Common symptoms include shortness of breath and a dry, hacking cough. In some cases fibrosis happens quickly, while in others, the process is much slower.

For detailed information on the available treatment options, please visit the following link. http://www.cancer.gov/cancertopics/pdq/treatment/myeloma/Patient/page4

Preparing for your appointment If you're following a standard well-baby exam schedule, your baby will likely visit with your family's health care provider or a pediatrician soon. ... For baby acne, some basic questions to ask your doctor include: Is my baby's condition likely temporary or long lasting? What treatments are available? What advice do you have for my baby's skin care? Will this acne scar my baby's face?

Retrieved 31 July 2016 . ^ "Se han interrumpido legalmente 138 mil embarazos en ocho años" . Excélsior (in Spanish). ... Retrieved 2009-10-18 . ^ "Temen se extienda prohibición al aborto en el país" . El Financiero en línea (in Spanish). ... ISBN 978-3659527661 . ^ "La legalidad del aborto en México a discusión en la Suprema Corte" . ... "Una de cada 3 mujeres que interrumpe su embarazo en el DF es ama de casa" . CNN: Mexico . Retrieved 16 March 2014 . ^ a b Grupo de Informacion en Reproduccion Elegida. "Aborto: Capitulo Uno" (PDF) .

Usog or balis is a topic in psycho-medicine in Filipino Psychology (but considered just as a Filipino superstition in Western Psychology) where an affliction or psychological disorder is attributed to a greeting by a stranger, or an evil eye hex . It usually affects an unsuspecting child, usually an infant or toddler, who has been greeted by a visitor or a stranger. [1] In some limited areas, it is said that the condition is also caused by the stranger having an evil eye or masamang mata in Tagalog , lurking around. ... There are observations that a stranger (or a newcomer or even a visiting relative) especially someone with a strong personality (physically big, boisterous, has strong smell, domineering, etc.) may easily distress a child. ... Some have observed that at times even praising a shy child by a visiting relative caused an usog . [4] [7] The saliva from the stranger, granted that he or she is healthy and consistent with his or her oral hygiene , is relatively clean [8] and contains enough antimicrobial compounds such as lactoferrin , lactoperoxidase , and secretory immunoglobulin A which can help clear pathogens from the child and benefit the child against infection. [9] Furthermore, human saliva has opiorphin , a newly researched pain-killing substance. ... More than the superstitious folks, researchers dealing with Filipino Psychology say they have observed this phenomenon with regularity and suggest that this be added to the Psychiatric Disorders Handbook DSM-V . [4] See also [ edit ] Evil eye Lihi Albulario Saliva Opiorphin References [ edit ] ^ PWE-USOG / PWE-BUYAG: Miscellaneous Therapies in Philippine Alternative Medicine ^ http://www.viloria.com/secondthoughts/archives/00000176.html ^ Fadul, J. ... ISBN 978-971-542-570-4 . ^ Youtube Usog ^ http://neurophilosophy.wordpress.com/2006/11/14/lick-your-wounds/ Neurophilosophy: Lick your wounds ^ Discover Magazine, "The Biology of ...Saliva" October 2005 ^ Wisner, Anne; Evelyne Dufour; Michaël Messaoudi; Amine Nejdi; Audrey Marcel; Marie-Noelle Ungeheuer; Catherine Rougeot (November 13, 2006).

Current Norwegian legislation and public health policy provides for abortion on request in the first 12 weeks of gestation, by application up to the 18th week, and thereafter only under special circumstances until the fetus is viable, which is usually presumed at 21 weeks and 6 days. ... ("Grundlaget for al frihet er rådighet over egen krop og hvad i den er. Det motsatte er en slaves tilstand") In the period between 1920 and 1929, about 100 individuals were sentenced for an illegal abortion. ... Gradual liberalization and a core feminist cause [ edit ] Year Number of abortions Rate 1965 3455 n/a 1970 7941 n/a 1975 15132 n/a 1976 14754 0.542 1980 (on request) 13531 0.468 In 1960, a new law allowed abortion by application approved by a commission of two physicians, and only on the basis of medical, eugenic, or criminal criteria; and with the consent of the husband if the applicant was married. ... Sage . 24 (1): 23–38. doi : 10.1177/1350506815619878 . References [ edit ] ^ https://www.regjeringen.no/no/dokumenter/about-the-abortion-act/id419252/ ^ https://www.regjeringen.no/no/dokumenter/about-the-abortion-act/id419252/ ^ http://www.ssb.no/vis/magasinet/slik_lever_vi/art-2005-02-18-01.html ^ Christine Svendsen (12 May 2012) Aborterte fostre levde i over en time før hjertet hadde sluttet å slå NRK.

Cholecystectomy and bilioenteric anastomosis may be required. Roux-en-Y hepaticojejunostomy has shown good outcome in some studies. [4] Epidemiology [ edit ] Mirizzi's syndrome occurs in approximately 0.1% of patients with gallstones . [5] It is found in 0.7 to 2.5 percent of cholecystectomies . [1] It affects males and females equally, but tends to affect older people more often. ... Mirizzi was educated and trained in his hometown and later visited some of the best hospitals throughout the United States for further education and training. ... Society for Surgery of the Alimentary Tract. http://www.ssat.com/cgi-bin/abstracts/09ddw/P7.cgi ^ "eMRCS" . www.emrcs.com .

Episcleritis Eye with Episcleritis Specialty Ophthalmology Symptoms Eye redness without pain Watery eyes Types Nodular and simple/diffuse Diagnostic method History and physical examination Differential diagnosis Scleritis Treatment Artificial tears , supportive care Medication Topical corticosteroids Non-steroidal anti-inflammatory drugs . Prognosis Good Episcleritis is a benign, self-limiting inflammatory disease affecting part of the eye called the episclera . The episclera is a thin layer of tissue that lies between the conjunctiva and the connective tissue layer that forms the white of the eye ( sclera ). ... Contents 1 Signs and symptoms 2 Pathophysiology 3 Diagnosis 4 Treatment 5 Prognosis 6 Epidemiology 7 References 8 External links Signs and symptoms [ edit ] Episcleritis of a 40 years old female Symptoms of episcleritis typically include painless redness of the eye (mild pain is possible but atypical), and watery eyes . [1] The pain of episcleritis is typically mild, less severe than in scleritis , [2] and may be tender to palpation. [3] There are two types of episcleritis: the diffuse type, where the redness involves the entire episclera, and the nodular type, where the redness appears more nodular , involving only a small, well-circumscribed area ( sectoral ). [4] The diffuse type of episcleritis may be less painful than the nodular type. Sometimes, small nodules are present within the episclera, which move slightly over the sclera with gentle pressure. [4] Discharge is absent with episcleritis, and vision is unaffected. [4] Patients with episcleritis experience far less photophobia than patients with uveitis . [1] Episcleritis does not cause the presence of cells or flare in the anterior chamber of the eye. [1] In 80 percent of cases, episcleritis affects only one eye, [5] whereas scleritis often affects both eyes. ... ISBN 978-0071769648 . ^ a b c d e f Kunimoto, Derek; Kunal Kanitkar; Mary Makar (2004). The Wills eye manual: office and emergency room diagnosis and treatment of eye disease (4 ed.).

If you develop severe diarrhea after visiting an area with active cholera, see your doctor. ... If soap and water aren't available, use an alcohol-based hand sanitizer. Drink only safe water, including bottled water or water you've boiled or disinfected yourself. ... Diagnosis Although signs and symptoms of severe cholera can be unmistakable in areas where it's common, the only way to confirm a diagnosis is to identify the bacteria in a stool sample. ... When you make your appointment, ask if there are restrictions you need to follow before your visit. Make a list of: Your symptoms, when they began and how severe they are Recent exposure to possible sources of infection, particularly if you've traveled abroad recently Key medical information, including other conditions for which you're being treated All medications, vitamins or other supplements you take, including doses Questions to ask your doctor Some questions to ask your doctor about cholera include: Are there other possible causes for my symptoms? ... Am I at risk of any long-term complications from cholera? Am I contagious? How can I reduce my risk of passing my illness to others?

Someone allergic to walnuts or pecans may not have an allergy to cashews or pistachios, because the two groups are only distantly related and do not necessarily share related allergenic proteins. ... Argentina decided to prohibit precautionary allergen labeling since 2010, and instead puts the onus on the manufacturer to control the manufacturing process and label only those allergenic ingredients known to be in the products. ... Retrieved 12 January 2018 . ^ a b c d e f Allen KJ, Turner PJ, Pawankar R, Taylor S, Sicherer S, Lack G, Rosario N, Ebisawa M, Wong G, Mills EN, Beyer K, Fiocchi A, Sampson HA (2014). ... CS1 maint: extra text: authors list ( link ) ^ https://acaai.org/allergies/types/food-allergies/types-food-allergy/tree-nut-allergy ^ https://kidshealth.org/en/parents/allergy.html ^ https://acaai.org/allergies/types/food-allergies/types-food-allergy/tree-nut-allergy ^ https://acaai.org/allergies/types/food-allergies/types-food-allergy/tree-nut-allergy ^ a b Bublin M, Breiteneder H (2014). ... J Pharm Sci . 107 (5): 1263–1268. doi : 10.1016/j.xphs.2017.12.021 . PMID 29287928 . ^ Mills EN, Valovirta E, Madsen C, Taylor SL, Vieths S, Anklam E, Baumgartner S, Koch P, Crevel RW, Frewer L (2004).

Complications Giant cell arteritis can cause serious complications, including: Blindness. Diminished blood flow to your eyes can cause sudden, painless vision loss in one or, rarely, both eyes. ... For giant cell arteritis, questions to ask your doctor include: What's the most likely cause of my symptoms? What are other possible causes? What tests will I need? What are my treatment options? What side effects can I expect from the medication? How long do I need to stay on medication, and what's my long-term prognosis? Will giant cell arteritis come back? ... How can I best manage them together? Do I need to change my diet? Do I need to take supplements?

For Chiari malformation, some basic questions to ask your doctor include: What is likely causing my symptoms or condition? Other than the most likely cause, what are possible causes for my symptoms or condition? ... If you don't think I need to be treated now, how will you monitor me for changes in my condition? If you recommend surgery, what should I expect from my recovery? What is the risk of complications from surgery? What is my long-term prognosis after surgery? ... Should I see a specialist? What will that cost, and will my insurance cover seeing a specialist? ... Have you developed any problems with your eyes and ears, such as blurred vision or a ringing or buzzing in your ears?

Contents 1 History 1.1 Examples in fiction 1.2 Examples in science 2 See also 3 References 4 External links History [ edit ] The term was coined by the German physician Christoph Wilhelm Hufeland in 1819, when, in a preface to an influential book by German-Russian doctor C. von Brühl-Cramer, [1] he translated Brühl-Cramer's term " trunksucht " as "dipsomania". [2] [3] [4] Brühl-Cramer classified dipsomania in terms of continuous, remittent, intermittent, periodic and mixed forms, and in his book he discussed its cause, pathogenesis , sequelae , and treatment options, all influenced by prevailing ideas about the laws of chemistry and concepts of excitability. [5] Due to the influence of Brühl-Cramer's pioneering work, dipsomania became popular in medical circles throughout the 19th century. [6] Political scientist Mariana Valverde describes dipsomania as "the most medical" of the many terms used to describe habitual drunkenness in the 19th century. [7] Along with terms such as "inebriety", the idea of dipsomania was used as part of an effort of medical professionals and reformers to change attitudes about habitual drunkenness from being a criminally punishable vice to being a medically treatable disease. [8] As historian Roy MacLeod wrote about this dipsomania reform movement, it "illuminates certain features of the gradual transformation taking place in national attitudes towards the prevention and cure of social illnesses during the last quarter of the 19th century." [8] Although dipsomania was used in a variety of somewhat contradictory ways by different individuals, by the late 19th century the term was usually used to describe a periodic or acute condition, in contrast to chronic drunkenness. [9] In his 1893 book Clinical Lessons on Mental Diseases: The Mental State of Dipsomania , Magnan characterized dipsomania as a crisis lasting from one day to two weeks, and consisting of a rapid and huge ingestion of alcohol or whatever other strong, excitatory liquid was available. [9] Magnan further described dipsomania as solitary alcohol abuse, with loss of all other interests, and these crises recurred at indeterminate intervals, separated by periods when the subject was generally sober. [9] Similarly, in 1892 the influential English physician and mental health expert Daniel Hack Tuke defined dipsomania as a syndrome involving "an irresistible obsession and impulse to drink, coming on in attacks, during which the patients are in a condition of impotence of will and manifest great anguish." [10] Tuke clarifies that dipsomania can be distinguished from what was at the time considered alcoholism by six key factors. ... Alcoholism has no definite course." [12] Fourth, "a dipsomaniac satisfies a pathological and imperious want; he does not like alcohol, and takes it against his will," whereas "an alcoholic individual has no actual want; he only obeys a vice, a proclivity, and an alteration of his moral sense." [12] Fifth, a dipsomaniac is conscious and ashamed of his condition, whereas an alcoholic is sometimes unaware of, but more often indifferent to it. ... "All this time I have been liable to fits of ether dipsomania, kept away at intervals only by rigorous abstention from thought on the subject." ... London: Macmillan and Co., Limited. p. 1065. Works cited Tuke, Daniel Hack (1892). A Dictionary of Psychological Medicine: Giving the Definition, Etymology and Synonyms of the Terms Used in Medical Psychology with the Symptoms, Treatment, and Pathology of Insanity and the Law of Lunacy in Great Britain and Ireland . 1 . ... CS1 maint: ref=harv ( link ) External links [ edit ] Bucknill, John Charles; Daniel Hack Tuke (1879). A Manual of Psychological Medicine: Containing the Lunacy Laws, the Nosology, Aetiology, Statistics, Description, Diagnosis, Pathology, and Treatment of Insanity (Fourth ed.).

If you've already been diagnosed with lichen sclerosus, see your health care provider every 6 to 12 months. These visits are important to check for any skin changes or side effects of treatment. ... After several weeks, your health care provider will likely suggest that you use it only twice a week to prevent symptoms from returning. ... Some basic questions to ask your health care provider about possible lichen sclerosus include: What's the most likely cause of my symptoms? What treatment approach do you suggest, if any? If the first treatment doesn't work, what will you suggest next? How much do you expect my symptoms will improve with treatment — and how soon? Will I need treatment for this condition for the rest of my life? What self-care steps can I follow to ease my symptoms?

Many women who are told that hysterectomy is their only option can have an abdominal myomectomy instead. ... This surgery removes the uterus. It remains the only proven permanent solution for uterine fibroids. ... Use it to note important information during your visit. Prepare a list of questions to ask. ... Are the fibroids located on the inside or outside of my uterus? What kinds of tests might I need? ... Will I need a medication before or after surgery? Will my uterine fibroids affect my ability to become pregnant?

Daily cleaning of the hooves also contributes to the prevention of thrush. [2] In general, thrush is relatively easy to treat, although it can easily return and it can take up to a year for a fully healthy frog to regrow after a severe infection. References [ edit ] ^ https://www.thehorse.com/articles/27319/the-lowdown-on-thrush ^ a b c d Ensminger, M. ... ISBN 0-8134-2883-1 . Further reading [ edit ] http://www.equisearch.com/horses_care/health/hoof_care/eqthrush305/ https://www.thehorse.com/articles/26470/brushing-up-on-thrush https://www.thehorse.com/articles/32743/thrush-that-black-smelly-gooey-stuff https://www.thehorse.com/articles/20341/thwarting-thrush https://practicalhorsemanmag.com/health-archive/how-to-treat-my-horses-thrush-27863

Epidermal nevus syndrome (ENS) is a rare congenitally acquired syndrome, characterized by the presence of epidermal nevi in association with various developmental abnormalities of the skin, eyes, nervous, skeletal, cardiovascular and urogenital systems. ... Most are present at birth, occur sporadically and affect both sexes. All well-defined ENS are lethal gene syndromes, except nevus comedonicus syndrome. ... Management and treatment No ideal medical therapy for the cutaneous lesions of ENS exists. The skin lesions may be amenable to surgery.

Mexico’s government has created nutrition programs, to deal with nutritional issues such as obesity; especially in vulnerable people and low-income sectors. [18] These include food distribution among low-income communities, micronutrient supplementation, and fortification of food. [18] All of this is made to fight the deficiency of vitamins and minerals. ... The House passed the proposed measure to charge a 5% tax on packaged food that contains 275 calories (1,150 kJ) or more per 100 grams, on grounds that such high-energy items typically contain large amounts of salt and sugar and few essential nutrients. [22] Subsequent studies have indicated that the one peso per liter tax rate has only led to a small reduction in soft drink consumption, and the fall in calorie consumption was described as "nothing compared to the drop in calories people needed to consume in order to not be obese". [23] The effectiveness of the tax on junk food was subject to debate. [ citation needed ] See also [ edit ] List of countries by Body Mass Index (BMI) References [ edit ] ^ a b c d e Popkin, Barry (2004). ... PMID 15387482 . ^ The nutrition transition and obesity : Food and Agricultural Order of the United Nations. ^ a b c d Sobrepeso y obesidad, Gobierno Del Distrito Federal, April 2013, http://www.who.int/topics/obesity/en/index.html . ^ a b "Fat Mexico - Obesity on the rise in Mexico" , The Economist . ^ a b c d e Bermudez, Odilia I.; Tucker, Katherine L. (2003). ... Retrieved 24 April 2013 . ^ Tuckman, 2008 ^ Lucha libre vs Obesidad, April 2013, http://www.seguro-popular.gob.mx/index.php?option=com_content&view=article&id=547&Itemid=472 . ^ CAMPAÑA "MÍDETE Y ACTÍVATE, April 2013, http://www.cns.salud.gob.mx/contenidos/midete.html . ^ Mexico Tries Taxes to Combat Obesity, https://www.wsj.com/articles/SB10001424052702304864504579141462546165166 ^ editor, Denis Campbell Health policy (2016-03-17).

For example, older women have demonstrated higher levels of knowledge regarding HIV/AIDS than younger women in Malawi. [2] Because men typically have greater access to education and other social resources, they are often more knowledgeable about HIV prevention and transmission than women. [2] While men are, on average, able to list 2.2 ways to prevent HIV transmission, women are only able to list 1.5 ways. [2] Only 38% of women surveyed in 2003-2004 understood that their husbands would be less likely to contract HIV if they used condoms during intercourse with prostitutes and other women from high-risk groups. [9] In addition, men who are raised in urban environments are, on average, more informed about HIV/AIDS than men who are raised in rural environments, presumably because urban children typically have greater access to educational resources than rural children. [2] Among both men and women, higher levels of education correspond to increased knowledge about HIV/AIDS: men and women who have received secondary school educations are significantly more likely to understand complex aspects of the disease, such as the fact that people who appear healthy can still be HIV-positive, than those who have not. [2] Finally, people who have lost friends or family members to the disease are likely to have greater knowledge about HIV/AIDS due to their personal, firsthand exposure to the problem. [2] The aforementioned study by Barden-O'Fallon et al., which surveyed 940 women and 661 men, indicated that, despite their knowledge and awareness, many people in Malawi do not feel personally susceptible to HIV infection. [2] On average, only 23% of the adults who were surveyed during this study, both male and female, believed that they were likely to contract HIV and die of AIDS. [2] Greater HIV/AIDS awareness among men does not seem to correspond with increased perceived risk; on the other hand, increased levels of knowledge about HIV/AIDS do correlate positively to perceived risk among women. [2] Another study conducted in rural Malawi between 1998 and 2001 by Kirsten P. ... In Malawi, HIV/AIDS is usually transmitted through heterosexual sex , but the epidemic has also significantly impacted the homosexual male population in Malawi. [1] In addition, women in Malawi are more likely to be HIV-positive than men, suggesting that women are particularly vulnerable to HIV/AIDS. [1] Finally, the disease has affected children and young adults both directly and indirectly; 170,000 Malawian children were HIV-positive in 2011, and the number of orphans in Malawi has increased dramatically since the epidemic began in 1985. [1] Men [ edit ] Due to the vast scope of the HIV/AIDS epidemic, many Malawian men believe that HIV contraction and death from AIDS are inevitable. [3] Older men in particular often claim that the HIV/AIDS epidemic is a punishment issued by God or other supernatural forces. [3] Other men refer to their own irresponsible sexual behaviors when explaining why they believe that death from AIDS is inevitable. [3] These men sometimes claim that unprotected sex is natural (and therefore necessary and good) when justifying their lack of condom use during sex with extramarital partners. [3] Finally, some men identify as HIV-positive without having undergone testing for HIV, preferring to believe that they have already been infected so they can avoid adopting undesirable preventive measures such as condom use or strict fidelity . [3] Because of these fatalistic beliefs, many men continue engaging in extramarital sexual relations despite the prevalence of HIV/AIDS in Malawi. [8] However, despite these widespread feelings of fatalism, some men believe that they can avoid HIV contraction by modifying their personal behaviors. [3] Men who decide to change their behaviors to reduce their risk of infection are unlikely to use condoms consistently, particularly during marital intercourse; instead, they usually continue engaging in extramarital sexual relations, but alter the ways in which they choose their sexual partners. [3] For example, before selecting extramarital sexual partners, men sometimes survey their peers to determine whether their potential partners are likely to have exposed themselves to the virus. [10] Men who choose their sexual partners based on external appearances and peer recommendations often believe that women who violate traditional gender norms by, for example, wearing modern clothing are more likely to carry HIV, while young girls, who are perceived as sexually inexperienced, are considered "pure." [3] Because of this perception, many people are concerned that schoolchildren in Malawi, particularly girls, are becoming exposed to the virus through sexual harassment or abuse by their instructors. [6] Women [ edit ] According to traditional gender roles in Malawi, men operate primarily in the formal work sector and are responsible for supporting their families through paid labor, whereas women, who are valued for their domestic skills, are responsible for agricultural labor and care work ; this gender-based division of labor decreases women's autonomy , thereby increasing their vulnerability to HIV/AIDS. [9] Even within the home, women often lack bargaining power because they have limited access to education , formal employment , and other resources that could give them a sense of financial and personal independence. [9] Women who are able to work in the formal sector typically earn significantly less money than men , even when they are completing the same tasks, making it difficult for them to elevate their status. [9] Many women are convinced that their husbands are putting their lives at risk by engaging in extramarital sexual relations without using protection; however, because of their secondary status, they are often unwilling to initiate discussions about HIV/AIDS in the home. [9] Most women in Malawi do not view divorce as a viable option, even when their husbands are HIV-positive and refuse to protect them from the virus by wearing condoms during marital intercourse. [9] Because they lack the education and training needed to seek gainful employment , women are not usually able to support themselves and their children outside of marriage without resorting to commercial sex work for money. [9] However, despite their vulnerability, some women in rural Malawi believe that they do, to a certain extent, have control over their own health and well-being. [11] They tell their husbands that the HIV/AIDS epidemic has made sexual infidelity extremely dangerous and encourage them to refrain from engaging in extramarital sexual contact. [11] In addition, many women are convinced that, by appealing to the vulnerability of their children (who will probably be orphaned if their parents contract HIV), they can convince their husbands to use condoms consistently during extramarital sexual encounters. [11] Other women seek support from their friends and family members when they believe that their husbands' unsafe behaviors are putting their lives at risk. [11] Finally, as a last resort, women might warn their husbands that they will visit the ankhoswe , or traditional marriage counselor, and demand divorce if their husbands refuse to remain faithful and actively prevent the transmission of the disease. [11] Children [ edit ] AIDS orphans in Lilongwe, Malawi The number of orphaned children in Malawi has increased dramatically since the HIV/AIDS epidemic began in 1985, with certain surveys indicating that more than 35% of schoolchildren have experienced the death of at least one parent due to HIV/AIDS. [6] Because HIV is transmitted sexually, married couples who engage in unprotected sexual relations put their children at increased risk of becoming double orphans , or children who have lost both parents to HIV/AIDS. [6] Older children who have lost both parents to HIV/AIDS often become responsible for the care of their younger siblings, and many double orphans drop out of school or migrate to urban areas to try to support themselves and their siblings. [6] Girls who have been orphaned by HIV/AIDS have unusually high rates of school absenteeism in Malawi. [6] When parents die of HIV/AIDS, extended family members usually become the children's primary caregivers : in Malawi, 44% of double orphans are adopted by grandparents or other close relatives. [6] Extended family members often provide crucial support to HIV/AIDS orphans; [12] however, some sources indicate that extended family members mistreat orphans whose parents have died from HIV/AIDS. [6] For example, family members who are unable to support adopted children often arrange early marriages for female orphans, who may then become victims of domestic violence and sexual abuse . [6] Evidence suggests that schoolchildren in Malawi are at risk of being exposed to HIV by their teachers, who sometimes value them as sexual partners because they believe that children have not yet been exposed to the virus. [6] Children are particularly vulnerable to exploitation by adults who offer them money in exchange for sex; because they are often unable to afford basic necessities, they might feel compelled to accept gifts in exchange for sex out of desperation. [6] Interviews indicate that teachers and school administrators in Malawi often misinterpret the definition of sexual assault , as some believe that sexual relations between teachers and students are appropriate as long as the children have consented . [6] Although most schools have strict policies against sexual abuse , children are often hesitant to accuse adults of wrongdoing, and many administrators are unwilling or unable to investigate the truth behind the accusations. [6] Marriage and relationships [ edit ] Although couples are starting to use condoms during extramarital intercourse more frequently, condom use during marital sex is still viewed as inappropriate by many Malawians; in 2000, only 2.3% of people reported using condoms regularly during sexual intercourse with their spouses. [4] Some people believe that condoms are only necessary during sex with high-risk partners such as sex workers , and that condom use during marital sex implies infidelity . [4] Others believe that marital condom use violates the religious purposes of marriage: sexual pleasure and reproduction . [4] In a study published in 2007 by Agnes M. ... According to a 2003 study by Eliya Msiyaphazi Zulu and Gloria Chepngeno, although higher levels of education do correspond to greater knowledge about HIV/AIDS, education levels do not significantly impact the likelihood that couples will discuss HIV-related prevention strategies. [13] Economic impact [ edit ] Farmers with composting materials in Malawi A 2002 study conducted by CARE International across three districts in the Central Region of Malawi considers how HIV/AIDS has affected economic well-being in rural Malawi. [14] When skilled laborers are infected with HIV, they are usually unable to work; therefore, they often shift agricultural production on their land to less labor-intensive crops, sacrificing the opportunity to grow more profitable, labor-intensive crops such as tobacco . [15] When family members fall ill with HIV/AIDS, their relatives invest time in their treatment and care, further reducing household productivity. [14] In addition, when family members are infected with HIV, households often use the money they would normally invest in agriculture to cover medical expenses, further decreasing economic stability at the household level. [14] Finally, when adults contract HIV, their children often remain home from school to work in the fields, threatening long-term productivity and economic advancement in Malawi. [15] CARE International proposes several strategies that might reduce the destructive economic impact of HIV/AIDS on rural households . [14] They recommend introducing new technologies that improve productivity to allow households affected by HIV/AIDS to continue supporting themselves through agriculture. [14] Women in patrilineal / patrilocal villages are often unable to support themselves and their children when their husbands die of HIV/AIDS; therefore, helping women acquire traditionally masculine agricultural skills might decrease their vulnerability while improving agricultural productivity at the household and community levels. [14] CARE International recommends increasing cooperation at the community level by establishing labor and food banks in areas that have been devastated by the HIV/AIDS epidemic. [14] Finally, CARE International highlights the importance of increasing access to information about HIV/AIDS in Malawi to help families prepare for and cope with the economic burdens associated with the epidemic. [14] Impact on health services [ edit ] The HIV/AIDS epidemic in Malawi has been characterized by drastic declines in the number of health workers available to provide treatment and care and increasing strain on health services: more than half of all hospital admissions in Malawi are related to HIV/AIDS. [16] However, Malawi currently faces a significant deficit in human resources : only 159 doctors were practicing in Malawi in 2007. [17] The World Health Organization 's Essential Health Package recommends placing at least three health workers at every health facility in the country, but the vast majority of Malawi's health facilities fail to meet this standard. [17] While migration to more developed countries in search of better opportunities, also known as " brain drain ," is partially responsible for the shortage of health care workers in Malawi, many health care workers have been personally affected by the HIV/AIDS epidemic; in fact, an average of 48 nurses die of HIV/AIDS in Malawi every year. [1] The HIV/AIDS epidemic has resulted in high levels of absenteeism among health workers in Malawi, who often leave work to spend time with HIV-positive friends or relatives, and the Malawian government has failed to respond to the declining number of full-time employees working in the health sector. [16] Health workers who are not chronically absent frequently abandon their jobs because they are unable to cope with the heavy patient loads or because they are afraid that working in a medical environment will increase their risk of becoming infected with HIV. [16] Malawi has adopted task shifting strategies to overcome the shortage of workers available for HIV/AIDS treatment and care. [17] Task shifting, which has been successful in many other regions, involves training less specialized health workers to perform health-related tasks that do not require professional training, such as the initiation of antiretroviral therapy . [17] For example, at Thyolo District Hospital , health workers spend one week learning how to initiate antiretroviral therapy in a classroom setting and an additional two weeks practicing their knowledge in a supervised clinical setting; after completing this course, they are legally (under Ministry of Health guidelines) allowed to initiate antiretroviral therapy. [17] Another form of task shifting involves training health-oriented counselors in HIV testing and counseling , which relieves nurses of this additional task. [17] Interventions [ edit ] Malawi has taken many steps towards slowing the spread of HIV/AIDS, such as increasing access to condoms and improving testing services and treatment options. [1] Many of these efforts have been funded by international donors including the World Bank , the Global Fund , the World Health Organization , the President's Emergency Plan for AIDS Relief (PEPFAR), and the Joint United Nations Programme on HIV and AIDS (UNAIDS). [1] The World Bank has lent $407.9 million to Malawi, the Global Fund has agreed to give $390 million, and PEPFAR has donated $25 million for prevention and treatment campaigns. [1] Antiretroviral therapy [ edit ] The number of people using antiretroviral therapy in Malawi has increased dramatically in the past decade: between 2004 and 2011, an estimated 300,000 people gained access to antiretroviral treatment. [1] In addition to improving access to antiretroviral therapy, in 2008, Malawi introduced the World Health Organization 's treatment guidelines for antiretroviral therapy, which improved the quality of treatment available to Malawians. [1] However, Malawi's proposal for a new antiretroviral treatment plan in 2011, which would have cost $105 million per year, was rejected by the Global Fund , threatening Malawi's ability to continue expanding access to antiretroviral treatment. [1] In 2000, Malawi's Ministry of Health and Population began developing a plan to distribute antiretroviral drugs to the population, and, as of 2003, there were several sites providing antiretroviral drugs in Malawi. [16] The Lighthouse, a trust in Lilongwe that fights HIV/AIDS, provides antiretroviral drugs at a cost of 2,500 kwacha per month. [16] Queen Elizabeth Central Hospital in Blantyre provides antiretroviral therapy through its outpatient department, and Médecins Sans Frontières distributes antiretroviral drugs to patients for free in the Chiradzulu and Thyolo Districts. [16] Many different private providers sell antiretroviral drugs, particularly in cities; however, very few patients can afford to receive drugs from the private sector in Malawi. [16] In addition, private providers are not currently required to obtain certification before selling antiretroviral drugs, and, therefore, this practice is not closely monitored. [16] Finally, some employees receive access to antiretroviral drugs through the health insurance policies provided by their employers, but this practice is not widespread. [16] Due to the advent of antiretroviral drugs, HIV/AIDS has become a manageable disease for people who can access and afford treatment; however, antiretroviral therapy remains largely unaffordable and inaccessible to most people in Malawi. [16] For example, the South East region of Malawi has disproportionately low access to antiretroviral drugs. [1] In many rural areas, poor health infrastructure combined with widespread famine have made sustained, high-quality antiretroviral therapy difficult or impossible. [1] In addition, donations from the Global Fund to Fight AIDS, Tuberculosis, and Malaria were used to fund antiretroviral therapy programs that distributed medication on a "first-come, first-served" basis, making the drugs more accessible to the male, urban, educated population. [16] Because there are no explicit policies regarding the fair distribution of antiretroviral drugs in Malawi, individual health care workers often become responsible for deciding who will receive treatment, which inevitably leads to inequitable distribution. [16] Condom distribution [ edit ] Although condoms effectively prevent the sexual transmission of HIV, several factors have limited widespread condom distribution and uptake in Malawi. [1] People living in non-urban areas often have difficulty accessing condoms, and condoms are not typically available at bars and other social locations where they could have a significant impact on HIV prevention. [1] Many people oppose condoms because they believe that condoms make sex less enjoyable or because they question their ability to prevent the transmission of HIV. [1] However, despite these factors, many unmarried couples have started using condoms more consistently as concern and fear about the HIV/AIDS epidemic have increased. [4] Non-governmental organizations such as Population Services International (Malawi), an organization that strives to improve the health of Malawians, and Banja La Mtsogolo, an organization that distributes information and resources related to family planning , have conducted campaigns advertising condom use as an effective form of protection against HIV/AIDS. [1] Banja La Mtsogolo provides condoms to both men and women, and has significantly improved the availability of condoms for women in particular. [1] Because of efforts by Population Services International, Banja La Mtsogolo, and many other organizations, condoms have become more widely available to many people in Malawi. [1] Voluntary counseling and testing [ edit ] People living in areas with high rates of HIV/AIDS face several psychological barriers when deciding whether to undergo testing for HIV . [1] For example, people may prefer not to know if they are HIV-positive because, due to the obstacles they often face in gaining access to antiretroviral drugs, many view HIV/AIDS diagnoses as death sentences. [1] Others may simply believe that they are HIV-negative, either because they practice strict monogamy and consistently use condoms during sexual intercourse or because they are in denial about the prevalence of the disease. [1] However, despite these barriers, both mobile and static testing services have become more widely available in Malawi recently: 1,392 testing and counseling sites existed in 2011. [1] Certain non-governmental organization such as the Malawi AIDS Counseling and Resource Organisation (MACRO) provide door-to-door counseling and testing services, which have drastically improved the accessibility of HIV testing. [7] See also [ edit ] Malawi portal Viruses portal Sub-Saharan Africa HIV/AIDS in Africa Diseases of poverty Epidemiology of HIV/AIDS Misconceptions about HIV and AIDS AIDS orphan Healthcare in Malawi Sex for Fish References [ edit ] ^ a b c d e f g h i j k l m n o p q r s t u v w x y z aa ab ac ad ae af ag ah ai aj "HIV & AIDS in Malawi" . ... "The Impact of the HIV/AIDS Epidemic on the Education Sector in Sub-Saharan Africa: A Synthesis of the Findings and Recommendations of Three Country Studies (review)". ... Review of Agricultural Economics . 28 (3): 429–39. doi : 10.1111/j.1467-9353.2006.00309.x . ^ a b c d e f g h i j k l Kemp, Julia; Jean Marion Aitken; Sarah LeGrand; Biziwick Mwale (2003). "Equity in health sector responses to HIV/AIDS in Malawi".

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