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Global Health, Pediatrics, Public Safety, Research, Stanford News, Women's Health

Empowerment training prevents rape of Kenyan girls

Empowerment training prevents rape of Kenyan girls

Adolescent girls in the slums of Nairobi, Kenya, are frequent targets of sexual harassment and assault: Nearly one in five of them is raped each year. When these crimes are perpetrated against Nairobi’s teen girls, they’re often expected to react with shame and silence.

But a small non-governmental organization, No Means No Worldwide, has a strategy to change that. The co-founders, Jake Sinclair, MD, and Lee Paiva, an American husband-and-wife team, developed a curriculum of empowerment training to teach girls that it’s OK to say “no” to unwanted sexual advances. The training also gives girls specific verbal and physical skills to defend themselves, as well as information about where to go for help after a rape or other sexual assault.

The results are impressive. Stanford researchers who work with Sinclair and Paiva report today in Pediatrics that the empowerment training cut annual rates of rape by more than a third. Among the group of 1,978 girls trained during the study, more than half used their new knowledge to fend off attempted rape, and 65 percent stopped instances of harassment, halting hundreds of incidents.

From our press release about the research:

“Clearly, girls should never be placed in these situations in the first place,” said Clea Sarnquist, DrPH, the study’s lead author and a senior research scholar in pediatrics at Stanford. Changing males’ attitudes and behavior about assault is an important area for the team’s current and future work, she said. “But with such a high prevalence of rape, these girls need something to protect them now. By giving them the tools to speak up and the knowledge that ‘I have domain over my own body,’ we’re giving them the opportunity to protect themselves.”

The video above, one of a series of testimonials that No Means No Worldwide has collected from Nairobi girls, shows the power of that sense of domain over one’s body. In the video, a schoolgirl named Catherine tells how she stopped a male student from harassing her. When the video begins, it’s impossible not to notice how young and vulnerable she seems. But then she recounts how, when this boy followed her and demanded sex, she remembered her self-defense classes.

“I stood and maintained eye contact,” she says in the video. “I warned him that day and told him he should never in his life dare follow me.”

As she says the words, her demeanor transforms: She draws herself up straight, looks directly in the camera, and raises her index finger in a gesture of commanding attention.

Maryanne Wangui, a young Kenyan woman who recorded many of the testimonials, said something to me that resonates with Catherine’s account and sticks in my mind: “If you give girls the right skills, they know what to do. It doesn’t matter the age of the girl or the size of the girl; they’re all powerful inside.”

Previously: Self-defense training reduces rapes in Kenya
Video courtesy of No Means No Worldwide

Behavioral Science, Mental Health, Public Safety, Stanford News

Stanford’s Keith Humphreys on Golden Gate Bridge suicide prevention: Get the nets

GGBridgeOver on the Huffington Post, Keith Humphreys, PhD, professor of psychiatry and behavioral science at Stanford, writes about a tragic phenomenon in the Bay Area: the popularity of suicide by jumping from the Golden Gate Bridge. He makes a case to put public money toward installing nets and other suicide-prevention services there and in other suicide “hotspots.”

From the post:

Professor Richard Seiden [PhD] painstakingly tracked down death records for the 515 individuals who had been prevented by police from jumping off the bridge from 1937 to 1971. Remarkably, only 6 percent had committed suicide. Even if every individual who died in what was believed to be an accident were assumed to have intentionally caused their own deaths, the proportion of suicides rose only to 10 percent. In other words, 90 percent or more of people stopped from committing suicide at the Golden Gate Bridge lived out the full natural extent of their lives.

Previously: Full-length video available for Stanford’s Health Policy Forum on serious mental illnessLucile Packard Children’s Hospital partners with high schools on student mental health programs and ECT for depression – not so shocking
Photo by image_monger

Parenting, Public Safety, Research, Sports

Is repetitive heading in soccer a health hazard?

Is repetitive heading in soccer a health hazard?

soccer_headerIn the 20 years that I played soccer as a child and young adult, I used my head countless times to challenge and control the ball as it sailed through the air. During practices, coaches gave instructions on which part of the head to use in making contact and redirecting the ball so that the impact was less painful. They also trained me and my teammates on the body mechanics of receiving the ball to maintain possession. But there was never a discussion on the potential health affects of repetitively heading the ball.

So I was interested to read about a paper (subscription required) recently published in Brain Injury wherein researchers raise concerns about long-term consequences of repetitive heading. In the study, Canadian researchers analyzed nearly 50 papers that examining the incidence of concussion in soccer. Among their findings:

  • Overall, concussions accounted for 5.8 per cent to 8.6 per cent of total injuries sustained during games.
  • In particular, girls’ soccer accounted for 8.2 per cent of sports-related concussions, the second highest sport after football.
  • Research papers that looked at the mechanism of injury found 41.1 per cent of concussions resulted from contact by an elbow, arm or hand to the head.
  • Another study showed 62.7 per cent of varsity soccer players had suffered symptoms of a concussion during their playing careers, yet only 19.2 per cent realized it.
  • Studies on the long-term effects of heading found greater memory, planning and perceptual deficits in forwards and defenders, players who execute more headers.
  • One study found professional players reporting the highest prevalence of heading during their careers did poorest in tests of verbal and visual memory as well as attention.

Considering that an estimated 265 million(.pdf) people worldwide play soccer, researchers say these findings show more research on the long-term consequences of repetitive heading is greatly needed.

Previously: Kids and concussions: What to keep in mind, Measuring vs. reporting concussions in cheerleading, Can a single concussion cause lasting brain damage? and A conversation with Daniel Garza about football and concussions
Photo by Gordon Marino

In the News, Parenting, Pediatrics, Public Safety

Carseats save lives, but only if kids are buckled in

Carseats save lives, but only if kids are buckled in

carseatA new study shows failure to properly restrain children in carseats or a seatbelt remains a leading cause of death for children involved in motor vehicle accidents. As reported today on the Well blog, the death rate decreased from 2002 to 2011, but  thousands of children under 12 unfortunately died because they were not buckled in. Using a carseat or seatbelt could have saved many of those lives:

In 2011, 33 percent of children who died in motor vehicle accidents were not buckled in. While only 2 percent of children under age 1 rode unrestrained, 22 percent of those in that age group who died were unbuckled. An estimated 3,308 children under 4 are alive today because they were properly buckled in.

“We can do more to help protect our children on the road,” [lead author Erin K. Sauber-Schatz, PhD] said “We have to make sure that children are buckled into age- and size-appropriate seats and seatbelts on every trip, no matter how short the trip.”

Many hospitals, including Lucile Packard Children’s Hospital Stanford, offer car seat installations and inspections for new parents.

Previously: Precious cargo: Keeping kids safe in cars and planes
Photo by Kari Bluff

In the News, Infectious Disease, Men's Health, Public Safety, Research, Stanford News

Exploring how gender affects the immune system

Exploring how gender affects the immune system

man_coldA piece published today on Slate examines how sex hormones, like estrogen and testosterone, may impact the strength of men and women’s immune systems. As noted in the article, recent research from Stanford immunologist Mark Davis, PhD, who directs Stanford’s Institute for Immunity, Transplantation and Infection, and his colleagues offers new insights on the issue:

… it’s been difficult to establish any direct link between levels of sex hormones circulating in the blood and the performance of men’s and women’s immune systems.

Recent research is now beginning to firmly establish that link. This month, a team of scientists at Stanford University has reported some of the best evidence yet that testosterone directly influences immune system function in men. The researchers took blood samples from male and female volunteers who were given a flu shot. Women had higher levels of immune system molecules circulating in their blood than men, and they produced more effective antibodies against the flu virus. And there were not only differences between men and women, but there were differences among men—the men with the weakest response to the flu shot had high levels of both testosterone and testosterone-induced enzymes, suggesting that high levels of testosterone can suppress immunity.

This finding that testosterone may dial down the immune system in humans is consistent with the results of studies of other animals, ranging from fish to chimps.

For more details on the study and why high testosterone may provide a less obvious evolutionary advantage, read this December Scope post from my colleague Bruce Goldman.

Previously: In men, a high testosterone count can mean a low immune responseAdults’ immune systems “remember” microscopic monsters they’ve seen beforeImmunology escapes from the mouse trap and Immunology meets infotech
Photo by Iain Farrell

Parenting, Public Safety

Tips from a doctor (and a mom) for a safe Halloween

Tips from a doctor (and a mom) for a safe Halloween

Avery trick or treatingHappy Halloween! Whether you’re trick-or-treating or heading to a party tonight, make sure you and yours stay safe and healthy. Recently we spotlighted a list of recommendations from Lucile Packard Children’s Hospital on how to keep the fun while ditching some of the calories (and sugar) imposed by trick-or-treating. During a Mayo Clinic Twitter chat earlier this week, Seattle pediatrician Wendy Sue Swanson, MD (@seattlemamadoc), mother of two boys, also offered tips on having a safe and healthy Halloween. Among her suggestions:

  • Start the evening with a family dinner and agree on a plan to limit candy consumption. Introduce kids to the Switch Witch.
  • Ensure a costume’s proper fit (to avoid tripping) and affix flashing lights and reflectors for better visibility after dark. Also, make sure your kids can see: Try non-toxic face paint instead of a vision-obscuring mask. Know the risks of wearing decorative contact lenses.
  • If staying in, stock your caldron with healthy treats or stickers, pencils, and other non-food items to include children with food allergies or medical concerns.
  • Stay sober when escorting children. Whether driving or walking, keep your eyes on the road and off your phone.
  • Prepare your children for surprises that may be scary, even in the spirit of fun. Make sure children have a parent’s phone number memorized and a plan of how to reconnect if they get lost.
  • For teens who go out on their own, choose small groups and have a code word in place in case they want to be picked up from a party early.
  • Inspect candy before allowing little children to eat it, and beware of choking hazards such as marshmallows and similarly squishy treats.

Swanson’s boys will be dressing up as a Seattle Seahawks fan and a Lego piece.

Previously: How to avoid a candy-coated Halloween and Debunking a Halloween myth: Sugar and hyperactivity
Photo by Michelle Brandt

In the News, Public Health, Public Safety, Technology

Now that’s using your head: Bike-helmet monitor alerts emergency contacts after a crash

Now that's using your head: Bike-helmet monitor alerts emergency contacts after a crash

kids riding bikes - big

For me, the hardest thing about loving someone is knowing I can’t always be with them. That’s why I keep my eyes peeled for the latest technological gadgets that can connect me to the people I love, even when they’re far away.

Today, a story from Wired caught my attention. It’s a bike helmet monitor – about the size of chocolate truffle – that sends a text to your emergency medical contact(s) of choice if it senses you’ve been in an accident.

From the article:

It attaches to any helmet — clipped into a vent, as pictured, or stuck on with a super-sticker — and registers impacts via both a three-axis gyroscope and a three-axis accelerometer. A proprietary algorithm determines whether the hit exceeds brain-trauma threshold. If there’s cause for worry, the ICEdot alerts your phone over low-energy Bluetooth. This triggers the ICEdot app to sound an alarm and begin a countdown. If you don’t wake up and turn it off before it times out, the app texts your GPS coordinates to your emergency contacts.

Sound complicated? It is, but not for the user. Setup is simple and fast: Register online, download the app, connect with the sensor, and you’re done.

Since bike crashes can result in potentially serious injuries, including concussions, this little device could give bikers, and their loved ones, some peace of mind.

Holly MacCormick is a writing intern in the medical school’s Office of Communication & Public Affairs. She is a graduate student in ecology and evolutionary biology at University of California-Santa Cruz.

Previously: Study shows concussion recovery may take longer for female, younger athletesCan high-tech helmets safeguard young athletes against concussions?University leaders raise awareness about the importance of bike helmetsRattled by one child’s injury, a whole family becomes accident-prone, and Health benefits of bike commuting outweigh the risks
Photo by Divine in the Daily

Global Health, Infectious Disease, Public Health, Public Safety, Research, Stanford News

Global community must do a better job of managing risk of Nipah virus, expert says

Global community must do a better job of managing risk of Nipah virus, expert says

fruit batIf a South Asian disease that’s commonly associated with fruit bats and pig farms doesn’t top your list of things to think about today, you may want to read this story in the current issue of Inside Stanford Medicine. The piece focuses on Nipah virus – a disease that has no known treatment or vaccine - and discusses a recent commentary on it from Steve Luby, MD, director of research for Stanford’s Center for Innovation in Global Health. In his piece, Luby explains how global travel can spread diseases and lists some of the reasons why diseases that affect low-income countries should be of global concern.

From the Inside Stanford Medicine article:

Discovered in 1999, Nipah can be traced to Pteropus bats, commonly known as fruit bats, which carry the virus but are immune to it. In Bangladesh, these bats transmit the virus to humans through raw date palm sap, which the bats are known to lick and urinate in as it is harvested for human consumption. Children love the treat with puffed rice in the morning.

Sustained person-to-person transmission of Nipah through contact with bodily secretions has been limited so far. Still, there is significant cause for concern that Nipah could spread faster and wider. Fruit bats can be found over a range stretching from Pakistan across South and Southeast Asia, up the coast of Southern China and down into Australia. Climate change and other environmental factors could expand the bats’ range.

Rich countries need to help improve poor countries’ health-care systems — specifically, making sure health-care workers have access to protection such as gloves and hand washing — to help prevent spread, Luby said. In densely populated Bangladesh, health-care providers who treat Nipah patients typically lack gloves and masks, while patient attendants often lack soap and water for hand washing.

Beyond stopping the spread of Nipah, such measures would reduce the risk of influenza and other disease pandemics, according to Luby. “I think it’s important that taxpayers in the U.S. recognize that investments in prevention in low-income, high-risk countries can protect their own lives.”

Luby’s commentary appears in the journal Antiviral Research.

Holly MacCormick is a writing intern in the medical school’s Office of Communication & Public Affairs. She is a graduate student in ecology and evolutionary biology at University of California-Santa Cruz.

Previously: H7N9 got you aflutter? Wired offers help sorting fact from fictionClosing the net on malariaWhat I did this summer: Stanford medical student works to improve pediatric surgical care in TanzaniaImproving treatment for infant respiratory distress in developing countriesWHO’s math may not add up for developing nations and Stanford pump project makes clean water no longer a pipe dream
Photo of fruit bat by Joachim Muller

Addiction, Health Policy, Public Health, Public Safety

How police officers are tackling drug overdose

police car

Drug overdose is now the most common cause of accidental death in the United States, primarily because of the vastly increased availability of pharmaceutical-grade opioids (e.g., Oxycodone, Vicodin). The size and impact of the epidemic can be lessened by a range of public policies, including one that the White House has been touting: Equipping first responders with naloxone hydrochloride.

In opioid overdose, breathing slows to a very low level or even stops completely, which deprives the brain of oxygen. Death or permanent organ damage can be the horrifying result. Enter naloxone, an old, off-patent (and hence inexpensive) medication with a powerful ability to force opioids out of brain receptors. Overdose is thus rapidly reversed.

Naloxone does not cure addiction. Nor does its effect last more than 30-90 minutes. However, that window of time can be used to get the overdosed person to a hospital and subsequently it is hoped into addiction treatment.

Police officers and fire fighters are often the people who discover people who have overdosed. They typically call for medical backup in such cases, but even if the EMTs take only 15 minutes to arrive, that can be too late. Training in how to recognize overdose and to then administer naloxone allows those first responders to save lives that would otherwise be lost.

Police in Quincy, Massachusetts began carrying naloxone in their cruisers in October of 2010, and have been reversing about one overdose every ten days since. Police and firefighters in other parts of the country are now copying Quincy’s successful approach.

The Obama Administration’s embrace of improving naloxone’s availability is one of many signs of how quickly U.S. drug policy has moved in a public health direction. Only a few years ago, drug policy officials in the G.W. Bush Administration condemned the use of naloxone. Today, Obama drug policy officials give out awards to successful naloxone access expansion programs. The result will be fewer overdose and more chances for people with addictions to receive the help they need to become healthy and productive.

Addiction expert Keith Humphreys, PhD, is a professor of psychiatry and behavioral sciences at Stanford and a career research scientist at the Palo Alto VA. He recently completed a one-year stint as a senior advisor in the Office of National Drug Control Policy in Washington.

Previously: Do opium and opioids increase mortality risk?
Photo by Scott Davidson

Emergency Medicine, Patient Care, Public Safety, Stanford News

Ready for anything: Emergency responders refine protocols in simulated explosion at Stanford Stadium

Ready for anything: Emergency responders refine protocols in simulated explosion at Stanford Stadium

12947-drill_victims_ffPlanning and practice are two mainstays of any emergency response team. That’s why Stanford routinely conducts emergency drills such as a simulated explosion at Stanford Stadium last week. ”Rather than waiting for something you have to lean in and anticipate,” Palo Alto Police Chief Dennis Burns said in a Stanford Report story.

The two-hour drill simulated what it might be like if an explosion resulting in mass casualties occurred in Stanford Stadium. The event helped Stanford Hospital and police test their ability to coordinate a large emergency response effort with volunteers and more than 20 agencies from Santa Clara and San Mateo counties. “The exercise itself confirmed for us what works well and what needs to be fine tuned,” said Stanford Police Chief Laura Wilson.

Since clear and accurate communication is essential in times of crisis, this emergency drill was also used by Stanford’s Office of University Communications to assess their protocol for conveying critical information to the media, patient’s loved-ones, and the Stanford community. From the report:

Kathy Harris, a public safety program manager who planned the exercise, said the components of the drill were identified long before the Boston Marathon emergency and the Asiana Airlines crash at San Francisco International Airport. The scenario was designed to test multiple procedures, including the need to change the command post in the middle of a response and to react to an unstable situation. “This was not a reaction to anything but part of our routine pro-active emergency planning,” she said.

Holly MacCormick is a writing intern in the medical school’s Office of Communication & Public Affairs. She is a graduate student in ecology and evolutionary biology at University of California-Santa Cruz.

Previously: Plane crash creates unexpected learning environment for medical students“Preparation is everything:” More on how Stanford and Packard got ready for the Asiana crashAfter the plane crash: Inside the command center with Stanford Hospital’s chief of staffBehind-the-scenes look at treating SFO plane-crash survivors and “Everyone came together right away:” How Stanford response teams treated SFO plane-crash victims
Photo by L.A. Cicero

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