Differential trends in the compression of mortality: Assessing the antecedents to current gaps in health expectancy in New Zealand

Health Expectancies (HEs) for New Zealand show significant differentials between Maori and non-Maori, but also by gender and period. These differentials correlate with findings from both generation and synthetic life-tables relating to New Zealand’s epidemiologic transition. At the beginning of that transition quartile 1 (Q(1)), and Median (Med) d(x) values were close and centred at young ages; during the transition the gap became very wide; at the transition’s end the gap again narrowed. Cohort and synthetic trends in d(x), l(x), M, Qs and Meds are reviewed and linked to recent HEs. Data point to epidemic polarisation. Cohort analysis allows the evaluation of the role of past experiences on the recent HEs, and thus point to possible strategies for reducing gaps in both d(x), and HEs

Sexual discourse in the context of AIDS: dominant themes on adolescent sexuality among primary school pupils in Magu district, Tanzania

School pupils in Tanzania have been identified as a risk group for HIV/AIDS, so a large part of TANESA’S anthropological research is aimed at charting and understanding forms of sexual risk behaviour among adolescents with a view to influencing change. This study presents the dominant themes of sexual discourse among adolescent primary school pupils in Magu district along the south-eastern shores of Lake Victoria in Tanzania. The themes are: love and sex; sexual desire; money and rewards; and deception. The fear of pregnancy also emerges as a dominant theme. Because of the nature and extent of their sexual relationships, school pupils will be increasingly exposed to the risk of HIV and STD infection. This is exacerbated by the lack of condom availability and the proscribed nature of sex (and therefore condom use) among primary school pupils

Provider-Initiated HIV Testing for Migrants in Spain: A Qualitative Study with Health Care Workers and Foreign-Born Sexual Minorities

INTRODUCTION: Provider-initiated HIV testing (PITC) is increasingly adopted in Europe. The success of the approach at identifying new HIV cases relies on its effectiveness at testing individuals most at risk. However, its suitability to reach populations facing overlapping vulnerabilities is under researched. This qualitative study examined HIV testing experiences and perceptions amongst Latin-American migrant men who have sex with men and transgender females in Spain, as well as health professionals' experiences offering HIV tests to migrants in Barcelona and Madrid. METHODS: We conducted 32 in-depth interviews and 8 discussion groups with 38 Latin-American migrants and 21 health professionals. We imported verbatim transcripts and detailed field work notes into the qualitative software package Nvivo-10 and applied to all data a coding framework to examine systematically different HIV testing dimensions and modalities. The dimensions analysed were based on the World Health Organization "5 Cs" principles: Consent, Counselling, Connection to treatment, Correctness of results and Confidentiality. RESULTS: Health professionals reported that PITC was conceptually acceptable for them, although their perceived inability to adequately communicate HIV+ results and resulting bottle necks in the flow of care were recurrent concerns. Endorsement and adherence to the principles underpinning the rights-based response to HIV varied widely across health settings. The offer of an HIV test during routine consultations was generally appreciated by users as a way of avoiding the embarrassment of asking for it. Several participants deemed compulsory testing as acceptable on public health grounds. In spite of-and sometimes because of-partial endorsement of rights-based approaches, PITC was acceptable in a population with high levels of internalised stigma. CONCLUSION: PITC is a promising approach to reach sexual minority migrants who hold high levels of internalised stigma but explicit extra efforts are needed to safeguard the rights of the most vulnerable

Communication About Microbicide Use Between Couples in KwaZulu-Natal, South Africa

The ways in which couples communicate about microbicides is likely to influence microbicide uptake and usage. We collected quantitative data about whether women in a microbicide trial discussed microbicides with their partners and explored communication about microbicides during 79 in-depth-interviews with women enrolled in the trial and 17 focus-group discussions with community members. After 4 weeks in the trial, 60 % of 1092 women had discussed microbicides with their partners; in multivariate analysis, this was associated with younger age, clinic of enrolment and not living in households that owned cattle. After 52 weeks, 84 % of women had discussed microbicides; in multivariate analysis, this was associated with not living in households that owned cattle, not living in a household that relied on the cheapest water source, allocation to 0.5 % PRO2000 gel and consistent gel adherence. Qualitative findings highlighted that women in committed relationships were expected to discuss microbicides with their partners and preferred to use microbicides with their partner's knowledge. Women had different reasons for, and ways of, discussing microbicides and these were influenced by the couple's decision-making roles. Although there was tolerance for the use of microbicides without a partner's knowledge, the women who used microbicides secretly appeared to be women who were least able to discuss microbicides. In KwaZulu-Natal, socio-cultural norms informing sexual communication are amenable to microbicide introduction

Intravaginal insertion in KwaZulu-Natal: sexual practices and preferences in the context of microbicide gel use.

Intravaginal insertion is often associated with the concept of 'dry' sex. All HIV-prevention microbicides tested to date have been vaginally applied lubricant-based gels. In this paper, we examine whether the use of intravaginal insertions could be in conflict with the introduction of vaginal microbicide gels. The Africa Centre site was part of the Microbicides Development Programme evaluating PRO2000/5 microbicide gel. We conducted in-depth-interviews and focus-group discussions with women enrolled in the trial as well as women and men from the community. The analysis focused on people's knowledge of intravaginal insertion in the community and trial participants' experience of using trial gels. Intravaginal use of a variety of products was widely acknowledged. We found that the experience of using trial gels - which made sex 'hot', 'tight' and 'dry' - matched the desired outcomes of intravaginal insertion. We found that vaginal 'dryness' described the removal of excessive amounts of unusual discharge, rather than the removal of normal vaginal secretions and that intravaginal insertion is not exclusively associated with a desire for 'dry' sex. Study findings provide evidence that vaginal microbicide gels may be more acceptable in communities where intravaginal insertion is practiced than was previously thought

Development of behaviour change communication strategy for a vaccination-linked malaria control tool in southern Tanzania.

BACKGROUND\ud \ud Intermittent preventive treatment of malaria in infants (IPTi) using sulphadoxine-pyrimethamine and linked to the expanded programme on immunization (EPI) is a promising strategy for malaria control in young children. As evidence grows on the efficacy of IPTi as public health strategy, information is needed so that this novel control tool can be put into practice promptly, once a policy recommendation is made to implement it. This paper describes the development of a behaviour change communication strategy to support implementation of IPTi by the routine health services in southern Tanzania, in the context of a five-year research programme evaluating the community effectiveness of IPTi.\ud \ud METHODS\ud \ud Mixed methods including a rapid qualitative assessment and quantitative health facility survey were used to investigate communities' and providers' knowledge and practices relating to malaria, EPI, sulphadoxine-pyrimethamine and existing health posters. Results were applied to develop an appropriate behaviour change communication strategy for IPTi involving personal communication between mothers and health staff, supported by a brand name and two posters.\ud \ud RESULTS\ud \ud Malaria in young children was considered to be a nuisance because it causes sleepless nights. Vaccination services were well accepted and their use was considered the mother's responsibility. Babies were generally taken for vaccination despite complaints about fevers and swellings after the injections. Sulphadoxine-pyrimethamine was widely used for malaria treatment and intermittent preventive treatment of malaria in pregnancy, despite widespread rumours of adverse reactions based on hearsay and newspaper reports. Almost all health providers said that they or their spouse were ready to take SP in pregnancy (96%, 223/242). A brand name, key messages and images were developed and pre-tested as behaviour change communication materials. The posters contained public health messages, which explained the intervention itself, how and when children receive it and safety issues. Implementation of IPTi started in January 2005 and evaluation is ongoing.\ud \ud CONCLUSION\ud \ud Behaviour Change Communication (BCC) strategies for health interventions must be both culturally appropriate and technically sound. A mixed methods approach can facilitate an interactive process among relevant actors to develop a BCC strategy

Growing Vitis vinifera grapes in New York State. I - Performance of new and interesting varieties

47 pages, includes color images. Varieties: Bacchus, Cabernet Sauvignon, Cabernet franc, Chardonnay, Clevener Mariafeld, Comtessa, Ehrenfelser, Furmint, Gamay Beaujolais, Gewurztraminer, Melon, Merlot, Metternich, Morio Muscat, Muscat Ottonel, Noblessa, Optima, Ortega, Perle, Petit Sirah, Pinot blanc, Pinot gris, Pinot noir, Portugieser Blau(er), Reichensteiner, Rieslaner, Sauvignon blanc, Scheurebe, Siegerrebe, Spatburgunder (Blauer), Sylvaner, White Riesling, Zinfandel.Issued circa 1990, this publication is a collaborative effort between the New York Wine & Grape Foundation and the Communications Services unit of the New York State Agricultural Experiment Station, Cornell University, Geneva NY. This is the only report in the series (although subsequent titles were originally planned). It describes 33 varieties of Vitis vinifera which were evaluated for potential use in New York State –of those, 11 are recommended. Some history and background information is given as well as regional precipitation and temperature data for grape test sites

Testaro: Efficient Ensemble Testing for Web Accessibility

As automated web accessibility testing tools become enriched with new and improved tests, it can be impractical to leverage those advances. Each tool offers unique benefits, but effectively using multiple tools would require integrating them into a uniform testing and reporting scheme. Such integration is complex, because tools vary in what they try to detect, what they actually detect, and how they classify, describe, and report defects. Consequently, testers typically use only one tool. Testaro is a novel open-source NPM package that checks compliance with about 650 rules defined by an ensemble of 8 tools: alfa, Axe, Equal Access, HTML CodeSniffer, Nu Html Checker, QualWeb, Testaro, and WAVE. Attendees at the demonstration will, within 5 minutes, create jobs for Testaro, run them, and generate unified reports documenting more accessibility issues than any single tool can discover.Comment: 4 pages, 2 tables. To be published in Proceedings of the 25th International ACM SIGACCESS Conference on Computers and Accessibility (ASSETS '23), October 22-25, 2023, New York, NY, US

Keynote Address

Most modern environmentalists during their formative years have had little actual contact with wildlife under natural conditions. Their wildlife philosophies have been developed via the mass media and from experiences with animals as pets or confined in zoos. In general, modern environmentalists are sincere, dedicated, idealistic and enthusiastic, but they often lack realism and are blessed with the innocence of naivete. The majority of people in the United States now exhibit strong affection for wild animals and are deeply concerned over any actions perceived as causing pain to individual animals. These attitudes towards wild animals will impact on future wildlife damage control programs. In order to preserve scientifically sound wildlife damage control programs, efforts must be increased in non-lethal control methodology. Also, solid unbiased evaluations of wildlife damage control programs must be conducted and the results of those evaluations disseminated to the general public