Background: Maternal and perinatal mortality are major problems for which progress in subSaharan Africa has been inadequate, even though childbirth services are available, even in the poorest countries. Reducing them is the aim of two of the main Millennium Development Goals. Many initiatives have been undertaken to remedy this situation, such as the Advances in Labour and Risk Management (ALARM) International Program, whose purpose is to improve the quality of obstetric services in low-income countries. However, few interventions have been evaluated, in this context, using rigorous methods for analyzing effectiveness in terms of health outcomes. The objective of this trial is to evaluate the effectiveness of the ALARM International Program (AIP) in reducing maternal mortality in referral hospitals in Senegal and Mali. Secondary goals include evaluation of the relationships between effectiveness and resource availability, service organization, medical practices, and satisfaction among health personnel.

Bending effect on the magnetic anisotropy in 20 nm Co2FeAl Heusler thin film grown on Kapton® has been studied by ferromagnetic resonance and glued on curved sample carrier with various radii. The results reported in this letter show that the magnetic anisotropy is drastically changed in this system by bending the thin films. This effect is attributed to the interfacial strain transmission from the substrate to the film and to the magnetoelastic behavior of the Co2FeAl film. Moreover two approaches to determine the in-plane magnetostriction coefficient of the film, leading to a value that is close to λ CF A = 14 × 10 −6 , have been proposed.

Context: The social and economic context in which Malian adolescents begin sexual activity is different from that experienced by previous generations. Little is known about the forces that currently shape adolescents' sexuality and affect their reproductive health. Methods: A representative sample of 1,696 Malian adolescents (775 males and 921 females) aged 15-19 were interviewed in 1998 about sexual behavior and knowledge. Thirty focus-group discussions provided complementary insights into the context of and reasons for adolescents' first sexual encounters. Results: Nearly half of sexually experienced urban males said they would have preferred to delay their first intercourse, compared with about one-fifth of females and of rural males. Males most often said curiosity and peer pressure (including pressure from their girlfriends) had led them to begin having sex earlier than they would have liked, while females in urban areas cited love and those in rural areas cited a promise of marriage. Focus groups, however, suggested that young urban women often had sex to obtain cash to meet their material needs and desires. Unmarried urban females who exhibited high self-esteem and an internal locus of control were significantly more likely to be satisfied with the timing of their first sexual encounter; these factors had no effect among males. Among adolescents who were satisfied with the timing of their first sexual experience, both males and females were more likely to have used a modern contraceptive at first intercourse, and females were more likely to have ever used a modern method. Multivariate analyses, however, indicated that a large part of the effect among females was mediated by psychological factors: High self-esteem and an internal locus of control were associated with an increased likelihood of having ever used contraceptives. Among young men, everuse was strongly associated with self-esteem and was only weakly associated with the timing of first intercourse. Conclusions: In Mali, young women's psychological characteristics are strongly associated with their sexual experience (including the timing of their first sexual encounter) and ultimately with their ability to protect themselves from sexual health risks.

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