Bettina Shell‐duncan
Biographic Data
| ID | 127106 |
|---|---|
| NAME | Bettina Shell‐duncan |
| GIVEN NAMES | Bettina |
| FAMILY NAME | Shell‐duncan |
| SIGNATURE | DUNCAN B S |
| AFFILIATIONS | University of Washington |
| ORCID | 0000-0001-5020-5029 |
| VERIFIED | Yes |
| TOTAL WORKS | 33 |
| TOTAL CITATIONS | 168 |
| AUTHOR COUNT | 33 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 1993 |
| LATEST PUBLICATION YEAR | 2025 |
| H-INDEX | 6 |
The Attention‐Deficit/Hyperactivity Disorder‐Associated DRD4 7R Allele Predicts Household Economic Status but Not Nutritional Status in Northern Kenyan Rendille Children
OBJECTIVES: Around 11% of U.S. children are diagnosed with attention-deficit/hyperactivity disorder (ADHD). One hypothesis for ADHD's relatively high prevalence is that behaviors associated with ADHD were advantageous in past environments where they were positively selected for. A previous study showed that an allele associated with ADHD-the 7R allele of the gene encoding the D(4) dopamine receptor (DRD4)-had a positive effect on the nutritional …
Scaling Up Change: A Critical Review and Practical Guide to Harnessing Social Norms for Climate Action
Anthropogenic carbon emissions have the potential to trigger changes in climate and ecosystems that would be catastrophic for the well-being of humans and other species. Widespread shifts in production and consumption patterns are urgently needed to address climate change. Although transnational agreements and national policy are necessary for a transition to a fully decarbonized global economy, fluctuating political priorities and lobbying by ve…
Persistence of female genital mutilation/cutting in two Kenyan communities: What can we learn from change that falls short of abandonment
Literature on dynamics of change in female genital mutilation/cutting (FGM/C) portray two common but conflicting views. On one side, FGM/C is seen as static and deeply entrenched, with parents lacking agency to interpret culture, evaluate options and adopt changes. An alternative perspective focuses on the fluidity of social norms, influencing whether and how FGM/C is practised. This study asks: in counties where FGM/C persists at high rates, Kis…
Plurality of beliefs about female genital mutilation amidst decades of intervention programming in Narok and Kisii Counties, Kenya
Female genital mutilation derails efforts to achieve gender equality and the empowerment of girls and women. In Kenya, national estimates show a steady decline in prevalence, although there is considerable variation at the sub-national level. There is a need to better understand female genital mutilation-related norms and meanings and whether there have been changes in these given long-term and diverse efforts to promote abandonment. Focusing on …
Social and structural factors influencing women’s agency regarding female genital mutilation/cutting: An intersectional analysis – a reply to ‘The prosecution of Dawoodi Bohra women’ by Richard Shwede…
Countries around the world have passed laws specifically banning female genital mutilation/cutting. Legal restrictions vary as to whether they apply to both girls and adult women or to minors only, and few address a second set of genital cutting procedures known as ‘female genital cosmetic surgeries’. Different legal framings reflect variation in views regarding women’s autonomy and their ability to provide meaningful consent. Social norms theory…
Social norm coordination and readiness to change female genital cutting: Evidence from Senegambia
These findings support the social coordination norm model, and reveal distinct normative schema among cut and uncut women. Furthermore, our findings point to a dynamic reassessment of social benefits and health costs underlying FGC decision-making and readiness to change FGC. The reappraisal of social benefits may be an unrecognized opportunity for programs aiming to discourage FGC
Women’s business? A social network study of the influence of men on decision-making regarding female genital mutilation/cutting in Senegal
There exist two dominant but conflicting views on the role of men in the perpetuation female genital mutilation/cutting (FGM/C). One paints men as culprits, with FGM/C viewed as a manifestation of patriarchal oppression of women. An alternative portrays men as relatively uninvolved in a practice described as 'women's business'. These two perspectives lead to divergent predictions: if FGM/C underpins patriarchal structures, men should be expected …
A Spatial Analysis of the Prevalence of Female Genital Mutilation/Cutting among 0–14-Year-Old Girls in Kenya
Female genital mutilation/cutting (FGM/C), also known as female circumcision, is a global public health and human rights problem affecting women and girls. Several concerted efforts to eliminate the practice are underway in several sub-Saharan African countries where the practice is most prevalent. Studies have reported variations in the practice with some countries experiencing relatively slow decline in prevalence. This study investigates the r…
Trends in female genital mutilation/cutting in Senegal: What can we learn from successive household surveys in sub-Saharan African countries
Findings from two consecutive surveys reveal that while no significant changes in FGM/C prevalence are found at the national level, mixed changes are visible at the regional level, as well as at the individual level. The modelled covariate results confirmed that the patterns of FGM/C differ markedly with region of residence and age remaining significant risk factors in both surveys, suggesting that community factors (convention theory), above and…
Hay fever, asthma, and eczema and early infectious diseases among children in Kilimanjaro, Tanzania
OBJECTIVES: To investigate the hygiene (or "old friends") hypothesis in a high-infectious disease (ID) environment, rural Kilimanjaro, Tanzania. METHODS: Among a cross-sectional sample of 2- to 7-year-old children, we collected physician-diagnosed hay fever, asthma, and eczema, history of hospitalization, family size, and household environment information via questionnaire; performed active and passive surveillance for ID; and, evaluated total im…
My intention was a child but I was very afraid: Fertility intentions and HIV risk perceptions among HIV-serodiscordant couples experiencing pregnancy in Kenya
We sought to understand fertility intentions and HIV risk considerations among Kenyan HIV-serodiscordant couples who became pregnant during a prospective study. We conducted individual in-depth interviews (n = 36) and focus group discussions (n = 4) and performed qualitative data analysis and interpretation using an inductive approach. Although most of the couples were aware of the risk of horizontal and vertical HIV transmission, almost all coup…
Effect of settlement on nutrition and health status of pastoral Gabra women of reproductive age in Kalacha Location, Marsabit County, Kenya
Objective The objective of the present study was to evaluate the effect of settlement on the nutrition and health status of pastoral women of reproductive age. Design A cross-sectional survey that included a 24 h dietary recall was administered to 224 randomly selected Gabra women. Height and weight were used to compute BMI. Whole capillary blood was used to measure Hb. Additional capillary blood was collected on filter paper and dried blood spot…
Predictors of delayed‐type hypersensitivity to Candida albicans and anti‐epstein‐barr virus antibody among children in Kilimanjaro, Tanzania
We evaluated sex, age, nutritional status, and infectious disease (ID) as predictors of two biomarkers of cell‐mediated immunity (CMI), delayed‐type hypersensitivity to Candida albicans (DTH‐ Candida ), and anti‐Epstein‐Barr virus antibody (EBV Ab), among 200 children in Kilimanjaro, Tanzania. DTH‐ Candida, which decreases with compromised CMI, was positively associated with age (OR: 1.27; 95% CI: 1.02, 1.57) and triceps skinfold (TSF; OR: 1.16; …
Legislating Change? Responses to Criminalizing Female Genital Cutting in Senegal
Although the international community has recently promoted legislation as an important reform strategy for ending female genital cutting (FGC), there exist divergent views on its potential effects. Supporters argue that legal prohibition of FGC has a general deterrent effect, while others argue legislation can be perceived as coercive, and derail local efforts to end the practice. This study examines the range of responses observed in rural Seneg…
A qualitative study of barriers to consistent condom use among HIV-1 serodiscordant couples in Kenya
This study explored barriers to consistent condom use among heterosexual HIV-1 serodiscordant couples who were aware of the HIV-1 serodiscordant status and had been informed about condom use as a risk reduction strategy. We conducted 28 in-depth interviews and 9 focus group discussions among purposively selected heterosexual HIV-1 serodiscordant couples from Thika and Nairobi districts in Kenya. We analyzed the transcribed data with a grounded th…
Vitamin A dynamics in breastmilk and liver stores: A life history perspective
OBJECTIVES: Newborns are dependent on breastmilk vitamin A for building hepatic stores of vitamin A that will become critical for survival after weaning. It has been documented that vitamin A concentrations in breastmilk decline across the first year postpartum in both well-nourished and malnourished populations. The reason for this decline has been assumed to be a sign of concurrently depleting maternal hepatic stores. This study investigates th…
Dynamics of change in the practice of female genital cutting in Senegambia: Testing predictions of social convention theory
Evaluation of iron deficiency as a nutritional adaptation to infectious disease: An evolutionary medicine perspective
An evolutionary perspective suggests that iron deficiency may have opposing effects on infectious disease risk, decreasing susceptibility by restricting iron availability to pathogens, and increasing susceptibility by compromising cellular immunocompetence. In some environments, the trade‐off between these effects may result in optimal iron intake that is inadequate to fully meet body iron needs. Thus, it has been suggested that moderate iron def…
Women's autonomy and its relationship to children's nutrition among the Rendille of northern Kenya
This study explores the effect of women's autonomy on children's health. Research was conducted among the Rendille, a traditionally nomadic pastoralist population living in northern Kenya. Using data collected from 435 women and 934 of their children, we tested the hypothesis that women with higher levels of autonomy would have children with better nutrition. Results of our study indicated that while women's autonomy had no effect on younger—ages…
Pesticides Protect the Fruit, but Not the People”: Using Community-Based Ethnography to Understand Farmworker Pesticide-Exposure Risks
Objectives. We used community-based ethnography and public health risk assessment to assess beliefs about pesticide exposure risks among farmworkers in the Lower Yakima Valley of Washington State. Methods. We used unstructured and semistructured interviews, work-site observation, and detailed field notes to gather data on pesticide exposure risks from 99 farmworkers. Results. Farmworkers' pesticide-relevant beliefs and attitudes could be grouped …
Feasibility of using retinol-binding protein from capillary blood specimens to estimate serum retinol concentrations and the prevalence of vitamin A deficiency in low-resource settings
Vitamin A deficiency (VAD) is a significant public health problem in many countries. While cost-effective interventions are available to control VAD, reliable information is needed to the track progress of control programmes. However, assessment of VAD is uncommon because current approaches are expensive and not feasible in low-resource settings. The present study explores the utility of retinol-binding protein (RBP), analysed by enzyme-linked im…
From Health to Human Rights: Female Genital Cutting and the Politics of Intervention
The international campaign to eliminate female genital cutting (FGC) has, since the early 1990s, actively attempted to divorce itself from a health framework, adopting instead a human rights framework to justify intervention. Several key questions emerge regarding the prominent placement of FGC in the international human rights movement: What are the ramifications of framing FGC as a human rights violation? What actions are mandated by a human ri…
Contingency, Context, and Change: Negotiating Female Genital Cutting in The Gambia and Senegal
Ylva Hernlund, Bettina Shell-Duncan, Contingency, Context, and Change: Negotiating Female Genital Cutting in The Gambia and Senegal, Africa Today, Vol. 53, No. 4, Female Genital Cutting (Summer, 2007), pp. 43-57
The Day I Will Never Forget
Less Money Less Food: Voices From Women in Urban Poor Families in Thailand
Food insecurity is a public health problem. Information on how cultures perceive the experience of a financial crisis and resultant food insecurity is limited. Our purpose in this study was to understand how poor families residing in urban slums in Thailand perceive their food situation. Interviews were conducted with 30 women aged 20-65 years who were household food providers. Content analysis revealed three themes: experiencing changes, being v…
"The medicalization of female "circumcision: Harm Reduction or Promotion of a Dangerous Practice
From Health to Human Rights: Female Genital Cutting and the Politics of Intervention
The international campaign to eliminate female genital cutting (FGC) has, since the early 1990s, actively attempted to divorce itself from a health framework, adopting instead a human rights framework to justify intervention. Several key questions emerge regarding the prominent placement of FGC in the international human rights movement: What are the ramifications of framing FGC as a human rights violation? What actions are mandated by a human ri…
Dynamics of change in the practice of female genital cutting in Senegambia: Testing predictions of social convention theory
Legislating Change? Responses to Criminalizing Female Genital Cutting in Senegal
Although the international community has recently promoted legislation as an important reform strategy for ending female genital cutting (FGC), there exist divergent views on its potential effects. Supporters argue that legal prohibition of FGC has a general deterrent effect, while others argue legislation can be perceived as coercive, and derail local efforts to end the practice. This study examines the range of responses observed in rural Seneg…
The maternal depletion transition in northern Kenya: The Effects of Settlement, Development and Disparity
The female circumcision controversy: An Anthropological Perspective
Social and structural factors influencing women’s agency regarding female genital mutilation/cutting: An intersectional analysis – a reply to ‘The prosecution of Dawoodi Bohra women’ by Richard Shwede…
Countries around the world have passed laws specifically banning female genital mutilation/cutting. Legal restrictions vary as to whether they apply to both girls and adult women or to minors only, and few address a second set of genital cutting procedures known as ‘female genital cosmetic surgeries’. Different legal framings reflect variation in views regarding women’s autonomy and their ability to provide meaningful consent. Social norms theory…
Contingency, Context, and Change: Negotiating Female Genital Cutting in The Gambia and Senegal
Ylva Hernlund, Bettina Shell-Duncan, Contingency, Context, and Change: Negotiating Female Genital Cutting in The Gambia and Senegal, Africa Today, Vol. 53, No. 4, Female Genital Cutting (Summer, 2007), pp. 43-57
Predictors of delayed‐type hypersensitivity to Candida albicans and anti‐epstein‐barr virus antibody among children in Kilimanjaro, Tanzania
We evaluated sex, age, nutritional status, and infectious disease (ID) as predictors of two biomarkers of cell‐mediated immunity (CMI), delayed‐type hypersensitivity to Candida albicans (DTH‐ Candida ), and anti‐Epstein‐Barr virus antibody (EBV Ab), among 200 children in Kilimanjaro, Tanzania. DTH‐ Candida, which decreases with compromised CMI, was positively associated with age (OR: 1.27; 95% CI: 1.02, 1.57) and triceps skinfold (TSF; OR: 1.16; …
Pesticides Protect the Fruit, but Not the People”: Using Community-Based Ethnography to Understand Farmworker Pesticide-Exposure Risks
Objectives. We used community-based ethnography and public health risk assessment to assess beliefs about pesticide exposure risks among farmworkers in the Lower Yakima Valley of Washington State. Methods. We used unstructured and semistructured interviews, work-site observation, and detailed field notes to gather data on pesticide exposure risks from 99 farmworkers. Results. Farmworkers' pesticide-relevant beliefs and attitudes could be grouped …
The Day I Will Never Forget
Premarital childbearing in northwest Kenya: Challenging the concept of illegitimacy
A number of African countries, including Kenya, have experienced a marked rise in births among unmarried women. In Western countries, reproduction outside of marriage is assumed to be illegitimate and a social problem. One hypothesis used to explain the increasing incidence of premarital fertility in Africa is a breakdown of traditional social controls by the extended family over the sexual behavior of adolescents. A competing hypothesis suggests…
Cell‐mediated immunocompetence among nomadic Turkana children
Cell‐mediated immune function is readily impaired by nutritional and disease stress, while depressed cellular immunity, in turn, increases an individual's susceptibility to infection. The measurement of cellular immunity through delayed‐type hypersensitivity (DTH) testing can provide important prognostic information, including the prediction of future health and survival, and can easily be performed in nonclinical settings. In a sample of 64 noma…
Impact of seasonal variation in food availability and disease stress on the health status of nomadic Turkana children: A longitudinal analysis of morbidity, immunity, and nutritional status
The possible influence of seasonal variations in rainfall, resource availability, and morbidity on immune function and nutritional status was examined in a longitudinal study of 54 nomadic Turkana children, 6 months to 10 years of age. The highly seasonal nature of rainfall in the arid semidesert environment of the Turkana District, northwestern Kenya, was associated with varying levels of animal milk production and meat and blood consumption. De…
Evaluation of infection and nutritional status as determinants of cellular immunosuppression
While an association between severe protein-energy malnutrition and diminished cellular immunity has been documented, the impact of lesser grades of malnutrition on cellular immunosuppression is less clear. This study emphasizes that the relationship between mild-to- moderate malnutrition and cellular immune function, assessed through delayed-type hypersensitivity testing, is often obscured by the immunosuppressive effects of concurrent infection…
Premarital childbearing in northwest Kenya: Challenging the concept of illegitimacy
A number of African countries, including Kenya, have experienced a marked rise in births among unmarried women. In Western countries, reproduction outside of marriage is assumed to be illegitimate and a social problem. One hypothesis used to explain the increasing incidence of premarital fertility in Africa is a breakdown of traditional social controls by the extended family over the sexual behavior of adolescents. A competing hypothesis suggests…
Child nutrition in the transition from nomadic pastoralism to settled lifestyles: Individual, household, and community-level factors
The research reported here examines child nutrition in a population that is currently experiencing a transition in subsistence, shifting from nomadic pastoralism to a variety of settled lifestyles. We investigate the range of nutritional consequences of settlement both within and between communities by examining individual, household, and community-level predictors of child nutritional status. Data are drawn from the Rendille Demographic and Heal…
"The medicalization of female "circumcision: Harm Reduction or Promotion of a Dangerous Practice
The female circumcision controversy: An Anthropological Perspective
Less Money Less Food: Voices From Women in Urban Poor Families in Thailand
Food insecurity is a public health problem. Information on how cultures perceive the experience of a financial crisis and resultant food insecurity is limited. Our purpose in this study was to understand how poor families residing in urban slums in Thailand perceive their food situation. Interviews were conducted with 30 women aged 20-65 years who were household food providers. Content analysis revealed three themes: experiencing changes, being v…
The maternal depletion transition in northern Kenya: The Effects of Settlement, Development and Disparity
The Day I Will Never Forget
Contingency, Context, and Change: Negotiating Female Genital Cutting in The Gambia and Senegal
Ylva Hernlund, Bettina Shell-Duncan, Contingency, Context, and Change: Negotiating Female Genital Cutting in The Gambia and Senegal, Africa Today, Vol. 53, No. 4, Female Genital Cutting (Summer, 2007), pp. 43-57
Feasibility of using retinol-binding protein from capillary blood specimens to estimate serum retinol concentrations and the prevalence of vitamin A deficiency in low-resource settings
Vitamin A deficiency (VAD) is a significant public health problem in many countries. While cost-effective interventions are available to control VAD, reliable information is needed to the track progress of control programmes. However, assessment of VAD is uncommon because current approaches are expensive and not feasible in low-resource settings. The present study explores the utility of retinol-binding protein (RBP), analysed by enzyme-linked im…
From Health to Human Rights: Female Genital Cutting and the Politics of Intervention
The international campaign to eliminate female genital cutting (FGC) has, since the early 1990s, actively attempted to divorce itself from a health framework, adopting instead a human rights framework to justify intervention. Several key questions emerge regarding the prominent placement of FGC in the international human rights movement: What are the ramifications of framing FGC as a human rights violation? What actions are mandated by a human ri…
Evaluation of iron deficiency as a nutritional adaptation to infectious disease: An evolutionary medicine perspective
An evolutionary perspective suggests that iron deficiency may have opposing effects on infectious disease risk, decreasing susceptibility by restricting iron availability to pathogens, and increasing susceptibility by compromising cellular immunocompetence. In some environments, the trade‐off between these effects may result in optimal iron intake that is inadequate to fully meet body iron needs. Thus, it has been suggested that moderate iron def…
Women's autonomy and its relationship to children's nutrition among the Rendille of northern Kenya
This study explores the effect of women's autonomy on children's health. Research was conducted among the Rendille, a traditionally nomadic pastoralist population living in northern Kenya. Using data collected from 435 women and 934 of their children, we tested the hypothesis that women with higher levels of autonomy would have children with better nutrition. Results of our study indicated that while women's autonomy had no effect on younger—ages…
Pesticides Protect the Fruit, but Not the People”: Using Community-Based Ethnography to Understand Farmworker Pesticide-Exposure Risks
Objectives. We used community-based ethnography and public health risk assessment to assess beliefs about pesticide exposure risks among farmworkers in the Lower Yakima Valley of Washington State. Methods. We used unstructured and semistructured interviews, work-site observation, and detailed field notes to gather data on pesticide exposure risks from 99 farmworkers. Results. Farmworkers' pesticide-relevant beliefs and attitudes could be grouped …
Vitamin A dynamics in breastmilk and liver stores: A life history perspective
OBJECTIVES: Newborns are dependent on breastmilk vitamin A for building hepatic stores of vitamin A that will become critical for survival after weaning. It has been documented that vitamin A concentrations in breastmilk decline across the first year postpartum in both well-nourished and malnourished populations. The reason for this decline has been assumed to be a sign of concurrently depleting maternal hepatic stores. This study investigates th…
Dynamics of change in the practice of female genital cutting in Senegambia: Testing predictions of social convention theory
A qualitative study of barriers to consistent condom use among HIV-1 serodiscordant couples in Kenya
This study explored barriers to consistent condom use among heterosexual HIV-1 serodiscordant couples who were aware of the HIV-1 serodiscordant status and had been informed about condom use as a risk reduction strategy. We conducted 28 in-depth interviews and 9 focus group discussions among purposively selected heterosexual HIV-1 serodiscordant couples from Thika and Nairobi districts in Kenya. We analyzed the transcribed data with a grounded th…
Effect of settlement on nutrition and health status of pastoral Gabra women of reproductive age in Kalacha Location, Marsabit County, Kenya
Objective The objective of the present study was to evaluate the effect of settlement on the nutrition and health status of pastoral women of reproductive age. Design A cross-sectional survey that included a 24 h dietary recall was administered to 224 randomly selected Gabra women. Height and weight were used to compute BMI. Whole capillary blood was used to measure Hb. Additional capillary blood was collected on filter paper and dried blood spot…
Predictors of delayed‐type hypersensitivity to Candida albicans and anti‐epstein‐barr virus antibody among children in Kilimanjaro, Tanzania
We evaluated sex, age, nutritional status, and infectious disease (ID) as predictors of two biomarkers of cell‐mediated immunity (CMI), delayed‐type hypersensitivity to Candida albicans (DTH‐ Candida ), and anti‐Epstein‐Barr virus antibody (EBV Ab), among 200 children in Kilimanjaro, Tanzania. DTH‐ Candida, which decreases with compromised CMI, was positively associated with age (OR: 1.27; 95% CI: 1.02, 1.57) and triceps skinfold (TSF; OR: 1.16; …
Legislating Change? Responses to Criminalizing Female Genital Cutting in Senegal
Although the international community has recently promoted legislation as an important reform strategy for ending female genital cutting (FGC), there exist divergent views on its potential effects. Supporters argue that legal prohibition of FGC has a general deterrent effect, while others argue legislation can be perceived as coercive, and derail local efforts to end the practice. This study examines the range of responses observed in rural Seneg…
My intention was a child but I was very afraid: Fertility intentions and HIV risk perceptions among HIV-serodiscordant couples experiencing pregnancy in Kenya
We sought to understand fertility intentions and HIV risk considerations among Kenyan HIV-serodiscordant couples who became pregnant during a prospective study. We conducted individual in-depth interviews (n = 36) and focus group discussions (n = 4) and performed qualitative data analysis and interpretation using an inductive approach. Although most of the couples were aware of the risk of horizontal and vertical HIV transmission, almost all coup…
Hay fever, asthma, and eczema and early infectious diseases among children in Kilimanjaro, Tanzania
OBJECTIVES: To investigate the hygiene (or "old friends") hypothesis in a high-infectious disease (ID) environment, rural Kilimanjaro, Tanzania. METHODS: Among a cross-sectional sample of 2- to 7-year-old children, we collected physician-diagnosed hay fever, asthma, and eczema, history of hospitalization, family size, and household environment information via questionnaire; performed active and passive surveillance for ID; and, evaluated total im…
A Spatial Analysis of the Prevalence of Female Genital Mutilation/Cutting among 0–14-Year-Old Girls in Kenya
Female genital mutilation/cutting (FGM/C), also known as female circumcision, is a global public health and human rights problem affecting women and girls. Several concerted efforts to eliminate the practice are underway in several sub-Saharan African countries where the practice is most prevalent. Studies have reported variations in the practice with some countries experiencing relatively slow decline in prevalence. This study investigates the r…
Medicine (26 works) · Sociology (17 works) · Political science (14 works) · Environmental health (13 works) · Female Genital Mutilation/Cutting Issues (13 works) · Demography (12 works) · Genital Health and Disease (10 works) · Geography (10 works) · Population (10 works) · Biology (8 works)