exam 2

Women's Health

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Trafficking

..."The recruitment, transportation, transfer, harboring, or receipt of persons. It involves using threat, force, or other forms of coercion, abduction, fraud, and deception, to control another person for exploitation."

Chronic disease

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Half the sky

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War/Prisoners

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Globally what % of women have experienced IPV?

An estimated 35% of women have been subject to physical or sexual violence from an intimate partner

Geographically where are the most people hungry (continent)?

Asia

Food security vs insecurity

Food security exists when all people have reliable access to a sufficient amount of nutritious, safe, and culturally appropriate food Food insecurity refers to a state of chronic, deprived economic or physical access to food, either in quantity or quality, such that dietary intake fails to meet nutritional needs and support the health of all individuals in a household or community

Access to education- equitable between men and women?

Girls that do not finish secondary education are more likely to: have an earlier age of sexual initiation engage in risky sexual behavior and consequently, be at greater risk of dying from pregnancy-related causes. Education improves health behaviors: Girls in school were more likely to have heard of sexually transmitted diseases or infections than girls not in school. Girls in school were also more likely than girls not in school to boil water before drinking

Most common type of cancer

Lung cancer: the most frequently occurring cancer worldwide and a type of cancer that is primarily due to tobacco use, accounts for 1.69 million deaths a year

Main nutrients

Main nutrients discussed (4) and why they are important (e.g. leading cause of xx) and where they are important (e.g. particularly in xx) vitamin A Vitamin A is an essential nutrient that participates in the visual cycle The role of vitamin A in the visual cycle is specifically related to the retinal form - helps in response to light (night blindness) Its other functions are to help assist with Gene transcription, Immune function, Embryonic development and reproduction, Bone metabolism, Skin, and cellular health Antioxidant activity→ reduces the risk for MORTALITY It is found in a variety of plants, but mostly in leafy green vegetables, yellow and orange fruits (papaya, mango, apricot) that are not citrus, and carrots. It's also found in some animal products, including liver, milk, and eggs Vitamin A Deficiency Vitamin A deficiency is the: The leading cause of preventable pediatric blindness a major determinant of childhood morbidity and mortality in low-income countries It is estimated to affect approximately one-third of children under the age of five around the world and to claim the lives of 670,000 children under five annually. Approximately 250,000-500,000 children in developing countries become blind each year owing to vitamin A deficiency, with the highest prevalence in Southeast Asia and Africa. Adequate supply, but not excess vitamin A, is vital for pregnant and breastfeeding women for normal fetal development. Deficiencies cannot be compensated by postnatal supplementation. Excess vitamin A, which is most common with high dose vitamin supplements, can cause birth defects and therefore should not exceed recommended daily values Early weaning from breast milk can also increase the risk of vitamin A deficiency. Iron Deficiency Iron deficiency is a condition resulting from too little iron in the body. Globally, over 30% of people are anemic, many due to iron deficiencies Iron deficiency is the most common nutritional deficiency and the leading cause of anemia in the United States. The terms anemia, iron deficiency, and iron deficiency anemia often are used interchangeably but equivalent. Iron deficiency ranges from depleted iron stores without functional or health impairment to iron deficiency with anemia, which affects the functioning of several organ systems. Iron deficiency is a concern because it can: Iron deficiency can delay normal infant motor function (normal activity and movement) or mental function (normal thinking and processing skills). Iron deficiency anemia during pregnancy can increase the risk for small or early (preterm) babies. Small or early babies are more likely to have health problems or die in the first year of life than infants who are born full-term and are not small. Iron deficiency can cause fatigue that impairs the ability to do physical work in adults. Iron deficiency may also affect memory or other mental function in teens. Iodine Iodine helps determine the level of metabolism and energy in the body while assisting to metabolize excess fat It is important for physical and mental development Iodine is responsible for loosening mucus in the respiratory tract and acting as a natural antiseptic It helps to prevent goiter (low levels of thyroxine in the blood) and thyroid disorders Foods that are rich in iodine include: Asparagus, Garlic , Lima beans, Mushrooms , Seafood, Sea salt and fortified salt, Sesame seeds, Soybeans, and Spinach People who live in mountainous regions do not consume adequate amounts of iodine in their diets, because they do not consume much seafood and mountain soil often lacks iodine Iodine Deficiency Iodine deficiency is one of the primary causes of cognitive impairment in children. While the number of countries where iodine deficiency is a public problem has halved, 54 countries still struggle with widespread iodine deficiency. In areas where there are little iodine in the diet, typically remote inland areas where no marine foods are eaten, iodine deficiency gives rise to hypothyroidism, symptoms of which are extreme fatigue, goiter, mental slowing, depression, weight gain, and low basal body temperatures. Iodine deficiency is the leading cause of preventable mental retardation, a result that occurs primarily when babies or small children are rendered hypothyroidism by a lack of the element. Iodine deficiency is also a problem in certain areas of Europe. In Germany, it has been estimated to cause a billion dollars in health care costs per year. Zinc Zinc is an essential mineral that is naturally present in some foods, added to others, and available as a dietary supplement. It is also found in many cold lozenges and some over-the-counter drugs sold as cold remedies. Zinc is involved in numerous aspects of cellular metabolism. It is required for the catalytic activity of approximately 100 enzymes and it plays a role in immune function, protein synthesis, wound healing, DNA synthesis, and cell division. Zinc also supports normal growth and development during pregnancy, childhood, and adolescence and is required for a proper sense of taste and smell. A daily intake of zinc is required to maintain a steady-state because the body has no specialized zinc storage system. The best sources of zinc are red and white meat, as well as shellfish. Zinc deficiency is characterized by growth retardation, loss of appetite, and impaired immune function. In more severe cases, zinc deficiency causes hair loss, diarrhea, delayed sexual maturation, impotence, hypogonadism (sex glands produce little or no hormones) in males, and eye and skin lesions. Weight loss, delayed healing of wounds, taste abnormalities, and mental lethargy can also occur. Many of these symptoms are non-specific and often associated with other health conditions; therefore, a medical examination is necessary to ascertain whether a zinc deficiency is present. Iron Iodine zinc

God Gulf

Religion and Family planning both sides have good intentions- but the gulf between results in... "Gag rule"- withdraw family planning money (conservative approach): draws funding from any organization that has a link with abortion services Previously, UNFPA (before 1985), through improved contraceptive access had reduced abortion rates by 40%, less than in the U.S., averting 500,000 abortions per year United Nations Population Fund (UNFPA)- de-funded by Bush due to work with China (that has 1 child policy) in 1985 UNFPA does not provide abortions or fund them, it provides counseling, oversight, and aims to improve access for family planning and related issues Contraceptives: Pathfinder International: CURRENTLY- 225 million women don't have access to contraception https://www.guttmacher.org/video/2014/investing-sexual-and-reproductive-health-developing-world Trump will withdraw $600 mill from family planning services over his 4 year term Brussels conference- "She Decides" coalition raised $180 million; over 50 countries are committed estimates without alternative funding, the ban will cause 6.5 million unintended pregnancies, 2.1 million unsafe abortions and 21,700 maternal deaths. HIV- punishment and blame towards people who have contracted HIV: these people are "immoral" thoughts that discussing sex makes it more likely→ so limited sex education Bush - abstinence ONLY campaigns may delay the start of sexual activity but once it starts people are less likely to use contraceptives resulting in more pregnancies, abortions, STDs and HIV condoms are extremely cost-effective Obama- ended the gag rule and restored funding Idea that African are more promiscuous than westerners--> not true→ average no of sexual partners is the same--> transmission rate is higher because of medical conditions that increase chance of spreading such as untreated STDs

Leading risk factors for cancer

Tobacco use in both developed and developing countries Chronic infections in developing countries A complex array of diet and physical activity factors

Evidence that child survival is improved when women are educated- factual bases?

Two decades of research show that children benefit when their mother's status is raised. Illiterate women - where? In South American and Western European territories men and women have very similar levels of literacy. Elsewhere, particularly in India, China, Pakistan, and the Islamic Republic of Iran, there are much larger numbers of women who cannot read or write compared to men.

Food production vs. consumption- can we feed everyone?

YES! Globally, per capita, food availability has risen from about 2220 kcal/person/day in the early 1960s to 2790 kcal/person/day in 2006-08 Four dimensions of food security are defined by the Food and Agriculture Organization: Food Availability Food Access Food Utilization Food Stability

Nutrition transition

affects groups or societies caught in a nutrition transition: a shift in diet away from traditional staple diets toward more processed foods of higher energy (calorie) density from fat and refined sugars and decreased dietary fiber and roughage lifestyle changes that lead to reductions in physical activity A shift towards overconsumption and inactivity increase the risk of degenerative, cardiovascular, and neo-plastic (i.e.- non-communicable) diseases, which are rapidly becoming leading causes of adult morbidity and mortality throughout middle-income countries

Education/Economics- strategies to improve girls attendance in school (2); a strategy to improve the economic well-being

deworming menstruation assistance- sanitary napkins iodine supplementation for pregnant women pay families directly to keep girls in school and get medical check-ups scholarships can help Economic well-being (how or why to improve it): micro-credit--successful in Asia, not as successful in Africa because of burden of health issues policies to allow women to inherit money from husbands enabling women to play a role in the government some evidence suggests that women may manage money better--> less money on beer and sugar and prostitutes--? What do we think?

Persons at highest risk for malnutrition

lack food security and necessary resources to adequately feed and care for themselves highest risk of under-nutrition : the fetus infants and pre-school-aged children women of reproductive age older persons

Biggest risk factors for chronic disease

tobacco, the diet-physical activity complex, and alcohol

Leading causes of death in the U.S. and globally (both noncommunicable versus infectious and specific top 3 diseases)

Cardiovascular diseases, (CVD) especially coronary heart disease and stroke, caused 17.7 million deaths; cancer, 8.8 million deaths; chronic respiratory disease, 3.9 million deaths; and diabetes, almost 1.6 million deaths.

Obstetric fistulas definition and impact on well-being

Each year between 50,000 to 100,000 women worldwide are affected by obstetric fistula, a hole in the birth canal. The development of obstetric fistula is directly linked to one of the major causes of maternal mortality: obstructed labor. Women who experience obstetric fistula suffer constant incontinence, shame, social segregation, and health problems. It is estimated that more than 2 million young women live with untreated obstetric fistula in Asia and sub-Saharan Africa. Obstetric fistula is preventable; it can largely be avoided by: delaying the age of first pregnancy; the cessation of harmful traditional practices; sexual assault; and timely access to obstetric care. It includes incontinence (inability to hold one's bowels), severe infections and ulcerations of the vaginal tract, and often paralysis caused by nerve damage. Sufferers from this disorder are usually also subject to severe social stigma due to odor, perceptions of un-cleanliness, a mistaken assumption of venereal disease, and, in some cases, the inability to have children Other potential direct causes for the development of obstetric fistula are sexual abuse and rape, especially within conflict/post-conflict areas

Female genital cutting/mutilation definition and strategies to address

Female genital mutilation (FGM) includes procedures that intentionally alter or cause injury to the female genital organs for non-medical reasons. The procedure has no health benefits for girls and women. Procedures can cause severe bleeding and problems urinating, and later cysts, infections, as well as complications in childbirth and increased risk of newborn deaths. FGM/C prevalence varies significantly from country to country, from as low as 1% in Cameroon and Uganda to as high as 98% in Somalia, 96% in Guinea, and 93% in Djibouti. (DHS Surveys) In a 1997 joint statement, WHO, UNICEF, and UNFPA adopted the term and clearly stated that healthcare, wartime providers who perform such procedures are violating women's human rights and the fundamental medical ethic of "first, do no harm." Despite this, evidence from DHS and MICS indicate a growing trend towards the medicalization of FGM/C. In Egypt, mothers report that three out of four cases of FGM/C procedures performed on their daughters were provided by a trained medical professional. In fact, the percentage of girls cut by health care providers increased from 55% in 1995 to 77% in 2008. What do we think- should it be performed by trained medical professionals? This is considered a human rights violation? What are some promising approaches/practices to end FGM/C? Example from the Field: The Grandmother Project in Senegal a three-year initiative in southern Senegal aimed at strengthening positive cultural values and practices and promoting the adoption of positive community attitudes, including the abandonment of FGM/C. The Project involved intergenerational dialogue that depended on the active participation of elders, especially grandmothers. Because grandmothers are often viewed as respected members of the community, they become invaluable resources and potential agents of change. Results of the project (collected through a rapid assessment, surveys, and qualitative reviews) found that the program led to: strengthened social cohesion and changes in social norms and practices related to girls' well-being. For example, in the baseline survey conducted in 2008, nearly half of mothers (45%) and grandmothers (47%) said they would be ashamed to have a daughter or granddaughter who is not cut. Two years later, in the online survey, only 3% of mothers and grandmothers expressed the same sentiment. Similarly, while the 2008 baseline revealed that the majority of mothers (88%) and grandmothers (86%) believed FGM/C to be a cultural obligation, the online survey showed that only 9% of mothers and 5% of gra

Maternal mortality

Maternal mortality- main reasons (2) Biology- evolution made women have smaller hips for running and larger head for more complex brain processes...not well equipped for childbirth Lack of schooling- education linked to lowered family sizes, greater contraception, use of hospitals, higher income Lack of rural health systems- limited availability of urgent care surgery, antibiotics, trained birth attendants, doctors and nurses (that are competent and show up for work) Disregard for women- the lower value placed on women, in the 1920s maternal mortality was as low as in developing countries in US then women obtained the right to vote and has improved dramatically; mythological and theological justifications-- women are evil and lesser beings

Experience in a refugee camp (what is it like, how long is the stay etc..)

Pre-Escape War, severe discrimination, or persecution often make it too dangerous for people to remain in their homeland. This stage is characterized by: Fear of detection Anxiety about conditions Pressure about escape Fear of persecution Anticipated sadness over losses Escape Fearful for their safety or lives, refugees are forced to flee. They may leave secretly or are chased out. Many die trying to escape. Those lucky enough to escape their country are considered refugees. May Experience Panic Shock Fear Danger Hunger Fatigue Separation Fear of victimization Fear of being detected or caught in the crossfire Refugee Camp Once a person becomes a refugee, they are likely to remain a refugee for many years. Many will be displaced for nearly two decades. It is a life in limbo. A refugee camp is intended as temporary accommodation for people who have been forced to flee their homes because of violence and persecution. They are constructed while crises unfold for people fleeing for their lives. These hastily built shelters provide immediate protection and safety for the world's most vulnerable people. Camps allow UNHCR to deliver lifesaving aid like food, water, and medical attention during an emergency. Boredom Shock Depression Anger Hope mingled with disappointment Adjustment to new living conditions Hopelessness Fear of the unknown Culture shock Survivor's guilt Helplessness Powerlessness Self-doubt Struggle to meet survival needs Confusion Understanding of and differences between refugees and asylees Refugee •A refugee receives permission to come to the U.S. from outside of the country. •Refugees are resettled with the help of a refugee resettlement agency. Asylee •An asylee is already in the U.S. when s/he applies for protection. •Asylees have to prove that they have reason to fear persecution in their home country. 1951 Refugee Convention The 1951 Geneva Convention is the main international instrument of refugee law. The Convention clearly spells out who a refugee is and the kind of legal protection, other assistance, and social rights he or she should receive from the countries that have signed the document. The Convention also defines a refugee's obligations to host governments and certain categories of people, such as war criminals, who do not qualify for refugee status.