Suchergebnisse

1. Motherhood as a Category of Risk -- 2. The Colonial Community: Managing Native Motherhood -- 3. The International Community: Making Motherhood Safe from Afar -- 4. The National Community: Making Motherhood Safe in Tanzania -- 5. Situating the Fieldwork Setting: The Shinyanga Region in Historical Perspective -- 6. The Community of Bulangwa -- 7. Risk and Tradition -- 8. The Prenatal Period, Part 1: The Risk of Infertility -- 9. The Prenatal Period, Part 2: Risks during Pregnancy -- 10. Risks during Childbirth -- 11. Risks during the Postpartum Period -- 12. Risk and Maternal Health

This article explores the meaning and place of "traditional" forms of sex education within the cultural and historical context of the Shinyanga Region of west central Tanzania. Although structured puberty initiation rituals may have been an important source of information about sexuality and reproduction for Tanzanian adolescents in the past, such rituals were not common to all Tanzanian settings. The Shinyanga Region is a case in point. Drawing upon the anthropological and sociological literature for west central Tanzania, as well my ethnographic fieldwork in a small, rural community from 1992 to 1994, I explore answers to several interrelated questions: How did young women who lived in this geographic setting learn about sexuality and reproduction in the past? Did instruction about such matters consist of practices that were uniform and structured events, or was information passed on in a less uniform, nonstructured way? Would a revival of these practices, whatever their form, benefit young women today?

Die Autorin untersucht Stellenwert und Bedeutung traditioneller Formen der Sexualerziehung im soziokulturellen und geschichtlichen Kontext der Shinyanga-Region in Tansania. Sie geht unter anderm folgenden Fragen nach: Wie wurden Frauen der Region in der Vergangenheit mit Fragen der Sexualität und der Reproduktion vertraut? Wurden Instruktionen in gleichförmiger und strukturierter Weise oder eher informell weitergegeben? Würde die Wiederbelebung möglicherweise verschütteter Traditionen Frauen der Gegenwart nützen können? (DÜI-Kör)

Continuing its role as a leader in air pollution policymaking, California led the nation by passing the first global warming legislation in the U.S.: the Global Warming Solutions Act or Assembly Bill 32 (AB 32). The legislation requires California to decrease greenhouse gas (GHG) emissions to 1990 levels by 2020 (approximately a 27 percent reduction) using an enforceable statewide target to be phased in beginning in 2012. In addition, in 2005 Governor Schwarzenegger issued Executive Order S-3-05, which charges California with the task of reducing GHG emissions to 2000 levels by 2010, reducing emissions to 1990 levels by 2020, and reducing emissions to 80 percent below 1990 levels by 2050. This report represents a body of work conducted to assist the State of California in its efforts to develop a plan to achieve the emission targets set forth by AB 32. This research includes a literature review, expert interviews, and regional stakeholder workshops to identify and explore possible policy processes (e.g., cap and trade, budgets, feebates, etc.), mechanisms (e.g., smart growth and ITS), and strategies that could be employed to meet AB 32's GHG reduction goals.

OBJECTIVES: The overuse of antimalarial drugs is widespread. Effective methods to improve prescribing practice remain unclear. We evaluated the impact of 10 interventions that introduced rapid diagnostic tests for malaria (mRDTs) on the use of tests and adherence to results in different contexts. DESIGN: A comparative case study approach, analysing variation in outcomes across different settings. SETTING: Studies from the ACT Consortium evaluating mRDTs with a range of supporting interventions in 6 malaria endemic countries. Providers were governmental or non-governmental healthcare workers, private retail sector workers or community volunteers. Each study arm in a distinct setting was considered a case. PARTICIPANTS: 28 cases from 10 studies were included, representing 148 461 patients seeking care for suspected malaria. INTERVENTIONS: The interventions included different mRDT training packages, supervision, supplies and community sensitisation. OUTCOME MEASURES: Analysis explored variation in: (1) uptake of mRDTs (% febrile patients tested); (2) provider adherence to positive mRDTs (% Plasmodium falciparum positive prescribed/given Artemisinin Combination Treatment); (3) provider adherence to negative mRDTs (% P. falciparum negative not prescribed/given antimalarial). RESULTS: Outcomes varied widely across cases: 12-100% mRDT uptake; 44-98% adherence to positive mRDTs; 27-100% adherence to negative mRDTs. Providers appeared more motivated to perform well when mRDTs and intervention characteristics fitted with their own priorities. Goodness of fit of mRDTs with existing consultation and diagnostic practices appeared crucial to maximising the impact of mRDTs on care, as did prior familiarity with malaria testing; adequate human resources and supplies; possible alternative treatments for mRDT-negative patients; a more directive intervention approach and local preferences for ACTs. CONCLUSIONS: Basic training and resources are essential but insufficient to maximise the potential of mRDTs in many contexts. Programme design should respond to assessments of provider priorities, expectations and capacities. As mRDTs become established, the intensity of supporting interventions required seems likely to reduce.

Objectives: The overuse of antimalarial drugs is widespread. Effective methods to improve prescribing practice remain unclear. We evaluated the impact of 10 interventions that introduced rapid diagnostic tests for malaria (mRDTs) on the use of tests and adherence to results in different contexts. Design: A comparative case study approach, analysing variation in outcomes across different settings. Setting: Studies from the ACT Consortium evaluating mRDTs with a range of supporting interventions in 6 malaria endemic countries. Providers were governmental or non-governmental healthcare workers, private retail sector workers or community volunteers. Each study arm in a distinct setting was considered a case. Participants: 28 cases from 10 studies were included, representing 148 461 patients seeking care for suspected malaria. Interventions: The interventions included different mRDT training packages, supervision, supplies and community sensitisation. Outcome measures: Analysis explored variation in: (1) uptake of mRDTs (% febrile patients tested); (2) provider adherence to positive mRDTs (% Plasmodium falciparum positive prescribed/given Artemisinin Combination Treatment); (3) provider adherence to negative mRDTs (% P. falciparum negative not prescribed/given antimalarial). Results: Outcomes varied widely across cases: 12-100% mRDT uptake; 44-98% adherence to positive mRDTs; 27-100% adherence to negative mRDTs. Providers appeared more motivated to perform well when mRDTs and intervention characteristics fitted with their own priorities. Goodness of fit of mRDTs with existing consultation and diagnostic practices appeared crucial to maximising the impact of mRDTs on care, as did prior familiarity with malaria testing; adequate human resources and supplies; possible alternative treatments for mRDT-negative patients; a more directive intervention approach and local preferences for ACTs. Conclusions: Basic training and resources are essential but insufficient to maximise the potential of mRDTs in many contexts. Programme design should respond to assessments of provider priorities, expectations and capacities. As mRDTs become established, the intensity of supporting interventions required seems likely to reduce.

OBJECTIVES: The overuse of antimalarial drugs is widespread. Effective methods to improve prescribing practice remain unclear. We evaluated the impact of 10 interventions that introduced rapid diagnostic tests for malaria (mRDTs) on the use of tests and adherence to results in different contexts. DESIGN: A comparative case study approach, analysing variation in outcomes across different settings. SETTING: Studies from the ACT Consortium evaluating mRDTs with a range of supporting interventions in 6 malaria endemic countries. Providers were governmental or non-governmental healthcare workers, private retail sector workers or community volunteers. Each study arm in a distinct setting was considered a case. PARTICIPANTS: 28 cases from 10 studies were included, representing 148 461 patients seeking care for suspected malaria. INTERVENTIONS: The interventions included different mRDT training packages, supervision, supplies and community sensitisation. OUTCOME MEASURES: Analysis explored variation in: (1) uptake of mRDTs (% febrile patients tested); (2) provider adherence to positive mRDTs (% Plasmodium falciparum positive prescribed/given Artemisinin Combination Treatment); (3) provider adherence to negative mRDTs (% P. falciparum negative not prescribed/given antimalarial). RESULTS: Outcomes varied widely across cases: 12-100% mRDT uptake; 44-98% adherence to positive mRDTs; 27-100% adherence to negative mRDTs. Providers appeared more motivated to perform well when mRDTs and intervention characteristics fitted with their own priorities. Goodness of fit of mRDTs with existing consultation and diagnostic practices appeared crucial to maximising the impact of mRDTs on care, as did prior familiarity with malaria testing; adequate human resources and supplies; possible alternative treatments for mRDT-negative patients; a more directive intervention approach and local preferences for ACTs. CONCLUSIONS: Basic training and resources are essential but insufficient to maximise the potential of mRDTs in many contexts. Programme design should respond to assessments of provider priorities, expectations and capacities. As mRDTs become established, the intensity of supporting interventions required seems likely to reduce.