Identifying barriers to ART initiation and adherence: An exploratory qualitative study on PMTCT in Zambia

Background Though antiretroviral therapy (ART) is widely available, HIV positive pregnant women in Zambia are less likely to start and remain on therapy throughout pregnancy and after delivery. This study sought to understand readiness to start ART among HIV pregnant women from the perspectives of both women and men in order to suggest more holistic programs to support women to continue life-long ART after delivery. Methods We conducted a qualitative study with HIV positive pregnant women before and after ART initiation, and men with female partners, to understand readiness to start lifelong ART. We conducted 28 in-depth interviews among women and 2 focus group discussions among male partners. Data were transcribed verbatim and analyzed in NVivo 12 using thematic analysis. Emerging themes from the data were organized using the social ecological framework. Results Men thought of their female partners as young and needing their supervision to initiate and stay on ART. Women agreed that disclosure and partner support were necessary preconditions to ART initiation and adherence and, expressed fear of divorce as a prominent barrier to disclosure. Maternal love and desire to look after one’s children instilled a sense of responsibility among women which motivated them to overcome individual, interpersonal and health system level barriers to initiation and adherence. Women preferred adherence strategies that were discrete, the effectiveness of which, depended on women’s intrinsic motivation. Conclusion The results support current policies in Zambia to encourage male engagement in ART care. To appeal to male partners, messaging on ART should be centered on emphasizing the importance of male involvement to ensure women remain engaged in ART care. Programs aimed at supporting postpartum ART adherence should design messages that appeal to both men’s role in couples’ joint decision-making and women’s maternal love as motivators for adherence.

As long as (I think) my husband agrees…: role of perceived partner approval in contraceptive use among couples living in military camps in Kinshasa, DRC

Background Male partner’s approval is a key determinant of contraceptive use for women living in Sub-Saharan Africa and improving men’s support and couple communication is a cornerstone of family planning programs. However, approval is often only measured through the women’s perception of their partner’s opinion. Methods This study conducted in Kinshasa compares contraceptive approval variables from matched male and female partners (n = 252 couples) to establish the frequency of (in)accurate perceptions by the woman, then test their association with modern contraceptive use. Additional regressions estimate individual and couple variables associated with (in)correct perceptions. Results Results confirm women are poorly aware of their partner’s opinion but indicate that perceived approval or disapproval by the woman is a much stronger determinant of modern contraceptive use than her partner’s actual opinion. Higher educational achievement from the woman is the strongest driver of misunderstanding her partner’s approval. Conclusions Women’s perceptions of partner’s approval are much stronger determinant of contraceptive use than the latter’s actual opinion, and stereotyping men’s opinion of family planning is a common error of appreciation. However, findings also suggest these misunderstandings might serve women’s capacity to negotiate contraceptive use.

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Princezny z Hájku. K problematice elity ve střední době bronzové

The topic of this study is the possibilities of archaeological identification of the local elite in the Bronze Age. We‘re targeting the female elite, who are characterized by a particular form of costume. In a case study of the barrow cemetery of Šťáhlavy – Hájek, we are trying to show that the elite status of women in the Bronze Age was not based on their personal qualities, but rather on their affinity with an elite family. Their social status may therefore have been hereditary. On the other hand, it turns out that certain particularities of the costume (different types of necklaces, etc.) may point to different origins of women and thus the exchange of female partners within the wider elite community.

DOMESTIC VIOLENCE AMONG WOMEN IN NIGERIA AND ITS HEALTH IMPLICATION - REVIEW

Purpose: All too frequent the media is filled with news of high-profile domestic violence cases. It is becoming a routine for one to wake up and hear or read the news of domestic violence. Wives are murdered by their husbands, unmarried ladies are daily murdered by a rejected lover and other form of inhuman treatment which are meted mainly on the female. Many women do not report the abuse because they are ashamed that their marriages are not working and for most women in Nigeria, divorce is not an option, so they suffer in silence. This work is aimed at reviewing the different types of domestic violence among women in Nigeria and its health implication, as well as proffered solutions. Methodology: The method used in the collection of these data was qualitative. Officially published literatures which included textbooks, journals, newspapers and surveys were reviewed. Findings: Factors associated with the occurrence of domestic violence occurrence in Nigeria included ethnicity, culture, religious practices, socio-economic dependence, gender inequality, psychological factors, power and control. Reports revealed high level of violence against women in Nigeria. Up to two-thirds of women in Nigeria’s Lagos state have experienced domestic violence. In South East, Nigeria, 70% of respondents reported abuse in their family, with 92% of the victims being female partners and 8% being male. A study on women’s perception of wife beating in Nigeria showed that 64.4% and 50.4% of ever married and unmarried women respectively expressed consent for wife beating. Unique contribution to theory, practice and policy: Noticing and acknowledging the signs of an abusive relationship are the first step to ending it. No one should live in fear of the person they love. Domestic violence does not discriminate, it can happen among heterosexual couples and those in same-sex relationship. It can occur within all age range, ethnic background and economic levels. While women are more commonly victimized, men are also abused especially verbally and emotionally, though it can be physical at times. Domestic violence should never be acceptable, whether it is coming from a man or woman. It destroys ones self-esteem with other health consequences.

Probabilistic Modelling of Demographic Changes in Singapore’s Neighbourhoods

Predicting the temporal evolution of the demography and the residents’ spatial movements would immensely aid the estate development and urban planning. The evolution of population in three townships of Singapore is simulated at neighbourhood scale using a novel agent-based probabilistic approach with inputs from large-scale survey and statistical data. The demographic changes due to age-dependent rates of death and fertility are studied by considering the inter-ethnic marriages that has a varying probability depending on the ethnicities of the male and female partners. The predicted changes in the age and household compositions and family types have been found to reflect the population trends in Singapore over the past years. The decline in family types that contain children and the structure of age composition over years underline the issue of prevailing low fertility rates. The strategies for incorporating the population relocation to consider the long-term spatial movement are also discussed. In Singapore’s context, we consider in the relocation model an added complexity of ethnic quota for the residential units developed by public housing board. The ethnicity dependent parameter coupled with other parameters that represent the number of children in a household besides their size, the household income, the proximity of children’s schools, and the places of employment could play a strong role in predicting the spatial evolution of the residents. These predictions can be used by the urban planners and policy makers to improve the quality of life in Singapore.

Modeling and Sensitivity Analysis of Dynamical Transmission of Lassa Fever

Lassa fever is an acute viral disease which occurs across West Africa regions. In view of this a non-linear deterministic model was considered to study dynamics spread of Lassa fever. Existence and uniqueness of the model were determined and the basic reproduction number of the model was computed using next-generation matrix, and sensitivity analysis of the model was performed and shows that the most sensitive parameters to the dynamical spread of Lassa fever are human birth rate bH, followed by average number of female partners acquired by susceptible male c2, and transmission rate resulting from sexual interaction between infected male and susceptible female h2 have the highest values. It concludes that average number of female partners acquired by susceptible male and sexual transmission rate between the infected male and susceptible female should be reduced. Keywords: Existence and Uniqueness, disease free equilibrium, basic reproduction numbers and sensitivity analysis.

The Netherlands’ first architectural couples: women architects in their own right?

In the period up to the end of the Second World War, 21 women in the Netherlands completed an academic architectural course. Five of these women married a fellow architect and conducted a joint architectural practice with their husband. These practices profited from the post-war reconstruction boom and, in the 1950s and ’60s, from the growing demand for housing and utilitarian buildings. Jannie Kammer-Kret, Toki Lammers-Koeleman, Jeanne van Rood-van Rijswijk, Koos Pot-Keegstra and Lotte Stam-Beese contrived to flourish in their chosen profession, and all had successful careers. The collaborative model embraced by these couples, which allowed the female partners to develop their potential to the full, was surprisingly emancipated for the time. Although a home-based office, with its combination of business with household and children, held obvious appeal for the woman, the initiative for such arrangements sometimes came from the husband. There were several variations on the respectful and equitable collaborative model, ranging from one in which each partner worked independently on their own commissions to one in which the melding of individual contributions was such that it was no longer possible to attribute designs to one or the other partner. What these models demonstrate is that the women architects did not need to depend on the name and fame of their husband but were perfectly capable of shaping their own career. The work of these women architects was strongly influenced by Nieuwe Bouwen principles as reflected in the application of a functionalist and sober formal idiom, averse to superfluous decoration. Unsurprisingly, given the professional circles they both frequented, their partners held similar architectural views. This undoubtedly contributed to mutual inspiration and possibly also to two-way influence. The output of women architects is astonishingly varied. These women responded to the spirit of the times and to the sometimes difficult economic circumstances by employing new types of dwellings, building materials and techniques, designing buildings for new groups of residents or by familiarizing themselves with the latest requirements of industrial clients or government bodies. Their portfolios encompassed commissions for utilitarian buildings as well as for the more predictable houses. Their household experience and practicality proved particularly useful in the design of private homes, residential aged care and schools, finding expression in efficient floor plans, modern furnishings and new, easy to clean materials. This is also evident in the home-cum-practice they designed for themselves, where they were able to give free rein to those principles.

The Effect of Dialectical Behavioral Therapy on Emotion Dysregulation in Couples

Background: Divorce rates have increased during the last decade, leading to a greater focus of marital scholars on the importance of understanding couple-maintaining strategies within marital life. Distresses in couples are attributable to difficulties controlling felt, experienced, and expressed emotions; thus, emotion dysregulation is a core stressor in couples with maladaptive responses. Objective: The aim of the study was to evaluate the effect of Dialectical Behaviour Therapy (DBT) on outpatient couples to treat emotion dysregulation. Methods: We recruited 20 couples with marital distress in which partners presented emotion dysregulation. We offered the couples the opportunity to join a couple DBT group at their convenience and based on the immediate availability of treatment slots. We measured the treatment efficacy using psychometric tools (the Difficulties in Emotion Regulation Scale (DERS) and the Dyadic Adjustment Ccale (DAS) at baseline and after DBT therapy. Results: Both male and female partners presented significant improvements in marital adjustment DAS and emotion regulation scores. Female partners showed significantly greater amplitude changes in both scales. Female partners showed significant improvement in most DERS subscales (except the GOALS subscale); on the other hand, male partners showed significant improvements in impulse, awareness, strategies, and clarity subscales. We found significant improvements in most DAS subscales in both sexes; only affectional expression remained unchanged before and after therapy. Conclusion: DBT for couples is an effective approach to treat emotion dysregulation.