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Addressing gender-based violence risks among displaced adolescent girls and young women (AGYW) is challenging. Delivering interventions through mobile phone platforms could help overcome challenges...

From early in the epidemic, education has been central to HIV prevention, treatment, and care. This paper reflects on lessons learned over the last 30 years. It signals the limits of high level international commitments to education and HIV and the strategies of information-giving and life skills development adopted in their wake. It argues for the adoption of a more genuinely educational approach to HIV, sex, and sexuality education in which difficult questions are raised, diversity is recognized, and options are provided for a differentiated yet effective response. The lead currently offered by community organizations and the social media should be built upon in developing forms of HIV education that are more honest and contextually relevant than previously.

Since the early 1990s, life skills education has benefitted substantially from international agency advocacy and support, linked to its implementation in several countries as a key component of the education sector response to sexual health and HIV. The concept of life skills was first promoted by the World Health Organization through its programme on mental health as a means of promoting psychosocial competence. Since then, it has been extended to address a wider range of issues. Life skills-based HIV and sex education has proved to be a durable concept in education sector policy discourse on HIV and AIDS, despite a growing literature on the shortcomings in terms of its effectiveness in implementation in schools and delivering intended learning outcomes. Using a literature review, this paper aims to re-examine the adequacy of the life skills-based HIV education approach including empirical evidence for its effectiveness in educating about and preventing HIV infection among young people. Findings suggest ...

Throughout much of the twentieth century, there has been debate about the best form that sexuality education might take. The end of the 2000s saw the development of no less than four sets of guidelines intended to signal some form of consensus. In this chapter, we review something of this chequered history: looking at the debates that took place in relation to the development of the UNESCO guidelines, the principal actors involved, and the manner in which a degree of shared perspective and ‘consensus’ came to be achieved. Present guidelines, while marking an advance over the past, highlight the ‘seriously unfinished’ nature of this work, as patterns of heterosexual ‘coupling’ and relationships diversify, and as issues of gender and sexual diversity come more firmly to the fore.

Since very early in the epidemic, education has been identified as central to an effective response. Three different kinds of education can be distinguished: education for HIV prevention, education about treatment, and education to prevent or mitigate the negative effects of the epidemic. This article also considers three different contexts in which education takes place: in schools, at the level of specific groups and across society as a whole. Some 30 years into the epidemic, it is vital that the potential of education is more fully recognized and embraced, not only by agencies and individuals with special expertise in the field (although this is essential), but also by everyone seeking to contribute to the ambitious goals of zero new infections, zero discrimination and zero AIDS-related deaths.

Education has long been identified as having a key role to play in reducing HIV-related risk and vulnerability, and in mitigating the impact of the epidemic on affected individuals and communities. This article reflects on progress over a 30-year period with respect to older and more emergent forms of education concerning HIV and AIDS: treatment education, education for HIV prevention, and education to encourage a positive and supportive community response. It points to a number of priorities for the future. These include analyzing more carefully different forms of HIV-related education, their consequences and effects, and identifying the specific effectivity of education in general and HIV-related education in particular in achieving positive outcomes. The potential of education to enable new ways of seeing, understanding, and hoping is stressed, as is the need to support education processes and systems that "think" faster than the epidemic.

SUMMARY In 2007, the World Health Organization, together with United Nations and international organization as well as experts, met to draw upon existing evidence and practical experience from regions, countries and individual schools in promoting health through schools. The goal of the meeting was to identify current and emerging global factors affecting schools, and to help them respond more effectively to health, education and development opportunities. At the meeting, a Statement was developed describing effective approaches and strategies that can be adopted by schools to promote health, education and development. Five key challenges were identified. These described the need to continue building evidence and capturing practical experience in school health; the importance of improving implementation processes to ensure optimal transfer of evidence into practice; the need to alleviating social and economic disadvantage in access to and successful completion of school education; the opportunity to harness media influences for positive benefit, and the continuing challenge to improve partnerships among different sectors and organizations. The participants also identified a range of actions needed to respond to these challenges, highlighting the need for action by local school communities, governments and international organizations to invest in quality education, and to increase participation of children and young people in school education. This paper describes the rationale for and process of the meeting and the development of the Statement and outlines some of the most immediate efforts made to implement the actions identified in the Statement. It also suggests further joint actions required for the implementation of the Statement.

PurposeThis paper aims to inform the development of policies and programmes to support children and young people's emotional wellbeing and mental health. It seeks to bring together findings both from recent systematic reviews, and from individual evaluation studies which have adopted a relatively rigorous methodology but whose findings have not to date been included in such analyses. Research undertaken in England is to be prioritised, to complement an existing evidence base comprised largely of findings from US‐based research.Design/methodology/approachUsing five key search strategies, studies were categorised into three main categories – “demonstrably effective approaches”, “promising approaches” and “approaches for which there is little or no supporting evidence” – according to robustness of evidence. Overall, 171 potentially relevant studies were identified, with 20 of these being robust enough for inclusion in the final review.FindingsIn schools, sustained broad‐based mental health promotion programmes combined with more targeted behavioural and cognitive‐behavioural therapy (CBT) for those children with identifiable emotional wellbeing and mental health needs, offer evidence of a demonstrably effective approach. Early and brief intervention programmes which reduce waiting times for services appear promising approaches and seem to reduce the number of sessions a family require. There is a reasonably strong evidence base to support targeted work with both parents and children.Practical implicationsBy providing a detailed description of the successful initiatives reviewed, this paper should help policy‐makers and practitioners to develop their work.Originality/valueBy complementing the relatively narrow evidence base offered by systematic reviews, this more broadly based review offers policy‐makers and practitioners in England an up‐to‐date, context‐relevant guide for programme development within this field.

The background and content of four international documents are particularly important in the definition of minimum standards for sexuality education. The documents are: From Evidence to Action: Advocating for Comprehensive Sexuality Education & Framework for Comprehensive Sexuality Education, published by the International Planned Parenthood Federation (IPPF) in 2009 and 2010; International Technical Guidance on Sexuality Education (ITGSE), published by the United Nations Educational, Scientific and Cultural Organization (UNESCO) and partners in 2009; It’s All One Curriculum: Guidelines and Activities for a Unified Approach to Sexuality, HIV, Gender and Human Rights Education, developed by the International Sexuality and HIV Curriculum Working Group and published by the Population Council in 2009; and Standards for Sexuality Education in Europe: A framework for policy makers, education and health authorities and specialists, publishedby the World Health Organization (WHO) Regional Office for Europe and the German Federal Centre for Health Education (BZgA) in 2010.

Latino adolescent reproductive health has become an increasingly important topic because of the growth in the numbers of Latino youth and because Latino youth are at high risk for negative reproductive health outcomes. Latinas now have the highest teen birth rates, and Latinos have disproportionately high rates of HIV/AIDS. These trends highlight the need for greater understanding of the sexual and reproductive health and behavior of Latino youth. This overview provides an introduction to key aspects of the Latino population. It then examines and synthesizes the existing literature by domains useful to the study of Latinos. Areas that receive in-depth coverage are socioeconomic status, family, national origin, peers and partners, and acculturation. Based on the current state of knowledge and the issues facing young Latinos, suggestions for future research and uses for existing data and past research are included.

Background.Alcohol consumption protects against coronary heart disease by as yet unclear mechanisms. The aim of this study was to determine the effect of ethanol on vascular smooth muscle cell (SMC) migration which plays an important role in the pathogenesis of atherosclerosis. Materials and methods.Cultures of human SMC under static (no flow) or pulsatile flow conditions (perfused transcapillary culture system) were pretreated in the absence or presence of ethanol (EtOH) whereupon their random migration (chemokinesis) was assessed by Transwell assay. Results.Ethanol pretreatment (24 h) dose dependently inhibited migration of HuSMC from static cultures with a maximal inhibition of 60.8 ± 4.4% observed at 40–80 mM, in the absence of any effect on cell adhesion or cell viability as assessed by trypan blue exclusion. In HuSMC exposed to pulsatile flow (0.3 to 25 ml/min, 24 h), there was a flow-dependent increase in migration ranging from a 1.3 ± 0.16- to 2.67 ± 0.26-fold increase, compared to static cells, concomitant with a significant increase in urokinase-type plasminogen activator (uPA) mRNA levels. Ethanol pretreatment (20–80 mM, 24 h) dose dependently inhibited the flow-induced increase in SMC migration but did not affect uPA mRNA expression. Conclusions.The inhibitory effect of ethanol on basal and flow-stimulated SMC migration may be relevant to its cardiovascular effectsin vivo.

This study addresses the effect of sustained increased pulsatile flow on nitric oxide synthase (NOS) and cyclooxygenase (Cox) expression and activity in co-cultured endothelial cells (EC) and vascular smooth muscle cells (SMC). Using a perfused transcapillary co-culture system which permits the chronic exposure of cultured EC and SMC to physiological shear stresses, co-cultures were exposed to step-wise increases in flow up to: (i) 2 ml/min (low flow: 0.5 dyn/cm 2 ); or (ii) 44 ml/min (high flow: 15 dyn/cm 2 ) and maintained for 72 h before SMC and EC were harvested separately. There was no NOS activity or protein expression in co-cultured SMC under flow conditions. There was a significant increase in eNOS activity in co-cultured EC under high flow conditions, compared to low flow, which correlated with an increase in eNOS expression and mRNA levels. The flow-induced increase in eNOS activity was potentiated by indomethacin treatment, suggesting a modulatory role for a cyclooxygenase product. Prostacyclin levels in co-culture perfusate were significantly elevated under high flow conditions. While both co-cultured EC and SMC expressed cyclooxygenase (Cox-I and Cox-II), they were differentially regulated by pulsatile flow. EC Cox-I and Cox-II protein expression were both decreased. Indomethacin treatment increased the expression of both Cox-I and Cox-II in co-cultured SMC under high flow conditions. We conclude that sustained increases in pulsatile flow maintain elevated eNOS and Cox protein expression and activity in EC while decreasing Cox expression in co-cultured SMC. These data suggest that regulation of these pathways may contribute to flow-induced vascular remodeling in vivo .

Background . Pulmonary hypertensive crisis can be initiated by episodes of hypercapnic acidosis. Hypercapnic vasoconstriction in the newborn pulmonary arterial circulation may be modulated by endogenous production of nitric oxide (NO) by the endothelial cell and effectively treated with inhalation of NO. Methods . Sixteen 48-hour-old piglets were randomized to receive a hypercapnic challenge after administration of either saline vehicle or the NO synthase inhibitor N -ω-nitro-l-arginine (L-NA). Pulmonary arterial pressure, flow, and radius measurements were taken at baseline, after infusion of vehicle or L-NA, during hypercapnia (inspired fraction of carbon dioxide, 0.15), and during inhalation of NO (100 ppm). Fourier analysis was used to calculate input mean impedance, reflecting distal arteriolar vasoconstriction, and characteristic impedance, reflecting proximal arterial geometry and distensibility. Results . Input mean impedance was increased with L-NA administration. Animals pretreated with L-NA also underwent a much larger increase in input mean impedance with exposure to hypercapnia than untreated animals. Characteristic impedance increased in the treated animals, but not in the controls. Conclusions . In the newborn pulmonary arterial circulation, endogenous NO production by the endothelial cell modulates resting tone distally, but not proximally. In addition, lack of a functional endothelium markedly potentiates the distal vasoconstrictor response to hypercapnia and produces proximal vasoconstriction. Despite impaired endothelial function, inhaled NO remains an effective vasodilator in hypercapnic pulmonary vasoconstriction.