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Washington, D.C., World Bank, Latin America and the Caribbean Region, Human Development Department, 2007 Oct. 55 p. (Policy Research Working Paper No. 4377)A new literature on the nature of and policies for youth in Latin America is emerging, but there is still very little known about who are the most vulnerable young people. This paper aims to characterize the heterogeneity in the youth population and identify ex ante the youth that are at-risk and should be targeted with prevention programs. Using non-parametric methodologies and specialized youth surveys from Mexico and Chile, the authors quantify and characterize the different subgroups of youth, according to the amount of risk in their lives, and find that approximately 20 percent of 18 to 24 year old Chileans and 40 percent of the same age cohort in Mexico are suffering the consequences of a range of negative behaviors. Another 8 to 20 percent demonstrate factors in their lives that pre-dispose them to becoming at-risk youth - they are the candidates for prevention programs. The analysis finds two observable variables that can be used to identify which children have a higher probability of becoming troubled youth: poverty and residing in rural areas. The analysis also finds that risky behaviors increase with age and differ by gender, thereby highlighting the need for program and policy differentiation along these two demographic dimensions. (author's)
Valiadation of a new clinical case definition for paediatric HIV infection, Bloemfontein, South Africa [letter]
Journal of Tropical Pediatrics. 2005 Dec; 51(6):387.In 2003 a study was published, evaluating the WHO clinical case definition for paediatric HIV infection in Bloemfontein, South Africa. It was found that the WHO case definition could only detect 14.5 per cent of children who were in fact symptomatic and HIV positive on age-appropriate serology testing. Following logistic regression analysis, a new case definition was proposed, namely that HIV is suspected in a child who has at least two of the following four signs: marasmus, hepatosplenomegaly, oropharyngeal candidiasis, and generalized lymphadenopathy. This new case definition had a sensitivity of 63.2 per cent and a specificity of 96.0 per cent. (excerpt)
PID risk for IUD users highest in first 20 days after insertion; risk then falls sharply and remains low.
Family Planning Perspectives. 1992 Sep-Oct; 24(5):235-6.Researchers analyzed data on 22,908 women obtained from randomized WHO studies from 23 countries to determine whether the IUD increases the risk of pelvic inflammatory disease (PID). 35% of the women used the TCu220C IUD, 39% other copper releasing IUDs, 16% a hormonal IUD, and 9% the Lippes Loop. The overall PID incidence rate was 0.4% of all IUD insertions or 1.6 cases/1000 woman years. The incidence was greatest during the 1st 20 days after insertion (9.7 cases/1000 women years) and then declined to 1.4/1000 woman years. In fact, the risk of PID was >6 times greater within 20 days after insertion than it was >20 days after insertion. This high risk immediately after insertion was evident in every region where PID existed, at all insertion times, and in all age groups. The higher risk within the 20 days after insertion was attributed to contamination of the uterus during insertion. Women who had an IUD inserted after 1980 experienced PID 50% less often than those who had had it inserted earlier, e.g., the rate ratio for 1977-80 was 1.5 but was 0.5 for 1981-83 and 0.34 for 1984 and after. This may have been due to physicians being more aware of contraindications for IUD use, particularly past infection with sexually transmitted diseases )STDs). The rate ratio was higher in Africa (2.6) than it was in Europe (1) but lower in Asia (0.46) and in the Americas (0.39). None of the subjects in China experienced PID. Older women were at lower risk of PID than 15-24 year olds (0.44 for 25-29 year olds, 0.38 for 30-34 year olds, and 0.35 for =or> 35 year olds). The researchers believed the higher risk life styles of the younger group accounted for this difference. Risk of PID decreased with family size (2.5 for 0 children, 0.56 for 2 children, and 0.39 for at least 4 children). The risk of PID did not differ with IUD type. The researchers concluded that the major determinant of PID is exposure to an STD rather than type of IUD.
International Family Planning Perspectives. 1991 Sep; 17(3):108-13.South Asia consisting of Bangladesh, India, Nepal Pakistan, and Sri Lanka, claims 1/5 to total world population with expected population growth of at least 200 million by the year 2000. Taking issue with assumptions behind World Bank (WB) and United Nations (UN) population projections for the region, the authors make less optimistic assumptions of country fertility and mortality trends when running population projections for the region. Following discussion of methodological issues for and analysis of population projections, the paper's alternate assumptions and projection results are presented and discussed. Projections were made for each country of the region over the period 1985-2010, based on assumptions that only very modest fertility declines and improvements in life expectancy would develop over most of the 1990s. South Asian population would therefore grow from over 1 billion in 1985, to 1.4 billion by 2000, and almost 1.8 billion by 2010. Overall slower fertility decline than assumed for the UN and WB projections point to larger population growth with momentum for continued, larger growth through the 21st century. Rapid, substantial population growth as envisioned by these projections will impede movement toward an urban-industrial economy, with a burgeoning labor force exceeding the absorptive capacity of the modern sector. Job seekers will pile up in agriculture and the informal sector. Demands upon the government to deliver education and health services will also be extraordinarily high. High-tech niches will, however, continue expanding in India and Pakistan with overall negative social effects. Their low demand for labor will exacerbate income disparities, fuel interpersonal, interclass, and interregional tensions, and only contribute to eventual ethnic, communal, and political conflict. Immediate, coordinated policy is urged to achieve balanced low mortality and low fertility over the next few decades.