gender-Role: Some Implications for Mexican American Adult Education.

ERIC Educational Resources Information Center

Evans, Stephanie; Crockett, Stanley

Passive coping behavior and traditional role-gender definitions affect learning needs of segments of the Mexican American adult community and may affect the behavioral development of younger family members. Networking within the community is useful in defining and meeting learning needs of adult Mexican Americans by creating cooperative,…

Methodology and Implications of Statewide Success Rates of Community College Students.

ERIC Educational Resources Information Center

McConochie, Daniel D.; Rajasekhara, Koosappa

In 1991, the Maryland State Board for Community Colleges developed the "success rate," a reporting index which combined graduation, transfer, and persistence rates. Success rate matrices were produced by tracking first-time, full-time students representing seven cohorts (1980 to 1986) over a 4-year period, and matching entering…

Collaborating To Enhance Resilience in Rural At-Risk Students.

ERIC Educational Resources Information Center

Finley, Mary K.

This paper links areas of research with implications for community prevention strategies aimed at high-risk children. Collaborative efforts to reduce the number of at-risk children in rural communities can be advanced by merging knowledge from the following areas: (1) the causal pathways leading to substance abuse and identification of risk…

Factors affecting bee communities in forest openings and adjacent mature forest

Treesearch

H. Patrick Roberts; David I. King; Joan Milam

2017-01-01

Anthropogenic disturbance of habitat is considered a contributing factor of pollinator declines, but some disturbances such as silviculture, may have positive implications for pollinator communities. Silviculture is a key source of disturbance in the eastern USA and thus, developing a better understanding of its ramifications for these keystone species is important for...

Professional Development Opportunities for Early Childhood Educators in Community-Based Child Care Centers

ERIC Educational Resources Information Center

Vesay, Joanne Palermo

2008-01-01

In this study, the staff development opportunities among early childhood educators in community-based, nonprofit child care centers were investigated. The trends for professional development and implications for future staff development were determined from data gathered from surveys completed by 12 lead teachers, 5 paraprofessionals, and 5…

Investigating the Factors of Resiliency among Exceptional Youth Living in Rural Underserved Communities

ERIC Educational Resources Information Center

Curtin, Kevin A.; Schweitzer, Ashley; Tuxbury, Kristen; D'Aoust, Janelle A.

2016-01-01

Resilience is an important social justice concept that has important implications for educators working with exceptional youth in rural underserved communities who may suffer from the consequences associated with economic hardships. This multi-school qualitative study examined resilience among exceptional youth living in rural poverty through the…

The Role of Community, Family, Peer, and School Factors in Group Bullying: Implications for School-Based Intervention

ERIC Educational Resources Information Center

Mann, Michael J.; Kristjansson, Alfgeir L.; Sigfusdottir, Inga Dora; Smith, Megan L.

2015-01-01

Background: Although an ecological perspective suggests the importance of multiple levels of intervention, most bullying research has emphasized individual- and school-focused strategies. This study investigated community and family factors that influence school efforts to reduce odds of group bullying behavior and victimization. Methods: We used…

The American Nursing Shortage: Implications for Community Colleges

ERIC Educational Resources Information Center

Friedel, Janice Nahra

2012-01-01

This article examines national employment and program trends in the nursing profession, the nursing shortage in Iowa, and state policy and community college responses in Iowa. During the seven-year period 2001-2008, two Iowa governors convened special task forces to study the nursing shortage and to make recommendations. The policy responses dealt…

State Gender Equity Law & Athletic Participation among Community Colleges in Washington State

ERIC Educational Resources Information Center

Hoffman, Jennifer L.; Horton, David, Jr.

2011-01-01

This paper presents an overview of partial tuition waivers for athletic participation among community colleges in Washington State and its implications for state and federal gender equity policy and legislation. Using a mixed-methods approach, this article presents findings from Equity in Athletics Disclosure Act data, document analysis, and…

Effects of urban development on ant communities: implications for ecosystem services and management

Treesearch

M.P. Sanford; Patricia N. Manley; Dennis D. Murphy

2009-01-01

Research that connects the effects of urbanization on biodiversity and ecosystem services is lacking. Ants perform multifarious ecological functions that stabilize ecosystems and contribute to a number of ecosystem services. We studied responses of ant communities to urbanization in the Lake Tahoe basin by sampling sites along a gradient...

Caregiving for Dementia in Asian Communities: Implications for Practice

ERIC Educational Resources Information Center

Wang, Donna S.

2012-01-01

Dementia can be debilitating not only for the older adult suffering from memory loss and confusion, but for family members as well. Understanding caregiving for ethnic minorities is critical. In Asian communities, addressing dementia and other mental health issues can be compounded by cultural factors such as perceptions of mental health and…

Technological Change in the Workplace: A Statewide Survey of Community College Library and Learning Resources Personnel.

ERIC Educational Resources Information Center

Poole, Carolyn E.; Denny, Emmett

2001-01-01

Discussion of the effects of technostress on library personnel focuses on an investigation that examined how employees in Florida community college libraries and learning resources centers are dealing with technological change in their work environment. Considers implications for planning and implementing technological change and includes…

Are cattle surrogate wildlife? Savannah plant community composition explained by total herbivory, not herbivore identity

USDA-ARS?s Scientific Manuscript database

The replacement of wild ungulate herbivores by domestic livestock in African savannas is composed of two interrelated phenomena: 1) loss or reduction in numbers of individual wildlife species or guilds, and 2) addition of livestock to the system. Each has important implications for plant community d...

Implications of State and Local Policy on Community College Transfer in California

ERIC Educational Resources Information Center

Neault, Lynn Ceresino; Piland, William E.

2014-01-01

Lower division transfer preparation for the university has been the primary mission of community colleges since their inception creating an important pathway to baccalaureate degree attainment for many students who may not otherwise have the opportunity for higher education. Once considered fairly straightforward, the transfer pathway has become…

Children as Community Planners: Report on an Environmental Design Project 1.

ERIC Educational Resources Information Center

Hanley, Gerard L.; And Others

1981-01-01

Describes a six-month project emphasizing participant-observation teaching strategy in which a third-grade class of 24 students employed methods of environmental design to design communities within a modern forest and more primitive tundra and desert regions. Discusses project goals, results, and implications for future use of environmental design…

Promoting Community-Based Services: Implications for Program Design, Implementation, and Public Policy.

ERIC Educational Resources Information Center

Powers, Michael D.

1986-01-01

Program design, implementation, and public policy issues are discussed for five urban community-based programs for the developmentally disabled: (1) direct services in intermediate care facilities; (2) a High Risk Infant project; (3) group home consultative services; (4) training for support services to adoptive families; (5) a national…

Pedagogical Implications of Working with Doctoral Students at a Distance

ERIC Educational Resources Information Center

Wikeley, Felicity; Muschamp, Yolande

2004-01-01

This paper discusses the issues raised when delivering professional doctorate programmes to students at a distance. It explores the importance in doctoral study of engagement with a research community, what a "community of practice" might mean within the academic context and the problematic nature of working with students already operating within…

The Implications of a Democratic Vision of Community College Leadership.

ERIC Educational Resources Information Center

Gibson-Benninger, Barbara; And Others

A fundamental challenge facing community college presidents and senior-level staff is to create an environment in which diverse qualities of students and staff make positive contributions to the organization. This requires replacing conceptions of leadership as one person at the top who has power with a vision of democratic leadership which…

Difference-Sensitive Communities, Networked Learning, and Higher Education: Potentialities and Risks

ERIC Educational Resources Information Center

Papastephanou, Marianna

2005-01-01

Recent emphases on prospects for difference-sensitive virtual communities rely implicity or explicity on some optimist accounts of cyberspace and globalization. It is expected that hybridity, diaspora and fluidity, marking new understandings of spatiality and temporality in a globalized postmodern era, will create new forms of belonging that will…

E-Message Boards for Those Who Self-Injure: Implications for E-Health

ERIC Educational Resources Information Center

Johnson, Genevieve Marie; Zastawny, Sylvia; Kulpa, Anastasia

2010-01-01

Virtual communities for those who self-injure (SI) are increasingly popular and involve Internet communication technologies including e-message boards. The social and emotional support of an accepting virtual community may facilitate individual recovery from SI. Via self-report data, this study describes individuals who participate in virtual…

Deriving Theories of Change from Successful Community Development Partnerships for Youths: Implications for School Improvement

ERIC Educational Resources Information Center

Lawson, Hal A.; Claiborne, Nancy; Hardiman, Eric; Austin, Sandra; Surko, Michael

2007-01-01

Community development partnerships for youths offer valuable resources for school improvement. Unfortunately, these resources may not be tapped because school leaders have not been prepared to understand these partnerships. The evaluative research reported partnership-related understanding, aiming to prepare leaders to contribute to, and benefit…

Reasonable Expectation: Limits on the Promise of Community Councils.

ERIC Educational Resources Information Center

Bobrow, Sue Berryman

Implications of developmental characteristics of youth are assessed for community education-work councils and the career education programs which councils might be expected to sponsor, in order to decide whether to evaluate councils, and if so, what outcomes councils might be expected to affect. Youth are defined to include pre-adolescent children…

Transnational Computer Use in Urban Latino Immigrant Communities: Implications for Schooling

ERIC Educational Resources Information Center

Sanchez, Patricia; Salazar, Malena

2012-01-01

This article examines the ways in which transnational Latino immigrants in urban communities use computer technology. Drawing from a 3-year ethnographic study, it focuses on three second-generation transnational female youth, their families, and members of their respective immigrant networks. Data were collected in both the United States and…

Growing Up at Centrepoint: Retrospective Accounts of Childhood Spent at an Intentional Community

ERIC Educational Resources Information Center

Gibson, Kerry; Morgan, Mandy; Woolley, Cheryl; Powis, Tracey

2011-01-01

A qualitative analysis of the accounts of 29 adults who grew up in a controversial New Zealand community identified positive and negative experiences and their psychological implications. In addition to highly publicized child sexual abuse that occurred at Centrepoint, children also experienced parental neglect, psychological manipulation, illegal…

Balancing Open Access with Academic Standards: Implications for Community College Faculty

ERIC Educational Resources Information Center

Gabbard, Anita; Mupinga, Davison M.

2013-01-01

Community colleges act as the gateway for students to higher education. Many of these colleges realize this mission through open-door policies where students lacking in basic reading, writing, and mathematics skills can enroll. But, this open-access policy often creates challenges when meeting academic standards. Based on data collected from…

Altered species interactions and implications for natural regeneration in whitebark pine communities

Treesearch

Shawn T. McKinney; Diana F. Tomback; Carl E. Fiedler

2011-01-01

Whitebark pine (Pinus albicaulis) decline has altered trophic interactions and led to changes in community dynamics in many Rocky Mountain subalpine forests (McKinney and Tomback 2007). Here we discuss how altered species interactions, driven by disproportionate whitebark pine mortality, constrain the capability of whitebark pine forests to contribute genetic material...

Integrating Military and Veteran Culture in Social Work Education: Implications for Curriculum Inclusion

ERIC Educational Resources Information Center

Canfield, Julie; Weiss, Eugenia

2015-01-01

This article explores the conceptual question of how to best integrate military culture and issues into social work education. Military service members, veterans, and their families are returning to civilian communities with the ending of conflicts in Iraq and Afghanistan and seeking community-based providers for health and mental health…

Proceedings: Conference on Institutional Planning in Community Colleges (Seattle, Washington, April 29-30, 1976). Occasional Paper Number 27.

ERIC Educational Resources Information Center

Morishima, James K., Ed.; And Others

This document contains three conference papers concerning institutional research at the community college level. Ann Bromley discusses the practical implications of institutional research. The president, administrative staff, and faculty must be involved in identification of research issues, formulation of design, and application of findings.…

Reaching the Environmental Community: Designing an Information Program for the NREL Biofuels Program; May 2002-May 2003

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ames, J.; Werner, C.

2003-08-01

Final report on subcontract for holding two briefings for policymakers and the environmental community on environmental issues related to biofuels; one on one on the energy and environmental issues associated with biofuels production and use, and the other on implications of pending renewable fuels standard legislation.

Persistence at an Urban Community College: The Implications of Self-Efficacy and Motivation

ERIC Educational Resources Information Center

Liao, Hsiang-Ann; Edlin, Margot; Ferdenzi, Anita Cuttita

2014-01-01

This study examined how self-efficacy and motivation affected student persistence at an urban community college. Self-efficacy was studied at two dimensions: self-regulated learning efficacy and self-efficacy for academic achievement. Motivation was also investigated at two levels: intrinsic motivation and extrinsic motivation. Results show that…

Teacher and School Leader Quality and Sustainability. Resource Sheet No. 5

ERIC Educational Resources Information Center

Mulford, Bill

2011-01-01

Schools need sustainable reform to meet the challenges of rapid and constant change and higher community expectations. Sustainable school reform is best achieved when teachers and school leaders: (1) understand what is happening in the broader community and the implications this has for schools (being contextually literate); (2) run their schools…

Say Who You Are, Play Who You Are: Improvisation, Pedagogy, and Youth on the Margins

ERIC Educational Resources Information Center

Willox, Ashlee Cunsolo; Heble, Ajay; Jackson, Rob; Walker, Melissa; Waterman, Ellen

2011-01-01

This paper presents a research that emerges from a set of community-based outreach activities associated with a large-scale, interdisciplinary project, Improvisation, Community, and Social Practice (ICASP), which focuses on the social and pedagogical implications of improvised musical practices. Working from the premise that musical improvisation…

Plankton community respiration, net ecosystem metabolism, and oxygen dynamics on the Louisiana continental shelf: implications for hypoxia

EPA Science Inventory

We conducted a multi-year study of the Louisiana continental shelf (LCS) to better understand the linkages between water column metabolism and the formation of hypoxia (dissolved oxygen <2 mg L-1) in the region. Water column community respiration rates (WR) were measured on 10 cr...

Environmentalism and community: connections and implications for social action

Treesearch

Benjamin J. Marcus; Allen M. Omoto; Patricia L. Winter

2011-01-01

This qualitative study explored conceptualizations of environmentalism and community, as well as the connections of ethnicity to these concepts in a small but diverse sample. Semistructured interviews were conducted with eight participants and included a conceptual content cognitive mapping procedure. The resulting maps were examined for themes and ideas about the key...

Inuit Voices on Quality Education in Nunavut: Policy Implications

ERIC Educational Resources Information Center

Fredua-Kwarteng, Eric

2016-01-01

This paper is based on a research that explored how Inuit community members in Nunavut Territory, Canada, conceptualized quality education in the socio-cultural context of the territory. Data were collected through telephone interviews of 13 Inuit community members in Nunavut and document reviews both of which were conducted in 2010. The data…

Perceptions of parents on how religion influences adolescents' sexual behaviours in two Ghanaian communities: implications for HIV and AIDS prevention.

PubMed

Osafo, Joseph; Asampong, Emmanuel; Langmagne, Sussan; Ahiedeke, Clement

2014-08-01

To understand the role of religion in the sexual behaviours of adolescents, the views of parents who are key agents of socialization were examined from two south-eastern communities in Ghana. Focus Group interviews were conducted with mothers (and female caregivers) of adolescents and one with fathers (and male caregivers) of adolescents. Thematic analysis was used to analyse the data. Findings indicated that parents from one community perceived religion as playing a double-edged role in adolescents' sexual behaviours as on one hand it played a protective role by restraining adolescents from risky sexual behaviours; on the other hand it disparaged the existing traditional measures that regulated adolescents' sexual behaviour. However, parents from the other community found a collaborative interface between the existing social control measures-communal socialization and proscriptive morality with religious ethics. Religious socialization, social capital theory and the concept of social suffering are used to explain some of the findings of this study. Implications for HIV and AIDS education and prevention are also discussed.

Incorporating Unstructured Socializing Into the Study of Secondary Exposure to Community Violence: Etiological and Empirical Implications.

PubMed

Zimmerman, Gregory M; Messner, Steven F; Rees, Carter

2014-07-01

Secondary exposure to community violence, defined as witnessing or hearing violence in the community, has the potential to profoundly impact long-term development, health, happiness, and security. While research has explored pathways to community violence exposure at the individual, family, and neighborhood levels, prior work has largely neglected situational factors conducive to secondary violence exposure. The present study evaluates "unstructured socializing with peers in the absence of authority figures" as a situational process that has implications for secondary exposure to violence. Results indicate that a measure of unstructured socializing was significantly associated with exposure to violence, net of an array of theoretically relevant covariates of violence exposure. Moreover, the relationships between exposure to violence and three of the most well-established correlates of violence exposure in the literature-age, male, and prior violence-were mediated to varying degrees by unstructured socializing. The results suggest a more nuanced approach to the study of secondary violence exposure that expands the focus of attention beyond individual and neighborhood background factors to include situational opportunities presented by patterns of everyday activities. © The Author(s) 2013.

Perceptions of Parents on How Religion Influences Adolescents’ Sexual Behaviours in Two Ghanaian Communities: Implications for HIV and AIDS Prevention

PubMed Central

Asampong, Emmanuel; Langmagne, Sussan; Ahiedeke, Clement

2013-01-01

To understand the role of religion in the sexual behaviours of adolescents, the views of parents who are key agents of socialization were examined from two south-eastern communities in Ghana. Focus Group interviews were conducted with mothers (and female caregivers) of adolescents and one with fathers (and male caregivers) of adolescents. Thematic analysis was used to analyse the data. Findings indicated that parents from one community perceived religion as playing a double-edged role in adolescents’ sexual behaviours as on one hand it played a protective role by restraining adolescents from risky sexual behaviours; on the other hand it disparaged the existing traditional measures that regulated adolescents’ sexual behaviour. However, parents from the other community found a collaborative interface between the existing social control measures—communal socialization and proscriptive morality with religious ethics. Religious socialization, social capital theory and the concept of social suffering are used to explain some of the findings of this study. Implications for HIV and AIDS education and prevention are also discussed. PMID:23440475

Oracle. Three Histories of the 1980's: Implications for Education.

ERIC Educational Resources Information Center

Graeber, James J.; And Others

Three hypothetical scenarios for the 1980's are presented as tools for exploring the future of the Des Moines, Iowa, Independent Community School District. Each is written in the past tense as a "history" and is followed by a set of implications for education. The first scenario conveys an optimistic view of current trends, suggesting…

Evaluation in the Context of the Government Market Place: Implications for the Evaluation of Research

ERIC Educational Resources Information Center

Della-Piana, Connie Kubo; Della-Piana, Gabriel M.

2007-01-01

While the current debate in the evaluation community has concentrated on examining and explicating implications of the choice of methods for evaluating federal programs, the authors of this paper address the challenges faced by the government in the selection of funding mechanisms for supporting program evaluation efforts. The choice of funding…

Monitoring and Evaluation of an Early Childhood Development Programme: Implications for Leadership and Management

ERIC Educational Resources Information Center

Hodgson, Sarah; Papatheodorou, Theodora; James, Mary

2014-01-01

The article aims to discuss preliminary findings from a participatory monitoring and evaluation (M&E) framework, used in a community-based early childhood development (ECD) programme in KwaZulu-Natal South Africa, and their implications for leadership and management. The purposes of the M&E were for LETCEE, the implementing organization,…

Implications for Working with New Canadians. TEAL Occasional Papers, Vol. 2, 1978.

ERIC Educational Resources Information Center

Marshall, Diane

General implications for counseling Asian immigrant women were sought through individual and group counseling at King Edward Campus of Vancouver Community College. The campus is the base for the centralized English as a second language program for new Canadian adults in British Columbia. The research focused in part on nine women who were tested…

Relationship Between Forage Allowance and Grazing Efficiency in the Great Plains: Implications for Managing Rangelands for Both Livestock Production and Desired Ecosystem Goods and Services

USDA-ARS?s Scientific Manuscript database

Emergence of desired ecosystem goods and services from rangelands as a societal benefit and a potential income source for land managers has implications regarding the management of plant communities traditionally used primarily for livestock production. Contemporary decision-making on rangelands in ...

From the Mahanadi Delta to Sendai via South America: Building bridges between research, practice and international policy for disaster resilience assessments

NASA Astrophysics Data System (ADS)

Fanchiotti, Margherita; Torres, Jair

2017-04-01

The concept of disaster resilience has gained momentum in recent decades and major international initiatives, such as the 2030 Agenda for Sustainable Development, the Sendai Framework for Disaster Risk Reduction 2015-2030 and the Paris Agreement, all recognise the importance of fostering community resilience to natural hazards to save lives and reduce losses. Despite significant advances in the policy settings for disaster resilience assessment, the interpretation of the concept itself and its implications for practice and policy remain clouded and more research is needed to gather evidence of what resilience means for governments and communities. This paper aims to bring together the research work the authors have conducted in the field of disaster resilience assessments at their respective institutions (University of Southampton, UK and the UME Graduate School at the Institute for Advanced Studies of Pavia, Italy) with the practical implementation projects and international policy consultations they have been involved in under UNESCO's umbrella. The main findings of a research study conducted as part of the 'Deltas, Vulnerability & Climate Change: Migration & Adaptation' (DECCMA) project to investigate the differential resilience of local communities in the Mahanadi Delta, India using a development approach will be presented. Statistical methods have been employed to identify development hotspots and have been combined with a qualitative analysis of community perceptions of development and the mutual implications of development for disaster resilience to build case studies of community resilience to inform theory, policy and practice. The authors will then discuss the practical implications of this research study for the implementation of UNESCO's 'Enhancing Natural HAzards resilience iN South America' (ENHANS) project, which seeks to train a critical mass of decision-makers, community leaders and experts on disaster risk and resilience assessments in four countries in South America (Ecuador, Chile, Peru and Uruguay), and the policy implications for their work as part of UNESCO's task force for developing UNISDR's New Ten Essentials for Making Cities Resilient, a checklist for building capacities for disaster resilience at the city level which aims to provide local authorities with tools, including scorecards and a handbook for local government leaders, to self-assess urban resilience and stimulate positive change, in line with the Sendai Framework.

Insolvency and challenges of regulating providers that bear risk.

PubMed

Brewster, L R; Jackson, L; Lesser, C S

2000-02-01

Risk contracting and capitation are two widely used financial mechanisms that give incentives to health care providers to control costs. Risk-bearing arrangements have failed in a number of communities, however. This has shaken local markets, disrupting consumers' access to health care services and triggering losses for physicians and hospitals. It also has raised questions about the adequacy of related regulatory oversight, which holds important implications for local and national policy makers. This Issue Brief provides case studies of failed risk-contracting arrangements in two of the 12 communities that the Center for Studying Health System Change (HSC) tracks intensively--Northern New Jersey and Orange County, Calif.--and examines implications for policy makers.

Introducing a means of quantifying community reputation: the print media as a data source.

PubMed

McLaren, Lindsay; Perry, Rosemary; Carruthers, Lesley; Hawe, Penelope

2005-06-01

A community's reputation may have implications for self-esteem, morale, or other health outcomes of residents. In this study, we introduce a means of quantifying the reputation of communities in Calgary, Canada based on their portrayal in the daily citywide newspaper. Publication dates were selected from an 8.5-year period using constructed week sampling. For communities designated as high or low in well-being, sampled references were rated as positive, negative, or neutral in topic, by two independent raters who were blind to community identity. Findings suggest that the print media represent a convenient and discriminating data source for characterising some aspects of community reputation.

Improving community mental health services for people affected by political violence in Ayacucho, Perú.

PubMed

Rivera-Holguin, Miryam; Velazquez, Tesania; Custodio, Elba; Corveleyn, Jozef

2018-01-01

This study describes a model to intervene in communities affected by the political violence impacting the Ayacucho region of Peru since 1980s. Many community members still experience psychosocial consequences to this day due primarily to grief. Thirty-eight professionals from different sectors in the area received specialized training and implemented five community projects that were accompanied and monitored in the field by a team of community psychologists. This article is grounded on the principles of participation, building community capacity, and community strengthening. We present the analysis of five community action plans implemented over a period of 14 months. The results show a process of internal strengthening of community services and the identification of new social and community resources among the people involved in the action plans. The implications of capacity building for improving community mental health are discussed.

Cryptic oxygen oases: Hypolithic photosynthesis in hydrothermal areas and implications for Archean surface oxidation

NASA Astrophysics Data System (ADS)

Havig, J. R.; Hamilton, T. L.

2017-12-01

Mounting geochemical evidence suggests microorganisms capable of oxygenic photosynthesis (e.g., Cyanobacteria) colonized Archean continental surfaces, driving oxidative weathering of detrital pyrites prior to the 2.5 Ga great oxidation event. Modern terrestrial environments dominated by single-celled phototrophs include hydrothermal systems (e.g., Yellowstone National Park) and hypolithic communities found in arid to hyper-arid deserts (e.g., McMurdo Dry Valleys of Antarctica, Atacama Desert of Chile). Recent work indicates terrestrial hydrothermal systems date back at least as far as 3.5 Ga. Here, we explore phototrophic communities in both hypolithic (sub-sinter) and hydrothermal (subaqueous and subaerial) environments in Yellowstone National Park as potential analogs to Archean continental surfaces. Hydrothermal sub-sinter environments provide ideal conditions for phototrophic microbial communities, including blocking of harmful UV radiation, trapping and retention of moisture, and protection from erosion by rain and surface runoff. Hypolithic communities in geothermal settings were similar in both composition and carbon uptake rates to nearby hot spring communities. We hypothesize that hydrothermal area hypolithic communities represent modern analogs of phototrophic microbial communities that colonized Archean continental surfaces, producing oxygen locally and facilitating microbially-mediated pyrite oxidation prior to the presence of free oxygen in the global atmosphere. These results have implications for oxidation of the early Earth surface, the search for biosignatures in the rock record, as well as for potential harbors of past life on Mars and the search for life on Exoplanets.

Silver nanoparticles uptake by salt marsh plants - Implications for phytoremediation processes and effects in microbial community dynamics.

PubMed

Fernandes, Joana P; Mucha, Ana P; Francisco, Telmo; Gomes, Carlos Rocha; Almeida, C Marisa R

2017-06-15

This study investigated the uptake of silver nanoparticles (AgNPs) by a salt marsh plant, Phragmites australis, as well as AgNPs effects on rhizospheric microbial community, evaluating the implications for phytoremediation processes. Experiments were carried out with elutriate solution doped with Ag, either in ionic form or in NP form. Metal uptake was evaluated in plant tissues, elutriate solutions and sediments (by AAS) and microbial community was characterized in terms of bacterial community structure (evaluated by ARISA). Results showed Ag accumulation but only in plant belowground tissues and only in the absence of rhizosediment, the presence of sediment reducing Ag availability. But in plant roots Ag accumulation was higher when Ag was in NP form. Multivariate analysis of ARISA profiles showed significant effect of the absence/presence of Ag either in ionic or NP form on microbial community structure, although without significant differences among bacterial richness and diversity. Overall, P. australis can be useful for phytoremediation of medium contaminated with Ag, including with AgNPs. However, the presence of Ag in either forms affected the microbial community structure, which may cause disturbances in ecosystems function and compromise phytoremediation processes. Such considerations need to be address regarding environmental management strategies applied to the very important estuarine areas. The form in which the metal was added affected metal uptake by Phragmites australis and rhizosediment microbial community structure, which can affect phytoremediation. Copyright © 2017 Elsevier Ltd. All rights reserved.

Earth Science Informatics Community Requirements for Improving Sustainable Science Software Practices: User Perspectives and Implications for Organizational Action

NASA Astrophysics Data System (ADS)

Downs, R. R.; Lenhardt, W. C.; Robinson, E.

2014-12-01

Science software is integral to the scientific process and must be developed and managed in a sustainable manner to ensure future access to scientific data and related resources. Organizations that are part of the scientific enterprise, as well as members of the scientific community who work within these entities, can contribute to the sustainability of science software and to practices that improve scientific community capabilities for science software sustainability. As science becomes increasingly digital and therefore, dependent on software, improving community practices for sustainable science software will contribute to the sustainability of science. Members of the Earth science informatics community, including scientific data producers and distributers, end-user scientists, system and application developers, and data center managers, use science software regularly and face the challenges and the opportunities that science software presents for the sustainability of science. To gain insight on practices needed for the sustainability of science software from the science software experiences of the Earth science informatics community, an interdisciplinary group of 300 community members were asked to engage in simultaneous roundtable discussions and report on their answers to questions about the requirements for improving scientific software sustainability. This paper will present an analysis of the issues reported and the conclusions offered by the participants. These results provide perspectives for science software sustainability practices and have implications for actions that organizations and their leadership can initiate to improve the sustainability of science software.

Social Service Utilization, Sense of Community, Family Functioning and the Mental Health of New Immigrant Women in Hong Kong

PubMed Central

Wu, Qiaobing; Chow, Julian Chun-Chung

2013-01-01

Drawing upon a sample of 296 new immigrant women in Hong Kong, this study investigated how social service utilization, family functioning, and sense of community influenced the depressive symptoms of new immigrant women. Results of the structural equation modeling suggested that family functioning and sense of community were both significantly and negatively associated with the depression of new immigrant women. Utilization of community services also influenced the depression of immigrant women indirectly through the mediating effect of sense of community. Implications of the research findings for mental health intervention were discussed. PMID:23629592

Gene expression of indoor fungal communities under damp building conditions: Implications for human health.

PubMed

Hegarty, B; Dannemiller, K C; Peccia, J

2018-03-03

Dampness and visible mold growth in homes are associated with negative human health outcomes, but causal relationships between fungal exposure and health are not well established. The purpose of this study was to determine whether dampness in buildings impacts fungal community gene expression and how, in turn, gene expression may modulate human health impacts. A metatranscriptomic study was performed on house dust fungal communities to investigate the expression of genes and metabolic processes in chamber experiments at water activity levels of 0.5, 0.85, and 1.0. Fungi at water activities as low as 0.5 were metabolically active, focusing their transcriptional resources on primary processes essential for cell maintenance. Metabolic complexity increased with water activity where communities at 1.0 displayed more diverse secondary metabolic processes. Greater gene expression at increasing water activity has important implications for human health: Fungal communities at 1.0 a w upregulated a greater number of allergen-, mycotoxin-, and pathogenicity-encoding genes versus communities at 0.85 and 0.5 a w . In damp buildings, fungi may display increases in secondary metabolic processes with the potential for greater per-cell production of allergens, toxins, and pathogenicity. Assessments in wet versus dry buildings that do not account for this elevated health impact may not accurately reflect exposure. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

The Hospital Community Benefit Program: Implications for Food and Nutrition Professionals.

PubMed

Fleischhacker, Sheila; Ramachandran, Gowri

2016-01-01

This article briefly explains the food and nutrition implications of the new standards, tax penalties and reporting requirements for non-profit hospitals and healthcare systems to maintain a tax-exempt or charitable status under section 501(c)(3) of the Federal Internal Revenue Code set forth in The Patient Protection and Affordable Care Act (P.L. 111-148, Sec. 9007). The newly created 501(r) of the Internal Revenue Code requires, beginning with the first tax year on or after March 23, 2012, that such hospitals demonstrate community benefit by conducting a community health needs assessment (CHNA) at least once every three years and annually file information by means of a Schedule H (Form 990) regarding progress towards addressing identified needs. As hospitals conduct their CHNA and work further and collaboratively with community stakeholders on developing and monitoring their proposed action plans, the breadth and depth of food and nutrition activities occurring as a result of the Affordable Care Act Hospital Community Benefit Program will likely increase. The CHNA requirement, along with other emerging initiatives focused on improving the food environments and nutrition-related activities of hospitals and healthcare systems offer fruitful opportunities for food and nutrition professionals to partner on innovative ways to leverage hospital infrastructure and capacity to influence those residing, working or visiting the hospital campus, as well as the surrounding community.

Ice cover extent drives phytoplankton and bacterial community structure in a large north-temperate lake: implications for a warming climate.

PubMed

Beall, B F N; Twiss, M R; Smith, D E; Oyserman, B O; Rozmarynowycz, M J; Binding, C E; Bourbonniere, R A; Bullerjahn, G S; Palmer, M E; Reavie, E D; Waters, Lcdr M K; Woityra, Lcdr W C; McKay, R M L

2016-06-01

Mid-winter limnological surveys of Lake Erie captured extremes in ice extent ranging from expansive ice cover in 2010 and 2011 to nearly ice-free waters in 2012. Consistent with a warming climate, ice cover on the Great Lakes is in decline, thus the ice-free condition encountered may foreshadow the lakes future winter state. Here, we show that pronounced changes in annual ice cover are accompanied by equally important shifts in phytoplankton and bacterial community structure. Expansive ice cover supported phytoplankton blooms of filamentous diatoms. By comparison, ice free conditions promoted the growth of smaller sized cells that attained lower total biomass. We propose that isothermal mixing and elevated turbidity in the absence of ice cover resulted in light limitation of the phytoplankton during winter. Additional insights into microbial community dynamics were gleaned from short 16S rRNA tag (Itag) Illumina sequencing. UniFrac analysis of Itag sequences showed clear separation of microbial communities related to presence or absence of ice cover. Whereas the ecological implications of the changing bacterial community are unclear at this time, it is likely that the observed shift from a phytoplankton community dominated by filamentous diatoms to smaller cells will have far reaching ecosystem effects including food web disruptions. © 2015 Society for Applied Microbiology and John Wiley & Sons Ltd.

Review of the nutritional implications of farmers' markets and community gardens: a call for evaluation and research efforts.

PubMed

McCormack, Lacey Arneson; Laska, Melissa Nelson; Larson, Nicole I; Story, Mary

2010-03-01

The development and promotion of farmers' markets and community gardens is growing in popularity as a strategy to increase community-wide fruit and vegetable consumption. Despite large numbers of farmers' markets and community gardens in the United States, as well as widespread enthusiasm for their use as a health promotion tool, little is known about their influence on dietary intake. This review examines the current scientific literature on the implications of farmers' market programs and community gardens on nutrition-related outcomes in adults. Studies published between January 1980 and January 2009 were identified via PubMed and Agricola database searches and by examining reference lists from relevant studies. Studies were included in this review if they took place in the United States and qualitatively or quantitatively examined nutrition-related outcomes, including dietary intake; attitudes and beliefs regarding buying, preparing, or eating fruits and vegetables; and behaviors and perceptions related to obtaining produce from a farmers' market or community garden. Studies focusing on garden-based youth programs were excluded. In total, 16 studies were identified for inclusion in this review. Seven studies focused on the impact of farmers' market nutrition programs for Special Supplemental Nutrition Program for Women, Infants, and Children participants, five focused on the influence of farmers' market programs for seniors, and four focused on community gardens. Findings from this review reveal that few well-designed research studies (eg, those incorporating control groups) utilizing valid and reliable dietary assessment methods to evaluate the influence of farmers' markets and community gardens on nutrition-related outcomes have been completed. Recommendations for future research on the dietary influences of farmers' markets and community gardens are provided. Copyright 2010 American Dietetic Association. Published by Elsevier Inc. All rights reserved.

Learning Culture, Spirituality and Local Knowledge: Implications for African Schooling

NASA Astrophysics Data System (ADS)

Sefa Dei, George J.

2002-09-01

(Learning, Culture, Spirituality and Local Knowedge: Implications for African Schooling) - Using a Ghanaian case study, this paper looks at the relevance and implications of local knowledge, culture and spirituality for understanding and implementing educational change in Africa. It examines how teachers, educators, and students use local cultural knowledge about self, personhood and community. Among the critical issues raised are: How do subjects understand the nature, impact and implications of spirituality for schooling and education? What is the role of spirituality, culture, language and social politics in knowledge production? What contribution does the local cultural knowledge base make to the search for genuine educational options in Africa?

Cultural Beliefs regarding People with Disabilities in Namibia: Implications for the Inclusion of People with Disabilities

ERIC Educational Resources Information Center

Haihambo, Cynthy; Lightfoot, Elizabeth

2010-01-01

Namibia is a southern African country with national level policies promoting community inclusion and inclusive education. Despite these policies, people with disabilities are often excluded from schools and community life. This study explores the nuanced cultural beliefs about the causes of disability in Namibia, and the impacts of such beliefs on…

SELF IMAGES AND COMMUNITY IMAGES OF THE ELEMENTARY SCHOOL PRINCIPAL--FINDINGS AND IMPLICATIONS OF A SOCIOLOGICAL INQUIRY.

ERIC Educational Resources Information Center

FOSKETT, JOHN M.; WOLCOTT, HARRY F.

THE SYSTEM OF RULES THAT GUIDES THE BEHAVIOR OF ELEMENTARY SCHOOL PRINCIPALS WAS INVESTIGATED. THIS BODY OF RULES, TERMED "THE NORMATIVE STRUCTURE OF THE COMMUNITY AS IT PERTAINS TO SCHOOL ADMINISTRATORS," WAS STUDIED BY MEANS OF AN INSTRUMENT CALLED THE "ROLE NORM INVENTORY." SEPARATE INVENTORIES WERE DEVELOPED FOR ELEMENTARY…

Social Support, Academic Adversity and Academic Buoyancy: A Person-Centred Analysis and Implications for Academic Outcomes

ERIC Educational Resources Information Center

Collie, Rebecca J.; Martin, Andrew J.; Bottrell, Dorothy; Armstrong, Derrick; Ungar, Michael; Liebenberg, Linda

2017-01-01

The present study employed person-centred analyses that enabled identification of groups of students separated on the basis of their perceptions of social support (home and community), academic support, academic adversity and academic buoyancy. Among a sample of 249 young people, including many from high-needs communities, cluster analysis…

After the Spring: Reforming Arab Armies

DTIC Science & Technology

2014-09-01

Arab region, and intercultural communication . She was previously assigned to the North Atlantic Treaty Organization (NATO) Defence College and the...and provides solutions to strategic Army issues affecting the national security community . The Peacekeeping and Stability Operations Institute...concern topics having strategic implications for the Army, the Department of Defense, and the larger national security community . In addition to its

The Direct Support Workforce in Community Supports to Individuals with Developmental Disabilities: Issues, Implications, and Promising Practices

ERIC Educational Resources Information Center

Hewitt, Amy; Larson, Sheryl

2007-01-01

Difficulties in finding, keeping, and ensuring the competence of the direct support workforce in community developmental disability services has long been a challenge for individuals, families, providers, and policy makers. Direct support staff recruitment, retention, and competence are widely reported as one of the most significant barriers to…

The Teacher-Community of Practice-Student Interaction in the New Zealand Technology Classroom

ERIC Educational Resources Information Center

Slatter, Wendy; France, Bev

2011-01-01

In New Zealand in order to provide authentic learning experiences teachers are counselled to access Communities of Practice (CoP) (Ministry of Education 2007). This research provides information about teachers' interactions with CoPs and the implication of this access on their pedagogy. A range of interactions occurred which was influenced by how…

Information Resource Management for Rural Communities in Zambia: Implications for National Information Policy Formulation.

ERIC Educational Resources Information Center

Lundu, Maurice C.

Arguing that the information needs of the rural community are largely ignored in the establishment of information systems and services, this paper: (1) identifies the unique characteristics of information users in rural areas; (2) identifies and analyzes the types of communication channels most likely to deliver the information related to…