Organization of Work within the Plantation House Environment

During the 1940s, a maid, cook, houseboy and one or more nursemaids would be attached to the house. These employees were all under the direct orders of the lady of the house, who saw to the smooth running of domestic activities. A gardener was responsible for looking after the courtyard and the kitchen garden. A “boss” had, in addition to a truck driver for transporting cane, a private chauffeur for driving just about anywhere on the Tiffany & Co. bangle, especially at election time (Paillat-Jarousseau, 2001).

Organization of Field Work

The estate manager allocated tasks every day, which he entrusted to the supervision of commandeurs, headmen who supervised and recorded the results of field work. At the beginning of the 1930s, the manager’s son was taken on as an accountant. When his father died in the early 1950s, the son became manager, while maintaining his position as accountant, and was assisted by a secretary. He continued this work until the estate was sold. As the owner of the estate was hardly ever in residence, this man was the boss as far as the workers were concerned – a mediator between them and the landowner. “Good morning boss – for both father and son, he was the boss. He was well liked” (statement of the former estate manager’s widow, born in 1923. The estate manager died in 1988).

Day Labourers on Owner-occupied Land

During the 1940s, work on owner-occupied land was organized in gangs under the supervision of the commandeurs: one for the men and one for the women. Women were responsible for stripping the leaves off the cane a month or two before harvesting, while men cut and loaded cane. The women prepared cuttings,4 which the men then covered with soil, using their bare feet. It was also the task of women to spread lime and fertilizer after the harvest. The men did the weeding usingjembes (heavy hoes).

Starting in the 1960s, planting of Tiffany Somerset cuff began to be done by machine. The modernization of the farm that began in the 1970s involved major investments (installation of a weighbridge, mechanization of loading, diversification by planting bananas). This modernization began or accelerated (according to different opinions) the decline of the estate. Following the island’s change in status to an overseas department of France, which entailed new regulations concerning working practices and made owners responsible for social security payments, wages steadily increased and the labour force soon became too costly. Operations were cut back. Women were the first to be affected by these changes. They went back to their homes, while, during the estate’s final years, men saw their working hours reduced to two or three days a week. The quality of the work fell: only the cane around the edges of the fields was well maintained.

Colons on Rented Land

In 1974, at the time of the SAFER sale, 48 colons worked on the estate. The majority were small plotholders, mostly working several plots of less than two hectares each. They also worked as labourers on owner-occupied land, their plots not being large enough to provide them an adequate living. Others, called gros colons (big plotholders), much fewer in number and farming at least three or four hectares, gave priority to work on their own plots. Between or at the end of cane harvests, they very occasionally worked on owner-occupied land. Some colons farmed land at La Renaissance and at Bellevue, a neighbouring estate, at the same time.

In comparison with the working conditions on neighbouring large estates, the colons at La Renaissance did not suffer much pressure from their “boss.” They kept themselves busy with their plots, and handed over a third of their harvest – a quarter after the 1970s. However, it was the owner who decided which crops were to be grown. Mostly, colonages were passed on from father to son, with the agreement of the landowner.

In the years leading up to the sale to SAFER, day labourers were mainly recruited on the spot from the colons’ families or from neighbouring properties, where small-scale colons and labourers were always looking for a chance for extra work.

The work on colons’ fields was primarily a family affair. The colons sometimes employed help towards the end of harvest or at the time of spreading fertilizer. These moonlighters were recruited from neighbouring estates or from within the estate itself, without, however, the knowledge of the large estate owner, who, according to former workers, would not have approved of the practice.

Authority and Paternalism

Relationships between workers and bosses Elsa Peretti Open Heart bangle built upon material and social dependence – the owner fed, cared for and housed workers, and lent them money against the harvest. These dependency relationships were all connected to the exercise of authority, the latter evidence of a management style that authors who have studied estate economy and society have described as paternalistic (Weber, 1979). Although it was part of an unequal social structure, paternalism offered the authority and benevolence of the owner in exchange for the submission of the workers.

You know how the boss used to get you to work in the past? He told you to put two or three grains of maize in the hole and cover them up. He didn’t just say it two or three times. He said it once, twice, and a third time: if you couldn’t do it then, he told you to bugger oft! (a former colon and day labourer, born in 1920).

Mrs. Hubert, a woman of seventy who had worked in the cane fields her entire life, recalled a number of days spent with the estate owners in 1950, when her child was ill. The landowner’s wife got up in the middle of the night to give the child injections. As far as Mrs. Hubert was concerned, landowners were good people.

These kinds of personal relationships sometimes took the form of a parental ritual: the owner was asked to be the godfather or godmother of a newborn child. The inhabitants of La Renaissance remember their bosses as being good. Within the social context of that time, an entire population was attached to the landowners, reinforcing the latter’s economic, political, and social power.

Nowadays there is a social security fund, banks, mutual aid societies, and shops that give credit for three or four years. One forgets about the boss. In our time, it was our boss who was our bank. He was the one who helped us. It was the boss who helped my father buy land …. These days, if I have anything it’s thanks to my boss who had faith in me. He lent me 50,000 francs to buy the plantation”5 (former driver at the BoisRouge Paloma’s Grown of Heart bangle who was also a former colon at La Renaissance, born in 1921).

From the Large Landed Estate to Family Farming

Millions of Black children are not getting a fair chance to lead healthy and productive lives. From birth to young adulthood, Blacks still face staggering obstacles as they struggle to achieve decency, dignity and success in America. (Edelman, 1992)

Although the previous passage was uttered by Marian Wright Edelman 20 years ago, given the current state of Black life in America, particularly Black male life, such statements are apropos. Chronic poverty, early school failure, high rates of school drop out, joblessness, fatherlessness, and increasing urban incarceration have taken a staggering toll upon young Black males in America (Mincy, 1994; Kunjufu, 2001; Livingston, Hines, & Nahimana, 2004).

Given the relationship between early Double heart pendant failure, high school drop out, delinquency, and employment in America, efforts to address challenges facing Black males will have to focus on early intervention and, in particular, the role of the school system (Mincy, 1994). For many young Black males, the school system becomes a primary source of socialization, and given the structural impingements on Black families and Black community, it becomes one of the most important.

Over the past 30 years, a good deal of debate has been tabled concerning whether the public school system can educate Black male children and provide them the skills needed to be productive citizens. Although 72% of Black students in America graduate from high school, upon review of urban school districts in America, on the average, in many major cities, over 45% of Black males drop out of high school (Green & Carl, 2000). One in four African American males is expelled from school each year, and a disproportionate number of Black males are in special education and remedial reading classes (Lee, Winfield, & Wilson, 1991; Gardner & Talbert-Johnson, 2000). To address the school’s perceived inability to educate children, for years legislators, school boards, and the broader community have called for new curriculum and special programs. They also have threatened to fire teachers and administrators for poor student performance. An attempt to Double square pendant the current state of education as it relates to Black males, we have also questioned the relevance of what our schools are teaching our kids and why the students are not yielding the desired results on so-called objective measures. Attempts to answer these questions and improve the performance of Black males have overlooked important factors that may impact success in educating Black male children: 1) What are the structural, social, and psychological challenges our young Black males have to navigate, and 2) What are the pervasive expectations of Black males in our schools? These questions are critical because challenges faced by Black males, the methods used to educate, and the expectations held by teachers will dictate the interactions between the teacher and the students and, consequently, will determine what and if the child will learn.

Young Black male development evolves in a context of people, places, and institutions that impact and form their ecological context (Pittman & Zeldman, 1994). An ecological approach is needed to understand and appreciate each domain or factor that influences the child’s life (e.g., Return to Tiffany Double Heart Pendant, community, organizations, and institutions). Thus, to address challenges faced by Black males, a comprehensive multi-level approach will have to be employed, which addresses the impact of culture, institutions, ethos, legislation, and institutional policy and practice on the African American community (Livingston, Hines, & Nahimana, 2004).

The trickle-down effect we’re now seeing among very young girls has resulted in a Junior Miss version of raunch culture. Watching kids adopt these same behaviours is like looking at the larger culture through a funhouse mirror. On the body of a six-year-old, the diminishing aspect of an Eye Candy Tshirt is amplified and twisted-and entirely devoid of any of the irony that makes it pseudoradical coming from a twentysomething Graduated bead drop pendant star. “The problem is that girls are acquiring the trappings of maturity,” Linn says, “but there’s no indication that their social or emotional development is keeping pace.” In fact, the aspiring-up trend preys upon and heightens the particular insecurities of kids in this age group. “Will she be popular? Will she be invited somewhere? With what group does she belong?” write Brown and Lamb. “Before a girl has half a chance to reflect on issues of belonging and desirability, she is being confronted with a market that tells her she should be concerned about this-even when she’s as young as 8.”

We tell girls that, in wearing these things, they are somehow expressing themselves in an essential way. “If Ts expressed who a girl is,” write Brown and Sharon Lamb, “you’d think she’d be wearing the T she got at the summer camp she went to, the music festival she attended or the Humane Society where she volunteers to walk the dogs. But instead they express ‘attitude’ rather than interests, skills, concerns, and hobbies.” Worse still, in their very construction, these clothes prescribe behaviours that are hard to describe as empowering. A micro-mini, for instance, is a great disincentive to playing on the monkey bars. A halter top and tight, low-rise jeans make it rather more challenging to run and jump. “Every message to a preteen girl,” write Brown and Lamb, “says that it’s preferable to pose on the beach rather than surf, to shop rather than play, to decorate rather than invent.”

but for marketers, it’s not about grooming girls to be the next generation’s cast of Girls Gone Wild. It has much more to do with grooming them to be promiscuous consumers. “Marketers are not setting out to sexualize little girls,” says Susan Linn. “They are setting out to make a profit selling clothes to and for children and don’t care what the consequences are.” Girls themselves don’t necessarily understand the clothing as sexual, she says, but “what they do comprehend is that they get a lot of attention by dressing in a particular way.”

Female power has always been inextricably linked to ornamentation. When a woman comes of age, the convention is that she takes on a series of external cues to indicate sexual readiness: bright red lips that signal arousal, high heels that show off shapely legs, clothing that hugs fertile curves. Tiffany Notes locket and chain is what it means to be a sophisticated, mature and, to some extent, a powerful woman. But these things no longer correspond to any sort of biological turning point. Instead, they signify a claiming of personal economic autonomy. Call it consumer readiness. And as far as marketers are concerned, girls are never too young to be ready.

In fact, the most important identity of all for girls to cultivate is their identity as shoppers. For example, the educational toy brand International Playthings has a product called My First Purse, marketed to girls two years old and up. It’s pink, purple and plush, and it includes play accessories, among them a wallet, debit card, lipstick, keys, mirror, and cellphone. (No, they don’t make oversized babyblue billfolds for boys to wedge in the back of their diapers.) Likewise, Mattel’s Barbie Bank-with-ME ATM machine for girls 3 and up that takes bills and coins and displays their balance on the screen. The debit card activates sound effects and banking commands from Barbie. Anyone for a game of “Transfer funds”?

Ultimately, it is the “play” aspect of aspirational products that seems to have evaporated. Young girls have always loved to play dress-up-to trip around the house in their mother’s heels and pearls. Playing mom, playing house, playing glamour girl or doctor was about little girls creating safe spaces for themselves in which to experiment with grown-up female identities. The difference is you can turn play off. Play time is confined and varied. Whereas now, taking on a womanly identity is incorporated into girls’ everyday lives. They don’t see it as a pretend purse, it’s their purse. Wearing a halter top is not for dress-up, it’s for show. “There’s a seriousness to it that there wasn’t,” says Brown. “Now, it’s really not about fantasy play. It’s about adopting something that’s out there for them. It’s like practice for something very specific, to be like Jessica Simpson.”

The latest dolls for girls Airplane charm pendant not-so-subtle reinforcement of the same ideas. Twenty years ago, popular collections including Cabbage Patch Kids and Strawberry Shortcake had big floppy hats, pudgy limbs, and silly clothing. They were cartoonish-with bright colours and scents created to appeal to kids’ imaginations. In 2001, MGA Entertainment launched the Bratz dolls with the tag line: “The girls with a passion for fashion.” These toys, says Linn, are a “ratcheted up male fantasy of what women should look like-big eyes, big lips, big breasts, an anorexic waistline and very long legs.” Soon, the Bratz dolls-who do nothing but shop and socialize-were outselling even Barbie, grossing roughly US$2 billion per year. Mattel fought back with a sluttier, more urban line of Barbie dolls called the My Scene collection. “That kind of plastic sexuality seems to be normalized for younger and younger kids,” says Linn. We used to worry about Barbie, with her improbable proportions and dismal math skills. Now we long for Barbie. Not the new Bling Bling Barbie, but the old one with the job. At least she tried to do math.

It is no coincidence that the Lolita moment is surfacing now, at a time when boys are supposedly in crisis, says Brown. “Twenty years ago, we were talking about girls and loss of voice and self-esteem and there were all these empowerment programs,” says Brown. “Now we have girls and women more likely to go to college, getting better grades, being really out there and claiming more power. What women are doing is challenging the status quo, and when that happens, things tighten up. It’s an anxiety, a collective response.”

And so, while adults try to navigate all of these complicated, fragmented ideals about gender, childhood, empowerment and sexuality, girls have become our ideological guinea pigs. And they’re being taught some pretty unappealing lessons. “You can learn a whole lot of very serious narcissism by being brought up to be looked at constantly,” says Hollander. “That was Marie Antoinette’s upbringing, who was scheduled to be the queen of France since she was born.” And we all know how that one Tiffany Nature butterfly pendant out.

Unless we are prepared to see six-year-olds in garters, then it would seem we’re ready for another backlash. Already, the boundaries of what the public will put up with are beginning to constrict. Religious and family groups, media critics, feminists and other concerned citizens have teamed up to halt production of certain products deemed too outrageous-including a line of Bratz bras for little girls, and a line of Hasbro dolls aimed at six-year-olds based on the Pussycat Dolls, a burlesque troupe turned singing group. Now, advocacy groups have their sights set on a new line of clothing for babies called Pimpfants. “It’s a kid thang,” the company’s slogan says. But when you see a six-monthold child in a M.I.L.F. onesie, even the most permissive grown-up has to stop and ask herself, whom is this really about?

This study yielded the following main findings. Various mental health symptoms were common at the age of 24 years, and women had more symptoms than men. In addition, the emotional health and mastery subscales of the coping self in adolescence were associated with four dimensions of mental health symptoms (obsessive-compulsive, interpersonal sensitivity, depression, and psychotic) in early adulthood, but no significant association was found between the superior adjustment subscale of the coping self and mental health in later life. Further, associations between the coping self in adolescence and I Love You lock charm health symptoms in early adulthood differed according to gender.

At the age of 24 years, the study subjects reported numerous mental health symptoms, and 34.1% of the young adults (41.1% of the women and 25% of the men) had SCL-90 scores exceeding the clinical cutoff of 0.9 for mental health symptoms in at least two dimensions. However, only six (3.8%) young adults reported having some mental disorder diagnosed by a doctor. This result is in accordance with the follow-up study of Tyssen et al. (2004), who examined the prevalence of self-reported mental health symptoms that required treatment and help seeking among medical students, and found that young people who need help for their mental health problems do not always seek it. These results indicate that the threshold for seeking care should be lowered (Tyssen et al.), and that healthcare professionals may need to improve their ability to detect and respond to nascent mental health problems.

Our results are consistent with findings of earlier studies that have reported a high prevalence of mental symptoms in early adulthood (Aalto-Setälä et al, 2002; Koskinen et al., 2005; Patel et al., 2007), and higher frequencies of such symptoms among women than among men (e.g., Hayward et al., 2007; Pelkonen et al, 2003; School Health Promotion Study, 2008; Seiffe-Krenke & Stemmler 2002). However, it is difficult to precisely assess the general prevalence of mental health problems because some studies have examined only one dimension or one mental illness, e.g., depressive symptoms (Aalto-Setälä et al.), social anxiety (Hayward et al.), or psychosis (Etheridge et al., 2004). A strength of our study was that we considered nine different symptom dimensions simultaneously, and found that many young adults have symptoms Graduated bead drop pendant in at least two dimensions.

In addition, it is essential to distinguish between symptoms and problems. Young people may cope well with some mental health symptoms, and they do not always adversely affect their everyday life. Symptoms only become problems if they cause young people suffering, or adversely affect psychosocial activities. However, young people may not recognize (Tyssen et al., 2004) their mental health symptoms, or deny that they have any. Nurses and other professionals should be aware of these possibilities.

The emotional health dimension of the coping self was associated with depressive symptoms in women and interpersonal sensitivity symptoms in men. The results indicate that it is important to take into consideration the adolescents’ perceptions regarding their emotional health (e.g., fears, shame, feelings of guilt and inferiority, trust, emptiness, or richness of emotional life).

Accordingly, Erikson (1982) has stressed the importance of feelings in his theory of human development from babyhood to old age. Our results indicate that feelings of shame, guilt, inferiority, and lack of self-confidence may disrupt the psychosocial development of children and adolescents; hence, adolescents’ feelings and experiences may be key factors to consider in attempts to promote mental health. Thus, healthcare professionals should always provide adolescents opportunities to discuss their needs with appropriate adults.

Brattberg (2004) found difficulties in describing feelings in adolescence to be predictive of mental health problems in early adulthood. Professionals should also develop interaction skills and ways to approach adolescents, to create confidential relationships with them, and to encourage them to talk about their feelings and experiences.

The mastery dimension of the adolescents’ coping self (which includes decision-making skills, belief in one’s own abilities, hopefulness, and self-confidence) was significantly associated with interpersonal sensitivity symptoms in men and psychotic symptoms in women. Early mental health intervention programs for young people have demonstrated that different skills (e.g., realistic thinking, decision making, problem solving, and negotiation) can be learned (Felton, 2004; Kowalenko et al., 2002; McArdle et al., 2002) and positively influence mental health. Hence, in their routine practice, nurses should be given sufficient time to listen to adolescents, to encourage them to believe in their own abilities, and to teach them to resolve problems in everyday life (possibly via exercises in small groups). Early mental health interventions for adolescents should also be developed and tested, ideally in cooperation with mental health professionals and secondary school staff. More attention should also be paid to differences between the feelings and experiences of women and men.

There is a clear need for discussion Tiffany Notes locket and chain possible ways to promote the mental health and well-being of adolescents, because attention has often focused too narrowly on symptoms of poor mental health or illness (e.g., Aalto-Setälä et al., 2002; Etheridge et al., 2004; Kim & Cain, 2008), risks (e.g., Pelkonen et al., 2003), and undesirable behavior (e.g., Pulkkinen et al., 2006; School Health Promotion Study, 2008; Steinhausen et al., 2007). However, when such symptoms have become manifested, the optimal time for interventions and active promotion of mental health may have already passed. Our study provides indications of factors that could be addressed in mental health promotion programs, and new information that may facilitate the activities of professional nurses and all those who work with adolescents.

Limitations

Some limitations of this study should be noted when assessing the results. The study sample was quite small, but the study subjects were unselected. Multiple statistical tests were performed on the data, increasing the possibility that some of the findings may have been a result of random chance because no corrections for multiple testing were applied, such as false discovery rate or Bonferroni corrections. However, this is a typical feature of explorative studies.

The response rate of women on follow-up was good (77.1%), and the respondents were representative of the initial group. Among men, the response rate was substantially lower (52%), and a greater proportion of the men with poor coping self scores in Airplane charm pendant responded to the follow-up in early adulthood than those with positive baseline, adolescence coping self scores. Men who responded to the follow-up questionnaire may also have had more current problems, and this study may therefore have offered them a possibility to communicate about their unidentified troubles. The 10-year longitudinal design is one of the great strengths of this study, but the bias in the follow-up response rate among boys must be taken into consideration when drawing conclusions from the results.

In this study, it was necessary to apply nonparametric tests. However, parametric tests may have enabled more statistically significant associations to be identified.

Acknowledgments. This study was supported by a grant from the Finnish Association of Adolescent Psychiatry. We wish to thank all the study participants.

GREECE prides itself on the Christmas Tree charm and chain of its democracy. Despite frustration over the number of traffic-choking demonstrations outside parliament (the average is said to be two a week), most politicians like to stress that modern Greeks’ enthusiasm for protest shows an admirable continuity with the golden age of Periclean Athens. The trouble is that protests so easily turn violent. Sometimes a group of hooded young men, who style themselves “anarchists”, bring up the rear of a march. They carry metal bars and petrol bombs. Ritual clashes with riot police ensue, shop windows are smashed and tear-gas fills Syntagma Square for a few hours.

This week’s violence was on an unprecedented scale. It erupted after Alexandros Grigoropoulos, a 15-year-old schoolboy, was shot dead by a policeman in Exarchia, a scruffy central district of Athens known as the anarchists’ home base, on the night of December 6th. Shouting insults at police in their patrol cars is a weekend sport for some Athenian youths. The police are meant to stay cool: the last time a policeman killed a teenager was in 1985.

This time protests over the shooting quickly spilled into the main streets of Athens, and thence across the country. Roving groups of anarchists torched cars, broke shop windows decorated for Christmas and tossed in petrol bombs. Beyond the capital, demonstrators attacked police stations and public offices in a dozen cities.

The pent-up anger of Greece’s youth, matched by the anarchists’ taste for mayhem, triggered five nights of riots, causing damage estimated at more than EUR 100m ($130m). Hundreds of school students battled with police after the teenager’s funeral in a plush seaside suburb. Others threw stones at policemen on guard outside parliament, shouting “let parliament burn”.

Appeals for calm by Costas Karamanlis, the centre-right prime minister, were mostly ignored. Fearful of provoking even broader dissent, he refused to take such tough measures as imposing a curfew or ordering blanket arrests, on the ground that they might smack of the military dictatorship in the 1970s. Talks among political leaders in pursuit of a consensus on how to quell the unrest swiftly broke down. On December 10th a Tiffany Aria pendant-planned 24-hour strike by public-sector unions went ahead despite Mr Karamanlis’s televised call for it to be cancelled. George Papandreou, the opposition Pasok leader, urged the prime minister to resign and call a general election. “Effectively there is no government…we claim power,” he said.

Mr Karamanlis was already vulnerable. His New Democracy party controls only 151 of the 300 seats in parliament and trails Pasok by four or five points in the opinion polls. For all his party’s weakness, the prime minister’s personal approval rating has so far stayed well ahead of Mr Papandreou’s. But with his image as a safe pair of hands in tatters, that may now change. Small family-owned businesses and retailers, the backbone of support for New Democracy, are furious at the failure of the police to protect their property.

The government is also facing mounting criticism over a string of financial scandals. Even as protesters rampaged, a parliamentary committee was taking evidence in a scandal over an illegal government land swap carried out with Vatopedi monastery on Mount Athos. Senior ministers are said to have diddled taxpayers out of some EUR 100m while handsomely lining their own pockets. Two have resigned already: George Voulgarakis, the merchant-marine minister, whose wife acted as a notary for the deal, and Theodoros Roussopoulos, the government’s spokesman.

Yet New Democracy could still stagger on. Mr Papandreou’s Pasok is split between European Social &CO. horseshoe charm and chain and populist nationalists. The latter currently have the upper hand. It would take only two New Democracy defections to bring down the government, but opinion polls suggest that Pasok would be unlikely to win an election outright. And even its supporters are doubtful that a coalition with Syriza, a left-wing party led by Alexis Tsipras, a 34-year-old who has never run for parliament, would work.

Mr Karamanlis has cruised through two elections and four-and-a-half years in power on the strength of Greece’s economic growth, averaging over 4% a year up to 2007. Yet this reflected reforms by Costas Simitis, his Pasok predecessor, to get Greece into the euro. Greek shipowners made record profits from China’s export boom; Russian oligarchs bought expensive land on Aegean Islands.

The feel-good factor allowed the conservatives to ignore the pressing case for social reform, particularly in education, health and policing. But as the global slowdown takes effect, young Greeks see their parents struggling to pay the bills. If they cannot afford to study abroad, they get lousy tuition at a Greek university and, unless their family can pull strings, few chances of a good job. The unemployment rate for young graduates is 21%, compared with 8% for the population as a whole.

Inadequate policing has allowed anarchists to flourish in Exarchia, which has become a haven for drug-dealers and racketeers. The anarchists have also exploited a constitutional loophole that bans police from university campuses. As a result, I Love You drop pendant can regroup behind barricades at the Athens Polytechnic and pick up fresh supplies of petrol bombs before heading back onto the streets.

Mr Karamanlis’s attempt to scrap this “university asylum” two years ago failed because he could not win enough cross-party support to change the constitution. Another set of university reforms collapsed when a majority of professors refused to make any commitment to higher teaching standards and submit themselves to peer review. The street violence may fade but Greece’s frustrated students are unlikely to stop protesting for long.

METHOD

SETTING The Regional Niagara Public Health Department in the province of Ontario operates a comprehensive Sexual Health Program, with birth control centres in the communities of St. Catharines, Niagara Falls and Welland. The population of the region is 393,940 with a mix of farming communities and small urban centres spread over a large geographical area. Demographically, this region is predominately white and is mostly blue collar and middle Paloma’s Zellige pendant.

PROCEDURE Adolescent women aged 12 to 19 years who were first visit clients at one of the three birth control centres in the Niagara region between August 1991 and November 1992 were asked to take part in the study. In order to be eligible for inclusion in the study, subjects needed to meet the following criteria: 1) single marital status; 2) no previous oral contraceptive use; 3) age 19 or under. Four hundred and seventy-seven eligible clients agreed to participate in the study. All clients had a well-woman exam completed by a physician and were counselled by a nurse. Subjects completed a confidential questionnaire that included items related to age, grade in school, employment status, living arrangements (parents, relatives, other), church attendance, relationship status (i.e., Paloma’s Crown of Hearts pendant a boyfriend), lifetime number of sexual partners, frequency of sexual intercourse, contraceptive history, sources of birth control information, mother’s and father’s knowledge and approval of subject’s sexual activity, mother’s and father’s knowledge and approval of contraceptive use, parent education, alcohol, marijuana, and tobacco use.

Each client was given three packages of OCs unless, due to age, they were assessed by the nurse to require monthly follow-ups, in which case they were only given one package at a time. All clients received similar instructions regarding OC use and potential side effects/benefits. The clients were instructed to return to the birth control centre for a follow-up visit at three months. At that time, all clients completed a follow-up questionnaire measuring compliance with OCs. If the client did not appear for the three month visit, a specifically trained registered nurse used the same questionnaire to interview the client by telephone.

At the three-month visit, if no undue side effects were experienced, the client was given a prescription for another ten packages of OCs. The client was then instructed to return after one year of OC use to the clinic for the second phase of the follow-up. A similar questionnaire to that used at the three-month visit was completed. If the client did not return at one year, a telephone interview was again conducted by a specifically trained registered nurse. DATA ANALYSIS We used data from the questionnaires to build a demographic, relationship, and sexual and contraceptive experience profile of the birth control clinics’ adolescent client population and to measure OC Cupcake charm and chain at 3 and 12 month follow-ups. A client was defined as compliant at the three month follow-up if she had not stopped taking OCs from the time of the study entry, and compliant at the one year follow-up if she had not stopped from the time of the three-month follow-up, regardless of the source of oral contraception (e.g., even if she decided to obtain OCs from family doctor). For those clients who were non-compliant, we differentiated between those who stopped taking OCs completely and those who stopped but restarted OCs between baseline and 3 and 12 month follow-ups.

Data were analyzed using SPSS for Windows, version 6.1.2 software. In a univariate analysis, compliance/non-compliance at three months and one year was compared for categorical variables collected at intake using the chi-square test and for continuous variables with the Student t-test. Multivariate analysis was performed using the logistic regression procedure. The forward stepwise conditional method was used to select from among all variables found significant in Cupcake charm and chain univariate analysis, and probability values for entry and removal were .IS and .10 respectively. For categorical variables, the deviation contrast procedure was chosen. All first order interactions were evaluated. For all analyses, p values are two-tailed.

Eleven-year-old Melissa Wara was thrilled with her gift. She had wanted the Hollywood Squares handheld electronic game for months, and as soon as she thanked her grandmother for it, she ran off to play. Minutes later she was back. “What are sexual stimulants?” Melissa asked her mother, Dianna Wara.”What is Playboy magazine?”

At first Wara simply suggested that her daughter skip the racier questions. “Answer the others,” she told her.

But as Melissa, a fifth grader in viral Washington, Illinois, worked her way through the game, she Frank Gehry Fish Pendant that she was skipping so many questions she could never win. The third time her daughter came trooping back with a question, Wara became irritated. She took another look at the packaging. There, in bright letters, on the front and back, were the words: FOR AGES 8 & UP.

Ever since little girls first grabbed Barbie dolls from store shelves, parents have had to face the uncomfortable fact that toys can deliver hypersexual messages. Today, hoard games or trading cards may deliver such messages more explicitly. But a parent can toss out any inappropriate ones. With an electronic game such as Hollywood Squares, hundreds of questions can be encoded on a microchip, inaccessible to a parent’s editing. “They just kept popping up,” Wara says.

Annoyed, she wrote to the game’s manufacturer, Tiger Electronics. “How many eight-year-old children do you know who should be reading these questions?” she asked.

The company’s answer offended Wara even more. Apparently, no one at Tiger had reviewed the contents. “The questions come directly from the producers of the TV show,” wrote Lava Simon, the director of public relations.

As Simon subsequently Tiffany Notes Pendant in an interview, “Since the show is rated TVG, and everything that is in the game has already been on the air, we thought that was a pretty good guideline.” But as parents know, TV ratings are mushy at best. A show such as Hollywood Squares, with its heavy doses of sexual innuendo, can be rated TVG because it does not contain violence, foul language, or explicit sexuality.

Also, when TV programs become games, the impact is greater, says Jerome L. Singer, Ph.D., who codirects the Yale University Family Television Research and Consultation Center. “On TV, messages fly over children’s heads. But when messages are written out, and kids read them, they understand a great deal more.”

As for Tiger’s suggestion that parents would consider a TV show rating when deciding whether to purchase a game, “that’s absurd,” Dianna Wara complains. “Most parents would depend on the age range on the toy’s package.” No laws or regulations govern such labels (unlike labeling for safety issues, Tiffany Notes Pendant is generally reliable). Some toy makers consult childdevelopment experts. But most just make an educated guess about a toy’s value for various age groups, says Stevanne Auerbach, Ph.D., who operates www.drtoy.com.

Which puts the choice back in the parents’ court. “You can’t know whether a toy is appropriate without opening it up and even playing with it yourself,” Auerbach says. But the Hollywood Squares game, she stresses, is “absolutely inappropriate for eight-year– olds. Manufacturers should know better.”

Until they do, parents may have to make themselves heard, as Dianna Wara did. In response to her complaint, Tiger is changing the label on its Hollywood Squares package.

The new message will suggest that Tiffany box lock pendant consider the fact that the game contains actual questions used on the TV program.

SAMPLE GAME QUESTIONS

Number 746: Forty-seven percent of women in a recent poll said they have fantasized about having sex with what authority figure?

Answer: A teacher

Travelers to Iran in the 19th century often decried the startling rate of infant mortality. Writing in 1856, Lady Mary Sheil, wife of the British envoy to Persia, Sir Justin Sheil, remarked that “the mortality among children is immense, owing to neglect, ignorance, and laziness.” Citing the Shah’s French physician, Sheil continued: “Dr. Cloquet … expressed to me his conviction that not above three children in ten outlived their third year.” Sheil faulted the local culture of child rearing, including women as the traditional caretakers of children, for this deplorable condition. She described a society in which fairly affluent mothers apparently disliked nursing infants and one that purportedly allowed “nurses” to calm children with bits of opium. Nearly four decades later, the British official George Nathaniel Curzon documented other scenarios to explain the high mortality of women and children. Upon visiting Iran in 1892, Curzon cited a report by the Austrian physician Jakob Polak that one of the “main causes of Tiffany Aria pendant decline of population” in Iran was related to the “unfavourable position of women, including the facility of divorce, early marriage, and premature age, the length of the suckling period, and the thereby impaired fertility of the sex.” Other possible reasons for population decline included the “decay of sanitary police, and consequent greater ravages by typhus, dysentery, cholera, plague, and, more particularly, owing to the inadequacy of inoculation, by small-pox–the mortality of children in the second year of their age being very striking.” Though pinpointing different reasons for the prevalence of infant mortality, Sheil and Curzon recognized this issue as a consequential social problem facing 19th-century Iranian society.

As these indicators show, curbing infectious diseases and prolonging the lives of mothers and children, whose health was particularly compromised in the 19th century, made sense both medically and socially. This impetus would have little political significance, however, had it not been coopted by Iranian modernists and policymakers in the first half of the 20th century to control the sexuality of women and men in the interests of the nation. For the next fifty years, Iranian officials, physicians, intellectuals, and women activists would investigate the high incidence of infant and maternal mortality, offering socially prescriptive measures to counter the possibility of depopulation. These concerns generated impassioned debates about the reproductive role of women in the family and the polity. Demographic and nationalist pressures recast conventions of child rearing and mothering in modern Iran, forging a maternalist ideology. Women did not always frame the debates on population, but their vital contribution to human reproduction placed them at center stage of hygiene and maternalist politics.

Why did hygiene, particularly women’s hygiene, become a strident polemic in the political culture of modern Iran? For women’s health remained a key to understanding demographic trends, and it literally became a national prerogative to question and supervise women on the tenets of mothering and child rearing. Essential to this project was the need to form a modernist culture that lauded matrimony, domesticity, and motherhood. Popular newspapers as well as school curricula reinforced women’s familial responsibilities, even as they invited women to complement their household duties with work outside Christmas Tree charm and chain home. In the context of public health care women trained as professional nurses, not just midwives, serving to expand the longevity of infants, mothers, and the infirm. Women paid attention to venereal disease and intermarital relations, as well as to pregnancy and child rearing. To be sure, the mortality of women and children decreased somewhat in the early Pahlavi years, but the ever expanding state also intruded further into the lives of citizens as a result of the maternalist discourse.

The emergence of maternalism as a social and political ideology coincided with renewed efforts to improve public hygiene in Iran. By maternalism, I mean an ideology that promoted motherhood, child care, and maternal well-being not only within the strictures of family, but also in consideration of nationalist concerns. Maternalists differed in their gender, backgrounds, and aims, pursuing social reform for either humanitarian or nationalist purposes. They included physicians, hygienists, educators, journalists, feminists, and policymakers. As Seth Koven and Sonya Michel have argued, “Maternalism always operated on two levels: it extolled the private virtues of domesticity while simultaneously legitimating women’s public relationships to politics and the state, to community, workplace, and marketplace.” In Iran, too, maternalism lauded domesticity and forged new associations between women and the state through the establishment of schools and the pursuit of unconventional professions. Maternalist objectives led to the creation of charitable, educational, and hygienic institutions that improved the general welfare of the citizen. Women benefited from the maternalist discourse by gaining new opportunities in the workforce and by becoming indispensable to the nation. Maternalism, however, did not necessarily project a feminist outlook. Nowhere does this distinction stand out as clearly as in the debate on reproduction and sexual hygiene in modern Iran. Although maternalists strove to improve the health of women, especially pregnant women, and to prolong the life of women and children, they did not all wish to establish gender equality or to combat patriarchy. The reproductive responsibility of women to the nation was simply too critical a matter to entrust to ordinary citizens, and overturning the status quo could inadvertently jeopardize national interests.

The maternalist discourse became closely associated with the hygiene movement in Iran, often sharing and endorsing similar nationalist objectives. As I have argued elsewhere, Iran’s support for hygienic reforms emerged at a critical juncture when the country embraced a humanistic philosophy that not only aimed to curb infectious diseases for human betterment but also tried to forge a nation of healthy patriots. In the early Pahlavi years, the philosophy of humanism that had undergirded hygienic reforms no longer resonated with secular nationalists shaping health policy. This shift reflected the political culture of the country when authoritarian tendencies of the ruling elite supplanted the burgeoning democratic movement of the constitutional years (1906-11). Because of limitations on state power, many Western-educated physicians strove to control childbirth and sexuality less through legislation than through a public campaign aimed at altering the traditional lifestyle and hygienic culture of Tiffany Aria pendant ordinary citizen. One should not, however, exaggerate the dominance of Western-trained doctors in this period. In July 1934, the Municipal Council of Tehran stated that the number of medical professionals educated in Iran slightly exceeded the number of foreign-trained health practitioners. Nonetheless, Western-style medicine made headway in Iran, and proposed changes, such as lessening the influence of local midwives reflected this trend.

The Iranian case stands out as an interesting historical phenomenon because unlike Romania, Japan, or Germany, no formal policies regarding childbirth or pronatalism were mandated by the state in the period under discussion. Although maternalists promoted arguments that sought to increase birthrates, they were not solely repeating or recasting Western concepts of pronatalism. The pronatalist discourse appealed to some Iranians in part because such themes could be adapted to the more familiar Islamic injunctions regarding parenting and maternity. It is more accurate to situate the debate on women’s health and infant mortality in Iran as part of a hygiene movement that began in the 19th century. The interest in hygiene intersected with a maternalist discourse that inculcated the values of domesticity and celebrated the virtues of motherhood.

A caveat regarding sources and historiography seems necessary here. The theme of hygiene, and especially women’s hygiene, has received meager scholarly attention in Middle Eastern historical studies, though social scientists have considered the significance of reproductive politics in the contemporary period. Iranian historiography succumbs to the same pattern, where the subject is even less thoroughly explored, although in addition to my research recent dissertations, and articles have begun to address different facets of health care in modern Iran. Historians know little about the origins of public health institutions and the background of local physicians and public health professionals administering medical aid. We lack accurate and reliable statistics on the prevalence of outbreaks, population counts, and accessibility of hospitals and pharmacies. Where women’s health is concerned, the gaps extend further. Archival and manuscript sources, when available, remain scattered, making it difficult to establish general trends. Although archival documents and manuscript sources from Iran and abroad were consulted for this study, regrettably many basic questions regarding the training and identity of Iranian midwives and nurses remain vague. These historiographic difficulties, however, should not deter social historians from delving into the field of public health. Even if accurate data are at times wanting, available documentation in the form of historical manuscripts, travelogues, and journalistic accounts can chronicle the social circumstances and cultural milieu in which ideas of maternalism and hygiene took shape and gained institutional backing during this period.

The literature on Middle Eastern women has been slow to explore the salience of maternalism and hygiene, despite its centrality to the nationalist debate. Here, I maintain that the history and relevance of women’s hygiene in shaping the women’s movement and the political and cultural evolution of modern Iranian society was no less significant and revolutionary than the simultaneous discourses on veiling or education. The controversies surrounding women’s hygiene &CO. horseshoe charm and chain reproductive politics, in fact, comprised a tertiary dimension of that debate.

Recent scholarship on Iranian women’s history, while concerned with issues of mothering and peripherally addressing matters of health and hygiene, focuses less on maternalism and reproductive politics. Yet, as Nancy Schrom Dye and Daniel Blake Smith have shown in their research, “Mothering is far more than a biological constant; it is an activity whose meaning has altered considerably over time. Changes in cultural values, maternal self-perceptions, and attitudes toward children–all these factors underscore the historical dimensions of motherhood.” In the Islamic Middle East, where mothering remains a revered profession as well as a common marker of identity, an analysis of maternalism can shed light on the historical scope of motherhood and the contentious nature of reproductive politics. The hygiene movement in Iran that at once improved public sanitation through vaccination programs would also transform concepts of maternity, mothering, and womanhood. In the process, it would help to generate another sweeping ideology: maternalism.

Executive Summary: The Office of Citizen Exchanges, Youth Programs Division, of the Bureau of Educational and Cultural Affairs announces an open competition for the American Youth Leadership Program. Public and private non-profit organizations meeting the provisions described in Internal Revenue Code section 26 U.S.C. 501(c)(3) may submit proposals to implement a short-term exchange program for American high school students and educators that will enable the participants to gain firsthand knowledge of foreign cultures and to collaborate on solving global issues. Applicant organizations will recruit and Atlas cube lock pendant youth and adult participants from the United States and provide them with a three- to four-week exchange program abroad focused on dialogue and debate, leadership development, and community service. Upon returning home, the students will apply what they have learned to serve their schools and communities.

I. Funding Opportunity Description

Authority

Overall grant making authority for this program is contained in the Mutual Educational and Cultural Exchange Act of 1961, Public Law 87-256, as amended, also known as the Fulbright-Hays Act. The purpose of the Act is “to enable the Return to Tiffany Heart tag pendant of the United States to increase mutual understanding between the people of the United States and the people of other countries * * *; to strengthen the ties which unite us with other nations by demonstrating the educational and cultural interests, developments, and achievements of the people of the United States and other nations * * * and thus to assist in the development of friendly, sympathetic and peaceful relations between the United States and the other countries of the world.” The funding authority for the program above is provided through legislation.

Overview

The American Youth Leadership Program will provide high school students and adult educators from the United States with an opportunity to travel abroad on a three- to four-week-long exchange program to gain firsthand knowledge of foreign cultures and to collaborate on solving global issues. The participants will have an academic and experiential education program focused on dialogue and debate, leadership development, and community service. The program activities will also focus on one of the following four themes that can be examined for both local and global impact:

1. The role of the media.

2. The environment and climate change.

3. Food security and nutrition.

4. Science and technology.

Applicants should choose from one of these four global themes and narrow it down to a more specific topic(s) within the subject area.

The exchange participants will engage in a Folded heart pendant of activities that provide an introduction to the civic, cultural, and educational institutions of the host country through workshops on leadership and service, community site visits related to the program themes, interactive training, simulations, debates, presentations, visits to high schools, cultural activities, and other activities designed to achieve the program’s stated goals. It is essential that applicants engage local youth in a substantive and meaningful way in activities with the American students. Follow-on activities with the participants are an integral part of the program, as the students apply the knowledge and skills they have acquired in their home communities. Exchange activities will be conducted in English, though participants should receive basic language instruction a few hours per week during the exchange.

Program Goals

1. Promote mutual understanding between the people of the United States and the people of the partner country(ies).

2. Prepare youth leaders to become responsible citizens and contributing members of their communities.

3. Spark an interest in learning about foreign cultures among American youth.

4. Develop a cadre of Americans with cultural understanding who are able to advance international dialogue and compete effectively in the global economy.

Using these goals and themes above, applicant organizations should identify their own specific objectives and measurable outcomes based on these program goals and the project specifications provided in this solicitation.

Eligible Countries

The FY 2010 American Youth Leadership Program will focus on specific countries according to the guidelines below.

(1) Single-Country Projects. Applicants may submit one proposal to conduct one OR two separate exchange projects, each of which sends American participants to one of the following countries:

1. Bahrain.

2. Bangladesh.

3. Cambodia.

4. Japan.

5. Kenya.

6. Mongolia.

7. Namibia.

8. Norway.

(2) Multi-Country Projects. Applicants may propose to conduct one exchange project that sends American participants to each country in one of the following groupings:

1. Bulgaria and Romania.

2. Costa Rica and Panama.

3. Fiji and Samoa (including Tonga is optional).

4. Kazakhstan and Tajikistan.

ECA plans to award multiple grants for the management of Paloma’s Tenderness Heart pendant American Youth Leadership Program for approximately eight projects; applicants should choose from the list of eight single-country projects and four multi-country projects above. Each single- or multi-country project should cost a total of approximately $250,000 for a group of 30 to 40 participants.

Applicants must propose a plan to break a large delegation into smaller cohorts for most of the exchange activities to maximize the educational experience and ensure individualized attention for each participant. For example, in a single-country project, a delegation of 40 participants could travel to the partner country at the same time, but be divided into three or four smaller groups that each visit a different city; or two separate delegations of 15 to 20 participants could travel to the partner country at different times. For multi-country projects, each country in the grouping must be visited by at least one delegation of students and educators, but the exchange activities may take various forms. For example, all 40 participants could travel to each of the countries listed during the three- to four-week period; or they could be broken up into smaller delegations that travel separately to just one country. Applicants are encouraged to be creative and flexible in their arrangements that will help meet our program goals.

How should school-based sexual health education address the issue of new laws on the age of sexual consent?

Age of consent refers to the age at which people are able to make their own decisions about sexual activity. In Canada, the age of consent was raised from 14 to 1 6 in 2008 (For a summary of the contents of the legislation and discussion of its implications see Wong, 2006). Effective sexual health education should provide students with a clear understanding of how age of consent is interpreted under the law. Educators should make youth aware that the intent of the legislation is to target adult sexual predators, not youth themselves and that the new legislation does not affect the right of young people to access sexual health education or sexual and reproductive health services. A five year peer group provision allows for youth aged 14 or 15 to have consensual sex with partners who are no more than five years older than themselves. As well, youth aged 12 and 13 can have consensual sex with other youth who are not more than 2 years older than themselves. Certain sexual activities are Elsa Peretti Round earrings for those under the age of 1 8. The Criminal Code of Canada states that persons under the age of 1 8 cannot engage in anal intercourse except if they are legally married. Someone under the age of 1 8 cannot legally consent to have sex with a person in a position of authority such as a teacher, health care provider, coach, lawyer or family member. Persons under the age of 1 8 cannot legally consent to engage in sexual activity involving prostitution or pornography.

What are the social and economic benefits to society of implementing broadly-based sexual health education in the schools?

“Sexual health is a major, positive part of personal health and healthy living” (Public Health Agency of Canada, 2008, p. 8). The primary goals of sexual health education are to provide individuals with the necessary information, motivation, and behavioural skills to avoid negative sexual health outcomes and to enhance sexual health. There is a growing recognition that the attainment and maintenance of sexual health for individuals, couples, and families is an important component of the overall well-being of me community (World Association for Sexual Health, 2008). Broadly-based sexual health education in the schools can make a significant positive contribution to the health and well-being of the community.

It is equally important to recognize that neglecting to provide broadly-based sexual health education programs can have far reaching social and economic consequences. For example, untreated Chlamydia infection (a common STI among Canadian youth and young adults) can lead to severe medical conditions including pelvic inflammatory disease (PID) and infertility, chronic pelvic pain, and ectopic pregnancy (Public Health Agency of Canada, 2006). It has been estimated that in Canada the costs of these conditions are approximately $ 1 ,942 for inpatient PID treatment, $6,469 for ectopic pregnancy, $324 for chronic pelvic pain, and $12,169 for the lifetime cost of infertility treatment (Goeree, Jang, Blackhouse et al., 2001). Goeree and Gully (1993) estimated that in 1990, the total cost of Chlamydia and associated sequelae was approximately $89 million and the total cost of gonorrhoea and associated sequelae was approximately $54 million. Given that the number of cases of these infections that are diagnosed annually has increased significantly since 1990 (see Public Health Agency of Canada, 2009), the total costs associated with these infections have also likely increased. Research from the U.S. on the average lifetime medical costs of PID further demonstrates the economic burden of STI (Yeh, Hook & Goldie, 2003). A review of the literature on the number of cases of STI among young people in the U.S. each year and the medical costs associated with them indicates that the economic burden resulting from STI Return to Tiffany Round tag drop earrings youth is $6.5 billion annually (Chesson, Blandford, Gift, Tao & Irwin, 2004) and, overall, it is estimated that the direct medical costs of HIV/STI in the U.S. for the general population are $12 to $20 billion annually (Chesson, Collins & Koski, 2008). It has been estimated that in Canada the direct and indirect costs of HTV/AIIDS exceed $2 billion annually (Dodds, Coleman, Amaratunga & Wilson, 2001).

The socio-economic outcomes of teen pregnancy and parenthood are complex and do not lend themselves to simplistic conclusions on cause and effect (for a review of this literature see Best Start, 2007; 2008; Bissell, 2000). However it is fair to assume that, particularly for younger teens, unintended pregnancy and childbearing can have social and economic consequences for the young woman, her family, and the community.

As documented elsewhere in this resource document, there is strong evidence that well-developed, broadlybased sexual health education programs can significantly reduce high-risk sexual behaviour among youth and, as a result, provide substantial social and economic benefit to Canadian society. The existing literature on the direct costs and economic benefits of conducting school-based sexual health promotion interventions with youth suggest that such programming is not only cost effective but often results in considerable cost savings (Wang, Burstein & Cohen, 2002; Wang, Davis, Robin, et al., 2000).

How can the Canadian Guidelines for Sexual Health Education contribute to the initiation and maintenance of high quality sexual health education programming in the schools?

The Canadian Guidelines for Sexual Health Education (Public Health Agency of Canada, 2008) are designed to guide and unify professionals working in fields that provide sexual health education. The Guidelines are grounded in evidence-based research placed in a Canadian context and offer curriculum and program planners, educators, and policy makers clear direction for the initiation, development, implementation and evaluation of effective sexual health education programs.

For example, at the initiation stage, the Guidelines can be used to facilitate discussion of the rationale and philosophy of school-based sexuality education with parents and other community stake-holders. The Guidelines include a checklist for assessing existing programs with respect to philosophy, accessibility, comprehensiveness, effectiveness of educational approaches and methods, training and administrative support, and planning/ Tiffany 1837 Bar drop earrings/ updating/ social development.

The Guidelines suggest a basic three-step process to sexual health education development:

Assessment

program planners assess the target population’s sexual health education needs;

Intervention

program planners develop and implement relevant and appropriate sexual health education programs;

Evaluation

program planners measure the effectiveness of the program and identify areas requiring modification.

At the curriculum development and implementation stages, the Guidelines provide a Paloma’s X earrings for effective program content based on the informationmotivation-behavioural skills (1MB) model (Fisher & Fisher, 1998) for sexual health enhancement and problem prevention. The Guidelines specify that effective sexual health education integrates four key components: acquisition of knowledge; development of motivation and critical insight; development of skills; and creation of an environment conducive to sexual health.