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Sex, studies or strife? What to integrate in adolescent health services.
Keywords: adolescents and young people, sexual and reproductive health, mental health, violence, education, India
WITH the advent of HIV/AIDS and a recognition that sexual activity for many people begins in adolescence, there has been a growing interest in adolescent sexual and reproductive health, and a recognition that these concerns are not being adequately addressed in the existing health system. In India, adolescents aged 10-19 years constitute 21.4% of the total population. However, until recently this age group was "usually subsumed under the categories of either youth or children" and data about them were rarely disaggregated. (1) Whilst the needs of children and pregnant women have been acknowledged in national programmes, neither services nor research have focused on adolescents or their unique health and information needs. (2)
In recent years there has been a growing awareness of adolescent needs in India, particularly in the voluntary sector, and an increase in research on adolescent issues. This trend is reflected in a recent review of the literature which identified 23 studies in India between 1990 and 2000 that focused on adolescent reproductive and sexual health, (3) virtually all on knowledge, attitudes and behaviour. Eight used a combination of qualitative and survey methods, three used qualitative methods only and 12 used questionnaires only. Most of" them revealed a lack of in-depth awareness among adolescents of issues related to sexuality, sexual health-promoting behaviour and risky sexual behaviour. One study reported findings on substance abuse. None of the studies sought to link reproductive and sexual health issues with other issues of special concern to adolescents, such as the role of education, friends, parents and family, and psychosocial needs.
The first and second authors of this study work with the Sangath Society in Goa, India, a non-governmental organisation (NGO) providing multi-disciplinary clinical services for children and adolescents. Sangath's programmes extend beyond the clinic and include partnerships with schools, other NGOs and community-based research. We decided with a colleague working in mental health and health education to conduct research in Goa that would examine adolescent health from a broad developmental perspective. In addition to sexual and reproductive health, we wanted the research to explore the profound changes taking place among young people as they develop a self-identity and personality, in an environment in which educational attainment is stressed and in the context of considerable culture change.
Goa is one of the smallest states in India, with a population of just over 1.4 million people. (4) Although ruled by the Portuguese for over 400 years, the main languages of the state are Konkani and English, and about 30% of the population are Catholic. Goa boasts some of the best human development indicators in India. The median age at first marriage for girls in Goa is 23 (as compared to 16.4 for all-India) and the total fertility rate 1.77 (where all-India is 2.85). (5) Thus, in contrast to some Indian states, the vast majority of adolescents in Goa are not married.
On the basis of clinical and field experience at Sangath, we decided to explore the concerns of adolescents, including reproductive and sexual health, but also encompassing psychosocial issues, experience of violence, relationships with parents and education.
The research was carried out in two stages, using a research design that combined qualitative and quantitative methods. It was conducted amongst students of the XI Standard in Higher Secondary Schools in South Goa in 1999-2000. In the first stage, qualitative methods were used with adolescents to elicit data on their needs, and four schools participated. For the second stage, a cross-sectional survey of adolescent needs, eight schools participated, including the four who had participated in the first stage. Two of the schools were in Margao, a commercial city; the other six were located in the rural and suburban parts of South Goa. In order to be as representative as possible, we chose co-educational schools from both the private and public sectors, and schools which included a wide variety of educational courses.
In the first stage, three types of qualitative research methods were used: free-listing, focus group discussions (FGDs) and key informant interviews. A total of 60 girls and 60 boys were purposively chosen, i.e. as volunteers, and were asked to make lists of general problems, health problems and the questions that arise with regard to sex that adolescents face. Analysis of the free-lists revealed some common themes: studies (e.g. educational difficulties), stress (e.g. conflict with parents) and sexuality and reproductive health issues. These themes were explored further in FGDs (two in each school, one with girls and one with boys). Each FGD had six to eight students from the XI Standard. Next, five boys and four girls from the XII class who were recognised by their teachers as peer leaders were invited to be key informants. These interviews were mainly conducted to clarify some of the issues arising from the FGDs, for example premarital heterosexual relationships, homosexual relationships, types of limits set by parents, and sources and solutions for stress-related problems. We also asked for their input on the content and format of the cross-sectional survey, which formed the second phase of the study.
For the cross-sectional survey, we developed a draft questionnaire based on the information generated in the first stage, which we discussed with groups of adolescents and teachers to check validity and wording. Different versions were prepared for boys and girls, to take into account gender differences regarding sexual relationships and sex-specific issues such as menstrual health. Konkani translations of the draft questionnaire were prepared using translation-back-translation and consensus methods. (6,7) The draft questionnaire was piloted with 30 students and revisions made to the content and style. The questionnaires were then presented to principals of all participating schools, with a request to discuss with and obtain consent from their respective Parent-Teacher Associations. The questionnaire was modified once more to incorporate suggestions and comments from parents and principals. It covered:
* demographic information (age, sex, parental education);
* education (scores in tenth class board exams, difficulties faced with regard to school, career choices, difficulties in studies);
* health problems, common symptoms (e.g. headaches), frequency and kind of health-seeking behaviour;
* concerns regarding physical appearance (e.g. body weight, skin colour);
* questions about mental health based on the General Health Questionnaire, a 12-item questionnaire that has been used in Goa before and validated in a Konkani version, (8) covering symptoms and experiences related to concentration, sleep, decision-making ability, mood, thoughts that
life was not worth living, and substance use (tobacco, alcohol, cannabis, opiates);
* parental relationships (spending time with parents, arguments, restrictions);
* sexual knowledge (masturbation, pregnancy, contraception, homosexuality and menstruation) and sources of information on sex;
* sexual behaviour (kissing, fondling, penetrative oral, anal and vaginal sex, homosexual relationships, age at first penetrative sexual experience, age of partner and reasons for first sex);
* experiences of violence and abuse (physical, verbal and sexual, perpetrator).
A variety of question formats were used including single choice ratings (yes/no or true/false/not sure), multiple choice questions and some open-ended questions. For example, in the mental health section, each item is scored 0 (no symptom) or 1 (symptom experienced), and the total score (0-12) serves as an estimate of the mental health status of the respondent. The higher the score, the poorer the mental health status. In the validation study in Goa, scores over 5 suggested significant emotional distress. (8)
The survey was conducted during school hours in the eight schools. Students were seated, as if in an examination hall, to ensure confidentiality of responses. Members of the study team explained the purpose of the survey, and students were given the opportunity to leave the room if they did not want to participate and to ask the study team questions. All questionnaires were anonymous. Experienced professionals (psychologists and social workers) were present throughout the 90 minutes allotted for completing the questionnaire. If any student was unclear about a specific question, they could clarify it with one of the professionals present. The name and contact telephone numbers of professional counsellors working with the Sangath Society were provided on the questionnaire.
Analysis and findings
The free-lists were analysed using a spreadsheet; categorisation of responses was carried out by the first two authors and two research associates independently. The final category definitions were decided by consensus. FGD and key informant interview data were analysed manually using the categories identified following the free-lists. The transcripts were analysed by the first author, who allocated the narrative data of transcript material from each key informant/FGD to various categories. These were checked by the other two authors and discrepancies dealt with. Issues which recurred between subjects were of particular interest because of their potential for generalisability. A selection of verbatim statements arising from the qualitative data and proportions of respondents for particular categories are presented. Survey data were analysed using SPSS for Windows and are reported here where relevant.
Of the 812 students present on the day of the survey, 811 agreed to participate. The average age was 16 (range 14-21). Just over half (53%) were boys. About half were Christian (49%) and most of the remainder (46%) Hindu. Students from the two urban schools comprised 63% of the sample. More than half the fathers and mothers had completed high school. Thus, the majority belonged to literate families.
The results are organised around the three main themes that arose: sexuality (sources of information, sexual practice, knowledge and attitudes); studies (schooling and careers); and strife (relationship with parents, health complaints, abuse, sexual harassment and coercion). Findings arising from the quantitative and qualitative studies are integrated for each of these themes. The full study findings, which include rural-urban and sex-disaggregated data have been published as a report. (9) Detailed analyses pertaining to sexual violence and its correlates have been published elsewhere. (10)
In the free-listing, 85% of the boys and 73% of the girls had at least one question about the meaning and practice of sex, for example:
"What is sex?"
"How is sex done?"
48% of the boys and 70% of the girls had questions regarding changes which occur during adolescence:
"Why does one feel this way only after 15?"
"Why do thoughts of sex come to our mind at this age?"
"Why do young students get excited when they look at naked pictures in hooks?"
Almost half of boys and girls listed questions regarding values, the rightness of certain behaviours and whether it was appropriate at their age:
"Is kissing a bad thing to do at the age of 16? Is it healthy at this age?"
"Is sex a moral or immoral thing? What is the value of doing sex between boys and girls?"
Sex-related differences were apparent in some of the questions asked in the free-lists. Boys were more curious about sexual pleasure (18 boys vs. 2 girls):
"Is there any pleasure in sex?"
"What type of happiness does a boy get by having relations with a girl?"
"Is having sex really enjoyable?"
On the other hand, girls were more curious to learn about childbirth and pregnancy (27 girls vs. 5 boys):
"How is a baby born? How does it come out?"
Concerns regarding masturbation were frequent amongst boys:
"Is it true that masturbation is bad for one's health"
"Does masturbation have an effect on our minds and bodies at this stage?"
The lack of knowledge was reflected in the survey as well, where a large proportion of responses to statements on level of knowledge were "unsure". For example, although more than 95% of adolescents had heard about AIDS and nearly 90% could say that HIV caused AIDS, more than half the girls and almost a third of boys were unable to say whether using a condom could help to prevent HIV infection. A comparable lack of knowledge was shown on matters relating to pregnancy and puberty. For example, half the girls were unsure if condoms could prevent pregnancy or whether oral sex could lead to pregnancy. About 80% of adolescents were unsure whether masturbation could cause health problems.
In the focus group discussions, both boys and girls described older friends as the preferred source of information on sexual matters because they were perceived as being more knowledgeable (than parents or teachers). Boys said they also obtained information on sex from movies, magazines and blue films, while girls were more likely to obtain information on sex from television. Some of the questions during the free-listing centred around the authenticity of such information.
These findings were confirmed in the survey. The most common person from whom information regarding sex was obtained was a friend (72% of boys and 63% of girls). Mothers were the next most important person for girls (36%) while doctors were cited by 26% of boys. Fathers were a source for only 60% of boys and 2% of girls. Pornographic films were a source of information for 51% of boys and 14% of girls. Non-pornographic books were also cited as important sources of information on sex (41% of boys and 45% of girls).
Responses on attitudes towards sexual relationships showed a marked difference between boys and girls. For example, nearly half of boys agreed with the survey statement that "Sex before marriage is all right if you take care that the girl does not get pregnant". In contrast, only 21% of girls agreed that "Sex before marriage is all right if you take care not to get pregnant". 30% of boys and 40% of girls agreed that boys enjoyed sex more than girls. 11% of boys agreed that sexual attraction between boys was acceptable, and 17% of girls agreed that sexual attraction between girls was acceptable. Key informants and FGD findings suggested that sexual relationships in the XIth grade were less common than among senior college students, in part because of the fear of AIDS. However, some older boys (from the senior college) were known to have relations with sex workers.
In the cross-sectional survey, although one-third of boys and one-third of girls said they had a romantic heterosexual relationship, only 6% overall admitted they had ever engaged in vaginal intercourse (8% of boys and 3% of girls). Oral sex was reported by 5% of boys and 1.3% of girls, while anal sex was reported by 3% of boys and 1.6% of girls. Of the 57 adolescents who had experienced any form of penetrative sexual intercourse, 55% reported this was coercive while 39% reported that they had sex because they were in love with their partners. Adolescents who were sexually active were significantly more likely to have experienced a sexually abusive experience (see below; p< 0.001). The majority of sexually active adolescents had had only one sexual partner (30 of the 52 who answered this question). Two adolescent boys reported that their sexual relationship had led to a pregnancy. 11% of boys reported a sexual attraction to another boy; 6% had had a sexual relationship with another boy. The corresponding figures for girls were 5.5% for sexual attraction to another girl and 2% for a sexual relationship.
The majority of the students were satisfied with the choices of stream they had made in higher secondary education. However, educational difficulties were cited as problems by 55% of boys and 63% of girls in the free-listing so these were explored further in the FGD and key informant interviews. The most commonly cited concern was the pressure on them to do well in their exams. Other concerns were the lack of interest that some felt for their studies, having been forced to choose educational streams by their parents, or a poor school environment.
"Nowadays it is very difficult for students to reach their goals because you have to get a very high percentage." (Free list, girl)
"Education has become such a headache--it is a problem for the youth. Our elders want us to be something that is beyond each student's limitations." (FGD, boy)
Career concerns were also common, in particular the lack of adequate information regarding career choices, lack of choices in Goa, financial difficulties in pursuing some careers and conflict with parents regarding career choices.
"The students in the 11th class have just finished school and they don't know what to do with their lives ... Some kids may have parents who are doctors and engineers. The parents want them to follow in their footsteps, but they feel they are not smart enough ... there is a lot of confusion ... Some have the capability but they don't study and because of this later on there is stress, some are confused and because of the confusion they lose more time. Some want to study but they cannot. They are weak." (Key informant interview, boy)
These concerns were reflected in the survey findings where more than half the boys and girls reported difficulties in coping with their studies. The commonest reasons cited were difficulty in concentrating (75% of boys and 64% of girls) and having too much pressure put on them (44% of boys and 47% of girls). 71% of boys and 81% of girls expressed the need for career guidance that took their own interests into account rather than pressure to choose careers they were not interested in; most (60%) said their parents were their preferred source of support for career guidance.
Relationships with parents
In the free-listing, 55% of boys and 67% of girls described difficulties in their relationships with their parents as the most common concern under general problems faced by adolescents. Arguments or fights with parents appeared uncommon but these students, the girls especially, spoke of wanting their parents to be understanding:
"... not be too strict for we might end up hating them ... to have time for us ... They should explain to us as we cannot reason out like adults." (FGD, girl)
"... to be friends, counsellors and advisors." (FGD, girl)
"My parents think I am still a child and not capable of doing things alone." (FGD, girl)
Annoyance with being treated differently from their brothers was commonly voiced by the gifts (38% of girls reported this in the free-listing, as compared to 7% of boys who complained of being treated less favourably than their sisters). Girls appeared more likely to be restricted in talking to or going out with the opposite sex, and in the clothes they wore.
"Parents should not be partial in their treatment of boys and girls--they should treat us equally." (FGD, girl)
"If I go to a friend's place and I am late by just five minutes, my parents will phone to ask my friend where I am. Then they start questioning me like detectives: 'Where were you? Why are you late?' I have to explain everything ..." (FGD, girl)
Indeed, many girls said: "They should have faith in us." Culture change and the resulting conflict with parents was cited by some adolescents as a cause of conflict with parents, as illustrated by this key informant account:
"Parents want us to follow the traditions and culture that is acceptable. Traditional beliefs are not acceptable to most boys and girls ... what is acceptable is modern times ... fashion and western culture in terms of clothing and fast food ... because western culture is more developed than ours ... They have more money and power." (Key informant, boy)
In the survey, more than half the boys and gifts felt they were not able to talk freely to their fathers; on the other hand, 75% of both boys and girls were able to talk freely to their mothers. The commonest restrictions placed on adolescents by their parents were not coming home late (58% of both boys and gifts), not going out with the opposite sex (38% boys and 63% girls) and not watching TV (51% boys and 40% girls). The qualitative data suggest that one reason for these gender differences was parental concern about gifts going out with boys because of the perceived greater vulnerability (than boys) to sexual advances. However, 9% of boys and 13% of girls felt they had been neglected (not given adequate care) by their parents. Just over 10% of boys and gifts, with no significant gender differences, had been physically hurt (e.g. hit, slapped, kicked) by parents in the previous year, while 21% of boys and 32% of gifts said they had been verbally abused.
Health complaints and care seeking
Table 1 shows the common health complaints mentioned by boys and girls in the free-listing and the survey. Most were physical complaints, including sexual health complaints, but a large minority were regarding mental health, stress or physical appearance. Overall, apart from mental health and stress complaints, more girls registered complaints than boys.
In the survey, most adolescents said they were in good physical health; of the 532 who answered questions about all eight health complaints listed, 49% reported that none had occurred more than once a week in the past month. The commonest, i.e. those which had occurred more than once a week in the previous month, were tiredness, colds and sore throats, and headaches. Some 11% of boys complained of a discharge from their genitals, while 20% of gifts complained of a vaginal discharge and 58% of girls complained of menstrual pain. These complaints of vaginal discharge do not, however, signify the presence of sexually transmitted infections; Patel and Oomman argue that the complaint may be a culturally determined idiom for help-seeking for severe psychosocial adversity. (11)
Barring colds and sore throats, for which more than one in three adolescents in the survey took some form of medication or consulted a doctor, overall more than 80% of those with complaints did not consult anyone and there was no significant difference between boys and girls.
Almost 30% of boys and 40% of girls had scores of 5 or more on the General Health Questionnaire, indicating a broad range of emotional distress. (The questionnaire is a screening measure, however, and does not generate diagnoses.) More than one in four adolescents responded that they had felt life was not worth living in the previous month. This does not signify a suicidal thought (questions regarding specific suicidal thoughts were removed from the final questionnaire after concerns expressed by a school principal) but denotes feelings of hopelessness about the future. The causes of such feelings were attributed mainly to the stress of education and relationships with parents. Substance abuse was very uncommon among boys and practically non-existent among girls. By far the commonest substances used were alcohol and tobacco. 11% of boys had ever tried either; regular use of either was reported by less than 3%.
Concerns about appearance were quite common, including concerns about being under- or overweight. In the free-listing and FGDs, girls frequently described worries about acne, losing hair and too-dark skin colour as well, while boys worried most about acne, being underweight and too-dark skin colour. The most common concern for girls, however, was fear of loss of hair.
Abuse, sexual harassment and coercion
In the survey, about a third of the adolescents said they had experienced verbal abuse by other students, while 13% of boys and 5% of girls said they had been physically abused by other students in the previous 12 months.
Non-consensual sexual experiences, i.e. sexual abuse and harassment, were common for both boys and girls. A third of adolescents had experienced at least one of five different types of sexual harassment in the previous year, most commonly from another student. The most common forms of harassment were someone talking about sex in a manner which made the adolescent uncomfortable (23% of boys and 13% of girls) or someone forcefully brushing their sexual organs against the adolescent (11% of boys and 17% of girls). 13% of boys and 9% of girls had been touched without their permission and 10% of boys and 3% of gifts had been forced by someone to touch them. Approximately 6% of both boys and girls had experienced coercive sexual intercourse. (Questions on frequency or action taken were not asked.)
Of special concern is that those who were victims of sexual violence were more likely to have a poor relationship with parents, poor academic performance and worse mental health scores. (9)
The objectives of this project were to understand the needs and concerns of adolescent secondary school students as perceived by the adolescents themselves. The findings are not generalisable to out-of-school adolescents in Goa, nor to adolescents in other states in India where the age at marriage is earlier and school completion rates are lower. * However, we believe our findings may be useful for planning services for school-based adolescents not only in Goa but in other states of India where indicators such as those on literacy, total fertility rate and age at marriages (5) are improving as well.
Our findings provide an overall reassuring picture of positive experiences of adolescent development. The majority of adolescents were healthy except for minor complaints and not engaging in risky behaviours such as substance abuse or unprotected sexual intercourse. However, there are concerns which require attention. Many of them reported strained relationships with parents over restrictions placed on them, which were often gender-specific. Furthermore, rates of emotional distress, as estimated using a screening questionnaire, were high, with more than a third of students in the survey reporting a significant number of symptoms associated with stress. Studies were often also a source of stress because of high parental expectations. High rates of verbal and physical violence and sexual abuse were also reported, much of it happening within relationships with older boys and girls. Many adolescents also expressed concern about their appearance, and although this is not serious from a clinical perspective, it is clearly important to adolescents themselves. Products aimed at 'lightening' skin colour, reducing hair loss and increasing muscle strength are being heavily promoted in India, and seem to be causing unwarranted anxiety in young people.
Sexuality was a major focus of interest and concern among adolescents, and there was a great lack of knowledge about sexuality and sexual health, especially among girls, and recourse to inappropriate sources of information, especially among boys. These findings are consonant with virtually all studies on knowledge of reproductive and sexual health amongst adolescents in India. (3,13) However, sex and reproduction were by no means the only, or necessarily the principal, concern of adolescents. Indeed, parental communication and education were important priorities from their perspective. Adolescent concerns covered a broad range of issues which are intimately connected with their developmental and psychosocial needs: education, relationships with parents and peers. As Jejeebhoy has said, in many adolescent health programmes in schools in India, family life and sex education appear to be only remotely relevant to the concerns of young people, focusing as they do on biological and scientific information over broader issues of sexuality, and very few address the range of needs of adolescents, married or unmarried. (14)
We believe that for adolescent health services to be able to meet adolescent health needs, reproductive and sexual health will need to be integrated with the broader concerns of adolescents themselves as well, including:
* appropriate and relevant sex education;
* strategies for the avoidance and prevention of abuse and violence;
* stress management;
* guidance on how to study and career guidance;
* advice regarding common health problems and concerns about appearance;
* family counselling services for those living in dysfunctional family settings; and
* life skills training for dealing with peer relationships and difficulties encountered.
Rather than integrating adolescent services with adult or child health services, the focus on integration should be to ensure that all adolescent concerns can be dealt with under the same roof. Furthermore, services should be delivered in accessible settings where adolescents will feel comfortable, i.e. schools for school-going adolescents rather than clinics. These services must be designed to provide information, education and counselling in an atmosphere of confidentiality and trust. It is important to provide gender-sensitive information, preferably involving youth in designing and imparting information. It is essential to recognise that the majority of adolescents will continue to live with their own parents, and as the age at marriage rises in most countries, this will only increase. It is thus important to incorporate partnerships with parents to ensure that adolescent needs and concerns can be adequately addressed in a culturally sensitive manner. Creating a space for parents, teachers and adolescents to interact, catering for the needs of all of them, would be ideal.
Some adolescents will need individual help or guidance, e.g. with serious psychological problems, substance abuse or suicide management. Mental health problems have become one of the most visible, and serious, health problems confronting adolescents in developing countries. (15) Although feelings of hopelessness in the month prior to our study were expressed, they are likely to he transient in most adolescents. However, they may lead to more systematic suicidal thinking in vulnerable adolescents and those without adequate social support. Problems like these may need to be dealt with by skilled medical or mental health professionals. An integrated adolescent service should incorporate appropriate referral and follow-up for those who need it.
Models of comprehensive, school-based adolescent health programmes in developed and developing countries, include those that function on the rationale that a broad-based, health-promoting intervention is preferable to discrete programmes aimed at specific risk behaviours, e.g. in South Africa. (16) School-linked health centres in the USA provide comprehensive medical, reproductive health, mental health and health education services for adolescents. (17, 18) The World Health Organization Mental Health Programme has developed a model for life skills education in schools which helps to promote psychosocial skills in young people. (19) There is, however, little evaluation of the effectiveness of these interventions on risk behaviour outcomes.
Adolescence is a universal experience in the transition to adulthood, and a life stage with distinct physiological, sexual and psychological characteristics. (20) It is associated not only with sexual maturation but also with profound changes as part of psychosocial development. School and community influences begin to compete with the home environment as key factors in young people's lives. Broader community influences, such as the media, have an increasingly important effect on attitudes and behaviours. The settings in which adolescents live, learn, work, play and worship provide opportunities for them to strengthen both their sense of identity and their social, emotional and intellectual skills. Adolescent health programmes in developing countries need to acknowledge these diverse developmental needs and realities.
Pour que les services de santo pour adolescents soient integres avec succes darts le systeme de soins de sante, ils doivent satisfaire les besoins juges essentiels par les adolescents. Cet article decrit une etude visant a definir les besoins des adolescents darts des ecoles secondaires du deuxieme cycle a Goa, Inde, en 1999-2000. L'etude a commence par l'etablissement d'une liste de questions, puis des discussions par groupes d'interet et des entretiens approfondis ont cerne les domaines de preoccupation. Une enquete avec questionnaire a ete menee aupres de 811 etudiants. Les conclusions montrent qu'il existe un besoin insatisfait d'information sur la santo genesique, mais egalement un vaste besoin de soutien psychologique pour les questions de sante comme la violence dans les ecoles, les mauvais rapports avec les parents, les troubles en rapport avec le stress et les difficultes scolaires, que les adolescents jugent souvent primordiales. Integrer ces questions dans les programmes sera probablement un e1ement essentiel du developpement de services de santo atteignant la majorite des adolescents scolarises en Inde.
Si se pretende integrar los servicios de salud para adolescentes en el sistema de salud existente, dichos servicios habran de satisfacer las necesidades percibidas como sobresalientes por los adolescentes mismos. Este articulo describe un estudio dirigido a descubrir las necesidades de los adolescentes en las secundarias superiores en Goa, India, en 1999-2000. El estudio comenzo con listas abiertas, seguidas por grupos focales y entrevistas en profundidad para revelar las areas de interns. Luego, se aplico una encuesta auto-administrada a 811 estudiantes. Los resultados demuestran la existencia de una necesidad no satisfecha de informacion acerca de la salud sexual y reproductiva, pero tambien una necesidad de apoyo psicosocial para enfrentar problemas de salud que a menudo son percibidos por los adolescentes como los mils importantes, tales como la violencia en las escuelas, las malas relaciones con los padres, y malestares causados por la tension y las dificultades escolares. Se indica que la integracion de estos temas en los programas sea un elemento esencial al desarrollar servicios y programas de salud capaces de llegar a la mayoria de los adolescentes escolares en la India.
Table 1. Frequent health complaints of boys and girls in free-listing, four schools, and survey respondents, eight schools, Goa Type of complaint Complaints Complaints by boys by girls Free-listing Total Total complaints complaints (n = 124) (n = 185) Physical health complaints 47% 43% Mental health complaints 27% 20% and stress Appearance 13% 23% Sexual health complaints 13% 14% Survey respondents Total Total respondents respondents (n = 430) (n = 381) Physical health complaints --Tiredness 20% 26% --Cold and sore throat 14% 23% --Headaches 9% 16% Sexual health complaints --Menstrual pain -- 58% --Discharge 11% 20% Mental health complaints 30% 40% Appearance --Acne 50% 44% --Excess body hair 16% 62% --Unpleasant body odour 19% 23% --Fear of hair loss 16% 63% --Being overweight 9% 20% --Being underweight 29% 16% --Being too tall 11% 9% --Being too short 18% 31% --Skin too dark 28% 35%
Without the active support of the parents, teachers and adolescents of the schools that participated, this project would not have been possible. We are grateful to Dr Tereze Pierre, Nimisha Kamat and Joaquim Godinho for their participation in data collection and the whole Sangath team. We are also grateful to the Ford Foundation-funded NIMHANS Small Grants Programme for Research on Sexuality and Sexual Behaviour for supporting this project.
* We found no studies of out-of-school populations in Goa. Some studies of married adolescents, e.g. Barua and Kurz in the neighbouring state of Maharashtra, found that health-seeking behaviour of married adolescents was much higher than we found in unmarried adolescents, possibly related to fears of illness interfering with domestic work and fertility. (12)
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(15.) Eddleston M, Rezvi Sheriff MH, Hawton K. Deliberate self-harm in Sri Lanka: an overlooked tragedy in the developing world. BMJ 1998;317:133-35.
(16.) Flisher A, Brown A, Mukoma W. Intervening through the school system. In: Miller WR, Weisner C, editors. Changing Substance Abuse through Health and Social Systems. New York: Kluwer/Plenum Press, 2002. pp. 171-82.
(17.) Kaplan DW, Calonge BN, Guernsey BP, Hanrahan MB. Managed care and school-based health centres. Use of health services. Journal of Adolescent Health 1998;23:344-53.
(18.) Fothergill K, Ballard E. The school-linked health center: a promising model of community-based care for adolescents. Journal of Adolescent Health 1998;23:29-38.
(19.) World Health Organization. Life Skills Education in Schools. Geneva: Programme on Mental Health, WHO, 1997.
(20.) Dehne KL, Riedner G. Adolescence: a dynamic concept. Reproductive Health Matters 2001 ;9(17): 11-15.
Gracy Andrew, (1) Vikram Patel, (a,b) Jayashree Ramakrishna (c)
(a) Clinical Psychologist, Sangath Society for Child Development and Family Guidance Goa, India
(b) Senior Lecturer, London School of Hygiene and Tropical Medicine, UK, and Chairman, Sangath Society. E-mail: vikpat@goatelecomcom
(c) Additional Professor, National Institute for Mental Health and Neurosciences, Bangalore, India
Reader Opinion
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Dr. Sidney Mallenbaum, MD
Neurology, Carilion Clinic
- 3 Riverside Cir
Roanoke, VA 24016
- 1 Office Location
- Email a Friend
- (540) 725-1226
Dr. Sidney Mallenbaum has been practicing medicine for 28 years. Dr. Mallenbaum graduated from the University of North Carolina School of Medicine at Chapel Hill in 1986. He practices medicine in Roanoke, VA and specializes in Neurology. Dr. Mallenbaum is affiliated with Carilion Franklin Memorial Hospital and Carilion Clinic Roanoke Memorial Hospital.
Gender: Male
Years in Practice: 28 Years
Languages Spoken: English
Medical School: University of North Carolina School of Medicine at Chapel Hill
Graduation Date: 1986
Hospital Affiliations: Carilion Franklin Memorial Hospital, Carilion Clinic Roanoke Memorial Hospital
Specialties: Neurology
©2005-2014 WebMD, LLC. All rights reserved.
WebMD does not provide medical advice, diagnosis or treatment. See additional information.


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$1,442 1 bed Danbury CT
$1,442 1 bed
Danbury CT, Danbury, 06811
Commute to Downtown Danbury
1 bed
This apartment is in Danbury. Nearby parks include Main Street Historic District, Hatters Park and Main Street Park.
Hillcroft at Danbury has a Walk Score of 35 out of 100. This location is a Car-Dependent neighborhood so most errands require a car.
Nearby schools include Immanuel Lutheran School, St Joseph Elementary School and Morris Street School.
The closest grocery stores are Polla Supermarket, C-Town Supermarkets and Bombay Sweet & Spicey.
Nearby coffee shops include Dunkin' Donuts, Dunkin' Donuts and Mimundo Coffee Shop. There are six restaurants within a 15 minute walk including Bella Rose Pizzeria, Uncle Al's Cafe and El Rancho Foods.
Hillcroft at Danbury is near Western Connecticut State University, Hatters Park and Main Street Park.
A full kitchen with microwave, loft, comfortable air-conditioning, and cable TV hookup. Come home to Hillcroft at Danbury, the community is a short to Terrywile Park and conveniently located to I-84, I-684 and 7. Hillcroft at Danbury provides an easy commute to ANYWHERE! Come in and relax in one of our NEWLY RENOVATED and charming Studio, One, Two, or Three bedroom apartment homes. Our tranquil wood settings and NEWLY RENOVATED APARTMENTS provide you with the spacious, comfortable and private living settings that you deserve. Here at Hillcroft you can enjoy the benefits of exceptional management and maintenance, as well as an array of modern amenities and living spaces designed to comfortably fit your lifestyle. Call us today.. . Price range: $1442 - $1467
A Google User
Mar 25, 2011
!!! Horrible !!! we moved to hillcroft at danbury recently, i made a BIG mistake choosing this apartment. Noise neighbors if your living downstair forget it you cant have quit moment at all you cant get good sleep upstair you can hear walking steps of upstair neighbor. more worse part is office staff is not friendly at all they don't care anyting two lazy women. stay away from this place horrible horrible... wall will crack after a while. you may get a new carpet house but if u walk around u can here the cranking noise of the wooden floor. it is so so thin, if you drill a small nail it will come out from the other side of the wall. so if u r living in a lower level apartment good luck, i am having a terrible time.... i have no place to complain. though leasing office was friendly according to the first impression, oh now they don't want to give time to us or even worry about how v r living in these cages. they will show you one aprtment and give a photocopy map nicly marked, but then u get the lease agreement appartment has changed. and they will not even mention to you unless u ask them. gym and da laundry is a big joke. laundry washing is $1, but you can not see your cloths get wet with water, heating is $1 but you have to do more than twice. better off going outside... oh ay home washer and dryer, if it is a combo, better off growing potato in it.. .
A Google User
Apr 04, 2009
Here is my story , I was looking forward to rent 1BR (300 off deal) in HillCroft since April 1st week but looks like the leasing office staff was trying to avoid us move in, we requested to see two 1 BR apartements but finally both were rented. I was in touch with leasing office since 1 week, finally it was very frustrating experience, goodluck for future residents!!
A Google User
May 28, 2012
Nice place to live
A Google User
Jan 01, 2011
Owner/manager tools | Report bad listing | From 4RentInNewYork.com
Danbury, Connecticut, 06811
Most errands require a car.
Score Details
Explore how far you can travel by car, bus, bike and foot from Hillcroft at Danbury.
View all Danbury apartments on a map.
Popular apartment searches include fireplace, hardwood floor and pool. View all Danbury apartments and rentals.
Hillcroft at Danbury is in the city of Danbury, CT. Danbury has an average Walk Score of 36 and has 80,893 residents.Learn More About Danbury


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Where a 3 year old was resisting a rest.
ponderosa46 66-70, M 4 Answers 1 Jun 10 in Parenting & Family
yes, cost taxpayers $15,000 dollars
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That's funny. I had to read this twice to get the gist of the post. Really good play on words.
Best Answer
Best Answer
I always thought that a cute play on words.
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Montana Headlines for June 18, 2014
The final Ravalli County Treasurer's report is released, snow shuts down a mountain pass, and a man is charged with stealing a motorcycle and hitting a child in the head are just a few of today's headlines.
The final Ravalli County Treasurer's report is released, snow shuts down a mountain pass, and a man is charged with stealing a motorcycle and hitting a child in the head are just a few of today's headlines.
MISSOULA, Mont. (AP) — A twin-engine airplane plane crashed and caught fire in the parking lot of a western Montana ski area, killing the pilot.
HELENA, Mont. (AP) — A 16-year-old Browning boy was killed and a 16-year-old girl was injured in a pickup rollover on BIA Route 1 near Browning.
HELENA, Mont. (AP) — The Lewis and Clark County sheriff's office is more prepared to respond to emergencies on three major Helena-area lakes this summer
Kenyon Noble is having their annual Home Show this Saturday, June 21 from 10 am - 2 pm. It's FREE fun for the whole family at the Bozeman Kenyon Noble location!
Stephanie Quayle, Nashville's newest rising country star and Bozeman native, is returning home to participate in her first Celebrity Mounted Shoot - The Bozeman Ford and American Bank "Shoot Against Cancer" on June 27 - 29.
It's Montana's gift to all the dads and grandpas: FREE fishing for all over Father's Day weekend, June 14 - 15.
In Bozeman, Belgrade and Three Forks, ALL kids and teens 18 and under can now enjoy a FREE, healthy lunch!
This Saturday, June 14, bring the kids to Kenyon Noble in Bozeman, Belgrade or Livingston so they can build dad a special Junior Carpenter Father's Day multi-purpose box!
MISSOULA, Mont. (AP) — Missoula authorities plan a crackdown on uncontrolled dogs in a popular hiking area after three attacks on sheep the city relies on to graze down noxious weeds.
HELENA, Mont. (AP) — A Montana man convicted in the beating death of a high school classmate will learn whether he gets another shot at freedom after 30 years of protesting his innocence.
BOZEMAN, Mont. (AP) — A Wilsall man sentenced to 40 years in prison for escaping from a Bozeman pre-release center and holding his former foster mother hostage has been denied a new trial.


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Crowded Kitchen Players will hold auditions for its production of "A Flea in Her Ear" at 8 p.m. Monday at McCoole's Arts & Events Place in Quakertown, as well as at 8 p.m. July 10 at Crowded Kitchen in Allentown.
The Georges Feydeau farce follows numerous and frantic husbands, wives and wanna-be paramours as they stalk one another in a Parisian mansion and through the halls and bedchambers of a notorious hotel.
The director is looking for nine men and five women ages 20 and older.
All roles are open and those who audition will be asked to perform cold readings from the script. Also needed are a stage manager, set builders and box-office volunteers.
The show opens Sept. 27 and runs through Oct. 13 at McCoole's.
McCoole's is at 10 S. Main St.; Crowded Kitchen is at 1680 Minesite Road.
For more information and directions: 610-395-7176; www.ckplayers.com; email email@example.com.


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We'll be continuing to meet Thursdays to learn traditional folk music from Ukraine and to sing together in the "village style". We are an open group, so anybody can join and anybody can bring a song to share (non-Ukrainian is okay! :) …. We'll be mostly working on seasonal songs, soon gearing up to Koliada (winter cycle of caroling).
Bring a snack, your song book and your vocal chords!
Shevchenko Museum- 1614 Bloor St. W very close to Dundas West station- limited parking available in back, and lots of parking along Bloor St.
Check our facebook group Kosa Kolektiv for the latest updates on cancellations or changes.
See you there!


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Short Sellers' Trading on Anomalies
Byoung-Hyoun Hwang
Cornell University - Dyson School of Applied Economics and Management; Korea University - Department of Finance
Baixiao Liu
Florida State University
September 30, 2014
This paper investigates the extent to which short sellers trade on anomalies and how these trades affect their profitability. Our evidence suggests that short sellers consider anomaly strategies, in particular those that have high Sharpe Ratios and low correlations with other anomaly strategies. Anomaly-based short selling contributes substantially to short sellers' profitability. In particular, our analysis implies that a 1% increase in anomaly-based short interest precedes 0.626% lower returns in the next month. A corresponding 1% increase in short interest that is not anomaly-based is associated with (only) 0.083% lower returns. In total, we estimate that at least 11.7% of short sellers' profitability can be traced to their trading on anomalies.
Number of Pages in PDF File: 43
Keywords: Short Sellers, Anomalies, Profitability
JEL Classification: G11, G12, G14, M41working papers series
Date posted: August 30, 2012 ; Last revised: October 1, 2014
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Positioning Microsoft Development Technologies for Custom Application Development
The approach for every type of application ("A single architecture/approach to rule them all") won't work. The Microsoft development stack and .NET are extremely flexible and offer many possibilities, but you have to select specific approaches and technologies depending on what kind of application or even subsystem you are going to build. Each application will […]
Sharing C# Across Windows, Android and iOS
1.4 Million new Android devices are activated every day. 500 Million iOS devices sold. You can target all of them today from your existing C# skills and code using MvvmCross. MvvmCross is a Mvvm Platform for Xamarin.iOS, Xamarin.Android, WindowsPhone, WindowsStore, WPF and Mac. It includes databinding support for Android XML, for iOS XIBs and for […]
Hack Yourself First and Other Security Tips
This interview with a Microsoft Developer Security MVP takes you through some of the most important security aspects of the web and what web developers should be thinking about when developing. It discusses strategies and implementation details that should be considered to make sure your web app is as secure as it can be.
One ASP.NET: A New Unified Project System for Web Developers
The introduction of One ASP.NET in Visual Studio 2013 enables developers to combine Web Forms, MVC, Web API and other ASP.NET project templates together in a single project. This video shows you how the new approach works, how it integrates with a new security wizard and what MVC scaffolding can now do, once a Visual […]
Discovering Type Providers in F# 3.0
Have you ever needed to access a data source in your application? Trick question! Are there developers who would answer no to that question? Of course not! Learn how quick and easy data access can be with F#'s new Type Providers. This presentation covers connecting to several different data sources using the relevant type providers, […]
Fast .NET Development using Dependency Injection, Code First EF, and SOLID Design
Creating robust decoupled programs using C# and Visual Studio 2012 has never been easier. The biggest problem is getting an overview that mere mortals can understand. The next problem is getting practical example code that can be applied to real problems.


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Centers for Medicare and Medicaid Services (CMS) has issued a proposed rule that would remove the reporting
exclusion that now exists for payments to medical speakers at continuing
medical education (CME) events. CMS said the exclusion, which is granted... Click Here To Read More
Democratic House members and more than 30 of their House colleagues have
launched a new Congressional caucus to press for the expansion of Medicaid
benefits in all 50 states.
Frank Johnson (D-GA) and Rep. G.K Butterfield (D-NC), the two co-chairs of the
caucus, said the group will rely on op-eds, floor speeches, social... Click Here To Read More
Alison Riddle-Fletcher, President of the National Dental Association (NDA),
died following a battle with cancer on July 1 at the age of 55. Dr. Riddle-Fletcher—who practiced in Baltimore
with her husband, Dr. Nathan Fletcher—was a third-generation dentist.
Riddle-Fletcher, who received her Doctor of Dental Surgery degree... Click Here To Read More
school faculty members or administrators who want to interface with members of Congress on issues
of importance to oral health are encouraged to apply for the ADEA/Sunstar
Americas, Inc./Harry W. Bruce, Jr. Legislative Fellowship. The fellow
selected spends three months in Washington, D.C., working on issues... Click Here To Read More
Americas, Inc./Jack Bresch Student Legislative Internship is a
six-week, stipend-supported internship in the Advocacy and Governmental Relations (ADEA AGR) portfolio of the ADEA Policy Center in Washington, D.C.
This student legislative internship provides a unique learning experience... Click Here To Read More
For those interested in following the
congressional proceedings, please access the U.S. House or Senate by way of the
following links:
are selected funding opportunities that might be of interest. You can search
for additional federal government funding opportunities at grants.gov.
Hospitals Graduate Medical Education (CHGME) Payment ProgramHealth
Resources & Services... Click Here To Read More
The Senate Appropriations Subcommittee on Labor, Health and Human Services
met in June to markup the Fiscal Year 2015 HHS appropriations bill. The full Appropriations Committee was scheduled to take up the bill on June 12, but that markup... Click Here To Read More
On June 11, 2014, Sen. Jay Rockefeller (D-WV) introduced S.
2461, the "Children's Health Insurance Program Extension Act of 2014." Unless
funding for the Children's Health Insurance Program is extended, the program
will... Click Here To Read More
The Senate Finance Committee, a key congressional body charged with
implementing health care reform, is requesting input to improve health care
data transparency from a wide variety of stakeholders.
In a June 12, 2014 ... Click Here To Read More


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What Handwriting Supposedly Says About You
Before You Try Botox, Read This First
21 Plastic Surgery Disasters
27 Russian Dating Site Members You Don't Want to Mail Order
15 DIY Projects for Your Man Cave
16 People Fortunately Saved from Their Horrible Tattoos
Think She's Cute? Just You Wait!
You'll Always Wear a Life Jacket After This
22 Maniacs Who Took It Too Far
Meet the Husband and Wife Who Look Like Identical Twins
50 Incredible Pictures That Might Teach You Something
Hot Women Of The World Cup
Hippo vs Crocodile Standoff: 7 Crazy Pics
Oh Great, Another 'Human Barbie'
Guy Rents Out Girlfriend to Raise Money for New iPhone 6
The 10 Largest Ships Ever Built
The First Stealth Helicopter in America
Brazilian 'Amazon Model' Gets Paid Big Bucks to Squash People
The 30 Most Embarrassing Halloween Mug Shot Photos of All-Time
Doctors Inject HIV Into Dying Girl: You'll Be Glad They Did
25 Things You Probably Google When You're All Alone
10 Most Devastating Disasters On The Planet
43 of The Most Magnificent Photobombs Ever Captured
10 Amazing Colorized Historical Photos
27 Perfectly Timed Disaster Photos
The Coolest Animal You've Never Heard Of
46 Perfectly Timed Photos You'll Have to Look Twice to Understand.
What Perfect Beauty Looks Like Around the World
Have You Ever Looked Inside A Navy SEAL Armory?
4 King Cobras Guard a Sleeping Baby and It's Terrifying


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Urban Gardening & Ecology Blog
Composting in the Classroom
Fall is the perfect time to start a classroom compost bin! On Tuesday, August 23, the NYC Compost Project in Brooklyn is offering the workshop Worm Composting in the Classroom. Teachers will learn how to set up and maintain an indoor worm bin, and have the opportunity to purchase a pound of worms and a bin to assemble on
Greenest Block in Brooklyn 2011 Winners
On Wednesday, August 3, the winners of the 17th Annual Greenest Block in Brooklyn contest were announced. The coveted first prize in the residential category was presented to East 25th Street between Clarendon Road and Avenue D. First place in the commercial category went to Atlantic Avenue between Bond Street and Nevins
Judging Brooklyn's Blocks
On a recent hot and sunny Thursday morning, I climbed into BBG's hybrid SUV armed with a ream of score sheets, a native flora handbook, and a sharp pencil. It was my first time as a staff judge in the Garden's Greenest Block in Brooklyn contest! My three judging teammates—a GreenBridge staff member, a
Greenest Block 2011 Gets Under Way
With a grand total of 36 residential semifinalists, whittled down from 188 original entrants, the first round of judging is now over for the 2011 Greenest Block in Brooklyn competition! GreenBridge program manager Nina Browne assures us that "the competition is fierce" this year. To view the semifinalists, visit Greenest
Gothamist Gardening Help
This week, BBG's Native Flora Garden curator Uli Lorimer weighed in on gothamist.com's new green thumb series giving his advice on native plants to grow in sun and shade in backyards around NYC. Some of the plants he suggests for shady backyards include ferns, snakeroot, and goldenrod. To see the full list of Uli's
BUGs Go Places
After a successful training program last fall, the very first class of certified Brooklyn Urban Gardeners (BUGs) is making a difference to community greening efforts throughout Brooklyn. "BUG gave me the tools, knowledge, and confidence to revitalize a community garden," reports Erik Rosenberg, a certified BUG


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The Perseid meteor shower ended last night, a fact that probably escaped most citizens of Miami. As city dwellers, we have to contend with the omnipresence of electricity, an invention that is anathema to star gazing. In order to take advantage of the once-a-year phenomenon, Riptide had to travel fa ... More >>
To read past installments of ¿Que Pasa, M.I.A?, click here. Trying to make a New Year's resolution stick is like trying to get all your friends to call you by a self-appointed nickname. (Dudes, bro, from now on call me Shatterstar. ) This year, I'm gonna buckle down and really stick to my res ... More >>
The singer, dancer, and lover starts '09 with his own New Times column.
The week's basically in full swing with several national shows today and tonight, so get moving. -- Arielle Castillo *If this is the first you're hearing about it, it may be too late for you to get to the Rockstar Mayhem Fest today at the Cruzan Amphitheatre in West Palm Beach... But just in case, ... More >>


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DailyFreeGames.com is the largest source of the best free online games including action games, arcade games, dress up games, girls games, puzzle games, racing games.


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Now that it's been on seen on television, magazines, streets, and Macklemore, the slicked back undercut has made it's way to the big screen as Brad Pitt's Fury hairstyle. This haircut is sometimes referred to as a Hitler youth or Nazi style but in Fury, it's the look for Nazi-fighting.Check out the photos below for more about how to get the look.This simple hairstyle makes a ... Get the hairstyle!
Slicked Back Hair
Want to look super cool? Check out all these classic slicked back hair looks.
Celebrity Men's Formal Hairstyles 2014
With school formals, holiday parties, and winter weddings on the horizon, it's time to think about how to style hair to match the suit or tuxedo you'll be wearing. Guys with short haircuts can style hair as usual but with medium length locks, you have options.If you're already rocking the slick look, you're all set but if you want to try something different, check out these men's formal ... Get the hairstyle!
Men's Short Hairstyles for Thick Hair 2014
These men's short hairstyles for thick hair 2014 are stylish and on trend cuts that also manage locks that can get unruly. All of these haircuts are versions of the latest styles with sides and back kept short and length on top. Layers and texturizing ensure that thick hair is easy to style.Check out these 3 pictures of short slick looks that are perfect for men with thick ... Get the hairstyle!
Best Hairstyles for Men 2014: 3 Different Slick Looks
Slick hair, hipster hair, the combover, or whatever you want to call it has been one of the most popular hairstyles for men of 2014 and 2013 too. It's easy to see why. These polished, flattering, and easy to style looks are one of the best hairstyles for men 2014.If you're looking for an update of the classic Don Draper 'do that never fails to impress, check out these 3 different ... Get the hairstyle!
10 of the Latest Hairstyles for Men 2014
Most of the latest men's hairstyle trends have vintage roots with a modern twist. There so many different combinations of slick hair, undercuts, and fades that create a range of unique looks. Check out these pictures for 10 of the latest hairstyles for men 2014 fresh from barbershops across Instagram. If you like one of these crispy cuts, don't worry about the terminology and just show ... Get the hairstyle!
The NYC Streets Style 2014 by Melodie Jeng
There are plenty of ways to find the latest looks. There's websites like this, magazines, then there's the street. In addition to our readers, there are plenty of dapper guys out there leading the way with men's hair and fashion, especially in style centers like New York, Paris, and Tokyo. Check out some of 2014's hottest looks for summer as seen on Melodie Jeng's The NYC Streets photo ... Get the hairstyle!
Best Hairstyles for Round Faces for Men
Choosing the best haircut isn't just about scoping out latest trends and picking your favorite. In addition to being on the forefront of fashion, barbers and stylists personalize every cut to work with your hair type and flatter your face shape. Some faces are longer, wider, more angular, and rounder and there's a cut to suit every one of them by minimizing certain features ... Get the hairstyle!
1950s Hairstyles for Men
Long before the fictional Don Draper hit the scene, there were plenty of retro style icons. The 1950s was a transformative time with the emergence or rock and roll, popularity of jazz, and Golden Age of Television (and before smoking was bad for you). Today we still look to 50s stars James Dean, Marlon Brando, and Cary Grant for inspiration.With the popularity of slick styles ... Get the hairstyle!
Soccer Hairstyles: The Best of the World Cup 2014
From David Beckham's always changing hair to Zinedine Zidane's signature shaved dome, soccer players are known for their bold and unique hairstyles (and that's not to mention Pavel Nedved, Kevin Keegan, and Andrés Guardado). The tradition continues in the 2014 World Cup with a range of fashion forward and stylish looks that look great and perform on and off the field. Check out this gallery for ... Get the hairstyle!
Top Hairstyles for Men 2014: Celebrities Rocking the Side Part
If we've learned anything from Mad Men, it's about the sartorial impact of a pocket square and the powerful definition of a side part. With the resurgence of slick hairstyles and especially the comb over, a groomed part is one of the top hairstyles for men in 2014.If you're not headed to a red carpet event, the side part can still be a part of everyday hairstyles. With an undercut, ... Get the hairstyle!


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Maybelline New York - Color Sensational Lip Color
Maybelline New York
Color Sensational Lip Color
- Overall rating:
Maybelline New York Color Sensational Lip Color features fresh and classic colours with an innovative formula that combines crystal-pure undiluted pigments to provide superior colour. A patented polymer seal keeps coverage light and smooth and leaves lips looking richly hued and multi dimensional. Other ingredients include honey, emollient waxes and vitamin E that moisturise. Available in Are You Red-dy, Barely Brown, Born With It, Coral Crush, Coral Fever, Coral Fire, Coral Pop, Crazy for Coffee, Fatal Red, Fifth Ave Fuchsia, Fuchsia Fever, Hooked On Pink, Let Me Pink, Make Me Pink, Mandarine Fuzz, Nearly There, On The Mauve, Party Pink, Pinkalicious, Pink Me Up, Pink & Proper, Pink Peony, Pink Satin, Pink Sand, Pink Wink, Pink Quartz, Plum Perfect, Red Revival, Rum Riche, Summer Sunset, Totally Toffee, Warm Latte and Warm Me Up.
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Consumer Hotline:
For stockists, please call 1300 369 327
Web site:
beautyheaven awards five loyalty points for each review we publish on our site. Both positive and negative reviews are published. Each review must be your own words and clearly demonstrate your experience of the product. Read our reviewing guidelines here.
Rating: Oct 22, 2014 1:13am
Best lippie ever
I really loved this lipstick. I have it in 530 Fatal Red and its the perfect 'red lipstick'. It comes in an attractive casing. The lipstick has a pleasant slightly coconut-ey scent (this could be my imagination) and stays on without leaving your lips feeling dry. It is nourishing and very easy to apply.
Read the full review of Color Sensational Lip Color by MelissaFay89.
Rating: Oct 15, 2014 7:22pm
Great lasting colour
This is a great product and well priced. I have this lipstick in 075 Let Me Pink &205 Nearly There. One is a nude pink and the other is a nude brown. The packaging is not very sturdy. The lip can come off easily, so I don't feel comfortable with this in my handbag. They have a slight harsh scent, which I don't like. But it doesn't bother me enough for me to stop using the lipsticks. The texture is creamy and easily applied. The wear is quite good and will last for a few hours without needing any touch ups.
Read the full review of Color Sensational Lip Color by Pep Peppa.
Rating: Oct 10, 2014 8:15pm
I don't regret buying it
I was feeling quite unsure about the colour I bought. The mandarin fizz 410 I'm pretty sure. I wanted to experiment with this brown/gold lipstick. But once I tried it on, with the hint of glitter on the lips with the colour it was gorgeous. It looks natural yet sophisicated and flirty. It's a great colour for fall/autumn or a night out with the girls. The smell of this lipstick is amazing! Smells like honey!
Read the full review of Color Sensational Lip Color by junejenny.
Rating: Oct 5, 2014 11:16am
Best in Beauty 2014 - Pigmented lipsticks
When I first heard of the Maybelline New York Colour Sensational Lip Colour range and had a look at the vast array of shades separated into pinks, nudes/browns, plums/mauves, reds/corals I was transfixed. The shades were all eye catching and bright, not dull or ordinary. The problem I was facing was trying to decide what would be the first shade I would purchase. I am a huge fan of a nude natural mouth in the evening to pair with a smokey eye, so I decided to settle on the shade Pink Peony which is a natural, soft nude pink which is close to two shades lighter than my natural lip colour and Born With It. There are 48 captivating shades to choose from so there is something for everyone, and every look you are attempting to create.
The packaging of the lipstick is ultra stylish. Each of the four colour ranges are packaged the same but differ with the lid that corresponds to the group, so a pink lipstick will have a pink lid for easy identification which is convenient. The lipstick upon application is extremely hydrating on the lips, it has a very smooth formulation and the colour glides on very easily. The lipstick has a slightly moist finish that reminds me of MAC lustre finish lipsticks and adds a wonderful sheen to the lip area. It is interesting to know that the lipsticks in the range actually come in different finishes, some are quite frosty, some have a pearly finish such as born with it, and some have a cream finish like pink peony. For this reason I suggest trying the shades out before purchasing them. The pigmentation and colour pay off of these lipsticks are fantastic, the colours are very rich and intense which is due to the crystal-pure undiluted pigments which are used in these lipsticks. I cannot stress enough how wonderful the formulation of these lipsticks are, they are so creamy and smooth which is done by including nourishing honey nectar, emollient waxes and vitamin E in the lipsticks. They always left my lips feeling soft and moisturised, and throughout the day I did not feel my lips becoming dry.
Another bonus of these lipsticks were that they actually had great staying power which was surprising as they are very creamy in texture. I did not need to touch up nearly as much as I usually do, and I think it is the infused waxes in the lipstick which help make the lipstick long wearing. The lipstick does not feather or bleed into the lips over time, and is hydrating enough to be worn alone without the use of a lip balm underneath or a lip pencil. The lipstick bullet allows for easy, precise application and allows you to get into the inner corners of the mouth with the tip. With an affordable price tag of $16.95, amazing range of colours, a creamy formulation that sets itself aside from other lipsticks on the market, this is definitely a lipstick range which I will continue to purchase from.
Read the full review of Color Sensational Lip Color by aleksandra.
Rating: Oct 2, 2014 10:18am
Incredible pigmentation
To be honest I did not expect much from this lipstick when I first bought it. I was on a quest to find a lipstick that would be as similar in colour to my all time favourite L'Oreal Color Riche in 371 Pink Passion ( unfortunately not available in Australia) as possible.
Maybelline Color Sensational in 910 SHOCKING CORAL does a pretty good job at it, being just slightly more pink but it is fine for me.
The packaging is very funky and elegant at the same time. The silver tube has got a lovely transparent vibrant coral cap. The lipstick smells very subtly of vanilla and something sweet in general. The fragrance of the product is not very overpowering.
What is the most surprising factor of the lipstick is its pigmentation! It is truly divine and one swipe on your lips is enough to create a full coverage look. The application is like a dream. The COLOR SENSATIONAL is easily applied straight from the bullet or using the lipbrush. I can't complain about the formula either as it is extremely creamy.
The finish is pretty shiny, not matte or satin at all. Very fresh and juicy. I feel very comfortable wearing this lipstick, not only doesn't it dry my lips out, it also stays put there for a very long time. The longevity of the product is definitely its asset too. In my opinion one doesn't need necessarily a lipliner with this lipstick. It does not feather, it does not "bleed". I really like it.
What is also very significant for me is the fact that it leaves a lovely satin on the lips and disappears evenly. I appreciate these factors very much. I have got several other picks in this category but will not be disappointed if Color Sensational wins BEST in BEAUTY 2014 in lipstick category. I highly recommend.
Read the full review of Color Sensational Lip Color by Anita1502.
Rating: Sep 29, 2014 12:54am
Best in Beauty 2014 - My Absolute Favourite!
The Color Sensational range is my absolute favourite and I have got almost every colour of this range. Great quality! The formula is reach and creamy. The colours are true to what you see and absolutely pigmented. The texture is soft, glides smoothly and keeps the lips moisturised. The colour doesn't feather and stays for a good amount of time.
Smells pleasant and the packaging is great.
I use this range regularly and it wont be wrong to say that these lipsticks are my all time favourite!
Read the full review of Color Sensational Lip Color by Ssajwani.
Rating: Sep 23, 2014 10:15am
Best in Beauty 2014!
One of the best lipsticks I've tried up to date! This lipstick in the shade, 045 Pink Me Up is one of my favourite pinky-nude lipsticks that would complement any makeup look, either a natural or smokey look and its the versatility which I love about it! The formula is extremely creamy and smooth, doesn't cling to dry patches on my lips and applies so perfectly. The packaging is very classy too, a pinkish-purple cap and silver ballet which rivals many high-end lipstick packaging. It lasts fairly well on my lips, a few hours before needing to be reapplied. The scent is absolutely heavenly too, a beautiful sweet creamy vanilla scent that is mouthwatering and reminds me slightly of the Mac lipsticks! It is suffice to say that this lipstick is one of my holy grails, I can just whip it out whenever I need a little pick-me-up and it never fails to impress me! Amazing quality, affordable price and amazing an absolute godsend! Definitely deserves the Best in Beauty award!
Read the full review of Color Sensational Lip Color by xochristii98.
Rating: Jul 22, 2014 8:56am
My go to... Everytime
I bought, 'Born with it', Code: 015; 20KN00 and I am in LOVE! I love the colour, its perfect for work and everyday use. I was on the hunt for a nude with a bit of colour for a while to find something I can wear with everything and wasn't too intense (I like the more natural look) and this is it. My only problem is there isn't enough of it! It wont be staying on once you eat cause of the colour it is but other than that it does last a few hours. I highly recommend this.
Read the full review of Color Sensational Lip Color by Daneed.
Rating: May 17, 2014 8:23am
Keep going back
Let me preface this by saying I have a love/hate relationship with lipstick. I love the look of it but generally find it really drying on my lips. I am not a big spender on lip products for this reason but time and again I keep coming back to this product. I have about ten different shades - they keep offering up awesome on trend colour and the price is just right especially when so many retailers offer 50% off every couple of weeks. The formulation is non drying. True it won't stay on all day but I eat and drink a lot and that's probably why. I reapply maybe three times a day and I'm happy with that. When it does come off it comes off evenly which is a big plus - I hate when lipstick comes off all patchy yuck!
Read the full review of Color Sensational Lip Color by Amanda936.
Rating: Apr 26, 2014 4:39pm
Pros and Cons
I have this lipstick in two shades. I find the price right and the shade selection phenomenal... but that is all. The formula is subpar. Its wearable but definitely not the most comfortable. One shade I have in Born With It has shimmer. As the lipstick wears, I find it leaves behind chunky pieces of shimmer and glitter. The other shade I have is Shocking Coral which is a lovely shade and a cream finish. It is highly pigmented but still not comfortable on the lips.
Read the full review of Color Sensational Lip Color by Carrie144.
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When Brendan Met Trudy (Stolen Nights) (2001)
Critics Consensus: The references to other films are rather overdone, and the direction is uneven.
Critics Consensus: The references to other films are rather overdone, and the direction is uneven.
Movie InfoBrendan (Peter McDonald) is an anal retentive teacher and film buff. One night he goes to a pub and meets Trudy (Flora Montgomery), an outgoing, lively woman who is his complete and utter opposite. Against all odds, Brendan asks her out, and although their first date is disastrous, they gradually form an unlikely relationship. But Brendan is hesitant to completely trust Trudy; not only does she go out at all hours of the night, there are also news reports of a woman in a black balaclava who has been castrating local men. Naturally, Brendan's already festering suspicion takes little time to explode into a paranoid frenzy, and hijinks ensue. … More
- Rating:
- PG (adult situations)
- Genre:
- Drama , Romance , Comedy
- Directed By:
- Kieron Walsh , Kieron J. Walsh
- Written By:
- Roddy Doyle
- In Theaters:
- Mar 9, 2001 Wide
- Runtime:
Peter McDonald
as Brendan
Flora Montgomery
as Trudy
Marie Mullen
as Mother
Pauline McLynn
as Nuala
Don Wycherley
as Niall
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Critic Reviews for When Brendan Met Trudy (Stolen Nights)
All Critics (71) | Top Critics (26) | Fresh (38) | Rotten (24)
Getting all the film references means you have to be a bit of a film buff yourself, but it's not essential to the enjoyment of this lighthearted satire.
Doyle should have spent more time on the story and less time in the video store searching for inspiration.
It feels churlish to complain about its borrowings from other films. But it feels insubstantial and redundant.
One of the smarter, more likable attempts at neo-screwball comedy to hit the screen in a while.
Being 'on' all the time is no easy task for an actor. But [Montgomery] makes it look natural.
The whole thing plays out a bit like an episode of Dream On, where film references are used in lieu of original thoughts or dialogue. The impact is, of course, directly correlated to whether or not you get what films are being referenced.
Not as formulaic as American-made romantic comedies, rent this one and pour yourself a Guinness.
...it will be remembered by true movie lovers a little better than it saccharine-coated competitors.
The type of film that begs to be called 'charming' and by doing so instead ends up grating.
If When Brendan Met Trudy suffers from anything, it's too much charm.
Maybe the film is only cotton candy, but as empty calories go, it's satisfying enough.
This unusual romance works brilliantly thanks to a terrific turn from McDonald and a career-making one from Montgomery.
About 15 minutes into the picture, the story takes a sharp left turn, never to return to normality. Having the rug pulled out from under you has rarely been so much fun.
Charming but awkward ode to the travails along the path to true romance.
An infectiously acerbic romantic comedy with liberal doses of pop culture and media satire thrown in for good measure.
Unfortunately, when he finds himself, apparently by convincing Trudy to come back to him, the film slides into sharp decline. In a screwball comedy, the man's turn -- to embrace girlish shenanigans and such -- is the end.
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Breaking Bad Finds New Life as a Comedy
Who would have thought that when Breaking Bad ended, it would live on as a sitcom. Well, sort of. Over the weekend, the Internet gave us two news videos which reveal that, not only... read more
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23rd Oct: It's time for the second TV Tropes Halloween Avatar Contest, theme: cute monsters! Details and voting here.
main index
"From coast to coast and around the globe, the greatest wrestlers in the world bring you the greatest wrestling in the world... that's the AWA!"The American Wrestling Association (AWA) was an American professional wrestling promotion based in Minneapolis, Minnesota that ran from 1960 to 1991.You can find the basics about the company's history at The Other Wiki.
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