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Background: Environmental exposures acting through different mechanisms have been linked with a number of cancers. Perfluoroalkyl chemicals (PFCs) are endocrine disrupting chemicals affecting estrogen homeostasis. Objectives: We examined the association between PFCs and a group of estrogen related cancers and explored if increased non-occupational exposure was associated with increased odds of developing these cancers. We also explored which of these chemical exposures was more correlated with each cancer. Methods: Using data from the National Health and Nutrition Examination Survey (NHANES), we selected participants ≥ 20 years of age. Our outcome variable was presence or absence of breast, prostate, ovarian and uterine cancer (yes/no); our exposure variables were serum PFCs. Logistic regression models were used in investigating the association between PFCs and cancer types and between quartiles of PFCs exposure concentrations and presence or absence of cancer while adjusting for covariates. Discriminant analysis was used to assess the correlation between individual PFCs compounds and individual cancer types. Results: PFCs were associated with increased odds of ovarian cancer; PFOA: 1.02(1.01, 1.02), PFOS: 1.01 (1.012, 1.013), PFHS 1.031 (1.030, 1.033), PFDE: 1.29(1.27, 1.30) and increased odds of breast cancer; PFOA: 1.089(1.089, 1.09), PFOS: 1.011(1.011, 1.011), PFNA: 1.031(1.030, 1.033), PFHS: 1.02 (1.02, 1.02), PFDE: 1.19(1.18, 1.19). PFCs were not associated with increased odds of prostate or uterine cancers. Comparing the odds in quartile 4 to quartile 1 for ovarian cancer, PFOA: 1.77(1.75,1.79), PFOS: 2.25(2.22, 2.28), PFHS: 1.86(1.84, 1.88), PFDE: 2.11(2.09, 2.14). For breast cancer, PFOA: 2.30(2.28, 2.31), PFOS: 1.47(1.46, 1.48), PFNA: 1.04(1.03, 1.05), PFHS:7.07(6.97,7.17), PFDE: 1.38(1.37, 1.39). PFOA was more correlated with breast cancer (0.7) and PFHS was more correlated with ovarian cancer (0.9). Discussion: PFCs were associated with increased odds of ovarian and breast cancers with a positive dose-response relationship. PFOA was more correlated with breast cancer and PFHS more with ovarian cancer.

Disease burden and lifestyle patterns have changed rapidly worldwide, especially in some Asian countries over the past 2 decades. However, cross-country comparative research is limited. This study investigated the nutritional status of preschool children and childbearing women in China, India, Nepal, and Pakistan selected based on their socioeconomic status, population size, and urbanization. Nationally representative data were used from the China National Nutrition and Health Surveillance Report, India National Family Health Survey, Nepal Demographic and Health Survey, Pakistan Demographic and Health Survey, the WHO repository, and the World Bank. The prevalence of underweight, overweight, and obesity and some ratios were compared. These rates varied across these 4 countries and were associated with their economic development levels. China's economic status and prevalence of childhood overweight/obesity (11.5%) were highest; India's economic status was higher than that of Nepal and Pakistan, but had higher rates of stunting, wasting, and underweight (38.4%, 21.0%, and 35.7%, respectively) in preschool children. Pakistan had the highest prevalence of overweight/obesity among childbearing women (52.4% in all, 63.0% in urban areas). Nepal had the lowest economic status and overweight/obesity rate in preschool children (1.2%). In general, the prevalence of overweight/obesity was higher in urban than in rural areas, except among childbearing women in China. Nutritional status and health burden are heavily influenced by economic development. The double burden of malnutrition poses prioritization challenges for policymakers and public health efforts. Prevention of obesity is urgently needed, at least in higher-income countries in Asia.

Objective: Adult women are disproportionately affected by overweight and obesity in Sub-Saharan African (SSA) countries. Existing evidence on the sociocultural context remains unconsolidated. In this qualitative research synthesis, we aggregate research literature on contextual factors that potentially predispose adult women and adolescent girls to overweight and obesity to inform research, policies and programs over the life course. Methods: PubMed, CINAHL, PsychInfo, ProQuest Central, EMBASE, and Web of Science were searched to locate qualitative research articles conducted in SSA countries beginning in the year 2000. After assessment for eligibility and critical appraisal, 17 studies were included in the synthesis. Textual data and quotes were synthesized using meta-aggregation methods proposed by the Joanna Briggs Institute. Results: The synthesized studies were conducted in South Africa, Ghana, Kenya and Botswana. The three overarching themes across these studies were body size and shape ideals, barriers to healthy eating, and barriers to physical activity, with cultural and social factors as cross-cutting influences within the major themes. Culturally, the supposedly ideal African woman was expected to be overweight or obese, and voluptuous, and this was associated with their identity. Although being overweight or obese was not acceptable to adolescent girls, they desired to be voluptuous. Healthy food choices among women and adolescent girls were hampered by several factors including affordability of nutritious foods and peer victimization. Both adult women and adolescent girls experienced ageism as a barrier to physical activity. Significance: This is the first qualitative research synthesis to amplify the voices of women and girls in SSA countries highlighting the challenges they face in maintaining a healthy body weight. Sociocultural, institutional and peer-related factors were powerful forces shaping body size preferences, food choices and participation in physical activity. Our study findings provide insights for the design of contextually appropriate obesity prevention interventions and lay the foundation for further research studies.

A systems theoretical analysis to capture the evolution and transition of the network systems supporting Ebola survivors and their affected communities, during the 2014-15 Ebola outbreak and recovery phases. The qualitative analysis includes a literature review, archival review, and interviews with representatives of key actors operating in strategic action fields. This paper uses a series of Diagrams that visually illustrate the various complex phases and their network changes that occurred and were established during the outbreak. This case analysis provides crucial phase information that both captures the historical events that informed the systems changes, including the development of the Ebola Survivors’ Support System (ESSS). Secondly, this analysis acts as, a model of understanding how disease support networks first emerge and can be better supported in other outbreaks.

Cervical cancer is the second most common cancer affecting women in developing countries and accounted for 84% of the global incidence of cervical cancer in 2012. Nicaragua is one country illustrating this disparity, with an annual cervical cancer mortality six times the U.S. rate. This may be explained by lack and poor utilization of effective screening programs, especially the Papanicolaou, or Pap, smear. This study resulted from a partnership formed by faculty and students from two U.S. universities and a Nicaraguan nonprofit organization to conduct projects to benefit a community in Nicaragua. To promote a free Pap smear program provided by the local clinic, a community-wide survey regarding Pap smear utilization was conducted with local health promotoras (promoters). Of 1,117 women, 78.4% reported ever having a Pap smear, of whom 11.1% had not received their results, while results were reported as normal by 78.9%, and abnormal by 10%. The most common reasons for not having a Pap smear were refusal to test, fear, and pain. Proportions of women who ever had a Pap smear varied by etapa (stage/neighborhood, p < .001). Findings are useful for policy development to improve the clinic’s screening services and encourage full utilization of Pap smears.

This article analyzes data collected from Liberian women afflicted by the Ebola virus disease, survivors of the virus and noninfected persons living in Ebola-affected homes. This research is one of the first statistical analyses examining factors diminishing quality of life: negative experiences, stigma, and psychosocial symptoms among females affected by the virus after the outbreak. The research presents a thorough literature review, including research related to other infectious diseases like HIV/AIDS, to inform the gap in studies on Ebola’s effects on quality of life. Women who are Ebola virus disease survivors demonstrate significant differences in stigma and psychosocial stress when compared to their female peers. This article attempts to broaden understanding of the conditions and mental health of women affected by Ebola.

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Childhood sexual abuse is represents a significant public health problem in the United States, as 21% of U.S. children experience sexual victimization prior to age 18. Research dedicated to preventing further sexual victimization has identified factors that influence the development of sexually abusive behavior. The abused-abuser hypothesis suggests that a prior history of sexual victimization may increase the risk of engaging in sexually abusive behavior among some victims. Some research has also investigated the relationship between characteristics of an individual's experiences of sexual abuse and the characteristics of their own sexually abusive behavior, but such research is scarce with inconsistent findings. For the present study, we first hypothesized that childhood sexual victimization is more prevalent among those who have engaged in sexually abusive behavior than those who have not. We also posited that among those who have engaged in sexually abusive behavior, their own sexual abuse experiences contribute to victim Page 188 2017 Appalachian Student Research Forum choice, the age at which they begin sexually abusing others, and the frequency of abuse. Our sample (N=529; 100% male; 84.7% Caucasian; M = 17.71) consisted of participants from two larger studies of university students with no known history of sexually abusive behavior (n = 286; 84.6% Caucasian; M = 20.18) and youth who have engaged in sexually abusive behaviors and received residential treatment in the Southeastern U.S (n = 243; 84.8% Caucasian; M =14.79). Data from university students were self-reported, while data from the residential youth were coded from archival records. Results of a chisquare analysis revealed that youth who have engaged in sexually abusive behavior were significantly more likely to have experienced childhood sexual abuse than non-sexual abusers,  2 (1, N=523) =210.788, p = .000. Additionally, within the sample of youth who have engaged in sexually abusive behavior, correlations were used to examine relationships between characteristics of their own sexual perpetrators and their victim choice. Results indicate being victimized by a male is significantly associated with having a male victim (r= .143, p=.033), being victimized by a relative is associated with sexually abusing a relative (r=.148, p=.024), and being victimized by a non-relative is associated with sexually abusing a non-relative (r=.194, p=.033). Findings thus far indicate that youth who have engaged in sexually abusive behavior have not only experienced greater sexual victimization than non-sexual abusers, but that the characteristics of their sexual perpetrators may relate to how they sexually abuse others, specifically with regard to victim choice. Additional analyses will examine whether these characteristics of sexual victimization influence the age of onset of their sexual offending and their number of arrests, sexual offenses, and victims. Future directions and limitations will also be explored.