Family Planning Practice Among Rural Reproductive-Age Married Women in Myanmar.

PubMed

Jirapongsuwan, Ann; Latt, Kyaw Thu; Siri, Sukhontha; Munsawaengsub, Chokchai

2016-05-01

A cross-sectional study was undertaken to investigate family planning (FP) practices and associated factors among reproductive-age married women. Data were collected by interviewing the 300 married women living in a rural area of Myanmar. The questionnaire had reliability coefficients ranging from .8 to .9. Results indicated that 73.3% of women performed FP, and contraceptive injection was the most common method. Significant associations were found with age 21 to 35 years (adjusted odds ratio [adj OR] = 3.748, 95% CI = 2.179-6.445), adequacy of income (adj OR = 2.520, 95% CI = 1.477-4.290), good attitude toward FP (adj OR = 0.386, 95% CI = 0.228-0.656), good support from health care providers (adj OR = 0.129, 95% CI = 0.054-0.313), good support from family (adj OR = 0.304, 95% CI = 0.163-0.565), good support from friends (adj OR = 0.344, 95% CI = 0.193-0.613), and FP practice. It is recommended that designing FP programs with peers and family involvement could increase the practice of FP among rural Myanmar women. © 2016 APJPH.

A major challenge. Entrepreneurship characterizes the work of the Soviet Family Health Association.

PubMed

Manuilova, I A

1991-09-01

The work of the Soviet Family Health Association (SFHA) is described. Created in January, 1989, the organization boasts 25 state-paid workers, and as of June 1991, membership of 15,000 corporate and individual members. Individual annual membership fee is 5 rubles, and entitles members to counseling and family planning (FP) services. The SFHA works in cooperation with the Commission on Family Planning Problems of the USSR's Academy of Sciences, and has been a member of the International Planned Parenthood Federation (IPPF) since 1990. Association activities include lectures for students, newly-weds, adolescents, and working women on modern contraceptive methods; research on attitude regarding sex, sex behaviors, and the perceived need for effective contraception; clinical trials of contraceptive suitability for women; and the training of doctors in FP and contraceptives. Problems central to the SFHA's operations include insufficient service and examination equipment, a shortage of hard currency, and the small number of FP specialists in the country. Solutions to these obstacles are sought through collaboration with the government, non-governmental organizations in the Soviet Union, and international groups. The SFHA has a series of activities planned for 1991 designed to foster wider acceptance of FP. Increased FP services at industrial enterprises, establishing more FP centers throughout the Soviet Union, and studying FP programs in other countries are among Association targets for the year. Research on and promotion of contraceptives has been virtually stagnant since abortion was declared illegal in 1936. Catching up on these lost decades and remaining self-reliant are challenges to the SPHA.

An analysis of the determinants of family planning volunteer workers' performance in Iloilo City.

PubMed

David, F; Chin, F

1993-01-01

This report analyzes data from a survey of 106 Barangay (village) Service Point Officers (BSPOs) associated with the City Population Office and 106 Barangay Health Workers (BHWs) associated with the City Health Office to compare the family planning (FP) service delivery performance of these voluntary workers in Iloilo City in the Philippines and to quantify the effects of the factors which influence their performance. Both the BSPOs and the BHWs assist in the delivery of health and FP services at the grassroots level. The survey data were supplemented with interviews with key informants, focus group discussions with married couples of reproductive age, clinic records, and observations of the BSPOs and BHWs at work. The analysis compared the sociodemographic characteristics of the two groups; the recruitment procedures followed (if any); FP training; actual FP-related work; involvement in community organizing; incentives received; supervision of the volunteers; attitude towards their work; FP knowledge, attitude, and practice; time allocated to FP activities; number of clients served; and number of clients counseled. Correlation analysis of factors influencing volunteer performance indicated that FP training had the largest positive influence on FP activities. The output of the workers was also positively affected by the amount of time spend in FP activities and by their involvement in community organizing. The commitment of the workers had a significant impact on the number of clients they resupplied with contraceptives. Variation in the FP performances of the two groups was caused by the fact that delivery of FP services is a major role of the BSPOs and only one of many responsibilities of the BHWs. These findings reinforce the planned restructuring of Iloilo City's FP program which would once again designate the Population Office as the lead agency. Increasing the knowledge of these volunteers about the side effects and contraindications of various methods should have a positive effect on continuation rates. Recruitment of volunteers should be based on the individual's level of interest and commitment.

Hillary Clinton visits Pathfinder projects in Brazil.

PubMed

1996-01-01

In October 1995, US First Lady Hillary Clinton visited a maternity hospital in Salvador, Brazil, in which a family planning (FP)/reproductive health program has been administered by Pathfinder International since 1981 with funding from USAID. During her tour of the facility, Clinton learned about the high degree of unmet need for FP in the region which results from a lack of sufficient resources to meet demand. Clinton, in turn, praised the state of Bahia for its emphasis on FP in low-income areas.

U.S. population policy.

PubMed

Piotrow, P T

1993-06-01

Some of the history and special features of the US population assistance program administered by USAID are recounted. Future predictions are also made for funding and new directions for the US population assistance program and environmental issues. The topics addressed were part of a talk given in 1992 at a meeting of the Council on Population Education held in Tokyo. Credit is given to Japan for its contribution to family planning (FP) efforts by setting an example of reducing population size within a decade and providing financial support internationally. Japan's example so impressed General William H. Draper, Jr. that he worked for the establishment of the USAID and the UN Population Fund, and funding for the International Planned Parenthood Federation. He encouraged Japanese officials to provide support for international population and (FP) programs. Currently, the US provides $350 million in population assistance. Encouragement was given for Japan to increase its international commitment of $80 million and to contribute to the Johns Hopkins University William H. Draper, Jr., fellowship fund for graduate students from developing countries to study modern health communication. The special features of the US population assistance program were identified as follows: 1) high funding levels, 2) availability of FP services, 3) adequate contraceptive supplies, 4) availability of professional population staff, and 5) an emphasis on data and evaluation. The single most important element of the USAID program is the reliance on private, nongovernmental organizations (NGOs), which can establish flexible, independent, innovative and cost- effective programs. Predictions for the future were that the US Congress would expand overseas population assistance. Domestic policy will have priority, and the future will depend on who occupies the key policy positions at the State Department and USAID. THere will be more emphasis on free political elections, on humanitarian issues, and on environmental issues. New directions will be to increase funding, reduce restrictions on population assistance, increase support for NGOs, expand FP communication programs, improve the quality of FP services, increase distribution of condoms, and increase coordination among donors. The enter educate approach to promoting FP is described.

Changing Face of Family Planning Funding in Kenya: A Cross-Sectional Survey of Two Urban Counties.

PubMed

Keyonzo, Nelson; Korir, Julius; Abilla, Faith; Sirera, Morine; Nyakwara, Peter; Bazant, Eva; Waka, Charles; Koskei, Nancy; Kabue, Mark

2017-12-01

As international development partners reduce funding for family planning (FP) programs, the need to estimate the financial resources devoted to FP is becoming increasingly important both at all levels. This cross-sectional assessment examined the FP financing sources, agents, and expenditures in two counties of Kenya for fiscal years 2010/2011 and 2011/2012 to guide local decision-making on financial allocations. Data were collected through a participatory process. This involved stakeholder interviews, review of financial records and service statistics, and a survey of facilities offering FP services. Financing sources and agents were identified, and source amounts calculated. Types of FP provider organizations and the amounts spent by expenditure categories were identified. Overall, five financing sources and seven agents for FP were identified. Total two-year expenditures were KSh 307.8 M (US$ 3.62 M). The government's share of funding rose from 12% to 21% over the two years (p=0.029). In 2010/2011, the largest expense categories were administration, commodities, and labor; however, spending on commodities increased by 47% (p=0.042). This study provides local managers with FP financing and expenditure information for use in budget allocation decision-making. These analyses can be done routinely and replicated in other local counties or countries in a context of devolution.

Family medicine residency program directors' plans to incorporate maintenance of certification into residency training: a CERA survey.

PubMed

Peterson, Lars E; Blackburn, Brenna; Phillips, Robert L; Mainous, Arch G

2014-04-01

Participation in Maintenance of Certification for Family Physicians (MC-FP) is now a requirement for residents to take the American Board of Family Medicine (ABFM) certification examination. The objective of this study was to determine baseline use of MC-FP products prior to this requirement and assess how family medicine residency program directors (FMPD) intended to integrate MC-FP into residency education. We used the CERA platform to survey FMPDs. In addition to the core CERA demographic questions, we asked about the use of MC-FP in residency, how FMPDs intended to incorporate MC-FP, and how useful they believe MC-FP will be for resident evaluation. Additionally, we compared select results with the ABFM administrative database. A total of 224 FMPDs responded, for a 50.6% response rate. There was agreement between CERA and ABFM data on the percentage of residencies already using Part 4 modules (39.3% versus 38.8%) but not Part 2 modules (24.7% versus 62.8%). Group MC-FP activities were the preferred method for both Part 2 (45.0%) and Part 4 (54.4%). Most FMPDs agreed that MC-FP will be effective in teaching quality improvement and assessing competencies. Respondents from dually accredited programs were more likely to have used Part 4, but not Part 2, activities prior to 2012. Prior to MC-FP becoming a requirement in residency, a sizeable minority of residencies were already using these tools for education. Assessment of competencies will be crucial in the Next Accreditation System, and MC-FP may help in tracking clinical development over a physician's career.

Pakistan's maternal and child health policy: analysis, lessons and the way forward.

PubMed

Siddiqi, S; Haq, I U; Ghaffar, A; Akhtar, T; Mahaini, R

2004-07-01

An estimated 400,000 infant and 16,500 maternal deaths occur annually in Pakistan. These translate into an infant mortality rate and maternal mortality ratio that should be unacceptable to any state. Disease states including communicable diseases and reproductive health (RH) problems, which are largely preventable account for over 50% of the disease burden. The analysis of Pakistan's maternal and child health (MCH) and family planning (FP) policy covers the period 1990-2002, and focuses on macroeconomic influences, priority programs and gaps, adequacy of resources, equity and organizational aspects, and the process of policy formulation. The overall MCH/FP policy is well directed. MCH/FP has been a priority in all policies; resource allocation, although unacceptably low, has substantially increased during the last decade; and there is a progressive shift from MCH to the reproductive health (RH) agenda. Areas in need of improvement include greater use of evidence as a basis for policy; increased priority to nutrition programs, measures to reduce neonatal and perinatal mortality, provision of emergency obstetric care, availability of skilled birth attendants, and a clear policy on integrated management of childhood illnesses. Enhanced planning capacity, development of a balanced human resource, improved governance to reduce staff absenteeism and frequent transfers, and a greater role of the private sector in the provision of services are some organizational aspects that need the governments' consideration. There are several lessons to be learnt: (i) Ministries of Health need sustained stewardship and well-documented evidence to protect cuts in resource allocation; (ii) frequent policy announcement sends inappropriate signals to managers and weakens on-going implementation; (iii) MCH/FP policies unless informed by evidence and participation of interest groups are unlikely to address gaps in programs; (iv) distributional and equity objectives of MCH/FP be addressed while setting overall national goals; (v) institutional capacity is a vital ingredient in translating MCH/FP policies into effective services. The suggested strategic directions emphasize, among others, the need for a comprehensive MCH/FP framework; strengthened stewardship in ministry of health, cost-effective strategies to address the gaps identified and doubling of the public sector resource allocation to MCH/FP over the next 5 years. The ability to ensure delivery of quality health services remains the biggest challenge in the Pakistani health sector. Unless sound policies are backed by well-functioning programs they are likely to become a victim of poor implementation.

Closing the poor-rich gap in contraceptive use in urban Kenya: are family planning programs increasingly reaching the urban poor?

PubMed

Fotso, Jean Christophe; Speizer, Ilene S; Mukiira, Carol; Kizito, Paul; Lumumba, Vane

2013-08-27

Kenya is characterized by high unmet need for family planning (FP) and high unplanned pregnancy, in a context of urban population explosion and increased urban poverty. It witnessed an improvement of its FP and reproductive health (RH) indicators in the recent past, after a period of stalled progress. The objectives of the paper are to: a) describe inequities in modern contraceptive use, types of methods used, and the main sources of contraceptives in urban Kenya; b) examine the extent to which differences in contraceptive use between the poor and the rich widened or shrank over time; and c) attempt to relate these findings to the FP programming context, with a focus on whether the services are increasingly reaching the urban poor. We use data from the 1993, 1998, 2003 and 2008/09 Kenya demographic and health survey. Bivariate analyses describe the patterns of modern contraceptive use and the types and sources of methods used, while multivariate logistic regression models assess how the gap between the poor and the rich varied over time. The quantitative analysis is complemented by a review on the major FP/RH programs carried out in Kenya. There was a dramatic change in contraceptive use between 2003 and 2008/09 that resulted in virtually no gap between the poor and the rich in 2008/09, by contrast to the period 1993-1998 during which the improvement in contraceptive use did not significantly benefit the urban poor. Indeed, the late 1990s marked the realization by the Government of Kenya and its development partners, of the need to deliberately target the poor with family planning services. Most urban women use short-term and less effective methods, with the proportion of long-acting method users dropping by half during the review period. The proportion of private sector users also declined between 2003 and 2008/09. The narrowing gap in the recent past between the urban poor and the urban rich in the use of modern contraception is undoubtedly good news, which, coupled with the review of the family program context, suggests that family planning programs may be increasingly reaching the urban poor.

The Effect of Integrating Family Planning with a Maternal and Newborn Health Program on Postpartum Contraceptive Use and Optimal Birth Spacing in Rural Bangladesh.

PubMed

Ahmed, Saifuddin; Ahmed, Salahuddin; McKaig, Catharine; Begum, Nazma; Mungia, Jaime; Norton, Maureen; Baqui, Abdullah H

2015-09-01

Meeting postpartum contraceptive need remains a major challenge in developing countries, where the majority of women deliver at home. Using a quasi-experimental trial design, we examine the effect of integrating family planning (FP) with a community-based maternal and newborn health (MNH) program on improving postpartum contraceptive use and reducing short birth intervals <24 months. In this two-arm trial, community health workers (CHWs) provided integrated FP counseling and services during home visits along with their outreach MNH activities in the intervention arm, but provided only MNH services in the control arm. The contraceptive prevalence rate (CPR) in the intervention arm was 15 percent higher than in the control arm at 12 months, and the difference in CPRs remained statistically significant throughout the 24 months of observation. The short birth interval of less than 24 months was significantly lower in the intervention arm. The study demonstrates that it is feasible and effective to integrate FP services into a community-based MNH care program for improving postpartum contraceptive use and lengthening birth intervals. © 2015 The Population Council, Inc.

Greater involvement of HIV-infected peer-mothers in provision of reproductive health services as "family planning champions" increases referrals and uptake of family planning among HIV-infected mothers.

PubMed

Mudiope, Peter; Musingye, Ezra; Makumbi, Carolyne Onyango; Bagenda, Danstan; Homsy, Jaco; Nakitende, Mai; Mubiru, Mike; Mosha, Linda Barlow; Kagawa, Mike; Namukwaya, Zikulah; Fowler, Mary Glenn

2017-06-27

In 2012, Makerere University Johns - Hopkins University, and Mulago National Referral Hospital, with support from the National Institute of Health (under Grant number: NOT AI-01-023) undertook operational research at Mulago National Hospital PMTCT/PNC clinics. The study employed Peer Family Planning Champions to offer health education, counselling, and triage aimed at increasing the identification, referral and family planning (FP) uptake among HIV positive mothers attending the clinic. The Peer Champion Intervention to improve FP uptake was introduced into Mulago Hospital PMTCT/PNC clinic, Kampala Uganda. During the intervention period, peers provided additional FP counselling and education; assisted in identification and referral of HIV Positive mothers in need of FP services; and accompanied referred mothers to FP clinics. We compiled and compared the average proportions of mothers in need that were referred and took up FP in the pre-intervention (3 months), intervention (6 months), and post-intervention(3 months) periods using interrupted time series with segmented regression models with an autoregressive term of one. Overall, during the intervention, the proportion of referred mothers in need of FP increased by 30.4 percentage points (P < 0.001), from 52.7 to 83.2 percentage points. FP uptake among mothers in need increased by over 31 percentage points (P < 0.001) from 47.2 to 78.5 percentage points during the intervention. There was a positive non-significant change in the weekly trend of referral β 3  = 2.9 percentage points (P = 0.077) and uptake β 3  = 1.9 percentage points (P = 0.176) during the intervention as compared to the pre-intervention but this was reversed during the post intervention. Over 57% (2494) mothers took up Depo-Provera injectable-FP method during the study. To support overstrained health care work force in post-natal clinics, peers in trained effective family planning can be a valuable addition to clinic staff in limited-resource settings. The study provides additional evidence on the utilization of peer mothers in HIV care, improves health services uptake including family planning which is a common practice in many donor supported programs. It also provides evidence that may be used to advocate for policy revisions in low-income countries to include peers as support staff especially in busy clinic settings with poor services uptake.

A diagnostic study of Department of Health training courses for family planning providers.

PubMed

Rood, S; Raquepo, M; Ladia, M A

1993-01-01

A study in the Philippines sought to observe and describe the family planning (FP) training program in two regions. This program trains physicians, nurses, and midwives as a team and includes a Basic/Comprehensive (B/C) course in FP with didactic and practicum elements, training in interpersonal communication skills (ICS) for those who have completed with B/C course, and a Preceptors Course for those who will supervise the practicum phase of the B/C course. The study gathered specific information on 1) trainee absenteeism and drop-out rates, 2) course content and effects, 3) the trainee selection process, 4) the practicum requirement for the B/C course, and 5) service delivery values and quality of care. Data were collected through observations, questionnaires, exit interviews with clients during the practicum phase, interviews with supervisors and public officials (mayors), and focus group discussions with regional trainers. This assessment led to the following recommendations: 1) maintain the current team approach; 2) reserve basic orientation-type subjects for office-based training to allow more time for FP topics in the training programs; 3) use caution in making a switch to "competency-based" training because of the possibility that supervision is inadequate for such a training method; 4) improve scheduling; 5) enforce the prerequisites for participation in the ICS and Preceptors Courses; 6) assign only one trainee to a preceptor area during the practicum and reduce the quota of IUD insertions to reduce pressure to obtain IUD acceptors; 7) create a "model" FP clinic each time a preceptor is trained; 8) pay more attention to natural FP methods; and 9) maintain an emphasis on quality of care.

An invisible benefit: integrated project on family planning and parasite control has expanded operations multi-dimensionally.

PubMed

Taniguchi, H

1985-11-01

Resolutions adopted by the 12th Annual Asian Parasite Control/Family Planning (APCO/FP) Conference held in Colombo, Sri Lanka urge the incorporation of quality of life issues of all dimensions in projects of all participating countries. 1 study discussed during the conference concerned health volunteers of the integrated project in Sri Lanka, which analyzes motivating factors which make community young people work on a voluntary basis. Another topic covered was the role of women in the achievement of primary health care. Video reports were presented by Bangladesh on family planning and parasite control activities, Brazil on utilization of existing organizations to improve successful integrated projects, China on making twin concerns of family planning and primary health care, Indonesia on strengthening urban FP/MCH clinics, Korea on health promotion through the integrated project, Malaysia on the NADI program, the Philippines on the Cebu model of integrated health care, and Thailand on fee charging urban programs.

Family planning in Guinea: a need for better public commitment.

PubMed

Delamou, Alexandre; Koivogui, Akoi; Dubourg, Dominique; Delvaux, Thérèse

2014-01-01

To describe the evolution of family planning (FP) in Guinea and to identify strengths, weaknesses, opportunities and threats of the current FP programme. Descriptive study of the evolution of FP in Guinea between 1992 and 2010. First, national laws as well as health policies and strategic plans related to reproductive health and family planning were reviewed. Second, FP indicators were extracted from the Guinean Demographic and Health Surveys (1992, 1999 and 2005). Third, FP services, sources of supply and data on FP funding were analysed. Laws, policies and strategic plans in Guinea are supportive of FP programme and services. Public and private actors are not sufficiently coordinated. The general government expenditure on health has remained stable at 6-7% between 2005 and 2011 despite a doubling of total expenditures on health, and contraceptives are supplied by foreign aid. Modern contraceptive prevalence slightly increased from 1.5% in 1992 to 6.8% in 2005 among women aged 15-49. A stronger national engagement in favour of repositioning FP should result in improved government funding of the FP programme and the promotion of long-acting and permanent methods. © 2013 John Wiley & Sons Ltd.

Fertility desires and unmet need for family planning among HIV infected individuals in two HIV clinics with differing models of family planning service delivery.

PubMed

Wanyenze, Rhoda K; Matovu, Joseph K B; Kamya, Moses R; Tumwesigye, Nazarius M; Nannyonga, Maria; Wagner, Glenn J

2015-01-28

Eliminating family planning (FP) unmet need among HIV-infected individuals (PLHIV) is critical to elimination of mother-to-child HIV transmission. We assessed FP unmet need among PLHIV attending two clinics with differing models of FP services. Nsambya Home Care provided only FP information while Mulago HIV clinic provided information and contraceptives onsite. In a cross-sectional study conducted between February-June 2011, we documented pregnancies, fertility desires, and contraceptive use among 797 HIV-infected men and women (408 in Mulago and 389 in Nsambya). FP unmet need was calculated among women who were married, unmarried but had sex within the past month, did not desire the last or future pregnancy at all or wished to postpone for ≥ two years and were not using contraceptives. Multivariable analyses for correlates of FP unmet need were computed for each clinic. Overall, 40% (315) had been pregnant since HIV diagnosis; 58% desired the pregnancies. Of those who were not pregnant, 49% (366) did not desire more children at all; 15.7% wanted children then and 35.3% later. The unmet need for FP in Nsambya (45.1%) was significantly higher than that in Mulago at 30.9% (p = 0.008). Age 40+ compared to 18-29 years (OR = 6.05; 95% CI: 1.69, 21.62 in Mulago and OR = 0.21; 95% CI: 0.05, 0.90 in Nsambya), other Christian denominations (Pentecostal and Seventh Day Adventists) compared to Catholics (OR = 7.18; 95% CI: 2.14, 24.13 in Mulago and OR = 0.23; 95% CI: 0.06, 0.80 in Nsambya), and monthly expenditure > USD 200 compared to < USD40 in Nsambya (OR = 0.17; 95% CI: 0.03, 0.90) were associated with FP unmet need. More than half of the pregnancies in this population were desired. Unmet need for FP was very high at both clinics and especially at the clinic which did not have contraceptives onsite. Lower income and younger women were most affected by the lack of contraceptives onsite. Comprehensive and aggressive FP programs are required for fertility support and elimination of FP unmet need among PLHIV, even with integration of FP information and supplies into HIV clinics.

Training: more user friendly.

PubMed

Horibe, N

1994-03-01

China launched its family planning program in 1971 by initially focusing on public information campaigns and providing services to married couples nationwide. It eventually instituted programs to improve maternal and child health/family planning (MCH/FP) through better quality service. Such programs introduced interpersonal communication and counseling to improve quality service. In 1990, with help from UNICEF and the United Nations Population Fund [UNFPA], the Ministry of Public Health (MOPH) implemented a project to improve MCH/FP in 300 of China's poorest counties. Its training activities are chiefly for physicians and emphasize safe motherhood, breast feeding, diarrhea, case management of acute respiratory infection, and FP. Interpersonal communication and counseling has been included in each of these areas. Also with UNFPA assistance, the State Family Planning Commission (SFPC) began a project in 1991, targeting township and village family planning workers, which concentrates on interpersonal communication and counseling in its service delivery system. MOPH and SFPC are China's 2 vertical service delivery systems and they do not cooperate at the central level. At the lower level, however, they work together in interpersonal communication and counseling training. The training uses the participatory training method, which encourages two-way communication. The curriculum addresses motivation; education and counseling; perception, values, and misconceptions; verbal and nonverbal communications; interviewing and listening skills; and how to help the client's decision making. Feedback is very important. The participatory method training class should not exceed 50 participants, but financial constraints make this difficult in China. Short-term benefits of the training are: inspiration to trainers, increased sensitivity to the clients' needs and feelings, and exposure to an international professional work ethic and practice.

China marks World Population Day. Address by Zhang Weiqing: (Excerpts).

PubMed

Zhang, W

1998-08-01

This is a summary of remarks by Minister Zhang Weiqing of China's State Family Planning Commission (SFPC) given on World Population Day in China. The world's population size has increased by 1 billion since 1987, and will reach 6 billion by 1999. As the most populous developing country in the world, China has a greater population pressure and bears a large responsibility regarding stabilization of the world's population and realization of sustainable development. China has a less developed economy and a high percentage of rural and illiterate persons, many of whom are below the poverty line. The interests of both present and future generations must be taken into account with regard to development. In addition, the modernization drive must include strategies for sustainable development and basic national policies of FP and environmental protection in order to achieve a balance among population growth, the economy, resources, and the environment. After 30 years of effort, China has succeeded in solving its population problem by integrating governmental guidance with voluntary public participation in FP. In 1997, the birthrate decreased to 16.57/1000, and the total fertility rate was below replacement level. Changes in attitude toward marriage and childbearing have occurred, as has awareness of voluntary participation in FP. However, some problems have emerged in the implementation of population and FP programs. China will carry out its programs strictly and effectively while developing the national economy. Goals include: 1) stressing the IEC program regarding contraception and regular FP management and services; 2) integrating the FP program with economic development; 3) helping the public to become well off; 4) protecting maternal and child health; 5) improving the status of women; 6) delivering reproductive services; and 7) improving social security measures. Efforts will be made to enable the public to have a more active part in implementing the FP program.

GO-NGO collaboration in FP programs.

PubMed

1997-10-01

JOICFP has conducted the Seminar on Family Planning Administration for Senior Officers II regularly since 1967, providing training in family planning to 1151 participants in more than 70 countries over the period. 16 representatives from governmental (GO) and nongovernmental organizations (NGOs) from Bangladesh, Ghana, Indonesia, Jordan, Mexico, Nepal, the Philippines, and Tanzania attended the 1997 seminar, held in Japan from August 25 through September 12. It was the first time that one representative each of a GO and an NGO from each country attended the training course. GO-NGO collaboration was emphasized throughout the seminar with the goal of fostering better GO-NGO working relationships. Participants were provided with background on the promotion of family planning and maternal and child health (FP/MCH) in Japan from postwar times up to the present and the role played by GO-NGO collaboration in the success of these activities and the preventive healthcare movement in general. The other major theme of the event was the development of strategies to achieve the self-reliance of programs such as the community-based promotion of integrated programs. Excerpts are presented from interviews with 3 participants.

Beyond Cairo: changing directions for population policies in the Asia-Pacific region.

PubMed

Jones, G W

1998-01-01

This article reviews post-Cairo thinking about population policies, program strategies by governments in the Asia-Pacific region, and the prospects for implementing reproductive health (RH) services. Cairo's action plan emphasizes development of broad social policy, sustainability, and RH. There is no mechanism of enforcement. Asia is very diverse in population size, trends in fertility and mortality, rates of economic development, patterns of migration, and development approaches. RH approaches are not controversial in Asian countries that are below, have, or are approaching replacement level fertility. Economic crises have occurred since the 1994 Cairo Plan. The region needs the Cairo focus on women's empowerment and a humane attitude to women in family planning (FP) implementation. The Cairo approach to human rights, equitable gender relations, RH and rights, and poverty alleviation is needed. It is not possible to specify what kind of FP program inputs will produce specific impacts, without considering broader policy and program contexts. Satisfaction of unmet need would more than exceed targets for fertility decline in 13 of 17 Asian countries. A focus on unmet need could take 10 years. All approaches require an expansion of service outreach. Research can determine cost effectiveness of essential RH services. RH requires institutional structures that promote a holistic view, gender sensitive quality care, and community participation. There is a need to retrain, upgrade skills, and reorient attitudes. Available financial services must be effectively used. RH must not dilute scarce FP resources.

A scoping review on determinants of unmet need for family planning among women of reproductive age in low and middle income countries.

PubMed

Wulifan, Joseph K; Brenner, Stephan; Jahn, Albrecht; De Allegri, Manuela

2016-01-15

Poor access and low contraceptive prevalence are common to many Low- and Middle-Income Countries (LMICs). Unmet need for family planning (FP), defined as the proportion of women wishing to limit or postpone child birth, but not using contraception, has been central to reproductive health efforts for decades and still remains relevant for most policy makers and FP programs in LMICs. There is still a lag in contraceptive uptake across regions resulting in high unmet need due to various socioeconomic and cultural factors. In this mixed method scoping review we analyzed quantitative, qualitative and mixed method studies to summarize those factors influencing unmet need among women in LMICs. We conducted our scoping review by employing mixed method approach. We included studies applying quantitative and qualitative methods retrieved from online data bases (PubMed, JSTOR, and Google Scholar). We also reviewed the indexes of journals specific to the field of reproductive health by using a set of keywords related to unmet contraception need, and non-contraception use in LMICs. We retrieved 283 articles and retained 34 articles meeting our inclusion criteria. Of these, 26 were quantitative studies and 8 qualitative studies. We found unmet need for FP to range between 20 % and 58% in most studies. Woman's age was negatively associated with total unmet need for FP, meaning as women get older the unmet need for FP decreases. The number of children was found to be a positively associated determinant for a woman's total unmet need. Also, woman's level of education was negatively associated--as a woman's education improves, her total unmet need decreases. Frequently reported reasons for non-contraception use were opposition from husband or husbands fear of infidelity, as well as woman's fear of side effects or other health concerns related to contraceptive methods. Factors associated with unmet need for FP and non-contraception use were common across different LMIC settings. This suggests that women in LMICs face similar barriers to FP and that it is still necessary for reproductive health programs to identify FP interventions that more specifically tackle unmet need.

Family planning decisions, perceptions and gender dynamics among couples in Mwanza, Tanzania: a qualitative study

PubMed Central

2013-01-01

Background Contraceptive use is low in developing countries which are still largely driven by male dominated culture and patriarchal values. This study explored family planning (FP) decisions, perceptions and gender dynamics among couples in Mwanza region of Tanzania. Methods Twelve focus group discussions and six in-depth interviews were used to collect information from married or cohabiting males and females aged 18–49. The participants were purposively selected. Qualitative methods were used to explore family planning decisions, perceptions and gender dynamics among couples. A guide with questions related to family planning perceptions, decisions and gender dynamics was used. The discussions and interviews were tape-recorded, transcribed verbatim and analyzed manually and subjected to content analysis. Results Four themes emerged during the study. First, “risks and costs” which refer to the side effects of FP methods and the treatment of side -effects as well as the costs inherit in being labeled as an unfaithful spouse. Second, “male involvement” as men showed little interest in participating in family planning issues. However, the same men were mentioned as key decision-makers even on the number of children a couple should have and the child spacing of these children. Third, “gender relations and communication” as participants indicated that few women participated in decision-making on family planning and the number of children to have. Fourth, “urban–rural differences”, life in rural favoring having more children than urban areas therefore, the value of children depended on the place of residence. Conclusion Family Planning programs should adapt the promotion of communication as well as joint decision-making on FP among couples as a strategy aimed at enhancing FP use. PMID:23721196

Contraceptive use in Indonesia: a history of the programme and the characteristics of users.

PubMed

Samosir, O B

1992-12-01

In Indonesia, President Suharto instituted a population policy in the late 1960s to achieve national development goals. The government also introduced education, health, and economic-oriented development programs. Since then, it has continued to provide political, legal, moral, administrative, and financial support to the national family planning (FP) program. The program was first introduced in the most populous provinces of Java and Bali. It eventually spread to the remaining provinces. It has 3 component programs to achieve national population goals: on extension program (IEC activities and free contraceptives), program maintenance (community-based distribution), and an institutionalization program (integrated programs, population education, and recruiting community leaders). In 1987, the FP Self-Reliance and Blue Circle Campaign programs began to turn FP responsibilities over to communities and individuals. Between 1967 and 1981, the total fertility rate (TFR) fell from 5.61 to 4.06. The greatest fertility declines were in Bali (48.11%) and North Sulawesi (47.2%). An analysis of 1987 National Indonesian Contraceptive Prevalence Survey data shows that the TFR fell from 4.3 to 3.5 (23%) between 1984 and 1987. Between 1980 and 1987, the contraceptive use rate rose from 27 to 48%. Java and Bali had the highest contraceptive user rates. Large family size had a significant positive effect on contraceptive use. Educated women were more likely to use contraceptives than uneducated women, especially in Outer Java-Bali regions. In some regions, the husband's education affected contraceptive use. Muslim women were less likely to use contraceptives than other women in Bali and Outer Java-Bali I. Even though urban women had the highest use rates, the FP program was more successful in rural areas. The success of the national FP program and other development programs accounted for the fertility decline as well as the decline in mortality, resulting in a fall in the population growth rate.

Reaching the hard to reach.

PubMed

Bhiwandi, P; Campbell, M; Potts, M

1994-01-01

The 1994 International Conference on Population and Development proposed increasing contraceptive couple protection from 550 million in 1995 to 880 million in 2015. The task for family planning (FP) programs is to provide access to services for, sometimes, inaccessible rural populations. FP need based on desire for no more children has ranged from under 20% in Senegal to almost 80% in Peru. Socioeconomic development was found not to be a prerequisite for fertility change. Gender inequalities in education and social autonomy must be changed. FP access is very important among women with a disadvantaged background or among women unsure about FP. Bangladesh is a good example of a country with increased contraceptive prevalence despite low income. The rule of thumb is that contraception increases of 15% contribute to a drop in family size of about one child. Program effectiveness is related to a variety of factors: contraceptive availability at many locations, acceptable price of contraception, delivery of the oral contraceptives without prescriptions, and other strategies. FP is a service not a medical treatment. A range of methods must be promoted and available from a range of facilities. Contraceptive use is dependent on the woman's stage in her lifecycle and is dependent on informed choice. Community-based distribution systems are effective, whereas free distribution by poorly-trained field workers is not always very effective because patient payment of all or part of the cost assures quality and freedom of choice. Effective programs for underprivileged groups involve aggressive, easy to manage programs that can be replicated rapidly. FP serves a useful function in depressing maternal mortality among the poor in Africa, who have no access to quality health services. Social marketing is an effective strategy for reaching remote areas. Political will and robust management are necessary commodities.

[Family planning programs and birth control in the third world].

PubMed

Wohlschlagl, H

1991-01-01

The population explosion has been abating since the 2nd half of the 1960s. The birth rate of the 3rd World dropped from 45/1000 during 1950-55 to 31/1000 during 1985-90. From the 1st half of the 1960s to the 1st half of the 1980s the total fertility of such countries dropped from 6.1 to 4.2 children/woman. In Taiwan, Singapore, Hong Kong, South Korea, and Malaysia living standards improved as a result of industrialization, and fertility decreased significantly. In Sri Lanka, China, North Vietnam, and Thailand the drop of fertility is explained by cultural and religious factors. In 1982 about 78% of the population of developing countries lived in 39 states that followed an official policy aimed at reducing the population. Another 16% lived in countries supporting the concept of a desired family size. However, World Bank data showed that in the mid-1980s in 27 developing countries no state family planning (FP) programs existed. India adopted an official FP program in 1952, Pakistan followed suit in 1960, South Korea in 1961, and China in 1962. In Latin America a split policy manifested itself: in Brazil birth control was rejected, only Colombia had a FP policy. In 1986 the governments of 68 of 131 developing countries representing 3.1 billion people considered the number of children per woman too high. 31 of these countries followed concrete population control policies. On the other hand, in 1986 24 countries of Africa with 40% of the continent's population took no measures to influence population growth. In Latin America and the Caribbean 18 of 33 countries were idle, except for Mexico that had a massive state FP program. These programs also improve maternal and child health with birth spacing of at least 2 years, and the prevention of pregnancies of too young women or those over 40. The evaluation of rapidly spreading FP programs in the 1970s was carried out by the World Fertility Survey in 41 countries. The impact of FP programs was more substantial than socioeconomic factors. Contraceptive use increased in Mexico from 13% in 1973 to 41% in 1978 among women of fertile age. According to 1984 and 1988 UN data modern methods of contraception were used by 70% of women in China, 60-65% in Southeast Asia, Costa Rica, and Puerto Rico. In contrast, less than 5% used them in most countries of Africa, 15-20% in West Asia, 25-30% in South Asia, and 40% in Latin America. The pill was the most popular method. From the early 1980s in South and East Asia 1/5 of women got sterilized after attaining the desired family size. Less than 10% of women used IUDs in developing countries. FP programs have benefited from higher education levels and economic incentives and sanctions and exemplified in Singapore, China, South Korea, Thailand, and Taiwan.

Evolution of China's family planning policy and fertility transition.

PubMed

Lin, F

1998-06-01

This article points out the important role of family planning (FP) in controlling population growth in China. The impact of development on fertility decline is much slower. China's current FP policy promotes deferred marriage and deferred childbearing and fewer, but healthier, births. The policy promotes one child per couple. Rural couples in certain circumstances, such as if the first birth is a girl, are allowed to have a second child that is properly spaced. FP should be promoted in ethnic inhabited areas. Under this policy, fertility declined from 2.59 to 2 children/woman during the period 1987-92. In more developed areas, fertility has declined below replacement level to 1.6. FP was first promoted in the National Program for Agricultural Development in the 1950s. Birth control was promoted in densely populated areas without high minority concentrations. Fertility hovered around 6.1 during 1950-57. The Cultural Revolution halted fertility decline. The 1974 FP policy emphasized deferred marriage and deferred childbearing, and spaced (by 4-5 years) but fewer births. Fertility declined from 4.2 to 2.3 during 1974-80, in response to the government directive. Rural population declined from 4.6 to 2.5, and urban population declined from 2.0 to 1.15. The one-child policy was promoted in 1980 and became official state policy. FP became an obligation to the state. Rural areas were less compliant with the one-child policy, which led to the 1984 allowances for a second child.

Integrating family planning and HIV services in western Kenya: the impact on HIV-infected patients' knowledge of family planning and male attitudes toward family planning.

PubMed

Onono, Maricianah; Guzé, Mary A; Grossman, Daniel; Steinfeld, Rachel; Bukusi, Elizabeth A; Shade, Starley; Cohen, Craig R; Newmann, Sara J

2015-01-01

Little information exists on the impact of integrating family planning (FP) services into HIV care and treatment on patients' familiarity with and attitudes toward FP. We conducted a cluster-randomized trial in 18 public HIV clinics with 12 randomized to integrated FP and HIV services and 6 to the standard referral-based system where patients are referred to an FP clinic. Serial cross-sectional surveys were done before (n = 488 women, 486 men) and after (n = 479 women, 481 men) the intervention to compare changes in familiarity with FP methods and attitudes toward FP between integrated and nonintegrated (NI) sites. We created an FP familiarity score based on the number of more effective FP methods patients could identify (score range: 0-6). Generalized estimating equations were used to control for clustering within sites. An increase in mean familiarity score between baseline (mean = 5.16) and post-intervention (mean = 5.46) occurred with an overall mean change of 0.26 (95% confidence intervals [CI] = 0.09, 0.45; p = 0.003) across all sites. At end line, there was no difference in increase of mean FP familiarity scores at intervention versus control sites (mean = 5.41 vs. 5.49, p = 0.94). We observed a relative decrease in the proportion of males agreeing that FP was "women's business" at integrated sites (baseline 42% to end line 30%; reduction of 12%) compared to males at NI sites (baseline 35% to end line 42%; increase of 7%; adjusted odds ration [aOR] = 0.43; 95% CI = 0.22, 0.85). Following FP-HIV integration, familiarity with FP methods increased but did not differ by study arm. Integration was associated with a decrease in negative attitudes toward FP among men.

Lessons we most enjoy learning.

PubMed

Coleman, P L

1993-03-01

In the mid-1970s, the Philippine Commission on Population (POPCOM) began to use entertainment programs for reaching people with messages on population and development issues. 2 major motion pictures contained family planning (FP) messages. Radio dramas, print media, and theater also were used to convey FP messages. The early experiments were continued in the late 1980s through the work of the Philippine Center for Population and Development (PCPD). PCPD, with the assistance of the Johns Hopkins University/Population Communication Services (JHU/PCS) project, embarked on a program which used popular music to encourage young people to become sexually responsible adults. In 1990, the Philippine Non-Governmental Organization Council (PNGOC), the Department of Health (DOH) and JHU/PCS began an effort funded by USAID to form a coalition with the entertainment community for social development causes. DOH, JHU/PCS, and USAID wanted to promote FP and health through the Enter-Educate concept. PNGOC and JHU/PCS contacted over 20 entertainment organizations and held more than 75 conferences, work shops, and meetings which attended by more than 300 people. The movement of Entertainment for Social Change was launched in October 1991 with the creation of the Enter-Educate Foundation, Inc. (EEF). The aims of EEF include rewards, professional approach, and establishment of a network of dedicated entertainment and social development professionals. In 1993, a television comedy series will focus on FP as well as on maternal and child health. Further plans at the local level include: tree planting; discussions on migration; talks about FP; meetings on community population and environment activities; and networking of organizations involved with youth, the environment, and population. JHU/PCS provides technical assistance for the production, monitoring, and evaluation of the project. With these efforts, the EEF is attempting to focus on the country's biggest problems: population and the environment.

Public Law 100-461, Foreign Operations, Export Financing and Related Programs Appropriations Act, 1989, 1 October 1988.

PubMed

1988-01-01

This Act does the following among other things: 1) prohibits using funds appropriated under the Act to lobby for abortion and 2) prohibits making development assistance funds available 1) to pay for abortions as a method of family planning (FP) or to motivate or coerce any person to perform abortions; 2) to pay for involuntary sterilization as a method of FP or to coerce or provide any financial incentive to any person to undergo sterilization; 3) to pay for biomedical research that relates to the methods of, or performance of, abortions or involuntary sterilization as a means of FP; or 4) to any country or organization if the use of such funds by such country or organization would violate any of the abortion or involuntary sterilization provisions. It also reaffirms the commitment of the US Congress to population, development assistance, and the need for informed voluntary FP. full text

How are we doing? Evaluation as part of sexuality education.

PubMed

Brick, P

1997-01-01

In 1986, Planned Parenthood of Greater Northern New Jersey (PPGNNJ) began to evaluate its sex education programs. First PPGNNJ staff evaluated a 1-day, 40-minute lesson designed to help high school students 1) identify risk behavior for unplanned pregnancy, 2) estimate risk, and 3) review basic contraceptive methods. This project showed that a single lesson could substantially increase knowledge about contraception and comfort with the idea of condoms and family planning (FP) clinic use. A second PPGNNJ evaluation project revealed that adding a motivational video to the lesson increased the feeling of comfort expressed about use of an FP clinic and that PPGNNJ staff were more effective than regular teachers in promoting change in attitudes about FP services, but teachers were more effective in promoting longterm knowledge of risk. Evaluation of five popular AIDS prevention videos revealed that all of the videos significantly increased HIV/AIDS knowledge and motivation to seek protection. However, the videos made many viewers feel helpless about their ability to protect themselves and unwilling to support an AIDS home in their neighborhood. PPGNNJ's staff also designed the "Human Sexuality Questionnaire" to determine the impact of a five-session sex education program delivered to high-risk youth. This tool is now used in program evaluation nationwide. Evaluation of two date rape prevention strategies (a single-lesson, interactive date-rape scenario and a video) revealed a significant impact on females and none on males. Testing of a 1994 video and discussion session designed to improve adolescent attitudes towards use of an FP clinic also had positive results. While these evaluation methodologies were not problem-free, evaluation forced PPGNNJ staff to define objectives and lessons, enter a new collaboration with schools, and use results to continually evaluate work.

The effect of family sex composition on fertility desires and family planning behaviors in urban Uttar Pradesh, India.

PubMed

Calhoun, Lisa M; Nanda, Priya; Speizer, Ilene S; Jain, Meenakshi

2013-09-11

A cultural preference for sons has been well documented in India, resulting in skewed sex ratios, especially exhibited in northwest India. Previous research has shown that family sex composition is associated with family planning (FP) use and couples' desire for more children. This study examines family sex composition and fertility and FP behaviors in urban Uttar Pradesh, India; little work has examined these issues in urban settings where family sizes are smaller and FP use is common. Data for this analysis comes from a 2010 representative survey of married, non-pregnant fecund women aged 15-49 from six cities in Uttar Pradesh, India. Multivariate analyses are used to examine the association between family sex composition and fertility desires and FP use. The multivariate results indicate that family sex composition is associated with fertility desires and FP use. Women without living children and without at least one child of each sex are significantly less likely to want no more children and women with both sons and daughters but more sons are significantly more likely to want no more children as compared to women that have both sons and daughters but more daughters. Women with no living children and women with daughters but no sons are less likely to be modern FP users than nonusers whereas women with both sons and daughters but more sons are more likely to be modern FP users than nonusers as compared to women with both sons and daughters but more daughters. These findings confirm that family sex composition affects fertility behavior and also reveals that preference for sons persists in urban Uttar Pradesh. These results underscore the importance of programs and policies that work to enhance the value of girl children.

The effect of family sex composition on fertility desires and family planning behaviors in urban Uttar Pradesh, India

PubMed Central

2013-01-01

Background A cultural preference for sons has been well documented in India, resulting in skewed sex ratios, especially exhibited in northwest India. Previous research has shown that family sex composition is associated with family planning (FP) use and couples’ desire for more children. This study examines family sex composition and fertility and FP behaviors in urban Uttar Pradesh, India; little work has examined these issues in urban settings where family sizes are smaller and FP use is common. Methods Data for this analysis comes from a 2010 representative survey of married, non-pregnant fecund women aged 15–49 from six cities in Uttar Pradesh, India. Multivariate analyses are used to examine the association between family sex composition and fertility desires and FP use. Results The multivariate results indicate that family sex composition is associated with fertility desires and FP use. Women without living children and without at least one child of each sex are significantly less likely to want no more children and women with both sons and daughters but more sons are significantly more likely to want no more children as compared to women that have both sons and daughters but more daughters. Women with no living children and women with daughters but no sons are less likely to be modern FP users than nonusers whereas women with both sons and daughters but more sons are more likely to be modern FP users than nonusers as compared to women with both sons and daughters but more daughters. Conclusions These findings confirm that family sex composition affects fertility behavior and also reveals that preference for sons persists in urban Uttar Pradesh. These results underscore the importance of programs and policies that work to enhance the value of girl children. PMID:24025670

A recipe for success: ingredients for a successful family planning program.

PubMed

Merrill, J

1992-09-01

The basic elements of a successful family planning (FP) program are variable between countries. Providing better access to modern contraceptives, access to general and reproductive health care, and increasing economic and educational opportunities contribute to reducing fertility rates. Effective distribution is constrained by rural, isolated populations and cultural attitudes. Indonesia has used floating clinics located on boats to reach inaccessible areas; Norplant and hormonal injection availability also contribute to the 53% contraceptive prevalence rate. The Japanese Organization for International Cooperation in Family Planning has shipped bicycles to developing countries. The result has been improved status among peers and greater program success. Contraceptive social marketing programs (CSM) have been successful in some countries to distribute contraceptives through local channels such as shops and stalls; people seem willing to pay also. CSM has been successful in Egypt in increasing condom sales. IUD use increased from 11% to 42% between 1975-88 with CSM. Multimedia promotion that is carefully researched and targeted is another way to increase contraceptive prevalence (CP) rates. A Brazilian multimedia vasectomy campaign led to an 80% monthly increase in Pro-Pater male health clinics. 240,000 women in Turkey were encouraged through multimedia efforts to switch to modern methods. In Zimbabwe, men have been the target of efforts to educate them about the advantages of small families. Women are recruited to implement FP services in INdia and in poor neighborhoods; an increase from 12% to 61% was achieved. Highly motivated workers with a respect for the community's values is essential to any successful FP program as is government support. China's policy has drawn criticism; China has welcomed a UN program which provides financial motivation. Thailand has been successful due to the commitment between public and private sectors; in 17 years CP rose from 10% to 68%. Family life education is prevalent; female literacy is high at 96%.

[Provide comprehensive service for state policy].

PubMed

Wu, X

1991-04-01

In recent years, Chinese insurance companies introduced family planning (FP) insurance series. These schemes originated from the "one child" and life insurance and accident insurance of the early 1980s, which were established in response to the need that came with the "one child" policy. In order to help relieve the difficulties of rural FP work, the People's Insurance Corporation extended these programs to a series of schemes. These schemes included e.g., and old age security program for the families with 1 daughter only, old age security for families with an only child, and the program for FP workers' personal safety. The purpose of these schemes was to guarantee security in old age for families with few children, to ensure compensation if accident occurs during delivery or as a result of birth control operations; and compensation for FP workers for physical assaults they encountered. As FP organizations have been directly involved in advertising the insurance programs, there has been support from local governments with human and financial resources, and these insurance programs have been expanding every year. The payment of the policy has been either entirely or partially borne by the employers of the insured. In the process of the development of the insurance program, some problems have occurred. 1st, competition between FP organizations and insurance companies have evolved in sponsoring the program for its profit. 2nd, some media reports have confused the payment of premiums with the compulsory levy of undue fees, which in a way, hindered the expansion of program enrollment. 3rd, some local administrations are short of funds to pay for the insurance premiums. 4th, the accrued income from the premiums is lower than the expected sum of the principle and interest if the same funds were deposited in a bank at current interest rate. Therefore, some schemes lack appeal. FP series insurance is a longer term program which will have an important impact on the realization of the aim of population policy, and on the welfare of the population. The government should give adequate emphasis to the management of the program. The fund from the policy premiums could be used in high return and low risk investment in order to increase the appeal of the insurance schemes. Besides the current resources for the payment of premiums, funds from government allocation, penalty payment from those who have birth above the quota, one-child allowance, donations from communities or individuals, and income from special lotteries could also be used to pay the premiums.

Advocacy in the Western Hemisphere Region: some FPA success stories.

PubMed

Andrews, D J

1996-01-01

The International Planned Parenthood Federation's Vision 2000 Strategic Plan has emphasized advocacy and the training of family planning associations (FPAs) in the Western Hemisphere region. During the summer of 1995 training programs in advocacy leadership management were sponsored for six FPAs in the Bahamas, Suriname, Belize, Colombia, Honduras, and Brazil. At the Western Hemisphere Regional Council Meeting in September 1995 awards were presented to FPAs for media outstanding projects. These FPAs used outreach to the community to promote the goals of Vision 2000. The Bahamas FPA won the Rosa Cisneros Award for articles published in a magazine that is distributed in primary and secondary schools and deals with the activities, achievements, and opinions of students. Issues include: love, relationships, responsibility, and teen pregnancy. A weekly television talk show also addresses the issues facing youth including education, music, community work, sexuality, pregnancy, and the relationship between teenagers and adults. The Family Planning Association of Honduras was also nominated for the award for a radio show on the health of mothers and children, the problems of adolescents, and FP. The newspaper Tiempo received the award for feature articles on social issues and FP. In 1994 the Association distributed thousands of booklets on contraceptives as well as fliers on vasectomy, female sterilization, oral contraceptives, IUDs, condoms, responsible parenthood, high-risk pregnancy, vaginal cytology, and cervical cancer. Similar posters were placed in hospitals and health centers, in 1997 FP posts, and 400 commercial outlets. The Family Planning Association of Suriname also carried out an impressive advocacy program during the period of 1968-93 with the goals of establishing a balance between population growth and the available resources to achieve well-being with regard to education, health care, nutrition, and housing.

Lazy evaluation of FP programs: A data-flow approach

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wei, Y.H.; Gaudiot, J.L.

1988-12-31

This paper presents a lazy evaluation system for the list-based functional language, Backus` FP in data-driven environment. A superset language of FP, called DFP (Demand-driven FP), is introduced. FP eager programs are transformed into DFP lazy programs which contain the notions of demands. The data-driven execution of DFP programs has the same effects of lazy evaluation. DFP lazy programs have the property of always evaluating a sufficient and necessary result. The infinite sequence generator is used to demonstrate the eager-lazy program transformation and the execution of the lazy programs.

Iran rebuilds family planning services.

PubMed

Butta, P

1993-07-01

After the revolution, the Islamic Republic of Iran instituted pronatalist policies which included lowering the minimum marriage age for girls to 9 years, abolishing some laws securing women's rights, and limiting availability of family planning (FP) services. By 1983, Iran's population growth rate was 3.9% which was among the highest worldwide. Before the revolution, Iran had 37 million people. About 2 million more people were added each year, resulting in a population size of 60 million by 1992. By the mid-1980s, economic development stood idle, there were not enough houses, children attended schools on 3 shifts, and malnutrition was spreading. In 1989, the government formed a population council and reestablished FP services. It also increased the minimum age of marriage for girls to 13 years, slightly improved women status, and eliminated fertility incentives for couples with at least 4 children. It also significantly increased funding for FP (from 560 million to 13 billion rials between 1990 and 1992). Government spending for FP will likely increase 2% annually until 2011. The government initiated a promotion of FP mass media campaign, emphasizing a 2-child family. Some posters showed a family with 2 girls. The mass media campaign promoted specific contraceptive methods (even tubal occlusion and vasectomy), a practice other Middle Eastern countries not do. 80% of sterilization acceptors claimed to learn about sterilization from the radio or newspapers. The Ministry of Health has invited the Association for Voluntary Surgical Contraception (AVSC) to help with its campaign to update sterilization techniques, including the non scalpel vasectomy technique. AVSC hopes to become even more involved in helping Iran update its national FP program.

Exposure to family planning messages and modern contraceptive use among men in urban Kenya, Nigeria, and Senegal: a cross-sectional study.

PubMed

Okigbo, Chinelo C; Speizer, Ilene S; Corroon, Meghan; Gueye, Abdou

2015-07-22

Family planning (FP) researchers and policy makers have often overlooked the importance of involving men in couples' fertility choices and contraception, despite the fact that male involvement is a vital factor in sexual and reproductive health programming. This study aimed to assess whether men's exposure to FP demand-generation activities is associated with their reported use of modern contraceptive methods. We used evaluation data from the Measurement, Learning & Evaluation project for the Urban Reproductive Health Initiative (URHI) in select cities of three African countries (Kenya, Nigeria, and Senegal) collected in 2012/2013. A two-stage cluster sampling design was used to select a representative sample of men in the study sites. The sample for this study includes men aged 15-59 years who had no missing data on any of the key variables: 696 men in Kenya, 2311 in Nigeria, and 1613 in Senegal. We conducted descriptive analyses and multivariate logistic regression analyses to assess the associations of interest. All analyses were weighted to account for the study design and non-response rates using Stata version 13. The proportion of men who reported use of modern contraceptive methods was 58 % in Kenya, 43 % in Nigeria, and 27 % in Senegal. About 80 % were exposed to at least one URHI demand-generation activity in each country. Certain URHI demand-generation activities were significantly associated with men's reported use of modern contraception. In Kenya, those who participated in URHI-led community events had four times higher odds of reporting use of modern methods (aOR: 3.70; p < 0.05) while in Senegal, exposure to URHI-television programs (aOR: 1.40; p < 0.05) and having heard a religious leader speak favorably about FP (aOR: 1.72; p < 0.05) were associated with modern contraceptive method use. No such associations were observed in Nigeria. Study findings are important for informing future FP program activities that seek to engage men. Program activities should be tailored by geographic context as results from this study indicate city and country-level variations. These types of gender-comprehensive and context-specific programs are likely to be the most successful at reducing unmet need for FP.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gopishankar, N; Agarwal, Priyanka; Bisht, Raj Kishor

Purpose: To evaluate forward and inverse planning methods for acoustic neuroma cases treated in Gamma Knife Perfexion. Methods: Five patients with acoustic neuroma tumour abutting brainstem were planned twice in LGP TPS (Version 10.1) using TMR10 algorithm. First plan was entirely based on forward planning (FP) in which each shot was chosen manually. Second plan was generated using inverse planning (IP) for which planning parameters like coverage, selectivity, gradient index (GI) and beam-on time threshold were set. Number of shots in IP was automatically selected by objective function using iterative process. In both planning methods MRI MPRAGE sequence images weremore » used for tumour localization and planning. A planning dose of 12Gy at 50% isodose level was chosen. Results and Discussion: Number of shots used in FP was greater than IP and beam-on time in FP was in average 1.4 times more than IP. One advantage of FP was that the brainstem volume subjected to 6Gy dose (25% isodose) was less in FP than IP. Our results showed use of more number of shots as in FP results in GI less than or equal to 2.55 which is close to its lower limit. Dose homogeneity index (DHI) analysis of FP and IP showed average values of 0.59 and 0.67 respectively. General trend in GK for planning in acoustic neuroma cases is to use small collimator shots to avoid dose to adjacent critical structures. More number of shots and prolonged treatment time causes inconvenience to the patients. Similarly overuse of automatic shot shaping as in IP results in increased scatter dose. A compromise is required in shot selection for these cases. Conclusion: IP method could be used in acoustic neuroma cases to decrease treatment time provided the source sector openings near brainstem are shielded or adjusted appropriately to reduce brainstem dose.« less

Innovations in traditional Vietnam.

PubMed

Waldner, R

1997-01-01

In Viet Nam, the 1990 designation of population as a top government concern resulted in a tenfold increase in spending on family planning (FP) and health. The Viet Nam FP Association has developed a number of innovative ways of promoting FP, including a telephone counseling service. The population of Viet Nam has doubled since 1960, and the average per capita income remains very low; thus, condoms and oral contraceptives (OCs) are prohibitively expensive for many families. The FP program provides free condoms, OCs, and IUDs but often runs out of supplies. Need for condoms is estimated at 200 million/year, but the two factories only produce 30 million. OCs are imported from Hungary and have a bad reputation among Vietnamese women. The most commonly used contraceptive is the IUD, but poor quality of care at insertion leads many women to suffer infections. Viet Nam has a high rate of legal abortion, with most procedures occurring in the first month of pregnancy. The FP Association has cautiously introduced sex education in the schools in a pilot program that will be continued nationwide. The Association also opened a special club for young people and one for miliary personnel. These clubs provide contraceptive information along with soft drinks and music. The government's two-child policy is widely accepted but must overcome the obstacles of large family preference in rural areas and of son preference.

Women's development key to MCH/FP.

PubMed

1991-05-01

The Sri Lankan government has included women in its development process thereby raising literacy levels to 91% for urban women and 87% for rural women. Their successful participation has in turn resulted in improvements in maternal and child health (MCH) and family planning (FP) acceptance. Indeed MCH/FP promotion could not have occurred without their participation in development. Since the 1960s, the Health and Women's Affairs Ministry continues to provide broad support for grass roots health care, such as strengthening the capacity of local clinics to increase coverage of health monitoring for women and children. There fore infant mortality in Sri Lanka has decreased from 47.5 in 1970 to 34 in 1980 to 19 in 1989. In addition, the total fertility rate fell from 5 in 1962-1964 to 3.4 in 1980-1982 to 2.8 in 1982-1987. The Ministry initiated its Integrated FP, Nutrition, and Parasite Control Project (IP) in 8 pilot areas in 1981. IP continues to encourage women's developed and MCH/FP at the grass roots level. In fact, FP acceptance rates increased from 31.8% in 1980 to 59% in 1989 in Nakulugamuwa and from 2.3% in 1980 to 70.5% in 1989 in Galnewa. The MCH component operating from community level clinics includes growth monitoring and immunization. Project activities include construction of latrines and wells, promotion of regular health examinations for mothers and children, FP education, counseling, nutrition promotion for children, and training programs for health staff, community volunteers, mothers' groups, and teachers. The volunteers form a link between the community and government health workers. Mothers' groups participate in school nutrition programs, home gardening, and income generation. Parasite control is consequently accomplished by community health and environmental sanitation promotion.

Community Dialogue to Shift Social Norms and Enable Family Planning: An Evaluation of the Family Planning Results Initiative in Kenya

PubMed Central

Creanga, Andreea A.; Galavotti, Christine; Wamalwa, Emmanuel

2016-01-01

Introduction Use of family planning (FP) is powerfully shaped by social and gender norms, including the perceived acceptability of FP and gender roles that limit women’s autonomy and restrict communication and decision-making between men and women. This study evaluated an intervention that catalyzed ongoing community dialogues about gender and FP in Siaya county, Nyanza Province, Kenya. Specifically, we explored the changes in perceived acceptability of FP, gender norms and use of FP. Methods We used a mixed-method approach. Information on married men and women’s socio-demographic characteristics, pregnancy intentions, gender-related beliefs, FP knowledge, attitudes, and use were collected during county-representative, cross-sectional household surveys at baseline (2009; n11 = 650 women; n12 = 305 men) and endline (2012; n21 = 617 women; n22 = 317 men); exposure to the intervention was measured at endline. We assessed changes in FP use at endline vs. baseline, and fitted multivariate logistic regression models for FP use to examine its association with intervention exposure and explore other predictors of use at endline. In-depth, qualitative interviews with 10 couples at endline further explored enablers and barriers to FP use. Results At baseline, 34.0% of women and 27.9% of men used a modern FP method compared to 51.2% and 52.2%, respectively, at endline (p<0.05). Exposure to FP dialogues was associated with 1.78 (95% CI: 1.20–2.63) times higher odds of using a modern FP method at endline for women, but this association was not significant for men. Women’s use of modern FP was significantly associated with higher spousal communication, control over own cash earnings, and FP self-efficacy. Men who reported high approval of FP were significantly more likely to use modern FP if reporting high approval of FP and more equitable gender beliefs. FP dialogues addressed persistent myths and misconceptions, normalized FP discussions, and increased its acceptability. Public examples of couples making joint FP decisions legitimized communication and decision-making with spouses about FP especially for men; women described partner support as key enabler of FP use. Conclusions Our evaluation demonstrates that an intervention that catalyzes open dialogue about gender and FP can shift social norms, enable more equitable couple communication and decision-making and, ultimately, increase use of FP. PMID:27124177

Preparing for the 21st century: introducing a service approach.

PubMed

He, S

1995-08-01

While China's strong population policy remains unchanged, the State Family Planning (FP) Commission is experimenting with innovations designed to improve service delivery and promote gender equity. China entered demographic transition with a large population base which obviated the luxury of achieving the transition gradually over time. Because mortality rates have dropped dramatically and there is a large cohort of people of reproductive age, China adds 14-15 million people to its population each year. Were it not for the FP program, China's current population of 1.2 billion would be about 300 million higher. Economic reform has meant that most Chinese people have their basic needs met and can strive to improve the quality of their lives. These same reforms have weakened the collective systems of financing reproductive health systems, however, and new systems of local support must be found. China's Agenda 21, which sets goals for the 21st century, cites the education of girls and women as a key step to achieving a sustainable population size. In addition to an emphasis on reproductive health, China is initiating programs in adolescent health, sex education, and AIDS prevention. China's National FP Program for 1995-2000 emphasizes these changes and identifies a strong information, education, and communication component as a priority. Innovations, such as a participatory approach to training grassroots workers in interpersonal skills and counseling, are being field tested as a preliminary step toward full implementation. Training workshops are also being held to prepare FP leaders to uphold FP laws and protest the rights of the public.

The Influence of Religion and Ethnicity on Family Planning Approval: A Case for Women in Rural Western Kenya.

PubMed

Bakibinga, Pauline; Mutombo, Namuunda; Mukiira, Carol; Kamande, Eva; Ezeh, Alex; Muga, Richard

2016-02-01

The role of sociocultural factors such as religion and ethnicity in aiding or hampering family planning (FP) uptake in rural Western Kenya, a region with persistently high fertility rates, is not well established. We explored whether attitudes towards FP can be attributed to religious affiliation and/or ethnicity among women in the region. Findings show that religion and ethnicity have no impact; the most significant factors are level of education and knowledge about the benefits of FP for the mother. FP interventions ought to include strategies aimed at enhancing women's knowledge about the positive impacts of family planning.

[Analysis of fundamental chains of family planning systematic engineering in the countryside].

PubMed

Liu, S

1991-02-01

Establishment of a system for old age support in rural areas of China is an important aspect to ensure the success of a family planning (FP) program. The necessity of such a system was examined from the following perspective. 1st, children are sources of old age support due to lack of social security and pension systems in rural areas. This had been the key reason motivating some rural farmers to ignore FP regulations and continue to have children. Unless the livelihood of a rural population is ensured in some way, it is difficult to achieve FP program objectives. 2nd, the increasing life expectancy and declining fertility made the population age process occur rapidly, e.g., the population aged 65 and over will increase from 7% at the end of the century to 17% in the 2030s. Living and health care of the old age population at that time would be an important need for the society. 3rd, changes in family patterns from extended to nuclear families have gradually changed the position of old people in the family which made it unfeasible to rely entirely on children for old age support. Several systems of old age support have been suggested. Government and the community should take responsibility for establishing a social security system. The role of the government will be in educating the public on the importance of social security programs, training professionals to work in these programs, formulating laws and regulations on social security, and supporting a social security system through taxation and welfare programs. The communities may help set up the organizational structure and make financial contributions to the social security system. Insurance companies or commercial banks may set up special coverage or saving programs for old age support. The role of children to support parents would still be important for a certain period of time. The current pilot projects on a rural social security system in 270 countries were an important starting point for helping the rural population to reduce the need for children and to reduce the opposition to family planning programs.

SU-E-J-86: Functional Conformal Planning for Stereotactic Body Radiation Therapy with CT-Pulmonary Ventilation Imaging

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kurosawa, T; Moriya, S; Sato, M

2015-06-15

Purpose: To evaluate the functional planning using CT-pulmonary ventilation imaging for conformal SBRT. Methods: The CT-pulmonary ventilation image was generated using the Jacobian metric in the in-house program with the NiftyReg software package. Using the ventilation image, the normal lung was split into three lung regions for functionality (high, moderate and low). The anatomical plan (AP) and functional plan (FP) were made for ten lung SBRT patients. For the AP, the beam angles were optimized with the dose-volume constraints for the normal lung sparing and the PTV coverage. For the FP, the gantry angles were also optimized with the additionalmore » constraint for high functional lung. The MLC aperture shapes were adjusted to the PTV with the additional 5 mm margin. The dosimetric parameters for PTV, the functional volumes, spinal cord and so on were compared in both plans. Results: Compared to the AP, the FP showed better dose sparing for high- and moderate-functional lungs with similar PTV coverage while not taking care of the low functional lung (High:−12.9±9.26% Moderate: −2.0±7.09%, Low: +4.1±12.2%). For the other normal organs, the FP and AP showed similar dose sparing in the eight patients. However, the FP showed that the maximum doses for spinal cord were increased with the significant increment of 16.4Gy and 21.0Gy in other two patients, respectively. Because the beam direction optimizer chose the unexpected directions passing through the spinal cord. Conclusion: Even the functional conformal SBRT can selectively reduce high- and moderatefunctional lung while keeping the PTV coverage. However, it would be careful that the optimizer would choose unexpected beam angles and the dose sparing for the other normal organs can be worse. Therefore, the planner needs to control the dose-volume constraints and also limit the beam angles in order to achieve the expected dose sparing and coverage.« less

Minister Peng stresses the necessity for improving the working style in family planning implementation.

PubMed

1993-06-01

China's State Counselor and Minister of the State Family Planning (FP) Commission is reported to have made suggestions on improving FP effectiveness to officials in Qianshan and Jinzhai counties of Anhui Province, in Hongya and Mingshan counties of Sichuan Province, and in Dezhau Prefecture and Tai'an City of Shandong Province. In Anhui Province, Minister Peng Peiyun emphasized the importance of FP at the grassroots level and the responsibility of providing education, publicity, and contraceptive services to each couple of childbearing age. Publicity is needed to popularize the advantages and necessity of deferred marriage, deferred childbearing, fewer and healthier births, and gender equality. In Sichuan, Minister Peng state that FP is important for economic development. Other benefits are an improved standard of living, an improvement in women's social status, the formation of healthier and happier families, and improvement in the quality of human resources. Minister Peng stressed that social reform could change existing habits and customs. Publicity should be specific to conditions in each province and include information on how to increase family income, scientific production skills, and good child-rearing practices. Contraceptive services should be available in every village, and quality must be improved. This means wider contraceptive choices, more concern for the day-to-day problems of families with one daughter, and improved training of FP technicians to increase safety and reliability. In Shandong Province, Minister Peng urged that quotas be retained, but the pressure should be reduced on subordinating departments. Targets for FP implementation can be attained when major departments cooperate with those on grass roots level. Requirements must be practical. All couples should be permitted to bear a second child after a birth interval of several years. Program quality can be improved by upgrading worker's skills and building a large group of qualified FP workers.

Mobilizing male opinion leaders’ support for family planning to improve maternal health: a theory-based qualitative study from Pakistan

PubMed Central

Azmat, Syed Khurram

2011-01-01

Purpose Pakistan is a patriarchal society in which male opinion leaders play an important role in determining health-seeking behaviors pertaining to family planning (FP) among their respective communities. This research focuses on cataloguing the perceptions of opinion leaders (clergymen, health professionals, and social workers) about the barriers for using services and practical solutions for promoting FP in the slums of Karachi, Pakistan. Materials and methods A qualitative study using an open-ended, semistructured interview schedule with hypothetical scenarios and in-depth interviews with a purposive sample of 45 opinion leaders (25 mosque imams/clergymen, 12 nonallopathic health professionals, and eight social workers/activists) was conducted in 2006–2007 in Karachi, Pakistan. Transcripts were coded thematically utilizing NVivo by using an adapted constant comparison analysis process as described by Strauss and Corbin. Results Seven key themes were derived from the in-depth interviews. Five themes provide insight into the opinion leaders’ perceptions of barriers to FP and modern contraception methods. Among the barriers religious taboos and cultural pressures were particularly note-worthy. Two themes offered opportunities for more effective development and implementation of FP programs. Conclusion It is evident from the study that opinion leaders in the community and the clergy lack the understanding of the importance of birth spacing. However, because they have a great deal of influence on the community at large, it is imperative to interact with them to build their capacity in order to propagate the messages of FP and improve maternal health and reproductive health in general. PMID:22247617

Guatemala -- strength is NGO cooperation.

PubMed

1999-04-01

In early 1999, representations of the UN Population Fund, JOICFP, and APROFAM met in Guatemala to monitor progress of an integrated program promoting reproductive health (RH) and family planning (FP) among Mayans in the Department of Solola. The team observed field activities, such as training, and assessed information, education, and communication (IEC) promotion; service delivery; institutional coordination; and adolescent health programs. The program is training traditional birth attendants (TBAs) to provide RH/FP and general medical services. At one site, a TBA acquires counseling for her clients from a physician via the telephone. This activity will be facilitated with the addition of radio receivers. Resources have been maximized by increasing collaboration among the project, the government, and local nongovernmental organizations. Referrals are being facilitated with improved communication tools and provision of a boat and ambulance for transporting clients. Cooperative efforts are also being made to promote community health and development, health education, and adolescent health.

Do client fees help or hurt?

PubMed

Barnett, B

1998-01-01

This article discusses the impact of client fees for family planning (FP) services on cost recovery and level of user services in developing countries. The UN Population Fund reports that developing country governments currently pay 75% of the costs of FP programs. Donors contribute 15%, and clients pay 10%. Current pressures are on FP services to broaden and improve their scope, while user demand is increasing. Program managers should consider the program's need for funds and the clients' willingness to pay. Clients are willing to pay about 1% of their income for contraception. A study of sterilization acceptance in Mexico finds that the average monthly case load declined by 10% after the 1st price increase from $43 to $55 and declined by 58% after the 2nd price increase to $60. Fewer low-income clients requested sterilization. A CEMOPLAF study in Ecuador finds that in three price increase situations the number of clients seeking services declined, but the economic mix of clients remained about the same. The decline was 20% in the group with a 20% price increase and 26% in the 40% increase group. In setting fees, the first need is to determine unit costs. The Futures Group International recommends considering political, regulatory, and institutional constraints for charging fees; priorities for revenue use; protection for poor clients; and monitoring of money collection and expenditure. Management Sciences for Health emphasizes consideration of the reasons for collection of fees, client affordability, and client perception of quality issues. Sliding scales can be used to protect poor clients. Charging fees for laboratory services can subsidize poor clients. A Bangladesh program operated a restaurant and catering service in order to subsidize FP services. Colombia's PROFAMILIA sells medical and surgical services and a social marketing program in order to expand clinics.

Analytical Approaches to Guide SLS Fault Management (FM) Development

NASA Technical Reports Server (NTRS)

Patterson, Jonathan D.

2012-01-01

Extensive analysis is needed to determine the right set of FM capabilities to provide the most coverage without significantly increasing the cost, reliability (FP/FN), and complexity of the overall vehicle systems. Strong collaboration with the stakeholders is required to support the determination of the best triggers and response options. The SLS Fault Management process has been documented in the Space Launch System Program (SLSP) Fault Management Plan (SLS-PLAN-085).

Review of performance-based incentives in community-based family planning programmes

PubMed Central

Bellows, Nicole M; Askew, Ian; Bellows, Benjamin

2015-01-01

Background One strategy for improving family planning (FP) uptake at the community level is the use of performance-based incentives (PBIs), which offer community distributors financial incentives to recruit more users of FP. This article examines the use of PBIs in community-based FP programmes via a literature search of the peer-reviewed and grey literature conducted in April 2013. Results A total of 28 community-based FP programmes in 21 countries were identified as having used PBIs. The most common approach was a sales commission model where distributors received commission for FP products sold, while a referral payment model for long-term methods was also used extensively. Six evaluations were identified that specifically examined the impact of the PBI in community-based FP programmes. Overall, the results of the evaluations are mixed and more research is needed; however, the findings suggest that easy-to-understand PBIs can be successful in increasing the use of FP at the community level. Conclusion For future use of PBIs in community-based FP programmes it is important to consider the ethics of incentivising FP and ensuring that PBIs are non-coercive and choice-enhancing. PMID:25037703

A demographic dividend of the FP2020 Initiative and the SDG reproductive health target: Case studies of India and Nigeria.

PubMed

Li, Qingfeng; Rimon, Jose G

2018-02-22

Background: The demographic dividend, defined as the economic growth potential resulting from favorable shifts in population age structure following rapid fertility decline, has been widely employed to advocate improving access to family planning. The current framework focuses on the long-term potential, while the short-term benefits may also help persuade policy makers to invest in family planning. Methods: We estimate the short- and medium-term economic benefits from two major family planning goals: the Family Planning 2020 (FP2020)'s goal of adding 120 million modern contraceptive users by 2020; Sustainable Development Goals (SDG) 3.7 of ensuring universal access to family planning by 2030. We apply the cohort component method to World Population Prospects and National Transfer Accounts data. India and Nigeria, respectively the most populous Asian and African country under the FP2020 initiative, are used as case studies. Results: Meeting the FP2020 target implies that on average, the number of children that need to be supported by every 100 working-age people would decrease by 8 persons in India and 11 persons in Nigeria in 2020; the associated reduction remains at 8 persons in India, but increases to 14 persons in Nigeria by 2030 under the SDG 3.7. In India meeting the FP2020 target would yield a saving of US$18.2 billion (PPP) in consumption expenditures for children and youth in the year 2020 alone, and that increased to US$89.7 billion by 2030. In Nigeria the consumption saved would be US$2.5 billion in 2020 and $12.9 billion by 2030. Conclusions: The tremendous economic benefits from meeting the FP2020 and SDG family planning targets demonstrate the cost-effectiveness of investment in promoting access to contraceptive methods. The gap already apparent between the observed and targeted trajectories indicates tremendous missing opportunities. Accelerated progress is needed to achieve the FP2020 and SDG goals and so reap the demographic dividend.

Impact of the World Health Organization's Decision-Making Tool for Family Planning Clients and Providers on the quality of family planning services in Iran.

PubMed

Farrokh-Eslamlou, Hamidreza; Aghlmand, Siamak; Eslami, Mohammad; Homer, Caroline S E

2014-04-01

We investigated whether use of the World Health Organization's (WHO's) Decision-Making Tool (DMT) for Family Planning Clients and Providers would improve the process and outcome quality indicators of family planning (FP) services in Iran. The DMT was adapted for the Iranian setting. The study evaluated 24 FP quality key indicators grouped into two main areas, namely process and outcome. The tool was implemented in 52 urban and rural public health facilities in four selected and representative provinces of Iran. A pre-post methodology was undertaken to examine whether use of the tool improved the quality of FP services and client satisfaction with the services. Quantitative data were collected through observations of counselling and exit interviews with clients using structured questionnaires. Different numbers of FP clients were recruited during the baseline and the post-intervention rounds (n=448 vs 547, respectively). The DMT improved many client-provider interaction indicators, including verbal and non-verbal communication (p<0.05). The tool also impacted positively on the client's choice of contraceptive method, providers' technical competence, and quality of information provided to clients (p<0.05). Use of the tool improved the clients' satisfaction with FP services (from 72% to 99%; p<0.05). The adapted WHO's DMT has the potential to improve the quality of FP services.

77 FR 37687 - Assistance to Firefighters Grant Program

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-22

... importance of mitigation activities, the FY 2012 FP&S will be allocated $35 million for grants. The FP&S... grants supporting eligible fire prevention activities and research and development activities that...,250) of AFG Program funds for the FP&S Grant Program. However, due to the importance of mitigation...

The role of traditional organization on family planning acceptance in Indonesia.

PubMed

Ancok, D

1991-01-01

The nature of and the reasons for the decline in Indonesian fertility and the utilization of the village traditional organization, banjar, in the family planning (FP) program are discussed. The total fertility rate computed from census data shows a decline in fertility from 5.6 in the mid-1960s to 4.1 for 1981-1984, a 28% decline in 15 years. A further 23% decline evidenced in the Contraceptive Prevalence Survey appeared as 4.3 children reproductive woman in 1981-83 and 3.3 between 1984-87. The success of the FP program in contributing a major impact on the decline is attributed to a strong political commitment to antinatalist policy which meant increased allocation to FP when government income was declining, effective organizational structure, and effective strategies such as the mobilization of traditional village organizations. The impact of FP can also be seen in the increase in the number of family acceptors. Another source of the fertility decline is due to the impact of development. 1) Improvement in education has contributed to fertility decline in the increase in the number graduating from elementary and secondary school, the increased value of children, the acceptance of new ideas, the postponement of marriage, and the increase in the never-married group. 2) The decline in the infant mortality rate from 142 in 1971 to 70.2/1000 births in 1982-87 due to the improvement in health facilities and service also contributed to fertility decline. 3) The growth in the number of women participating in the nonagricultural labor force has also contributed to fertility decline. To what extent each has contributed to the decline has not been empirically tested. Molyneaux' study is cited for demonstrating that both socioeconomic variables and contraceptive use, which are affected by socioeconomic variables and family planning, have influenced the fertility decline. Households with electricity, children engaged in the labor force, and frequency of mobile medical team visits had no effect. Another study found field worker and supervisor activities and community contraceptive distributors to be significant factors affecting contraceptive prevalence. The use of traditional organizations can be effective in other countries if the community conditions are the same. The following traditional organizations are described: simpan pinjam (savings and loan associations), arisan (rotating credit association), perkumpulan kematian (burial association), lumbung paceklik (emergency rice stores), kebatinan (mysticism group), pengajian (prayer group), and banjar (a residential group of 100 household heads). The banjar takes care of every aspect of a person's life and is compulsory and meets regularly. a 1976 study indicated the banjar as ideal for use in promoting FP, particularly if dynamic. Modern organizations at the village level, which were used to involve new acceptors, are also described. The Paguyuban KB (Family Planning Acceptors Group) promoted the program and was responsible for contraceptive distribution.

Review of performance-based incentives in community-based family planning programmes.

PubMed

Bellows, Nicole M; Askew, Ian; Bellows, Benjamin

2015-04-01

One strategy for improving family planning (FP) uptake at the community level is the use of performance-based incentives (PBIs), which offer community distributors financial incentives to recruit more users of FP. This article examines the use of PBIs in community-based FP programmes via a literature search of the peer-reviewed and grey literature conducted in April 2013. A total of 28 community-based FP programmes in 21 countries were identified as having used PBIs. The most common approach was a sales commission model where distributors received commission for FP products sold, while a referral payment model for long-term methods was also used extensively. Six evaluations were identified that specifically examined the impact of the PBI in community-based FP programmes. Overall, the results of the evaluations are mixed and more research is needed; however, the findings suggest that easy-to-understand PBIs can be successful in increasing the use of FP at the community level. For future use of PBIs in community-based FP programmes it is important to consider the ethics of incentivising FP and ensuring that PBIs are non-coercive and choice-enhancing. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Structural Determinants in Family Planning Service Utilization in Ethiopia: EDHS 2011 Analysis

PubMed Central

Gizachew Balew, Jembere; Cho, Yongtae; Tammy Kim, Clara; Ko, Woorim

2015-01-01

Family planning coverage has improved in Ethiopia in the last decade, though fertility is still about 5.8 in the rural setup. In this paper, the major structural determinants of family planning service were analyzed using a multilevel model from 8906 individual women observation in the 2011 EDHS data. The results show that there is a big variation in family planning use both at the individual and between group levels. More than 39% of the variation in FP use is explained by contextual cluster level differences. Most of the socioeconomic predictors; respondent's education, ethnicity, and partners' education as well as employment status and urbanization were found to be significant factors that affect FP use. Similarly health extension visit and media access were found to be strong factors that affect FP service at both individual and cluster levels. This evidence concludes that addressing these contextual factors is very crucial to strengthen FP use and fertility reduction in the nation, beyond individual behavioral changes. PMID:26783520

Family planning and development helping women world-wide.

PubMed

Mahler, H

1989-04-01

This article discusses the need for family planning (FP) as part of the development process, applauds its successes and rallies continued momentum of the FP movement. 500,000 women die each year from pregnancy- or labor-related conditions, and 10s of millions of women suffer pregnancy-related illnesses and impairments that undermine their social and economic productivity. Moreover, the 4 major factors that lead to high-risk pregnancies, namely, becoming pregnant before the age of 20, after the age of 35, after 4 or more pregnancies, and 2 years after an earlier pregnancy, all reveal the need for FP. These tragedies could be avoided by assuring better nutrition, primary health care for all, good antenatal attention and proper facilities and help in childbirth, access to good obstetric care in emergency situations, and universally available FP services. FP organizations must empower women with the knowledge of FP and the means to put it into practice. Developing countries, such as China, India, Indonesia, Thailand and Mexico, in addition to affluent industrialized countries have made strides in FP with the help of such organizations as the International Planned Parenthood Federation (IPPF). IPPF has helped to motivate large numbers of men and women to determine their ideal family size. It has provided the means for them to reach such goals and has ensured that acceptance of FP has been on a voluntary basis. IPPF has also advised and cajoled governments into becoming involved in FP. In the future, national strategies must produce the building blocks for better policies to help women become more responsible for their lives. The education of women will be vital to achieving this objective as well as other aspects of development.

Point of view: Paul Simon.

PubMed

Simon, P

1999-02-01

In this article, former US Senator Paul Simon notes that, in his lifetime, the population of the world has tripled and is expected to quadruple. Among the effects of this population growth will be a 55% increase in nitrate emissions that will feed algae and compromise fish supplies. The US was extremely short-sighted when it reduced funding for the international family planning (FP) programs that benefit all nations. False accusations that the UN Population Fund (UNFPA) operates with a "bloated bureaucracy" ignore the fact that this agency has only 166 employees. More appropriate criticism would assert that the task the UNFPA is trying to accomplish is too important and too vast for such a small staff. Without FP programs, earth would now have to support an additional 400 million people. While contraceptive use by married women in developing countries has increased from 10% in 1965 to above 50% today and life expectancy is increasing, we must recognize the fact that we are currently unable to provide most of the world's population with safe water and sanitation and that increased population size will only exacerbate this problem. Encouraging voluntary FP is humanitarian and prudent and will help protect the entire population of the world.

Men in family planning: changing the world one life at a time.

PubMed

Feldman, J

1992-01-01

While women created the family planning (FP) movement, men have also been involved since its inception (albeit in a minor way). Today men must redefine masculinity in order to become more effective as FP providers and clients. While women have carved out newly self-sufficient identities, men have had to search for new identities which appropriately respond to changing gender relations. The Planned Parenthood of Central and Northern Arizona has 12 males on a staff of 130. The male FP providers have an opportunity to redefine gender relations, masculinity, and reproductive responsibility through their interactions with clients, whether the clients are themselves male or female. The male FP providers have a rare opportunity to exhibit a balance between the "fierceness of the warrior patient and the warmth of the parent" in their dealings with clients. Female clients of male FP providers can realize a therapeutic, emotionally-corrective experience. Male clients of male providers can receive insights into women's lives; into healthful living; and into ways to achieve greater access to feelings, emotions, and experiences. The changes at hand in the world demand that traditionally female values such as nurturing and compassion be brought into the traditionally male world of ambition, profit, and power. Male FP providers can contribute to this improvement as they affect one client at a time.

Men's knowledge of and attitude with respect to family planning in a suburban Nigerian community.

PubMed

Odu, O O; Ijadunola, K T; Komolafe, J O; Adebimpe, W T

2006-01-01

Men's Knowledge of and attitudes to family planning (FP) in suburban and rural Nigeria is still poor despite a global move to increase the involvement of men in reproductive health matters. A cross-sectional survey was conducted to determine men's knowledge of and attitude to family planning at Ganmo, a sub-urban community on the outskirts of Ilorin, Nigeria. The study employed an interviewer administered semi-structured questionnaire to elicit information from 360 men in the households. Only males above the age of 15 years resident in the community were selected for interview A proportionate sampling procedure was employed in selecting the required numberof men from each of the 32 compounds that make up the community. Nearly all men (96.5%) were aware of family planning and a majority of them were aware of some common methods of family planning e.g. Oral Contraceptive Pills (OCPs) (72.5%), Injectables (69.2%), Condoms (86.6%) and Traditional methods (70.6%). Knowledge of other alternative female methods was low e.g. Norplant (17.5%), IUCD (26.3%), Diaphragm (39.8%), Vaginal cream (30.2%), Vaginal tablet (37.8%) and Vaginal sponge (16.8%), and Tubal Ligation (51.3%). Knowledge of male controlled FP methods like Withdrawal (49.6%), Rhythm or periodic abstinence (54.6%) and Vasectomy (28.6%) was also poor. The Respondents had low knowledge of common side effects of FP methods e.g. nausea (9.8%), vomiting (13.1%), abnormal menstruation (34.4%), pain (23.2%) and unwanted weight gain (17.0%); some 25.3%% of respondents had no knowledge of any side effects. The attitude of respondents to family planning was also relatively poor as only a moderate proportion of men supported the FP concept (52.7%) and the Nigerian Population Policy (54.8%) of "four children to a woman". Some 54.8% of respondents were in support of men discussing about FP with their spouses. The major reasons for non-approval of FP by men were the fear of side-effects (70.4%) and perception of FP as being against religion (52.1%). The predictors of poor FP attitude were not having formal education, practice of polygyny and to a lesser extent being a Muslim. The study concluded that, men at Ganmo have limited knowledge of, and poor attitude to FP An intensive drive at a community based adult reproductive health education was advocated among other recommendations.

Situation analysis study establishes baseline for future assessment of progress in Senegal.

PubMed

1995-08-01

A situation analysis study was conducted by the National Family Planning Program of the Senegalese Ministry of Health and Social Action, with technical assistance from the Population Council's Africa OR/TA Project II, to evaluate the availability, functioning, and quality of family planning (FP) services at all 180 functional Service Delivery Points (SDPs) of Senegal's ten regions. Almost one-third of the SDPs had not received a supervisory visit in the seven months prior to the study, and an additional one-fifth had had no supervisory visits at all. 6% had written job descriptions for their personnel, 8% had a plan of activities, and 2% had an objective in terms of the number of clients to serve. Clinic infrastructure was generally satisfactory, although electricity and water were lacking in 30% of SDPs in rural areas. Six out of 87 SDPs in the urban sector had the minimum equipment needed. The majority of FP providers were midwives whose formal training had been limited to the management of pills and IUDs; 32% of providers had no training in administering injectables. Information, education, and communication materials were unavailable at most SDPs. 6% featured FP talks on site on the day of the research visit; six out of ten lacked a visible sign indicating the availability of FP services. On average, FP services were available four days a week, but 53% of the SDPs started services an hour late on the day of the research visit, and many were limited to four hours of service per day. 67% provided injectables, and 78% supplied IUDs. Inadequate management of contraceptive stock was partly responsible for method shortages. Records were incomplete. 81% of new clients had access to and obtained their preferred contraceptive method; however, other appropriate methods were not discussed during consultations, and counseling on method side effects was inadequate. 56% of new clients were asked about their reproductive intentions. Counseling regarding sexually transmitted diseases (STDs) and human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) was practically nonexistent. Health problems found during FP consultations were rarely addressed. Non-medical barriers to the utilization of contraceptive methods existed in terms of age, parity, and marital status. Client waiting time was long, while consultation time was short. Most women had follow-up dates on their identification cards; 95% were told to return for supplies. The majority of clients were generally satisfied.

Evaluating a LARC Expansion Program in 14 Sub-Saharan African Countries: A Service Delivery Model for Meeting FP2020 Goals.

PubMed

Ngo, Thoai D; Nuccio, Olivia; Pereira, Shreya K; Footman, Katharine; Reiss, Kate

2017-09-01

Objectives In many sub-Saharan African countries, the use of long-acting reversible contraceptives (LARCs) is low while unmet need for family planning (FP) remains high. We evaluated the effectiveness of a LARC access expansion initiative in reaching young, less educated, poor, and rural women. Methods Starting in 2008, Marie Stopes International (MSI) has implemented a cross-country expansion intervention to increase access to LARCs through static clinics, mobile outreach units, and social franchising of private sector providers. We analyzed routine service statistics for 2008-2014 and 2014 client exit interview data. Indicators of effectiveness were the number of LARCs provided and the percentages of LARC clients who had not used a modern contraceptive in the last 3 months ("adopters"); switched from a short-term contraceptive to a LARC ("switchers"); were aged <25; lived in extreme poverty; had not completed primary school; lived in rural areas; and reported satisfaction with their overall experience at the facility/site. Results Our annual LARC service distribution increased 1037 % (from 149,881 to over 1.7 million) over 2008-2014. Of 3816 LARC clients interviewed, 46 % were adopters and 46 % switchers; 37 % were aged 15-24, 42 % had not completed primary education, and 56 % lived in a rural location. Satisfaction with services received was rated 4.46 out of 5. Conclusions The effectiveness of the LARC expansion in these 14 sub-Saharan African FP programs demonstrates vast untapped potential for wider use of LARC methods, and suggests that this service delivery model is a plausible way to support FP 2020 goals of reaching those with an unmet need for FP.

Fostering excellence

PubMed Central

Hogg, William; Kendall, Claire; Muggah, Elizabeth; Mayo-Bruinsma, Liesha; Ziebell, Laura

2014-01-01

Abstract Problem addressed A key priority in primary health care research is determining how to ensure the advancement of new family physician clinician investigators (FP-CIs). However, there is little consensus on what expectations should be implemented for new investigators to ensure the successful and timely acquisition of independent salary support. Objective of program Support new FP-CIs to maximize early career research success. Program description This program description aims to summarize the administrative and financial support provided by the C.T. Lamont Primary Health Care Research Centre in Ottawa, Ont, to early career FP-CIs; delineate career expectations; and describe the results in terms of research productivity on the part of new FP-CIs. Conclusion Family physician CI’s achieved a high level of research productivity during their first 5 years, but most did not secure external salary support. It might be unrealistic to expect new FP-CIs to be self-financing by the end of 5 years. This is a career-development program, and supporting new career FP-CIs requires a long-term investment. This understanding is critical to fostering and strengthening sustainable primary care research programs. PMID:24522688

Baby steps.

PubMed

Bader, E J; Truax, H

1991-01-01

The focus of the discussion of US national environmental efforts on population growth issues is on carrying capacity, the impact of the antiabortion movement, the insensitivity of some population control advocated to people of color, and congressional and presidential actions. Efforts are being made to surmount the mistrust that has characterized efforts to deal with population issues. The World Wildlife Fund, the Sierra Club, and the National Audubon Society recognize the need for population stabilization, albeit with meager budgets. Carrying capacity is the number of people the earth can sustain without rapidly depleting non-renewable resources or degrading resources necessary to sustain life. In 1970, Earth Day called for stabilization of the global population, but most celebrations of Earth Day in 1990 did not recognize this. Sensitive issues are involved, and the abortion controversy has muffled open forums on population growth. Lobbyists were successful in having the US withdraw funding for international family planning (FP) programs that had abortion components. Then Reagan eliminated all funding to the UN Fund for Population Activities, because of China's FP policies. The results for women have been disastrous. Zero Population Growth has been conducting information meetings for environmental groups. The National wildlife Federation has a new program linking population and environmental issues but will not deal with the issue of abortion. A Philadelphia editorial recommended implanted contraceptives for welfare mothers, which raised fears of the reemergence of the eugenic movement which sought involuntary sterilization or population control for the poor. Another effort was to protect the US from immigration as a way of curbing population growth. Meaningful change means education women, changing unfavorable survival conditions, and heeding the reasons women have children. Japan's FP Association criticizes population control efforts undertaken for economic and political benefit without attention being paid to people's lives. An informal coalition is supporting a large FP grant to the USAID. Senate leadership is more open for FP issues, and a bill has been proposed to increase international FP funds.

"India Population Projects" in Karnataka.

PubMed

Reddy, P H; Badari, V S

1991-12-01

An overview, objectives, implementation, and research and evaluation studies of 2 India Population Projects in Karnataka are presented. The India Population Project I (IPP-I) was conducted in Karnataka and Uttar Pradesh. India Population Project III (IPP-III) took place between 1984-92 in 6 districts of Karnataka: Belgaum, Bijapur, Dharwad, Bidar, Gulbarga, and Raichur, and 4 districts in Kerala. The 6 districts in Karnataka accounted for 36% (13.2 million) of the total national population. The project cost was Rs. 713.1 million which was shared by the World Bank, and the Indian national and regional government. Due to poor past performance, these projects were undertaken to improve health and family welfare status. Specific project objectives are outlined. IPP-I included an urban component, and optimal Government of India program, and an intensive rural initiative. The urban program aimed to improved pre- and postnatal services and facilities, and the family planning (FP) in Bangalore city. The rural program was primarily to provide auxiliary nurse-midwives and hospitals and clinics, and also supplemental feeding program for pregnant and nursing mothers and children up to 2 years. The government program provided FP staff and facilities. IPP-I had 3 units to oversee building construction, to recruit staff and provide supplies and equipment, and to establish a Population Center. IPP-III was concerned with service delivery; information, education, and communication efforts (IEC) and population education; research and evaluation; and project management. Both projects contributed significantly to improving the infrastructure. A brief account of the types and kinds of studies undertaken is given. Studies were grouped into longitudinal studies of fertility, mortality, and FP; management information and evaluation systems for health and family welfare programs; experimental strategies; and other studies. Research and evaluation studies in IPP-III encompassed studies in gaps in knowledge, skills, and practice of health and FP personnel; baseline and endline surveys; and operational evaluation of the management information and evaluation system; factors affecting primary health care in Gulbarga district; evaluation of radio health lessons and the impact of the Kalyana Matha Program; and studies of vaccination and child survival and maternal mortality. Training programs were also undertaken.

A demographic dividend of the FP2020 Initiative and the SDG reproductive health target: Case studies of India and Nigeria

PubMed Central

Li, Qingfeng; Rimon, Jose G.

2018-01-01

Background: The demographic dividend, defined as the economic growth potential resulting from favorable shifts in population age structure following rapid fertility decline, has been widely employed to advocate improving access to family planning. The current framework focuses on the long-term potential, while the short-term benefits may also help persuade policy makers to invest in family planning. Methods: We estimate the short- and medium-term economic benefits from two major family planning goals: the Family Planning 2020 (FP2020)’s goal of adding 120 million modern contraceptive users by 2020; Sustainable Development Goals (SDG) 3.7 of ensuring universal access to family planning by 2030. We apply the cohort component method to World Population Prospects and National Transfer Accounts data. India and Nigeria, respectively the most populous Asian and African country under the FP2020 initiative, are used as case studies. Results: Meeting the FP2020 target implies that on average, the number of children that need to be supported by every 100 working-age people would decrease by 8 persons in India and 11 persons in Nigeria in 2020; the associated reduction remains at 8 persons in India, but increases to 14 persons in Nigeria by 2030 under the SDG 3.7. In India meeting the FP2020 target would yield a saving of US$18.2 billion (PPP) in consumption expenditures for children and youth in the year 2020 alone, and that increased to US$89.7 billion by 2030. In Nigeria the consumption saved would be US$2.5 billion in 2020 and $12.9 billion by 2030. Conclusions: The tremendous economic benefits from meeting the FP2020 and SDG family planning targets demonstrate the cost-effectiveness of investment in promoting access to contraceptive methods. The gap already apparent between the observed and targeted trajectories indicates tremendous missing opportunities. Accelerated progress is needed to achieve the FP2020 and SDG goals and so reap the demographic dividend. PMID:29630076

Benefits of family planning: an assessment of women's knowledge in rural Western Kenya.

PubMed

Mutombo, Namuunda; Bakibinga, Pauline; Mukiira, Carol; Kamande, Eva

2014-03-18

The last two decades have seen an increase in literature reporting an increase in knowledge and use of contraceptives among individuals and couples in Kenya, as in the rest of Africa, but there is a dearth of information regarding knowledge about benefits of family planning (FP) in Kenya. To assess the factors associated with knowledge about the benefits of FP for women and children, among women in rural Western Kenya. Data are drawn from the Packard Western Kenya Project Baseline Survey, which collected data from rural women (aged 15-49 years). Ordinal regression was used on 923 women to determine levels of knowledge and associated factors regarding benefits of FP. Women in rural Western Kenya have low levels of knowledge about benefits of FP and are more knowledgeable about benefits for the mother rather than for the child. Only age, spousal communication and type of contraceptive method used are significant. Women's level of knowledge about benefits of FP is quite low and may be one of the reasons why fertility is still high in Western Kenya. Therefore, FP programmes need to focus on increasing women's knowledge about the benefits of FP in this region.

An analysis of pre-service family planning teaching in clinical and nursing education in Tanzania.

PubMed

Muganyizi, Projestine S; Ishengoma, Joyce; Kanama, Joseph; Kikumbih, Nassoro; Mwanga, Feddy; Killian, Richard; McGinn, Erin

2014-07-12

Promoting family planning (FP) is a key strategy for health, economic and population growth. Sub-Saharan Africa, with one of the lowest contraceptive prevalence and highest fertility rates globally, contributes half of the global maternal deaths. Improving the quality of FP services, including enhancing pre-service FP teaching, has the potential to improve contraceptive prevalence. In efforts to improve the quality of FP services in Tanzania, including provider skills, this study sought to identify gaps in pre-service FP teaching and suggest opportunities for strengthening the training. Data were collected from all medical schools and a representative sample of pre-service nursing, Assistant Medical Officer (AMO), Clinical Officer (CO) and assistant CO schools in mainland Tanzania. Teachers responsible for FP teaching at the schools were interviewed using a semi-structured questionnaire. Observations on availability of teaching resources and other evidence of FP teaching and evaluation were documented. Relevant approved teaching documents were assessed for their suitability as competency-based FP teaching tools against predefined criteria. Quantitative data were analyzed using EPI Info 6 and qualitative data were manually analyzed using content analysis. A total of 35 pre-service schools were evaluated for FP teaching including 30 technical education and five degree offering schools. Of the assessed 11 pre-service curricula, only one met the criteria for suitability of FP teaching. FP teaching was typically theoretical with only 22.9% of all the schools having systems in place to produce graduates who could skillfully provide FP methods. Across schools, the target skills were the same level of competence and skewed toward short acting methods of contraception. Only 23.3% (n = 7) of schools had skills laboratories, 76% (n = 22) were either physically connected or linked to FP clinics. None of the degree providing schools practiced FP at its own teaching hospital. Teachers were concerned with poor practical exposure and lack of teaching material. Pre-service FP teaching in Tanzania is theoretical, poorly guided, and skewed toward short acting methods; a majority of the schools are unable to produce competent FP service providers. Pre-service FP training should be strengthened with more focus on practical skills.

Reaching the hard-to-reach.

PubMed

Valdes, C

1992-01-01

Guatemala's family planning (FP) programs are innovative but contraceptive use is only 23%. Total fertility is 5.3 children/woman, and the 9.5 million population will double in 23 years. The problem is poverty and illiteracy among rural residents removed from health services. 80% live in poverty and 80% are illiterate. Government effort is devoted to combating diseases such as diarrhea so there are few funds for implementing a comprehensive population policy. There is support within the national government but FP lacks priority status. APROFAM's goals are to use innovative marketing methods to inform the rural population who lack access to and knowledge about FP. Service delivery is constrained by the difficulty in reaching remote areas where 4 out of 10 indigenous Guatemalans live. Infant mortality can reach as high as 200/1000 live births. Population growth has slowed, and APROFAM plans to reach 16,000 more in the future. Promotions are conducted in several languages and aired on radio, television, and in the print media. It has been found that market research is the most effective strategy in reaching indigenous families. APROFAM has also been effective in upgrading service facilities through training, client surveys, and setting improved clinic standards. Breastfeeding, training, and voluntary sterilization programs contribute to the primary care effort. The example is given of Paulina Lebron from a very poor area who has learned how to space her children and thus improve the standard of living for her family. Eventually, she convinced herself and her family that sterilization was necessary, and now the couple enjoy the bliss of newlyweds without fear of pregnancy.

Advance care planning and physician orders in nursing home residents with dementia: a nationwide retrospective study among professional caregivers and relatives.

PubMed

Vandervoort, An; Houttekier, Dirk; Van den Block, Lieve; van der Steen, Jenny T; Vander Stichele, Robert; Deliens, Luc

2014-02-01

Advance care planning (ACP) is key to good palliative care for nursing home (NH) residents with dementia. We examined the extent to which the family physicians (FPs), nurses, and the relative most involved in the resident's care are informed about ACP, written advance directives, and FP treatment orders (FP-orders) for NH residents dying with dementia. We also examined the congruence among FP, nurse, and relative regarding the content of ACP. This was a representative nationwide post-mortem study (2010) in Flanders, Belgium, using random cluster sampling. In selected NHs, all deaths of residents with dementia in a three month period were reported. A structured questionnaire was completed by the FP, the nurse, and the patient's relative. We identified 205 deceased residents with dementia in 69 NHs. Residents expressed their wishes regarding end-of-life care in 11.8% of cases according to the FP. The FP and nurse spoke with the resident in 22.0% and 9.7% of cases, respectively, and with the relative in 70.6% and 59.5%, respectively. An advance directive was present in 9.0%, 13.6%, and 18.4% of the cases according to the FP, nurse, and the relative, respectively. The FP-orders were present in 77.3% according to the FP, and discussed with the resident in 13.0% and with the relative in 79.3%. Congruence was fair (FP-nurse) on the documentation of FP-orders (k=0.26), and poor to slight on the presence of an advance directive (FP-relative, k=0.03; nurse-relative, k=-0.05; FP-nurse k=0.12). Communication regarding care is rarely patient driven and more often professional caregiver or family driven. The level of congruence between professional caregivers and relatives is low. Copyright © 2014 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

Population remains top priority for China.

PubMed

Li, H

1998-04-01

China, whose population was 430 million in 1840, is facing a population total of 1.3 billion in 2000. Population increased rapidly in the country during the 1950s, but early efforts at population control were abandoned from the start of the Cultural Revolution in 1966 until the 1970s. Today, the importance of family planning (FP) is recognized throughout Chinese society. With 20 million newborns adding 13 million people to the population each year, controlling the population increase will remain a top priority of China's population policy. Other priorities include 1) increasing the quality of life of the population by improving health, promoting literacy, and developing human resources; 2) facing the impact of population aging; 3) struggling to overcome the poverty experienced by 50 million people; and 4) dealing with the imbalanced sex ratio of newborns. China has been attempting to institute strategies to implement the Program of Action adopted by the 1994 International Conference on Population and Development and is attempting to adopt an integrated approach to population programs that combines FP with development measures and the delivery of multiple services to enhance reproductive health. Since 1984, China has worked with Japan's JOICFP on an Integrated Project that offers FP, maternal and child health services, and parasite control.

User Satisfaction with Family Planning Services in Government Health Centres in the Congo.

PubMed

Ndziessi, Gilbert; Bintsene-Mpika, Gickelle; Bileckot, Richard

2017-09-01

Patient satisfaction is considered an indicator of quality of care. This study aimed to assess the degree of clients' satisfaction with family planning (FP) services in government health centers in Congo. A cross-sectional study was conducted. A total of 635 clients nested in 27 health facilities were included in the analysis. Satisfaction was defined as "having a good perception of provider technical skills, being satisfied with the service organization and having a general positive appreciation of FP services. Statistical analyses were performed using SPSS v15. Among 635 clients, 57% perceived lack of technical competence in providers, 88% perceived good organization in FP services and 77% declared having general positive appreciation of FP services. Global level of client satisfaction was 42%. In conclusion client satisfaction with FP service was low and strengthening health workers technical competence is crucial. But, as the quality is multidimensional, other aspects especially significant funding investment and quality-assurance interventions must be taken into account.

An analysis of pre-service family planning teaching in clinical and nursing education in Tanzania

PubMed Central

2014-01-01

Background Promoting family planning (FP) is a key strategy for health, economic and population growth. Sub-Saharan Africa, with one of the lowest contraceptive prevalence and highest fertility rates globally, contributes half of the global maternal deaths. Improving the quality of FP services, including enhancing pre-service FP teaching, has the potential to improve contraceptive prevalence. In efforts to improve the quality of FP services in Tanzania, including provider skills, this study sought to identify gaps in pre-service FP teaching and suggest opportunities for strengthening the training. Methods Data were collected from all medical schools and a representative sample of pre-service nursing, Assistant Medical Officer (AMO), Clinical Officer (CO) and assistant CO schools in mainland Tanzania. Teachers responsible for FP teaching at the schools were interviewed using a semi-structured questionnaire. Observations on availability of teaching resources and other evidence of FP teaching and evaluation were documented. Relevant approved teaching documents were assessed for their suitability as competency-based FP teaching tools against predefined criteria. Quantitative data were analyzed using EPI Info 6 and qualitative data were manually analyzed using content analysis. Results A total of 35 pre-service schools were evaluated for FP teaching including 30 technical education and five degree offering schools. Of the assessed 11 pre-service curricula, only one met the criteria for suitability of FP teaching. FP teaching was typically theoretical with only 22.9% of all the schools having systems in place to produce graduates who could skillfully provide FP methods. Across schools, the target skills were the same level of competence and skewed toward short acting methods of contraception. Only 23.3% (n = 7) of schools had skills laboratories, 76% (n = 22) were either physically connected or linked to FP clinics. None of the degree providing schools practiced FP at its own teaching hospital. Teachers were concerned with poor practical exposure and lack of teaching material. Conclusions Pre-service FP teaching in Tanzania is theoretical, poorly guided, and skewed toward short acting methods; a majority of the schools are unable to produce competent FP service providers. Pre-service FP training should be strengthened with more focus on practical skills. PMID:25016391

Access to Money and Relation to Women's Use of Family Planning Methods Among Young Married Women in Rural India.

PubMed

Reed, Elizabeth; Donta, Balaiah; Dasgupta, Anindita; Ghule, Mohan; Battala, Madhusudana; Nair, Saritha; Silverman, Jay; Jadhav, Arun; Palaye, Prajakta; Saggurti, Niranjan; Raj, Anita

2016-06-01

Objectives The social positioning (i.e. social status and autonomy) of women in the household facilitates women's access to and decision-making power related to family planning (FP). Women's access to spending money, which may be an indicator of greater social positioning in the household, may also be greater among women who engage in income generating activities for their families, regardless of women's status in the household. However, in both scenarios, access to money may independently afford greater opportunity to obtain family planning services among women. This study seeks to assess whether access to money is associated with FP outcomes independently of women's social positioning in their households. Methods Using survey data from married couples in rural Maharashtra, India (n = 855), crude and adjusted regression was used to assess women's access to their own spending money in relation to past 3 month use of condoms and other forms of contraceptives (pills, injectables, intrauterine device). Results Access to money (59 %) was associated with condom and other contraceptive use (AORs ranged 1.5-1.8). These findings remained significant after adjusting for women's FP decision-making power in the household and mobility to seek FP services. Conclusion While preliminary, findings suggest that access to money may increase women's ability to obtain FP methods, even in contexts where social norms to support women's power in FP decision-making may not be readily adopted.

Access to Money and Relation to Women’s Use of Family Planning Methods among Young Married Women in Rural India

PubMed Central

Reed, Elizabeth; Donta, Balaiah; Dasgupta, Anindita; Ghule, Mohan; Battala, Madhusudana; Nair, Saritha; Silverman, Jay; Jadhav, Arun; Palaye, Prajakta; Saggurti, Niranjan; Raj, Anita

2016-01-01

Objectives The social positioning (i.e. social status and autonomy) of women in the household facilitates women’s access to and decision-making power related to family planning (FP). Women’s access to spending money, which may be an indicator of greater social positioning in the household, may also be greater among women who engage in income generating activities for their families, regardless of women’s status in the household. However, in both scenarios, access to money may independently afford greater opportunity to obtain family planning services among women. This study seeks to assess whether access to money is associated with FP outcomes independently of women’s social positioning in their households. Methods Using survey data from married couples in rural Maharashtra, India (n=855), crude and adjusted regression was used to assess women’s access to their own spending money in relation to past 3 month use of condoms and other forms of contraceptives (pills, injectables, intrauterine device). Results Access to money (59%) was associated with condom and other contraceptive use (AORs ranged: 1.5 – 1.8). These findings remained significant after adjusting for women’s FP decision-making power in the household and mobility to seek FP services. Conclusion While preliminary, findings suggest that access to money may increase women’s ability to obtain FP methods, even in contexts where social norms to support women’s power in FP decision-making may not be readily adopted. PMID:26971270

Assessing gaps and poverty-related inequalities in the public and private sector family planning supply environment of urban Nigeria.

PubMed

Levy, Jessica K; Curtis, Sian; Zimmer, Catherine; Speizer, Ilene S

2014-02-01

Nigeria is the most populous country in Africa, and its population is expected to double in <25 years (Central Intelligence Agency 2012; Fotso et al. 2011). Over half of the population already lives in an urban area, and by 2050, that proportion will increase to three quarters (United Nations, Department of Economic and Social Affairs, Population Division 2012; Measurement Learning & Evaluation Project, Nigerian Urban Reproductive Health Initiative, National Population Commission 2012). Reducing unwanted and unplanned pregnancies through reliable access to high-quality modern contraceptives, especially among the urban poor, could make a major contribution to moderating population growth and improving the livelihood of urban residents. This study uses facility census data to create and assign aggregate-level family planning (FP) supply index scores to 19 local government areas (LGAs) across six selected cities of Nigeria. It then explores the relationships between public and private sector FP services and determines whether contraceptive access and availability in either sector is correlated with community-level wealth. Data show pronounced variability in contraceptive access and availability across LGAs in both sectors, with a positive correlation between public sector and private sector supply environments and only localized associations between the FP supply environments and poverty. These results will be useful for program planners and policy makers to improve equal access to contraception through the expansion or redistribution of services in focused urban areas.

Integrated planning for regional development planning and water resources management under uncertainty: A case study of Xining, China

NASA Astrophysics Data System (ADS)

Fu, Z. H.; Zhao, H. J.; Wang, H.; Lu, W. T.; Wang, J.; Guo, H. C.

2017-11-01

Economic restructuring, water resources management, population planning and environmental protection are subjects to inner uncertainties of a compound system with objectives which are competitive alternatives. Optimization model and water quality model are usually used to solve problems in a certain aspect. To overcome the uncertainty and coupling in reginal planning management, an interval fuzzy program combined with water quality model for regional planning and management has been developed to obtain the absolutely ;optimal; solution in this study. The model is a hybrid methodology of interval parameter programming (IPP), fuzzy programing (FP), and a general one-dimensional water quality model. The method extends on the traditional interval parameter fuzzy programming method by integrating water quality model into the optimization framework. Meanwhile, as an abstract concept, water resources carrying capacity has been transformed into specific and calculable index. Besides, unlike many of the past studies about water resource management, population as a significant factor has been considered. The results suggested that the methodology was applicable for reflecting the complexities of the regional planning and management systems within the planning period. The government policy makers could establish effective industrial structure, water resources utilization patterns and population planning, and to better understand the tradeoffs among economic, water resources, population and environmental objectives.

Effectiveness of the population health and environment approach in improving family planning outcomes in the Gurage, Zone South Ethiopia.

PubMed

Sinaga, Makeda; Mohammed, Ahmed; Teklu, Negash; Stelljes, Kristen; Belachew, Tefera

2015-11-13

Family planning is a strategy of balancing population growth with economic development for sustainable use of natural resources. A high population growth induces increased demand for resources and the rate at which these resources are exploited. Population, health and environment are connected inextricably. Population growth unbalanced with economic development leads to food insecurity which exposes households to the consumption of food with reduced quality and quantity leading to increased risk of malnutrition and poor health. Food insecurity again obliges people to encroach into the natural environment leading to a spiraling progress to destitution. A study in the Philippines provided concrete evidence that integrated development programming incorporating population, health, and the environment (PHE) can be more effective in lowering population growth rates and preserving critical coastal ecosystems than single-sector development interventions". Although the PHE approach has been implemented for 5 years (2008-2012) Guraghe Zone of South Ethiopia, its outcomes have not been evaluated. The objective of this study was to evaluate the effectiveness of PHE approach for achieving family planning (FP) outcomes in Gurage Zone. A comparative cross-sectional study was conducted in October, 2012. A total of 962 married women in the reproductive age group were included in the study. Data were collected using an interviewer administered Amharic version questionnaire. Descriptive statistics and multivariable logistic regression analyses were performed to compare the PHE and non-PHE Woredas (district) based on family planning parameters adopted from Measure Evaluation Manual. Comparison of non-new family panning acceptor women showed that PHE Woreda had a significantly high CPR compared to non-PHE (78% vs 52%, P < 0.0001). Among these sub-groups, women in the PHE Woreda were over four times more likely to use family planning methods during the study period (P < 0.0001) compared with women in the non-PHE Woreda. Women whose husbands' supported their use of family planning methods were 17 times as likely to use family panning methods (AOR: 17.2, 95 % CI [11.1, 26.8]), P < 0.0001. This was even increased to 20 times more when we did sub-group analysis only for women who were not new acceptors (AOR: 20.4:95% CI [9.7, 42.7]), P < 0.0001. The qualitative results showed that there was a better integration of FP, health and environmental issues into the grassroots level interventions in the PHE Woreda through using students as a medium for reaching parents on family planning and environmental issues. The findings suggest that overall; PHE has positive outcomes in FP behaviors both among married women and their husbands. Integration of population, health and environmental issues need to be strengthened and scaled up to sustain the positive FP behaviors such as support of FP use. Strategies used in the PHE Woredas such as using schools and students as medium for integrated PHE interventions are commendable approaches that need to be strengthened.

[Corrected count].

PubMed

1991-11-27

The data of the 1991 census indicated that the population count of Brazil fell short of a former estimate by 3 million people. The population reached 150 million people with an annual increase of 2%, while projections in the previous decade expected an increase of 2.48% to 153 million people. This reduction indicates more widespread use of family planning (FP) and control of fertility among families of lower social status as more information is being provided to them. However, the Ministry of Health ordered an investigation of foreign family planning organizations because it was suspected that women were forced to undergo tubal ligation during vaccination campaigns. A strange alliance of left wing politicians and the Roman Catholic Church alleges a conspiracy of international FP organizations receiving foreign funds. The FP strategies of Bemfam and Pro-Pater offer women who have little alternative the opportunity to undergo tubal ligation or to receive oral contraceptives to control fertility. The ongoing government program of distributing booklets on FP is feeble and is not backed up by an education campaign. Charges of foreign interference are leveled while the government hypocritically ignores the grave problem of 4 million abortions a year. The population is expected to continue to grow until the year 2040 and then to stabilize at a low growth rate of .4%. In 1980, the number of children per woman was 4.4 whereas the 1991 census figures indicate this has dropped to 3.5. The excess population is associated with poverty and a forsaken caste in the interior. The population actually has decreased in the interior and in cities with 15,000 people. The phenomenon of the drop of fertility associated with rural exodus is contrasted with cities and villages where the population is 20% less than expected.

Implementation of CycleTel Family Advice: an SMS-based service to provide family planning and fertility awareness information in India.

PubMed

Ashcroft, Nicki; Shelus, Victoria; Garg, Himanshu; McLarnon-Silk, Courtney; Jennings, Victoria H

2017-01-01

CycleTel Family Advice (CFA), an SMS-based service designed to improve knowledge of fertility and family planning (FP), was delivered to over 100,000 people in India from April to August 2015. The goal of CFA was to increase knowledge on a range of reproductive health topics, e.g., the menstrual cycle, fertility, and FP, and to increase positive perceptions and use of FP. This paper focuses on the best practices and operational challenges for providing an SMS service based on the implementation experience of CFA. The implementation process for CFA was well documented, specifically program design, commercial partnerships, formative research, design of messages, and recruitment of users. The impact of CFA on knowledge, attitudes, and behaviors was assessed through phone surveys before and after message delivery. Programmatic data and phone surveys resulted in several operational findings, particularly in the areas of user behavior, partnership management, and mHealth research. While there were improvements in knowledge, there were not significant changes in FP use and couple communication. The intervention yielded insights into designing an mHealth intervention as well as the opportunities and challenges of implementing a stand-alone SMS-based service with a broad audience. Lessons learned were that (I) SMS-based interventions, without other supporting systems, may not lead to high user engagement or behavior change; (II) partnerships with private sector technical platforms can help overcome the difficult problem of marketing and outreach, but they bring limitations to user interface and dependencies on a commercial structure; (III) collecting demographic data required to provide tailored content may be a barrier to user acquisition; and (IV) while phone surveys are useful for evaluation of mHealth interventions, reaching users is challenging and response rates are low.

Student perceptions of reproductive health education in US medical schools: a qualitative analysis of students taking family planning electives.

PubMed

Veazey, Kathryn; Nieuwoudt, Claudia; Gavito, Christina; Tocce, Kristina

2015-01-01

Abortion services will be sought by an estimated one in three US women before they reach age 45. Despite the importance of family planning (FP) care, many medical schools do not currently offer formal education in this area, and students are unable to meet associated competency standards prior to graduation. The purpose of this study was to explore students' motivations in pursuing FP electives throughout the United States, their experiences during these courses, and any impact of these rotations on their plans for future practice. We conducted a qualitative study consisting of semi-structured interviews with medical students upon completing fourth-year FP electives at US medical schools. Thirty-seven LCME-accredited US medical schools offered fourth-year FP electives. Course directors at 21 of these institutions recruited study participants between June 2012 and June 2013. Interviews were transcribed, coded, and analyzed with ATLAS/ti software to identify salient themes. We interviewed 29 students representing 14 institutions from all regions of the United States (East Coast, Midwest, South, and West Coast). Five central themes emerged. Medical students are using FP electives to fill gaps in the standard curriculum. Elective participation did not change students' pre-elective stance on abortion. Many students intend to provide abortion in the future but identified possible limiting factors. Proficiency in contraception and options counseling were top competencies desired and gained. Students reported excellent satisfaction with FP electives and would recommend it to their peers, regardless of their personal beliefs. Interview data revealed that students are using FP electives to fill gaps within preclinical and clinical medical school curriculum. Future physicians will be unable to provide comprehensive care for their female patients if they are not provided with this education. Research should be directed at development and analysis of comprehensive FP curricula, which will allow students to obtain the knowledge necessary to best care for their patients.

Student perceptions of reproductive health education in US medical schools: a qualitative analysis of students taking family planning electives.

PubMed

Veazey, Kathryn; Nieuwoudt, Claudia; Gavito, Christina; Tocce, Kristina

2015-01-01

Background Abortion services will be sought by an estimated one in three US women before they reach age 45. Despite the importance of family planning (FP) care, many medical schools do not currently offer formal education in this area, and students are unable to meet associated competency standards prior to graduation. Purpose The purpose of this study was to explore students' motivations in pursuing FP electives throughout the United States, their experiences during these courses, and any impact of these rotations on their plans for future practice. Method We conducted a qualitative study consisting of semi-structured interviews with medical students upon completing fourth-year FP electives at US medical schools. Thirty-seven LCME-accredited US medical schools offered fourth-year FP electives. Course directors at 21 of these institutions recruited study participants between June 2012 and June 2013. Interviews were transcribed, coded, and analyzed with ATLAS/ti software to identify salient themes. Results We interviewed 29 students representing 14 institutions from all regions of the United States (East Coast, Midwest, South, and West Coast). Five central themes emerged. Medical students are using FP electives to fill gaps in the standard curriculum. Elective participation did not change students' pre-elective stance on abortion. Many students intend to provide abortion in the future but identified possible limiting factors. Proficiency in contraception and options counseling were top competencies desired and gained. Students reported excellent satisfaction with FP electives and would recommend it to their peers, regardless of their personal beliefs. Conclusions Interview data revealed that students are using FP electives to fill gaps within preclinical and clinical medical school curriculum. Future physicians will be unable to provide comprehensive care for their female patients if they are not provided with this education. Research should be directed at development and analysis of comprehensive FP curricula, which will allow students to obtain the knowledge necessary to best care for their patients.

Using service data: tools for taking action.

PubMed

1992-01-01

Program performance can be improved through use of a simple information system. The focus of the discussion is on analysis of service data, decision making, and program improvement. Clinic managers must collect and analyze their own data and not wait for supervisors from central or district offices to conduct thorough examination. Local decision making has the advantage of providing monitoring and modification of services in a timely way and in a way responsive to client needs. Information can be shared throughout all levels of local and central administration. The model for decision making is based on data collection, data analysis, decision making, action, evaluation, information dissemination, and feedback. Data need to be collected on types of clients (new acceptor or continuing user), type of contraceptive method and quantity dispensed, and how the client learned about the clinic. Supply data also needs to be collected on methods of contraceptives on hand, number dispensed by method to clients, and projected supplies; requests for additional supplies can thus be made in a timely and appropriate way. The basic clinic forms are the family planning (FP), client record, the client referral card, an appointment card, a complication card, a daily FP activity register, a FP activities worksheet, a monthly summary of FP activities, and a commodities request/receipt form. A suggestion sheet from users addresses issues about performance targets, continuing users, dropouts, staff motivation, and setting up a system. Suggestions are also provided on the importance of staff training in data collection and analysis and in creating awareness of the program's objectives. Discussion is directed to how to interpret new acceptor data and to look for patterns. A sample chart is provided of a summary of FP activities, possible interpretations, and possible actions to take. Analysis is given for new acceptor trends, contraceptive method mix, and sources of information. A short example illustrates how client card data and bar graphs of method mix by desire for no more children or for more children revealed that couples childbearing desires did not affect method choice.

Existing apathy.

PubMed

Sayila, A K

1992-06-01

The Planned Parenthood Association of Zambia (PPAZ) faces many challenges: inadequate programs for youth and at risk groups, inadequate trained personnel and resources to implement population-related programs, and adverse publicity regarding modern methods of family planning (FP). The Family Life Movement and Profile Movement of Zambia have accused PPAZ of promoting abortions through its FP campaigns. Some Christian organizations have promoted the idea of pill and condom use as encouraging promiscuity and immorality. The majority see the pill and condoms as a clever plot to sterilize women. Culturally, many people still believe in uncontrolled childbearing and that it gives high social standing to a man according to the number of children he has. Many avoid condom use because of a preference for skin-to-skin contact. Funding is erratic and program specific. To meet these many challenges, the government intervened and was able to form an agreement with the family life proponents and PPAZ to assist the government in population efforts. The population is growing at a rate of 3.8%/year is currently numbers 8,452 million people. There is population pressure because of diminishing resources. Infant mortality is high at 72/1000 children. Ministries and PPAZ have launched campaigns in urban and rural areas to educate the people about issues such as child spacing health care, and sexual disease prevention. PPAZ acceptors increased from 175,428 in 1989 to 188,357 in 1990. The Family Life Movement is counseling on natural and traditional methods. Traditional practices include abstinence withdrawal, and use of a medicinal belt (mpimpi), which has no scientific support. Ministry of Health research reports 40% effectiveness with modern methods and 10% effectiveness with traditional ones. PPAZ has scattered delivery sites. The Ministry of Health provides contraceptives through hospitals, missions, local councils, and the Zambia Flying Doctor Services. FP is also available through pharmacies, private physicians, and company clinics PPAZ in 1990 is training industrial nurses to run FP clinics in the workplace. PPAZ has also been involved in training of trainers. A collaborative effort between PPAZ, the Ministry of Health, and the General Nursing Council is targeted to allow medically qualified field officers to prescribe contraceptives. A recent survey reported that only 25.3% knew or used modern methods.

Contraceptive use and pregnancy rates among women receiving antiretroviral therapy in Malawi: a retrospective cohort study.

PubMed

Tweya, Hannock; Feldacker, Caryl; Gugsa, Salem; Phiri, Sam

2018-02-09

In 2011, family planning (FP) services were integrated at Martin Preuss Centre (MPC), in urban Lilongwe, Malawi. To date, no previous study evaluated pregnancy rates among HIV-positive women after the integration of FP services into HIV care at the facility. In this study, we investigated whether integration of FP services into HIV clinical care led to increased use of contraceptives and decreased pregnancy rates. This was a retrospective cohort analysis of HIV-positive women from 15 to 49 years of age who accessed antiretroviral therapy (ART) services at MPC. Ascertainment of FP needs, contraceptive methods and pregnancy status were done at ART initiation, and at each ART follow-up visit. Women were offered a wide range of contraceptive methods. Outcomes of interest were contraceptive use and rate of pregnancy. Incident pregnancy was ascertained through patient self-reports during clinic consultation. Trends of contraceptive use and pregnancy rates were analyzed using chi-square (χ2). A total of 10,472 women were included in the analysis and contributed 15,700 person-years of observation. Contraceptive use among all women receiving ART increased from 28% in 2012 to 62% in 2016 (p < 0.001). A total of 501 pregnancies occurred, including 13 multiple pregnancies, resulting in an overall pregnancy rates of 3.2 per 100 person-years. Rates of pregnancy decreased from 6.8 per 100 person-years in 2012 to 1.3 per 100 person-years in 2016 (p < 0.001). Integration of FP services into HIV care resulted in increased contraceptive use and, subsequently, decreased pregnancy rates in women receiving ART. HIV programs should consider offering FP services to women who are receiving ART.

Postpartum family planning integration with maternal, newborn and child health services: a cross-sectional analysis of client flow patterns in India and Kenya.

PubMed

Mackenzie, Devon; Pfitzer, Anne; Maly, Christina; Waka, Charles; Singh, Gajendra; Sanyal, Abanti

2018-04-03

Maternal, newborn and child health (MNCH) services represent opportunities to integrate postpartum family planning (PPFP). Objectives were to determine levels of MNCH-family planning (FP) integration and associations between integration, client characteristics and service delivery factors in facilities that received programmatic PPFP support. Cross-sectional client flow assessment conducted during May-July 2014, over 5 days at 10 purposively selected public sector facilities in India (4 hospitals) and Kenya (2 hospitals and 4 health centres). 2158 client visits tracked (1294 India; 864 Kenya). Women aged 18 or older accessing services while pregnant and/or with a child under 2 years. PPFP/postpartum intrauterine device-Bihar, India (2012-2013); Jharkhand, India (2009-2014); Embu, Kenya (2006-2010). Maternal, infant and young child nutrition/FP integration-Bondo, Kenya (2011-2014). Proportion of visits where clients received integrated MNCH-FP services, client characteristics as predictors of MNCH-FP integration and MNCH-FP integration as predictor of length of time spent at facility. Levels of MNCH-FP integration varied widely across facilities (5.3% to 63.0%), as did proportion of clients receiving MNCH-FP integrated services by service area. Clients travelling 30-59 min were half as likely to receive integrated services versus those travelling under 30 min (OR 0.5, 95% CI 0.4 to 0.7, P<0.001). Clients receiving MNCH-FP services (vs MNCH services only) spent an average of 10.5 min longer at the facility (95% CI -0.1 to 21.9, not statistically significant). Findings suggest importance of focused programmatic support for integration by MNCH service area. FP integration was highest in areas receiving specific support. Integration does not seem to impose an undue burden on clients in terms of time spent at the facility. Clients living furthest from facilities are least likely to receive integrated services. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Fostering excellence: roles, responsibilities, and expectations of new family physician clinician investigators.

PubMed

Hogg, William; Kendall, Claire; Muggah, Elizabeth; Mayo-Bruinsma, Liesha; Ziebell, Laura

2014-02-01

A key priority in primary health care research is determining how to ensure the advancement of new family physician clinician investigators (FP-CIs). However, there is little consensus on what expectations should be implemented for new investigators to ensure the successful and timely acquisition of independent salary support. Support new FP-CIs to maximize early career research success. This program description aims to summarize the administrative and financial support provided by the C.T. Lamont Primary Health Care Research Centre in Ottawa, Ont, to early career FP-CIs; delineate career expectations; and describe the results in terms of research productivity on the part of new FP-CIs. Family physician CI's achieved a high level of research productivity during their first 5 years, but most did not secure external salary support. It might be unrealistic to expect new FP-CIs to be self-financing by the end of 5 years. This is a career-development program, and supporting new career FP-CIs requires a long-term investment. This understanding is critical to fostering and strengthening sustainable primary care research programs.

Provider imposed restrictions to clients’ access to family planning in urban Uttar Pradesh, India: a mixed methods study

PubMed Central

2013-01-01

Background Medical barriers refer to unnecessary policies or procedures imposed by health care providers that are not necessarily medically advised; these restrictions impede clients’ access to family planning (FP). This mixed methods study investigates provider imposed barriers to provision of FP using recent quantitative and qualitative data from urban Uttar Pradesh, India. Methods Baseline quantitative data were collected in six cities in Uttar Pradesh, India from service delivery points (SDP), using facility audits, exit interviews, and provider surveys; for this study, the focus is on the provider surveys. More than 250 providers were surveyed in each city. Providers were asked about the FP methods they provide, and if they restrict clients’ access to each method based on age, parity, partner consent, or marital status. For the qualitative research, we conducted one-on-one interviews with 21 service providers in four of the six cities in Uttar Pradesh. Each interview lasted approximately 45 minutes. Results The quantitative findings show that providers restrict clients’ access to spacing and long-acting and permanent methods of FP based on age, parity, partner consent and marital status. Qualitative findings reinforce that providers, at times, make judgments about their clients’ education, FP needs and ability to understand FP options thereby imposing unnecessary barriers to FP methods. Conclusions Provider restrictions on FP methods are common in these urban Uttar Pradesh sites. This means that women who are young, unmarried, have few or no children, do not have the support of their partner, or are less educated may not be able to access or use FP or their preferred method. These findings highlight the need for in-service training for staff, with a focus on reviewing current guidelines and eligibility criteria for provision of methods. PMID:24365015

Functional programming interpreter. M. S. thesis

DOE Office of Scientific and Technical Information (OSTI.GOV)

Robison, A.D.

1987-03-01

Functional Programming (FP) sup BAC87 is an alternative to conventional imperative programming languages. This thesis describes an FP interpreter implementation. Superficially, FP appears to be a simple, but very inefficient language. Its simplicity, however, allows it to be interpreted quickly. Much of the inefficiency can be removed by simple interpreter techniques. This thesis describes the Illinois Functional Programming (IFP) interpreter, an interactive functional programming implementation which runs under both MS-DOS and UNIX. The IFP interpreter allows functions to be created, executed, and debugged in an environment very similar to UNIX. IFP's speed is competitive with other interpreted languages such asmore » BASIC.« less

Social Franchising: A Blockbuster to Address Unmet Need for Family Planning and to Advance Toward the FP2020 Goal.

PubMed

2015-06-17

Social franchising has scaled-up provision of voluntary family planning, especially long-acting reversible contraceptives, across Africa and Asia at a rapid and remarkable pace. The approach should be pursued vigorously, especially in countries with a significant private-sector presence, to advance the FP2020 goal of providing access to modern contraception to 120 million additional clients by 2020.

Combined internal medicine-psychiatry and family medicine-psychiatry training programs, 1999-2000: program directors' perspectives.

PubMed

Doebbeling, C C; Pitkin, A K; Malis, R; Yates, W R

2001-12-01

Despite tremendous growth in the number of combined-training residency programs, little is known about their directorships, financing, recruitment, curricula, and attrition rates, and the practice patterns of graduates. The authors surveyed residency program directors from combined internal medicine-psychiatry (IM/PSY) and family medicine-psychiatry (FP/PSY) programs to provide initial descriptive information. Programs' directors were determined from the American Medical Association's Graduate Medical Education Directory and FREIDA online database. Three mailings of a pretested questionnaire were sent to the 40 identified combined IM/PSY and FP/PSY residency programs. A total of 32 directors from 29 programs responded. Most programs were under the dual directorship of representatives from both the psychiatry department and either the internal medicine or the family medicine program. Although most directors responded that the residency program was based in psychiatry, both departments shared in administrative, recruiting, and financial responsibilities. Curricula varied widely, with limited focus on combined training experiences. Graduates (n = 41) tended to practice in academic settings (37%), where both aspects of training could be used. Others practiced in either community mental health centers or traditional private practice settings. The estimated attrition rate from combined residencies was 11%. Combined-training programs are directed by a diverse group of individuals, including dual-boarded physicians. Curricula vary widely, but most programs are within recommended guidelines. Further prospective studies are warranted to determine predictors of attrition and future practice plans.

Impact of family planning health talks by lay health workers on contraceptive knowledge and attitudes among HIV-infected patients in rural Kenya

PubMed Central

Onono, Maricianah; Blat, Cinthia; Miles, Sondra; Steinfeld, Rachel; Wekesa, Pauline; Bukusi, Elizabeth A.; Owuor, Kevin; Grossman, Daniel; Cohen, Craig R.; Newmann, Sara J.

2015-01-01

Objective To determine if a health talk on family planning (FP) by community clinic health assistants (CCHAs) will improve knowledge, attitudes and behavioral intentions about contraception in HIV-infected individuals. Methods A 15-min FP health talk was given by CCHAs in six rural HIV clinics to a sample of 49 HIV-infected men and women. Effects of the health talk were assessed through a questionnaire administered before the health talk and after completion of the participant's clinic visit. Results Following the health talk, there was a significant increase in knowledge about contraceptives (p < .0001), side-effects (p < .0001), and method-specific knowledge about IUCDs (p < .001), implants (p < .0001), and injectables (p < .05). Out of 31 women and 18 men enrolled, 14 (45%) women and 6 (33%) men intended to try a new contraceptive. Participant attitudes toward FP were high before and after the health talk (median 4 of 4). Conclusion A health talk delivered by CCHAs can increase knowledge of contraception and promote the intention to try new more effective contraception among HIV-infected individuals. Practice implications FP health talks administered by lay-health providers to HIV-infected individuals as they wait for HIV services can influence FP knowledge and intention to use FP. PMID:24316053

Impact of family planning health talks by lay health workers on contraceptive knowledge and attitudes among HIV-infected patients in rural Kenya.

PubMed

Onono, Maricianah; Blat, Cinthia; Miles, Sondra; Steinfeld, Rachel; Wekesa, Pauline; Bukusi, Elizabeth A; Owuor, Kevin; Grossman, Daniel; Cohen, Craig R; Newmann, Sara J

2014-03-01

To determine if a health talk on family planning (FP) by community clinic health assistants (CCHAs) will improve knowledge, attitudes and behavioral intentions about contraception in HIV-infected individuals. A 15-min FP health talk was given by CCHAs in six rural HIV clinics to a sample of 49 HIV-infected men and women. Effects of the health talk were assessed through a questionnaire administered before the health talk and after completion of the participant's clinic visit. Following the health talk, there was a significant increase in knowledge about contraceptives (p<.0001), side-effects (p<.0001), and method-specific knowledge about IUCDs (p<.001), implants (p<.0001), and injectables (p<.05). Out of 31 women and 18 men enrolled, 14 (45%) women and 6 (33%) men intended to try a new contraceptive. Participant attitudes toward FP were high before and after the health talk (median 4 of 4). A health talk delivered by CCHAs can increase knowledge of contraception and promote the intention to try new more effective contraception among HIV-infected individuals. FP health talks administered by lay-health providers to HIV-infected individuals as they wait for HIV services can influence FP knowledge and intention to use FP. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

The role of community-based health planning and services strategy in involving males in the provision of family planning services: a qualitative study in Southern Ghana

PubMed Central

2013-01-01

Background Reproductive health and Family Planning (FP) services have been of global concern especially in developing countries where fertility rates are high. Traditionally FP services had always targeted females with little or no attention given to males. To ensure equitable distribution of health services, Ministry of Health (MOH), Ghana adopted the Community-Based Health Planning and Services (CHPS) as a nationwide health policy with the aim of reducing obstacles to physical and geographical access to health care delivery including FP services. However, not much is known about the extent to which this policy has contributed to male involvement in FP services. This qualitative descriptive study was therefore designed to explore male involvement in FP services in communities with well functioning CHPS and those with less or no functioning CHPS structures. The study further solicited views of the community on the health status of children. Methods This was a qualitative descriptive study and adapted the design of an ongoing study to assess the impact of male involvement in FP referred to as the Navrongo experiment in Northern Ghana. Twelve focus group discussions were held with both male and female community members, six in communities with functional CHPS and six for communities with less/no-functional CHPS. In addition, fifty- nine (59) in-depth interviews were held with Community Health Officers (CHOs), Community Health Volunteers (CHVs) and Health Managers at both the districts and regional levels. The interviews and discussions were tape recorded digitally, transcribed and entered into QSR Nvivo 10© for analysis. Results The results revealed a general high perception of an improved health status of children in the last ten years in the communities. These improvements were attributed to immunization of children, exclusive breastfeeding, health education given to mothers on childcare, growth monitoring of children and accessible health care. Despite these achievements in the health of children, participants reported that malnutrition was still rife in the community. The results also revealed that spousal approval was still relevant for women in the use of contraceptives; however, the matrilineal system appears to give more autonomy to women in decision-making. The CHPS strategy was perceived as very helpful with full community participation at all levels of the implementation process. Males were more involved in FP services in communities with functioning CHPS than those without functioning CHPS. Conclusion The CHPS strategy has increased access to FP services but spousal consent was very important in the use of FP services. Involving males in reproductive health issues including FP is important to attain reproductive health targets. PMID:23890362

Measurement of unmet need for family planning: Longitudinal analysis of the impact of fertility desires on subsequent childbearing behaviors among urban women from Uttar Pradesh India

PubMed Central

Speizer, Ilene S.; Calhoun, Lisa; Hoke, Theresa; Sengupta, Ranajit

2013-01-01

Background The measure of unmet need relies on women’s reported fertility desires; previous research has demonstrated that fertility desires may be fluid and not firm. Study design Our study uses recently collected longitudinal data from four cities in Uttar Pradesh India to examine whether women’s fertility desires and family planning (FP) use at baseline predict pregnancy/birth experience in the two-year follow-up period. Results Multivariate models demonstrate that women who were using any method of FP and reported an intention to stop childbearing were the least likely to experience a pregnancy/birth in the two-year follow-up period. The stated desire to delay childbearing, whether or not the woman was using FP did not distinguish pregnancy/birth experience. Ninety- two percent of pregnancies/births over the follow-up period were considered “wanted then” suggesting post hoc rationalization of the pregnancy/birth even among those women who reported a desire to stop childbearing two years earlier. Conclusions More nuanced assessments of fertility intentions may be needed to adequately gauge latent family planning needs. Non-users of FP may be ambivalent about future childbearing and the timing of future births; these women may not have an unmet need for FP as typically defined. PMID:23706906

Kenya's Maternal Child Health Family Planning Program (Family Health).

PubMed

Kiereini, E M

1982-01-01

In an attempt to improve accessibility to health care for the majority of its population, the government of Kenya has, since 1970, undertaken an integration of its dispersed health care system. In 1972 the Ministry of Health carried out a study to identify the problems associated with health care in rural areas. A task force consisting of government and other officials carried out a situation analysis with a view to making specific recommendations for improving community health status. The 4 main health problems identified had to do with family health problems, communicable diseases, diseases related to poor environmental sanitation, and health problems related to poor nutrition. The analysis also revealed the importance of maternal and child health for overall health of the community. A Maternal Child Health Family Planning (MCH/FP) program was then designed to improve services to women aged 15-49 years and children below 5 years, the groups proven to be at greatest risk for ill health. Also integrated into this approach were family planning services. Health workers ranging from enrolled community nurses (equipped with knowledge and skills for diagnosing and treating common conditions) to traditional birth attendants, serve both rural and urban areas. In addition, registered public health nurses, supervising MCH/FP services in district facilities, also operate in urban areas. Rural populations also have the services of a clinical officer who is answerable to the district medical officer, and who has charge of the health center. The Family Health Field Educators Training Program, which was started in 1975 has not yet been evaluated, but it is evident that the efforts of the government to train and equip health workers has greatly improved the quality and availability of health care service to Kenyans.

Section 107 Detailed Project Report. Fort Gaines Channel (Government Cut) at Dauphin Island, Alabama

DTIC Science & Technology

1990-03-01

Engineer District, Mobile AREA &WORK UNIT NUMBERS Plan Dev. Sec., Planning Div., (CESAM-PD-FP)- P. 0. Box 2-288, Mobi,L.3.a6628-OO.....,__ 11I...C’ONTAOLLING OFFICE NAME AND ADDRESS M 2 REPORT DATE US. Army Engineer District, Mobile March 1990 Pian Development Sec., Plan. Div., (CESAM-PD-FP) 13 NUMBER...OF PAGES P- 0. Box 2288, Mobile , AL 36628-0001 162 t4. MONITORING AGENCY NAME & ADORESS(11 different from Controlling Office) 15. SECURITY CLASS. (ol

Toward a Model-Based Approach for Flight System Fault Protection

NASA Technical Reports Server (NTRS)

Day, John; Meakin, Peter; Murray, Alex

2012-01-01

Use SysML/UML to describe the physical structure of the system This part of the model would be shared with other teams - FS Systems Engineering, Planning & Execution, V&V, Operations, etc., in an integrated model-based engineering environment Use the UML Profile mechanism, defining Stereotypes to precisely express the concepts of the FP domain This extends the UML/SysML languages to contain our FP concepts Use UML/SysML, along with our profile, to capture FP concepts and relationships in the model Generate typical FP engineering products (the FMECA, Fault Tree, MRD, V&V Matrices)

Self-reliance through FP program.

PubMed

1988-03-01

The Yogyakarta Chapter of the Indonesian Planned Parenthood Association (IPPA), having been successful in bringing about a realization by the local community of the importance of family planning, has broadened its activities in an effort to further promote family welfare. Since 1980, the organization has begun a number of projects designed to increase the income of its client population. Given the fact that family planning acceptors of IPPA's Yogyakarta Chapter range from government officials' wives to farmers and school dropouts, its family income increase projects have been varied. Skills in such areas as bee breeding and hairdressing have been taught, and credit cooperatives have been established. These projects have been integrated with the group's family planning activities and have been paid for entirely with local funds. An integrated family planning/income increase project currently being operated by the Yogyakarta Chapter of IPPA is known as KBP2K. Along with the attempt to increase family income, the project aims to expand the acceptance of family planning and to retain existing acceptors in the family planning program. As of the 3rd quarter of 1987, 235 people had participated in the project and 59 new acceptors had been acquired. Family planning education was provided and classes were taught in various handicraft industries. Studies have revealed that the income levels of program participants significantly increased.

AID to restore support to pop groups shunned under Reagan and Bush.

PubMed

1993-08-24

US Congressional action on family planning (FP) foreign assistance and the directives of the new director of USAID are summarized. Brian Atwood, USAID Director, reported to Congress that the administration supported a restoration of funding (nonsupport has occurred since 1985) to the UN Population Fund (UNFPA), International Planned Parenthood (IPPF), and the WHO Human Reproduction Program (HRP). Support would be provided through a reallocation of $30 million in fiscal 1993 USAID money. UNFPA would receive $14.5 million, IPPF $12 million, and HRP $3.5 million. UNFPA funding would be allocated from funds included in the House-approved foreign aid appropriations bill, H.R. 2295 for fiscal 1994. UNFPA would be required to account separately for US funds and would not be allowed to direct any money to China; funding would be received by September 30. The UN Development Program would periodically report on China's population program. The US plans to pressure UNFPA to withdraw UNFPA funding from China, if significant improvement is not made in their FP operation. Population assistance funding for 1994 is still in the Foreign Operations Subcommittee of the Senate Appropriations Committee. Authorization was approved by the Senate Foreign Relations Subcommittee on International Economic Policy for $400 million to USAID and $50 million for UNFPA, with the provision that US funding to UNFPA will be reduced in fiscal 1994 if UNFPA funds to China exceed $9.7 million. The bill included the preceding year's restriction that the Permanent Representative of the US to the UN General Assembly must approve the bill before disbursement of funds to UNFPA. The House version had been previously (June 30) approved in the State Department authorization bill. A provision was also included requesting Clinton administration reports on revision of foreign assistance, a reduction by 20 of the number of countries receiving foreign aid, and approving 4 basic objectives for the poorest countries (sustainable economic growth, increasing democratic participation, attention to global issues, and responding to humanitarian needs). Another funding bill was introduced in the Senate (S.1096) with a similar one in the House (H.R. 2447) to set a goal of $11 billion for FP funding by the year 2000 and a 1994 fiscal authorization level of $725 million.

MCH promotes family planning.

PubMed

Duan, Y

1992-06-01

Family planning (FP) has been promoted in China through improvements in maternal and child health (MCH) which have affected people's attitude toward childbearing. A case study of FP in Taicang County of Jiangsu Province, China is given. Total population is 446,620; natural increase is 10/1000. 99% of births have been planned in recent years. Contraceptive prevalence has reached 92.71%. Contraceptive awareness has opened people up to health education in general. The community participates in management of human wastes, improvement of water supplies, and parasite control in rural areas. MCH was begun in the early 1980s with premarital examinations, prenatal examinations, postnatal visits, and physical checkups. A systematic program has established in 1983. A pilot program integrating FP, MCH, and parasite control operated between 1984 and 1986, in 7 townships was established and MCH was institutionalized. Increases occurred in comprehensive care for women from 49.1% in 1984 to 78.3% in 1986. Children's coverage rose from 78.2% to 85.9%. Perinatal mortality dropped from 30.2/1000 to 20.8/1000. Neonatal mortality declined from 21.3/1000 to 17.3/1000. Infant mortality also decreased from 31.6/1000 to 21.5/1000. Integration of programs throughout the county was achieved after 1987. 99% of women used the MCH handbook. Between 1987 and 1990, the perinatal, neonatal, and infant mortality rate dropped to 12.9/1000, 9.5/1000, and 14.7/1000, respectively. MCH achievements are attributed to a strengthening of the MCH network to improve access and improve MCH workers' level of professional skill, to the availability of premarriage and couples of reproductive age services and child care, and to the contribution of research. Careful monitoring during pregnancy helped reduce the incidence of difficult labors for high risk women from 17.55 in 1984 to 11-15% in recent years. 99.9% deliver in hospitals. There were no maternal deaths in 1989 or 1990. Neonatal tetanus has been eliminated. 94.2% of mothers receive postpartum visits. Special services at township hospitals are given to children deemed to be physically weak; 345 in 1990 were so treated. In villages, doctors monitor height and weight of children. 94.7% of children 0-1 year receive comprehensive care. Those 1-7 years also receive a high level of care. Security was enhanced by the MCH measures. Girls and boys are considered equal in good health.

Access to emergency hormonal contraception from community pharmacies and family planning clinics

PubMed Central

Lewington, Gaye; Marshall, Kay

2006-01-01

Aims To evaluate differences in the time taken to access progestogen-only emergency hormonal contraception (EHC) by young women from family planning (FP) or community pharmacy settings. Methods An observational study of 203 women requesting EHC from FP clinics and community pharmacies in South-west Kent Primary Care Trust (PCT) from December 2002 to October 2003. Results Access to EHC from community pharmacy was significantly faster than from FP clinics (16 h vs. 41 h, P < 0.001). Older teenagers tended to seek EHC more quickly and were more likely to have had a contraceptive failure rather than have used no contraception at all. Conclusion The results provide further support for pharmacist involvement in the supply of EHC. PMID:16669854

Ambivalence in pregnancy intentions: The effect of quality of care and context among a cohort of women attending family planning clinics in Kenya.

PubMed

Wekesa, Eliud; Askew, Ian; Abuya, Timothy

2018-01-01

Ambivalence in pregnancy intentions is well-documented in sub-Saharan African (SSA) settings and has been associated with inconsistent use of contraception, thereby exposing women using contraception to the possibility of unintended pregnancies. A better understanding of the potential role for client counseling interventions in enabling women to achieve their pregnancy intentions is essential for aiding program efforts to reduce unintended pregnancies. To measure ambivalence in pregnancy intentions longitudinally and determine its association with the quality of care received, controlling for demographic, socio-economic and contextual factors among a cohort of family planning (FP) clients in Kenya. This paper uses data drawn from a prospective cohort study of FP clients to investigate the relationship between the quality of care received during FP service delivery and the decisiveness of their pregnancy intentions over time. The study tests the hypothesis that higher quality of care enables women to be less ambivalent about their pregnancy intentions. Binary logistic regression with random effects and multinomial logistic regression were used to assess the predictive effect of the quality of care received by a woman on the decisiveness or ambivalence of her pregnancy intentions, and on any shifts in ambivalence over time, controlling for background characteristics. The study recruited 1,957 women aged 15-49 years attending twelve family planning clinics in four counties in Central Kenya; of these, 1,053 women were observed for four rounds of data collection over a period of 24 months and form the sample for analysis. A substantial proportion (43%) of women expressed ambivalence about their intentions to become pregnant at some point during the study period, while over half (57%) remained unequivocal throughout the study. Almost one third of women (31%) shifted from being unequivocal to ambivalent and 12% shifted from ambivalence to being unequivocal. Women experiencing higher quality of care have lower odds of ever expressing ambivalence and higher odds of remaining unequivocal over time, net of other factors. Quality of care was not associated with a shift in ambivalence over time. FP programs offering higher quality of care are likely to support women to be more decisive in their pregnancy intentions. Improving the quality of care can contribute to reduced ambivalence and consequently reduced likelihood of unintended pregnancy among contraceptive users. This study provides further evidence of the benefits gained through providing high quality services. ClinicalTrials.gov NCT01694862.

Integration of prevention and care of sexually transmitted infections with family planning services: what is the evidence for public health benefits?

PubMed Central

Dehne, K. L.; Snow, R.; O'Reilly, K. R.

2000-01-01

It has been widely believed that, by combining the services for preventing and treating sexually transmitted infections (STI) with those for family planning (FP), STI coverage would increase and the combined service would be of higher quality and more responsive to the needs of women. So far, there is little concrete evidence that integration has had such an impact. Besides the absence of documentation, a clear definition of integration is lacking. We therefore carried out a comprehensive review of concrete experiences with integrated services, and present a summary of our findings in this article. The results indicate that the tasks of STI prevention, such as education for risk reduction and counselling, have been integrated into family planning services much more frequently than the tasks of STI diagnosis and treatment. Some STI/FP integration efforts appear to have been beneficial, for instance when the integration of STI/HIV prevention had a positive impact on client satisfaction, and on the acceptance of family planning. Less clear is whether STI prevention, when concentrated among traditional FP clients, is having a positive impact on STI risk behaviours or condom use. A few projects have reported increases in STI caseloads following integration. In some projects, FP providers were trained in STI case management, but few clients were subsequently treated. PMID:10859857

Multi-scale comparison of the fine particle removal capacity of urban forests and wetlands.

PubMed

Zhang, Zhenming; Liu, Jiakai; Wu, Yanan; Yan, Guoxin; Zhu, Lijuan; Yu, Xinxiao

2017-04-10

As fine particle (FP) pollution is harmful to humans, previous studies have focused on the mechanisms of FP removal by forests. The current study aims to compare the FP removal capacities of urban forests and wetlands on the leaf, canopy, and landscape scales. Water washing and scanning electron microscopy are used to calculate particle accumulation on leaves, and models are used to estimate vegetation collection, sedimentation, and dry deposition. Results showed that, on the leaf scale, forest species are able to accumulate more FP on their leaf surface than aquatic species in wetlands. On the canopy scale, horizontal vegetation collection is the major process involved in FP removal, and the contribution of vertical sedimentation/emission can be ignored. Coniferous tree species also showed stronger FP collection ability than broadleaf species. In the landscape scale, deposition on the forest occurs to a greater extent than that on wetlands, and dry deposition is the major process of FP removal on rain-free days. In conclusion, when planning an urban green system, planting an urban forest should be the first option for FP mitigation.

Nutrition -- a key issue for Africa. PANFRICO IV notes importance of strengthening nutrition activities to assist FP promotion.

PubMed

1993-12-01

Malnutrition is a major concern in African countries. The incorporation of nutrition education into maternal-child health services has a direct effect on child survival and the promotion of family planning (FP). The 4th Regional Workshop on the integrated Project (PANFRICO IV) was held in Banjul, The Gambia, from September 27 through October 1, 1993, and focused on the role of nutrition in promoting the integrated project on FP, nutrition, and parasite control (IP). PANFRICO was supported by UNFPA and IPPF, and was attended by 50 participants from 15 countries, some of them IP-implementing countries such as Ethiopia, The Gambia, Ghana, Tanzania, and Zambia. Officials of UNFPA, IPPF, and JOICFP also attended the meeting, as well as two representatives of the Japan International Cooperation Agency. IPPF has supported IP since 1974 because of IP's commitment to community participation. This forum allowed participants to discuss how nutrition could be incorporated into the IP for increased acceptance of FP. Recommendations called for a stronger nutritional component in IP without losing sight of FP promotion as the main focus. The participants stressed that the improvement of the nutrition component requires government commitment, policy, analysis of the nutritional situation in planning for action, community participation (of men in particular) in implementation, intersectoral coordination of nutrition and FP strategies, and nutrition education.

Are men well served by family planning programs?

PubMed

Hardee, Karen; Croce-Galis, Melanie; Gay, Jill

2017-01-23

Although the range of contraceptives includes methods for men, namely condoms, vasectomy and withdrawal that men use directly, and the Standard Days Method (SDM) that requires their participation, family planning programming has primarily focused on women. What is known about reaching men as contraceptive users? This paper draws from a review of 47 interventions that reached men and proposes 10 key considerations for strengthening programming for men as contraceptive users. A review of programming shows that men and boys are not particularly well served by programs. Most programs operate from the perspective that women are contraceptive users and that men should support their partners, with insufficient attention to reaching men as contraceptive users in their own right. The notion that family planning is women's business only is outdated. There is sufficient evidence demonstrating men's desire for information and services, as well as men's positive response to existing programming to warrant further programming for men as FP users. The key considerations focus on getting information and services where men and boys need it; addressing gender norms that affect men's attitudes and use while respecting women's autonomy; reaching adolescent boys; including men as users in policies and guidelines; scaling up successful programming; filling gaps with implementation research and monitoring & evaluation; and creating more contraceptive options for men.

Evidence from cluster surveys on the association between home-based counseling and use of family planning in conflict-affected Darfur.

PubMed

Adam, Izzeldin F

2016-05-01

To examine the association between home counseling and awareness and use of modern family planning (FP) methods among women in internally displaced person (IDP) camps in conflict-affected West Darfur, Sudan. In a community-based cross-sectional study, two questionnaire-based surveys were performed in three camps. Home-based counseling had been introduced in March 2006. An initial survey (February 2007) and a follow-up survey (April 2009) targeted women of child-bearing age. A sample of 640 randomly selected women aged 15-49 years who had experienced pregnancy after joining the camp were interviewed for each survey. Overall, modern FP use increased from 10.9% (70/640) in 2007 to 21.6% (138/640) in 2009 (P<0.001). As compared with the initial survey, women in the follow-up survey were more likely to be aware of and to use any modern FP method (adjusted odds ratio [aOR] 5.4, 95% confidence interval [CI] 3.9-7.4; and aOR 2.8, 95% CI 2.0-4.1, respectively). Contraceptive pills were the most common modern method used. Home counseling and loss of a child under 5years were the most significant predictors of awareness and use of modern FP methods. After the introduction of home-based FP counseling for couples and FP services in clinics, women's awareness and use of modern FP methods increased in a conflict-affected setting. Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Free electron laser and fundamental physics

NASA Astrophysics Data System (ADS)

Dattoli, Giuseppe; Nguyen, Federico

2018-03-01

This review paper is devoted to the understanding of free-electron lasers (FEL) as devices for fundamental physics (FP) studies. After clarifying what FP stands for, we select some aspects of the FEL physics which can be viewed as fundamental. Furthermore, we discuss the perspective uses of the FEL in FP experiments. Regarding the FP aspects of the FEL, we analyze the quantum electrodynamics (QED) nature of the underlying laser mechanism. We look for the truly quantum signature in a process whose phenomenology is dominated by classical effects. As to the use of FEL as a tool for FP experiments we discuss the realization of a device dedicated to the study of non-linear effects in QED such as photon-photon scattering and shining-through-the-wall experiments planned to search for dark matter candidates like axions.

Examining relationship/family planning factors and sexual relationship power among immigrant Latino couples in the United States.

PubMed

Matsuda, Yui; McGrath, Jacqueline M; Knafl, George J; Worthington, Everett L; Jallo, Nancy; Corona, Rosalie

2014-01-01

The ability to influence partners' actions within an intimate relationship (sexual relationship power [SRP]) is a key concept in achieving optimum family planning (FP) among U.S. Latinos. The purpose of this study was to examine the associations between relationship/FP factors and SRP. The actor-partner interdependence model was used to analyze data for 40 couples. Both men's and women's sexual communications were positively associated with SRP, only women's relationship satisfaction was positively associated with SRP, women's general communication was negatively associated with men's SRP, and men's contraception attitudes were negatively associated with SRP. Couples interventions are needed, which account for SRP and gender differences. These findings provide direction for developing targeted interventions to achieve better FP for Latino couples.

The provision of emergency contraception in Kinshasa's private sector pharmacies: experiences of mystery clients.

PubMed

Hernandez, Julie H; Mbadu, Muanda Fidèle; Garcia, Mélissa; Glover, Annie

2018-01-01

Recent programmatic and research efforts on addressing gaps in health systems of low-income countries increasingly see task shifting, i.e. the provision of healthcare by non-medically trained personnel, as a possible solution to increase the availability of specific services and commodities. In Kinshasa, private-sector pharmacies are the primary and preferred provider of family planning (FP) methods, and thus constitute a potential resource for expanding access to specific contraceptives. The objective of this study is to explore selected pharmacies' readiness to serve women seeking emergency contraception (EC). This study used a mystery client (MC) methodology to visit 73 pharmacies in Kinshasa, Democratic Republic of Congo (DRC). Trained interviewers posed as novice EC users and asked specific questions to evaluate the pharmacy staff's technical knowledge of EC and their attitudes towards EC clients. The results of the MC visit were recorded immediately after the MC left the pharmacy. Findings indicate that more than two-thirds of EC providers were knowledgeable about EC dosage, timeframe, and side effects, and 90% were deemed helpful towards novice EC users. Rare but glaring misconceptions about EC timeframe (20% of providers) and long-term side effects (4% of providers), as well as frequent stock-out (22%) and cost issues highlight priorities for programmatic improvements. As new service delivery strategies are explored to complement the uneven network of health structures in DRC, this study suggests that, given proper training and integration in FP programming, private-sector pharmacies have the potential to meet specific contraceptive needs for women living in Kinshasa. Private pharmacies included in study sample in Kinshasa (DRC) have adequate family planning (FP) service skills to provide clients with emergency contraceptive pills. These higher-end outlets constitute an opportunity for expanding access to FP, although, under total market approaches, a more diverse range of drugs shops should be investigated. Copyright © 2017 The Author(s). Published by Elsevier Inc. All rights reserved.

Assessing the contraceptive supply environment in Kinshasa, DRC: trend data from PMA2020.

PubMed

Babazadeh, S; Lea, S; Kayembe, P; Akilimali, P; Eitmann, L; Anglewicz, P; Bertrand, J

2018-03-01

Performance Monitoring and Accountability 2020 (PMA2020) is a population-based and facility-based survey program conducted in 11 countries to track contraceptive use dynamics and the supply environment. Annual data collection provides trend data unavailable from any other source. Two-stage cluster sampling was used to select 58 enumeration areas in Kinshasa; data were collected in 2014, 2015 and 2016 from three to six service delivery points (SDPs) per EA. Of the 228-248 SDPs surveyed each year, only two-thirds reported to offer family planning (FP) services. Of those reporting to offer FP, one-fifth or more did not do so on the day of the survey. As of 2016, only one-half of SDPs offering FP had at least three methods available, a proxy for contraceptive choice; only one in five had at least five methods. Long-acting reversible contraceptives, including implants and IUDs, were less widely offered and more often stocked out than resupply methods, including condoms, pills and injectables. Contraceptive stockouts were rampant: in 2016, over a quarter of the SDPs experienced stockouts of all methods (except condoms) in the previous 3 months, and two of the three most widely used methods-implants and injectables-were also the most likely to be stocked out. The findings documented the inconsistency in pricing of methods across facilities; moreover, less than one quarter of SDPs posted prices. Patterns in the contraceptive supply environment remained relatively unchanged between 2014 and 2016. The PMA2020 SDP module provides timely, actionable information to the DRC government, FP implementing organizations and donors involved in FP service delivery in Kinshasa, DRC. Yet the value of this information will be determined by the ability of the local FP stakeholders to use it in bringing the needed improvements identified by this survey to the contraceptive supply environment. © The Authors 2017. Published by Oxford University Press on behalf of Entomological Society of America.

Assessing the contraceptive supply environment in Kinshasa, DRC: trend data from PMA2020

PubMed Central

Babazadeh, S; Lea, S; Kayembe, P; Akilimali, P; Eitmann, L; Anglewicz, P; Bertrand, J

2018-01-01

Abstract Performance Monitoring and Accountability 2020 (PMA2020) is a population-based and facility-based survey program conducted in 11 countries to track contraceptive use dynamics and the supply environment. Annual data collection provides trend data unavailable from any other source. Two-stage cluster sampling was used to select 58 enumeration areas in Kinshasa; data were collected in 2014, 2015 and 2016 from three to six service delivery points (SDPs) per EA. Of the 228–248 SDPs surveyed each year, only two-thirds reported to offer family planning (FP) services. Of those reporting to offer FP, one-fifth or more did not do so on the day of the survey. As of 2016, only one-half of SDPs offering FP had at least three methods available, a proxy for contraceptive choice; only one in five had at least five methods. Long-acting reversible contraceptives, including implants and IUDs, were less widely offered and more often stocked out than resupply methods, including condoms, pills and injectables. Contraceptive stockouts were rampant: in 2016, over a quarter of the SDPs experienced stockouts of all methods (except condoms) in the previous 3 months, and two of the three most widely used methods—implants and injectables—were also the most likely to be stocked out. The findings documented the inconsistency in pricing of methods across facilities; moreover, less than one quarter of SDPs posted prices. Patterns in the contraceptive supply environment remained relatively unchanged between 2014 and 2016. The PMA2020 SDP module provides timely, actionable information to the DRC government, FP implementing organizations and donors involved in FP service delivery in Kinshasa, DRC. Yet the value of this information will be determined by the ability of the local FP stakeholders to use it in bringing the needed improvements identified by this survey to the contraceptive supply environment. PMID:29136172

Highlights of session presentations. TSS / CST population IEC meeting.

PubMed

1995-01-01

The great deal of documentation which was prepared for the recent TSS/CST Population IEC (information, education, and communication) meeting from research, field experiments, and action projects will be useful to TSS/CST advisors and individual countries undertaking IEC and population education work. This article summarizes the 12 sessions held during the open forum. To illustrate some of the latest trends in population and health communication, the "enter-educate" approach and use of the interactive computer software called SCOPE (Strategic Communication Planning and Evaluation) were discussed. Next, ways in which to apply research effectively in IEC and population education were considered. Examples were provided of 1) a workshop methodology used to help a multidisciplinary group design a problem-solving communication strategy in Malaysia and Dominica; 2) the counseling training evaluation technique based on the GATHER (greet, ask, tell, help, explain, and return for follow-up) model; and 3) four types of evaluation of population education in schools. The third session was concerned with the program approach used in IEC and population education. Session 4 dealt with the implication of UNFPA support to family planning (FP) IEC. Counseling skills training and interpersonal communication were next on the agenda, followed by a consideration of how knowledge and policies are applied in the area of youth. The seventh session concentrated on ways to involve men in FP and reproductive health and included a discussion of a case study on the attitude and behavior of men with regard to FP which had IEC implications. The next session described the need to reconceptualize population education and what such a reconceptualization would entail. Session 9 was devoted to a consideration of gender issues and the education of girls. The tenth session covered the use of participatory approaches and community involvement in population communication programs. Innovative methodologies for school-based population education were described next, and the last session was concerned with new information technologies such as navigating the Internet and using new software for establishing databases.

Peng Peiyun and Jiang Zhenghua answer questions raised by both Chinese and foreign journalists.

PubMed

1993-04-01

In April 1993, the Minister and Vice Minister of the Chinese State Family Planning (FP) Commission held a news conference for Chinese and foreign journalists on population and FP. The Chinese FP program has lowered the birth rate by .5% in 5 years, thus adverting 15 million births. A 1992 survey of 385,000 people showed that the number of acceptors increased 12.3% during 1988-92, and unplanned births declined by 54.7% in the same period. Early marriage were 48% less frequent; marriage age increased from 21.8 to 22.5 years. The fertility rate has experienced this rapid decline because efforts were strengthened in the past 2 years. Despite achieving below replacement level fertility, efforts will continue to enact the current FP policy. Whereas the sex ratio is higher than international standards (111.3 vs. 106), China has instituted and publicized laws and incentives designed to improve the status of women and enhance the equality of women. The phenomenon of "converse elimination," which occurs with urban intellectuals being confined to one child, whereas rural inhabitants have more children, is a natural result of the condition of rural life which makes more children necessary because of the practical daily problems rural inhabitants face. China's population policy, however, is designed to stress both population control and improvement of the quality of human resources. The current policy was devised as a response to conditions which are unlikely to change before the year 2000. Rural areas require access to education, health care, and culture. The policy includes the use of incentives and disincentives for Fp workers, and this system is subject to abuse. The objective of the incentives and disincentives is encouraged and citizens have recourse in the courts if officials behave irresponsibly. A more favorable environment for FP will be created as China moves toward a socialist market economy. As labor migration from rural to urban areas increases, however, FP management will have to be combined with employment credentials to monitor possible unplanned births.

Family planning and sexual health organizations: management lessons for health system reform.

PubMed

Ambegaokar, Maia; Lush, Louisiana

2004-10-01

Advocates of health system reform are calling for, among other things, decentralized, autonomous managerial and financial control, use of contracting and incentives, and a greater reliance on market mechanisms in the delivery of health services. The family planning and sexual health (FP&SH) sector already has experience of these. In this paper, we set forth three typical means of service provision within the FP&SH sector since the mid-1900s: independent not-for-profit providers, vertical government programmes and social marketing programmes. In each case, we present the context within which the service delivery mechanism evolved, the management techniques that characterize it and the lessons learned in FP&SH that are applicable to the wider debate about improving health sector management. We conclude that the FP&SH sector can provide both positive and negative lessons in the areas of autonomous management, use of incentives to providers and acceptors, balancing of centralization against decentralization, and employing private sector marketing and distribution techniques for delivering health services. This experience has not been adequately acknowledged in the debates about how to improve the quality and quantity of health services for the poor in developing countries. Health sector reform advocates and FP&SH advocates should collaborate within countries and regions to apply these management lessons. Copyright 2004 Oxford University Press

Integration of Family Planning Services into HIV Care and Treatment Services: A Systematic Review.

PubMed

Haberlen, Sabina A; Narasimhan, Manjulaa; Beres, Laura K; Kennedy, Caitlin E

2017-06-01

Evidence on the feasibility, effectiveness, and cost-effectiveness of integrating family planning (FP) and HIV services has grown significantly since the 2004 Glion Call to Action. This systematic review adds to the knowledge base by characterizing the range of models used to integrate FP into HIV care and treatment, and synthesizing the evidence on integration outcomes among women living with HIV. Fourteen studies met our inclusion criteria, eight of which were published after the last systematic review on the topic in 2013. Overall, integration was associated with higher modern method contraceptive prevalence and knowledge, although there was insufficient evidence to evaluate its effects on unintended pregnancy or achieving safe and healthy pregnancy. Evidence for change in unmet need for FP was limited, although two of the three evaluations that measured unmet need suggested possible improvements associated with integrated services. However, improving access to FP services through integration was not always sufficient to increase the use of more effective (noncondom) modern methods among women who wanted to prevent pregnancy. Integration efforts, particularly in contexts where contraceptive use is low, must address community-wide and HIV-specific barriers to using effective FP methods alongside improving access to information, commodities, and services within routine HIV care. © 2017 The Population Council, Inc.

Costs and utilization of public sector family planning services in Pakistan.

PubMed

Abbas, Khadija; Khan, Adnan Ahmad; Khan, Ayesha

2013-04-01

The public sector provides a third of family planning (FP) services in Pakistan. However, these services are viewed as being underutilized and expensive. We explored the utilization patterns and costs of FP services in the public sector. We used overall budgets and time allocation by health and population departments to estimate the total costs of FP by these departments, costs per woman served, and costs per couple-year of protection (CYP). The public sector is the predominant provider of FP to the poorest and is the main provider of female sterilization services. The overall costs of FP in the public sector are USD 55 per woman served, annually (USD 17 per CYP). Within the public sector, the population welfare departments provide services at USD 72 per woman served, annually (USD 17 per CYP) and the health departments at USD 39 per woman per year (USD 29 per CYP). While the public sector has a critical niche in serving the poor and providing female sterilization, its services are considerably more expensive compared to international and even some Pakistani non-government organization (NGO) costs. This reflects inefficiencies in services provided, client mistrust in the quality of services provided, and inadequate referrals, and will require specific actions for improving referrals and the quality of services.

mfpa: Extension of mfp using the ACD covariate transformation for enhanced parametric multivariable modeling.

PubMed

Royston, Patrick; Sauerbrei, Willi

2016-01-01

In a recent article, Royston (2015, Stata Journal 15: 275-291) introduced the approximate cumulative distribution (acd) transformation of a continuous covariate x as a route toward modeling a sigmoid relationship between x and an outcome variable. In this article, we extend the approach to multivariable modeling by modifying the standard Stata program mfp. The result is a new program, mfpa, that has all the features of mfp plus the ability to fit a new model for user-selected covariates that we call fp1( p 1 , p 2 ). The fp1( p 1 , p 2 ) model comprises the best-fitting combination of a dimension-one fractional polynomial (fp1) function of x and an fp1 function of acd ( x ). We describe a new model-selection algorithm called function-selection procedure with acd transformation, which uses significance testing to attempt to simplify an fp1( p 1 , p 2 ) model to a submodel, an fp1 or linear model in x or in acd ( x ). The function-selection procedure with acd transformation is related in concept to the fsp (fp function-selection procedure), which is an integral part of mfp and which is used to simplify a dimension-two (fp2) function. We describe the mfpa command and give univariable and multivariable examples with real data to demonstrate its use.

The value of spatial analysis for tracking supply for family planning: the case of Kinshasa, DRC.

PubMed

Hernandez, Julie H; Akilimali, Pierre; Kayembe, Patrick; Dikamba, Nelly; Bertrand, Jane

2016-10-01

While geographic information systems (GIS) are frequently used to research accessibility issues for healthcare services around the world, sophisticated spatial analysis protocols and outputs often prove inappropriate and unsustainable to support evidence-based programme strategies in resource-constrained environments. This article examines how simple, open-source and interactive GIS tools have been used to locate family planning (FP) services delivery points in Kinshasa (Democratic Republic of Congo) and to identify underserved areas, determining the potential location of new service points, and to support advocacy for FP programmes. Using smartphone-based data collection applications (OpenDataKit), we conducted two surveys of FP facilities supported by partner organizations in 2012 and 2013 and used the results to assess gaps in FP services coverage, using both ratio of facilities per population and distance-based accessibility criteria. The cartographic outputs included both static analysis maps and interactive Google Earth displays, and sought to support advocacy and evidence-based planning for the placement of new service points. These maps, at the scale of Kinshasa or for each of the 35 health zones that cover the city, garnered a wide interest from the operational level of the health zones' Chief Medical Officers, who were consulted to contribute field knowledge on potential new service delivery points, to the FP programmes officers at the Ministry of Health, who could use the map to inform resources allocation decisions throughout the city. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Providers perspective and geographic and institutional factors associated with family planning counseling.

PubMed

de la Vara-Salazar, Elvia; Suárez-López, Leticia; Rivera, Leonor; Lazcano-Ponce, Eduardo

2018-06-01

Family planning (FP) counseling is an essential activity to prevent unplanned pregnancies and allow a fulfilling sex life. We defined adequate counseling in FP as the counseling given to women and men of reproductive age that provided complete information about use, application, effectiveness, side effects, and contraindications. Two objectives are proposed in this study. First, we seek to analyze geographic and institutional factors associated with FP counseling in primary and secondary healthcare facilities in Mexico. Second, we seek to identify the cultural barriers that providers perceive as a limitation of the clients so that they can come to request information related to FP and that are associated with FP counseling. This cross-sectional study uses a complex, probabilistic, stratified sampling design representative at national level by institution, region and rural-urban areas. We collected 16,829 provider questionnaires at healthcare facilities. Bivariate and logistic regression analyses were performed. Providers in rural areas had a greater possibility of offering adequate counseling (OR = 2.98; 95%CI 1.18-7.53). Providers in the northern region of the country were more likely to provide adequate counseling (OR = 5.37; 95% CI 1.91-15.12). Providers whom perceive religion as a limitation for clients to come to request information about FP are less likely to provide adequate counseling (OR = 0.37; 95% CI 0.15-0.88). Physical space exclusively for the provision of FP counseling and the availability of manuals were not associated with adequate counseling. There is a need to address the social and cultural influences on the quality of counseling in these healthcare facilities. Copyright © 2018 Elsevier B.V. All rights reserved.

Do Patient Characteristics Decide if Young Adult Cancer Patients Undergo Fertility Preservation?

PubMed

Flink, Dina M; Sheeder, Jeanelle; Kondapalli, Laxmi A

2017-06-01

The Fertility Attitudes and Cancer Treatment Study (FACTS) is a two-phase research initiative aimed to understand factors involved with decision making for future fertility. The FACTS will improve services and utilization of fertility preservation (FP) before cancer treatment. Phase-I examined patient characteristics as associated with FP decision. A retrospective cohort study of 108 reproductive-aged (18-45 years) males and females who received a fertility consultation before cancer treatment from January 1, 2012 to April 30, 2014 was conducted. Chi-square, student's t-test, and logistic regression were conducted to examine associations with FP decision. The utilization rate of FP following fertility consultation was 49%. Gender was the most significant factor contributing to FP decision; 74% of those who choose FP were male (odds ratio = 12.5; 95% confidence interval 5.1-31.4). Those who opted for FP were more likely to be Caucasian (p = 0.042), have a solid tumor (p = 0.03), and have a shorter time from diagnosis to fertility consultation (29.5 vs. 58.8 days; p = 0.017). Age, relationship, tumor location, treatment plan, and parity were not significant predictors of FP. Current perceptions about patient demographics do not predict FP utilization by young adult cancer patients. Providing patients an informed fertility consultation has demonstrated an increase in FP utilization to nearly one-half of patients. Despite gender being a significant factor in choosing FP, the study did not provide reasons as to why. The phase-II study will explore patients' reasons for FP decision in a qualitative design to understand these differences.

77 FR 71111 - Approval and Promulgation of Air Quality Implementation Plans; State of Florida; Regional Haze...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-29

..., modeling, and scientific knowledge about the relationships between pollutants and visibility impairment..., proposed amendment for reasonable progress are: City of Gainesville Deerhaven unit 5; Florida Power & Light (FP&L) Manatee units 1, 2; FP&L Turkey Point units 1, 2; Gulf Power Company Crist unit 7; Lakeland...

Fertility intentions and interest in integrated family planning services among women living with HIV in Nyanza Province, Kenya: a qualitative study.

PubMed

Harrington, Elizabeth K; Newmann, Sara J; Onono, Maricianah; Schwartz, Katie D; Bukusi, Elizabeth A; Cohen, Craig R; Grossman, Daniel

2012-01-01

Despite increasing efforts to address the reproductive health needs of people living with HIV, a high unmet need for contraception exists among HIV+ women in sub-Saharan Africa. This study explores the fertility intentions and family planning (FP) preferences of Kenyan women accessing HIV treatment. We conducted 30 semistructured interviews and qualitatively analyzed the data with a grounded theory approach. Fears of premature death, financial hardship, and perinatal HIV transmission emerged as reasons for participants' desire to delay/cease childbearing. Participants strongly identified FP needs, yet two-thirds were using male condoms alone or no modern method of contraception. Women preferred the HIV clinic as the site of FP access for reasons of convenience, provider expertise, and a sense of belonging, though some had privacy concerns. Our findings support the acceptability of integrated FP and HIV services. Efforts to empower women living with HIV to prevent unintended pregnancies must expand access to contraceptive methods, provide confidential services, and take into account women's varied reproductive intentions.

BKKBN and the expanding role of private sector FP services and commercial contraceptive sales in Indonesia.

PubMed

Suyono, H

1989-07-01

The Indonesian family planning program is an internationally recognized success. Launched in 1970, the program, coordinated by the National Family Planning Coordinating Board (BKKBN), now enrolls an average of 20,000 new acceptors each day. About 60% of eligible couples participate in the program. The key factors in the BKKBN's strategy are 1) a firm commitment from all government leaders, 2) a positive relationship with religious and other leaders, 3) decentralization and flexibility, 4) a shift from a traditional clinic-based to a community-based program, and 5) the integration of the program with health, family welfare, and other development activities. The next phase of the program emphasizes self-support or self-reliance in family planning. This means taking responsibility for one's own family planning, but it also means that those who are financially able to do so should pay for services and supplies. New projects have begun with the private sector. BKKBN has been working with professional doctors' and midwives' associations to promote private initiatives for family planning. The Kondom Dua Lima, a social marketing project with a private company, distributes and sells condoms in the commercial retail sales market. The Blue Circle Contraceptive Social Marketing Project provides low-cost but high-quality contraceptive supplies to fill the gap between free BKKBN supplies and the expensive contraceptives available through commercial pharmacies. BKKBN is working with the private sector to encourage its participation in the Indonesian goal of institutionalizing the small, happy, and prosperous family norm.

NGO involvement shows the way for FP officers.

PubMed

1999-11-01

This article reports the activities of a 3-week seminar and field trip that was attended by 15 Senior Family Planning (FP) officers from 15 countries in order to examine Japan's postwar experiences and governmental organization/nongovernmental organization (NGO) cooperation in public health and FP. In a span of three weeks, the participants attended lectures conducted by the Ministry of Health and Welfare on Maternal and Child Health Administration, and by the Japan Family Planning Association. They also took a tour to observe local government administration of health and welfare, as well as local government and NGO cooperation. They also observed community volunteer organizations, a hospital, nurse training and a primary school. During the summing-up and evaluation sessions in Tokyo, all participants expressed their satisfaction with the seminar and shared the lessons they learned during the field trip.

Workable solutions to FP in Africa.

PubMed

1991-12-01

The 3rd Pan African Conference on the Integrated Family Planning, Nutrition and Parasite Control Project (PANFRICO III) was held in October 1991 and organized by JOICFP, UNFPA and IPPF. The Ghana IP Steering Committee implemented it. In addition to the 5 IP implementing countries--Ethiopia, the Gambia, Ghana, Tanzania, and Zambia--other countries attending were: Kenya, Lesotho, Madagascar, Mali, Nigeria, Senegal, Sierra Leone, Swaziland, Togo, and Uganda. Governmental and nongovernmental organizations (NGOs) and international groups such as UNFPA, IPPF, FAO, and USAID also attended. The theme was seeking a strategic approach to family planning through primary health care. Participants resolved to increase the support and involvement of African governments in IP implementation. It was recognized that self-reliance, cost effectiveness, and efficient use of resources were important to sustainability. It was also agreed that IP should integrate family planning (FP) with Maternal and Child Health (MCH) and Primary Health Care (PHC) in order to overcome traditional and cultural obstacles to FP and to gain full participation of men in the communities. Horizontal integration was the primary thrust. there was agreement that there should be collaboration between UNFPA, IPPF, and JOICFP, and relevant governments and NGOs. Country-specific attention needs to be paid to expanding IP functions within the 5 IP countries. In Ghana, IP pilot areas have been successful in increasing the FP acceptance rate from 17.4% in 1988 to 51.9% in 1991. IP experiences in Indonesia were presented, including the concept of fee-charged PHC services in order to achieve self-reliance in FP/MCH projects. The response was the request for further technical cooperation between developing countries. The workshop activities were particularly beneficial, and requests were made for discussion of IEC, management, service delivery, nutrition, environmental sanitation, self-reliance, community participation, and evaluation. To further regional IP development within the country, it was suggested that national workshops be held. It was emphasized that FP and population are basic elements of socioeconomic development.

After the demographic transition: policy responses to low fertility in four Asian countries.

PubMed

Greenspan, A

1994-09-01

In the low fertility countries of South Korea, Taiwan, Singapore, and Thailand, policy-makers are concerned about the consequences of low growth. In South Korea, a family planning (FP) program was instituted in the early 1960s, and fertility declined to 1.6 by 1987. Rural fertility is still higher at 1.96, and abortion rates are high. 32.2% of fertility reduction is accomplished through abortion. South Korean population will not stabilize until 2021, at 50.6 million people. The elderly are expected to increase and strain housing, energy, and land resources. Government support for FP is being reduced, while private sector services are being enhanced. Government sterilization programs have been reduced significantly, and revisions in the Medical Insurance Law will cover part of contraceptive cost. Integrated services are being established. Many argue for an emphasis on birth spacing, child and family development, sex education, and care of the elderly. In Taiwan, replacement level fertility was reached in 1983. Policy in 1992 recommended increasing fertility from 1.6 to 2.1. The aim was to stabilize population without pronatalist interventions. Regardless of policy decisions, population growth will continue over the next 40 years, and the extent of aging will increase. In Singapore since the 1960s, the national government focused on encouraging small families through fertility incentives, mass media campaigns, and easy access to FP services. Fertility declined to 1.4 in 1988. Since 1983, government has established a variety of pronatalist incentives. In 1989, fertility increased to 1.8. The pronatalist shift is viewed as not likely to succeed in dealing with the concern for an adequate work force to support the elderly and economic development. In Thailand, fertility declined the fastest to 2.4 in 1993. The key factors were rapid economic and social development, a supportive cultural setting, strong demand for fertility control, and a successful FP program. The goal is to reduce fertility to 1.2 by 1996. Replacement level may be reached in 2000 or 2005. Future trends are not clear.

The role of family planning in achieving safe pregnancy for serodiscordant couples: commentary from the United States government's interagency task force on family planning and HIV service integration.

PubMed

Mason, Jennifer; Medley, Amy; Yeiser, Sarah; Nightingale, Vienna R; Mani, Nithya; Sripipatana, Tabitha; Abutu, Andrew; Johnston, Beverly; Watts, D Heather

2017-03-08

People living with HIV (PLHIV) have the right to exercise voluntary choices about their health, including their reproductive health. This commentary discusses the integral role that family planning (FP) plays in helping PLHIV, including those in serodiscordant relationships, achieve conception safely. The United States (US) President's Emergency Plan for AIDS Relief (PEPFAR) is committed to meeting the reproductive health needs of PLHIV by improving their access to voluntary FP counselling and services, including prevention of unintended pregnancy and counselling for safer conception. Inclusion of preconception care and counselling (PCC) as part of routine HIV services is critical to preventing unintended pregnancies and perinatal infections among PLHIV. PLHIV not desiring a current pregnancy should be provided with information and counselling on all available FP methods and then either given the method onsite or through a facilitated referral process. PLHIV, who desire children should be offered risk reduction counselling, support for HIV status disclosure and partner testing, information on safer conception options to reduce the risk of HIV transmission to the partner and the importance of adhering to antiretroviral treatment during pregnancy and breastfeeding to reduce the risk of vertical transmission to the infant. Integration of PCC, HIV and FP services at the same location is recommended to improve access to these services for PLHIV. Other considerations to be addressed include the social and structural context, the health system capacity to offer these services, and stigma and discrimination of providers. Evaluation of innovative service delivery models for delivering PCC services is needed, including provision in community-based settings. The US Government will continue to partner with local organizations, Ministries of Health, the private sector, civil society, multilateral and bilateral donors, and other key stakeholders to strengthen both the policy and programme environment to ensure that all PLHIV and serodiscordant couples have access to FP services, including prevention of unintended pregnancy and safer conception counselling.

Indonesia to become a larger donor to the UNFPA, Country Director J.S. Parsons predicts.

PubMed

Mann, R

1992-08-01

The UN Population Fund (UNFPA) is influential with governments because of its international coordinating role in line with the Amsterdam Declaration of 1989. The present shortage of funds for UNFPA can be traced to the weak world economy, monetary needs in eastern Europe and in the former USSR, and the stagnation of voluntary contributions to UNFPA. The reduction of funding has affected the Indonesian family planning (FP) program called BKKBN. Indonesia is a priority country for UNFPA because of the self-reliance and success of the national program; the efficient utilization of a staff of 46,000 working for 19 million acceptors; the total fertility rate drop from 5.6 in 1971 to 3.1 in 1991; a 95% and 93% knowledge of FP and contraceptives among married women, respectively; and the national contraceptive prevalence is 49.7%. Smaller private projects and strategies are recommended for nationwide adaptation. Unfulfilled needs include adolescent reproductive health care, slums, quality of services, and reaching remote fishing or highland communities. BKKBN has been assisting its Vietnamese counterpart with technical advice which is in accordance with the international objectives of UNFPA. BKKBN has also assisted Bangladesh, Pakistan, Nigeria, and Kenya. Indonesia could contribute condoms, pills, and IUDs to the UNFPA effort to increase its share, although not on the same order as Japan and the Netherlands. The 4th Asian and Pacific conference is scheduled to be held in Bali in August 1992 in preparation for the World Population Conference to be arranged in Egypt in 1994 with an agenda of policies and strategies for all the regions of Asia, Pacific, Middle East, and Latin America. The formulation of a World Population Declaration is envisioned on South to South cooperation on FP beholding BKKBN's experience in FP information exchange with other countries.

Measuring FLOPS Using Hardware Performance Counter Technologies on LC systems

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ahn, D H

2008-09-05

FLOPS (FLoating-point Operations Per Second) is a commonly used performance metric for scientific programs that rely heavily on floating-point (FP) calculations. The metric is based on the number of FP operations rather than instructions, thereby facilitating a fair comparison between different machines. A well-known use of this metric is the LINPACK benchmark that is used to generate the Top500 list. It measures how fast a computer solves a dense N by N system of linear equations Ax=b, which requires a known number of FP operations, and reports the result in millions of FP operations per second (MFLOPS). While running amore » benchmark with known FP workloads can provide insightful information about the efficiency of a machine's FP pipelines in relation to other machines, measuring FLOPS of an arbitrary scientific application in a platform-independent manner is nontrivial. The goal of this paper is twofold. First, we explore the FP microarchitectures of key processors that are underpinning the LC machines. Second, we present the hardware performance monitoring counter-based measurement techniques that a user can use to get the native FLOPS of his or her program, which are practical solutions readily available on LC platforms. By nature, however, these native FLOPS metrics are not directly comparable across different machines mainly because FP operations are not consistent across microarchitectures. Thus, the first goal of this paper represents the base reference by which a user can interpret the measured FLOPS more judiciously.« less

Role and goals of the EUR-OCEANS Consortium - Bringing marine scientists priorities and strategies to the European research planning agenda.

NASA Astrophysics Data System (ADS)

Cury, Philippe; Baisnée, Pierre-François

2010-05-01

The EUR-OCEANS Consortium is the follow-up structure of the homonym European Network of Excellence (NoE; 2005-2008, FP6 contract number 511106). It is a scientific network, benefiting from and relying upon the institutional commitment of the 27 research performing organisations forming its core (paying) membership. It aims at the long-term harmonization of European research efforts related to ocean ecosystems undergoing anthropogenic and natural forcing. More specifically, its objectives are to facilitate and promote: (1) top-level scientific research on the impacts of anthropogenic and natural forcing on ocean ecosystems, fostering collaborations across the European Research Area; (2) the optimal use of any shared technical infrastructures and scientific facilities; and (3) activities to spread excellence, such as the training of scientific personnel and students, or knowledge dissemination towards the general public and socio-economic users. A particular focus is put during the first scientific coordination mandate on the building of scenarios for marine ecosystems under anthropogenic and natural forcing in the XXI Century, and on the improvement of the science-policy interface. Through calls for projects and networking activities, the Consortium seeks to favour the emergence of coordinated projects on key hot topics on one hand, and the crystallisation of scientific priorities and strategies that could serve as input to ERA-NETs, ESFRI, Joint Programming Initiatives and European Research Planning actors in general. While being an active standalone structure, the Consortium is also engaged in the Euromarine FP7 project (submitted) aiming at the definition of a common coordinating or integrating structure for the three follow-up entities of FP6 marine science NoEs (Marine Genomics Europe, MarBEF, EUR-OCEANS). The 2009-2011 strategy and activity plan of EUR-OCEANS will be presented and the involvement of EUR-OCEANS members in other key projects or programmes will be summarized.

Family planning and contraception in Islamic countries: a critical review of the literature.

PubMed

Shaikh, Babar Tasneem; Azmat, Syed Khurram; Mazhar, Arslan

2013-04-01

The population of the world reached seven billion in 2012. Pakistan's population stands at more than 180 million, is growing rapidly, and has the highest unmet need for family planning (FP) in isolated rural areas. The low usage of contraception in the rural areas of Pakistan correlates with the level of isolation, poverty, illiteracy, and to a large extent, religious misinterpretations/misconceptions. Almost 25% of couples who desired FP services were not receiving them for a variety of reasons of which religion could be one, especially in the rural remote areas where the media is still not reaching and influencing mind-sets. In this scenario, the role of social marketing in bringing about attitudinal and behavioural change among users in underserved areas and gatekeepers and opinion makers in society must not be neglected. The work in promoting FP, contraception and birth spacing requires authentic evidence from similar sociocultural contexts and this endeavour of compiling case studies from various Islamic countries on their FP initiatives is a good step. Governments around the world, including many in the Islamic world, support FP programmes to enable individuals and couples to choose the number and timing of their children. This paper is a review of secondary data accessed through PubMed and Google Scholar. It provides an overview of Islamic countries' policies on, and support for FP and modern contraception. For this purpose, literature from Afghanistan, Bangladesh, Egypt, Indonesia, Iran, Jordan, Kuwait, Malaysia, Morocco, Nigeria, Pakistan, and Turkey was included. There are significant internal social and economic reasons to focus on FP in the Muslim world. Thus, arguments by religious scholars who see FP as an external western conspiracy aimed at curtailing the growth and strength of the Islamic world appear to be uninformed of both the socio-political and demographic realities in many Muslim countries, as well as the historical permissibility of contraception within the Islamic legacy. In fact, it can be argued that given the profound socio-economic and political difficulties in various parts of the Muslim world, a lack of FP and increasing populations would weaken and curtail the pace of overall development. Private institutions and the government must collaborate in leveraging initiatives and bridging gaps for more robust advocacy with clergymen and religious scholars to support the larger cause of FP and birth spacing i.e. improving infant and maternal health in Pakistan.

On the socioeconomic benefits of family planning work.

PubMed

Yang, D

1991-01-01

The focus of this article is on 1) the intended socioeconomic benefit of Chinese family planning (FP) versus the benefit of the maternal production sector, 2) the estimated costs of FP work, 3) and the principal ways to lower FP costs. Marxian population theory, which is ascribed to in socialist China, states that population and socioeconomic development are interconnected and must adapt to each other and that an excessively large or small population will upset the balance and retard development. Malthusians believe that large populations reduce income, and Adam Smith believed that more people meant a larger market and more income. It is believed that FP will bring socioeconomic benefits to China. The socioeconomic benefit of material production is the linkage between labor consumption and the amount of labor usage with the fruits and benefits of labor. FP invests in human, material, and financial resources to reduce the birth rate and the absolute number of births. The investment is recouped in population. The increased national income generated from a small outlay to produce an ideal population would be used to improve material and cultural lives. FP brings economic benefits and accelerates social development (ecological balances women's emancipation and improvement in the physical and mental health of women and children, improvement in cultural learning and employment, cultivation of socialist morality and new practices, and stability). In computing FP cost, consideration is given to total cost and unit cost. Cost is dependent on the state budget allocation, which was 445.76 million yuan in 1982 and was doubled by 1989. World Bank figures for 1984 affixed the FP budget in China at 979.6 million US dollars, of which 80% was provided by China. Per person, this means 21 cents for central, provincial, prefecture, and country spending, 34 cents for rural collective set-ups, 25 cents for child awards, and various subsidies, 15 cents for sterilization, and 5 cents for rural medical services, or 1 US dollar/person. Unit costs are the costs to reduce the population of one and include direct and indirect costs. The unit cost between 1970-82 was 35.5 yuan, but if outlays for families and industrial units are included, the cost was 70-100 yuan. Population growth, however, must be balanced so that aging does not cancel out the benefits from FP gains. Lower costs can be achieved by better FP administration.

Erap shuns birth control, bats for "responsible parenthood".

PubMed

Recently, the president of the Philippines made a public statement against the official government position of advocating freedom of choice in family planning. In announcing that he opposes "artificial birth control methods" to control population growth, Joseph Estrada noted that he was the eighth of 10 siblings and would not have been born if family planning (FP) had been available. Estrada, who has admitted fathering 10 children by different women, called for "responsible parenthood" but failed to explain what he means by this term. Estrada charged that efforts to promote FP have failed to reduce the rate of population growth in the Philippines and proposed that increased national productivity is a better way of responding to population growth. A representative of the Roman Catholic Church praised the president's stance, but the Department of Health Secretary said the president's statement was not inconsistent with the government's position on FP and would not trigger a change in policy.

Struggling to survive in Russia.

PubMed

Gadasina, A

1997-01-01

Abortion has long been the traditional method of family planning (FP) in Russia. Today, abortions are free, but contraception is not. The birth rate has decreased between 1989 and 1995, and the death rate has increased. The present economic situation has had a marked adverse effect on women who are expected to juggle jobs, household duties, and child care responsibilities. In order to survive, women sometimes must engage in work that compromises their health. Many women have resorted in prostitution, and this has caused an unprecedented explosion in the incidence of sexually transmitted diseases, especially syphilis. The number of people newly registered as HIV-positive in the first half of 1997 exceeded the total for 1996. While sex education is still restricted, erotica and pornography is widely available. Cases of syphilis are increasing among the young, and, in 1996, about 2500 girls under age 15 gave birth and an equal number had abortions. Only 12% of all pregnant women and 25% of newborn infants can be considered healthy. In 1994, the government launched a FP program that is being carried out by a few public and private organizations. One of these, the Russian FP Association, has created more than 50 branches in different regions, opened youth centers, and provided sex education and reproductive health counseling. The overall effort has led to a 27% reduction in abortions, and a 25% reduction in abortion mortality. These efforts, however, have been opposed by "pro-life" forces and by the Communist wing of the government that reduced the budget. The FP Association is fighting back by lobbying and explaining the need for its work.

South Korea's low fertility raises European-style issues.

PubMed

Haub, C

1991-10-01

A demographic revolution has taken place in South Korea as evidenced by the marked decline in total fertility rate (TFR) from 6 in 1960 to the 1987 level of 1.6. South Korea holds the record for low fertility among developing countries, with women in South Korea averaging fewer children in their lifetimes than do women in Europe. The 1987 TFR for South Korea was even less than that of Sweden, Norway, and France. Emphasizing high initial rates of contraceptive use, family planning (FP) has been a strong component of South Korea's 5-year plans since 1962. Strong governmental support backed the efforts of a large group of FP workers who provided free contraceptives from private physicians. High discontinuation rates resulted, however, and the abortion rate has soared to equal the number of live births. Albeit a developing nation, South Korea now faces the challenges of below replacement fertility more typical of more developed countries. Current fertility levels indicate population increase to approximately 50 million by 2020, followed by a slow decline. While reducing pressure on limited resources, population decline and demographic aging will also demand allocation of a higher proportion of government funds to medical care, and potentially threaten South Korea's competitiveness in the world labor market. Having effected decreases in population growth and fertility, the government reduced the annual sterilization target in 1986 from 300,000 to 60,000 by 1991, and will increasingly turn to the private sector and national health insurance for service provision to all but the poor. A 2-child family norm may be promoted, FP programs expanded to the unmarried and legislation developed to eliminate the preference for sons. Delivery systems may also be reorganized to encourage continued use of contraceptive methods.

Applying APPA Guidelines for Custodial Staffing: The Case of Slippery Rock University

ERIC Educational Resources Information Center

Iossifova, Albena; Hemphill, Dennis; Brest, Diana; Albert, Scott

2009-01-01

Founded in 1889, Slippery Rock University (SRU) is a state university with 8,500 students and 400 faculty. Facilities and planning (F&P) employs 178 staff, of which 50 are custodians. F&P is responsible for the maintenance of 560 acres and 60 major buildings that comprise approximately 2.3 million gross square feet. Currently work is…

Cost-Effectiveness Analysis of Family Planning Services Offered by Mobile Clinics versus Static Clinics in Assiut, Egypt.

PubMed

Al-Attar, Ghada S T; Bishai, David; El-Gibaly, Omaima

2017-03-01

Cost effectiveness studies of family planning (FP) services are very valuable in providing evidence-based data for decision makers in Egypt. Cost data came from record reviews for all 15 mobile clinics and a matched set of 15 static clinics and interviews with staff members of the selected clinics at Assiut Governorate. Effectiveness measures included couple years of protection (CYPs) and FP visits. Incremental cost-effectiveness ratios (ICER) and sensitivity analyses were calculated. Mobile clinics cost more per facility, produced more CYPs but had fewer FP visits. Sensitivity analysis was done using: total costs, CYP and FP visits of mobile and static clinics and showed that variations in CYP of mobile and static clinics altered the ICER for CYP from $2 -$6. Mobile clinics with their high emphasis on IUDs offer a reasonable cost effectiveness of $4.46 per additional CYP compared to static clinics. The ability of mobile clinics to reach more vulnerable women and to offer more long acting methods might affect a policy decision between these options. Static clinics should consider whether emphasizing IUDs may make their services more cost-effective.

Using machine learning algorithms to guide rehabilitation planning for home care clients.

PubMed

Zhu, Mu; Zhang, Zhanyang; Hirdes, John P; Stolee, Paul

2007-12-20

Targeting older clients for rehabilitation is a clinical challenge and a research priority. We investigate the potential of machine learning algorithms - Support Vector Machine (SVM) and K-Nearest Neighbors (KNN) - to guide rehabilitation planning for home care clients. This study is a secondary analysis of data on 24,724 longer-term clients from eight home care programs in Ontario. Data were collected with the RAI-HC assessment system, in which the Activities of Daily Living Clinical Assessment Protocol (ADLCAP) is used to identify clients with rehabilitation potential. For study purposes, a client is defined as having rehabilitation potential if there was: i) improvement in ADL functioning, or ii) discharge home. SVM and KNN results are compared with those obtained using the ADLCAP. For comparison, the machine learning algorithms use the same functional and health status indicators as the ADLCAP. The KNN and SVM algorithms achieved similar substantially improved performance over the ADLCAP, although false positive and false negative rates were still fairly high (FP > .18, FN > .34 versus FP > .29, FN. > .58 for ADLCAP). Results are used to suggest potential revisions to the ADLCAP. Machine learning algorithms achieved superior predictions than the current protocol. Machine learning results are less readily interpretable, but can also be used to guide development of improved clinical protocols.

Integration of family planning with maternal health services: an opportunity to increase postpartum modern contraceptive use in urban Uttar Pradesh, India.

PubMed

Achyut, Pranita; Mishra, Anurag; Montana, Livia; Sengupta, Ranajit; Calhoun, Lisa M; Nanda, Priya

2016-04-01

Maternal health (MH) services provide an invaluable opportunity to inform and educate women about family planning (FP). It is expected that this would enable women to choose an appropriate method and initiate contraception early in the postpartum period. In this study we examined interactions with health providers for MH services, and the effect of FP information provision during these interactions on the postpartum use of modern contraceptive methods. This study used midline data collected from 990 women who had delivered a live birth between January 2010 and the date of the midline survey in 2012. These women were asked a series of questions about their last delivery, including interactions with health providers during pregnancy, delivery and the postpartum period, if they received FP information during these interactions, and their contraceptive use during the postpartum period. The study found that FP information provision as part of antenatal care in the third trimester, delivery and the postpartum period have a positive association with postpartum modern contraceptive use in urban Uttar Pradesh. However, health providers often miss these opportunities. Despite a high proportion of women coming into contact with health providers when utilising MH services, only a small proportion received FP information during these interactions. Integration of FP with MH services can increase postpartum modern contraceptive use. With the launch of the National Urban Health Mission, there now exists appropriate policy and programmatic environments for integration of FP and MH services in urban settings in India. However, this will require a concentrated effort both to enhance the capacity of health providers and encourage supportive supervision. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Evaluating the impact of social franchising on family planning use in Kenya.

PubMed

Chakraborty, Nirali M; Mbondo, Mwende; Wanderi, Joyce

2016-06-18

In Kenya, as in many low-income countries, the private sector is an important component of health service delivery and of providing access to preventive and curative health services. The Tunza Social Franchise Network, operated by Population Services Kenya, is Kenya's largest network of private providers, comprising 329 clinics. Franchised clinics are only one source of family planning (FP), and this study seeks to understand whether access to a franchise increases the overall use or provides another alternative for women who would have found FP services in the public sector. A quasi-experimental study compared 50 catchment areas where there is a Tunza franchise and no other franchised provider with 50 purposively matched control areas within 20 km of each selected Tunza area, with a health facility, but no franchised facility. Data from 5609 women of reproductive age were collected on demographic and socioeconomic status, FP use, and care-seeking behavior. Multivariate logistic regression, with intervention and control respondents matched using coarsened exact matching, was conducted. Overall modern contraceptive use in this population was 53 %, with 24.8 % of women using a long-acting or permanent method (LAPM). There was no significant difference in odds of current or new FP use by group, adjusted for age. However, respondents in Tunza catchment areas are significantly more likely to be LAPM users (adj. OR = 1.49, p = 0.015). Further, women aged 18-24 and 41-49 in Tunza catchment areas have a significantly higher marginal probability of LAPM use than those in control areas. This study indicates that access to a franchise is correlated with access to and increased use of LAPMs, which are more effective, and cost-effective, methods of FP. While franchised facilities may provide additional points of access for FP and other services, the presence of the franchise does not, in and of itself, increase the use of FP in Kenya.

An evaluation of a family planning mobile job aid for community health workers in Tanzania.

PubMed

Braun, Rebecca; Lasway, Christine; Agarwal, Smisha; L'Engle, Kelly; Layer, Erica; Silas, Lucy; Mwakibete, Anna; Kudrati, Mustafa

2016-07-01

The global rapid growth in mobile technology provides unique opportunities to support community health workers (CHWs) in providing family planning (FP) services. FHI 360, Pathfinder International and D-tree International developed an evidence-based mobile job aid to support CHW counseling, screening, service provision and referrals, with mobile forms for client and service data, and text-message reporting and reminders. The purpose of this study is to evaluate the acceptability and potential benefits to service quality from the perspective of CHWs and their clients. The mobile job aid was piloted in Dar es Salaam, Tanzania. Data collection tools included a demographic survey of all 25 CHWs trained to use the mobile job aid, in-depth interviews with 20 of the CHWs after 3 months and a survey of 176 clients who received FP services from a CHW using the mobile job aid after 6 months. Both CHWs and their clients reported that the mobile job aid was a highly acceptable FP support tool. CHWs perceived benefits to service quality, including timelier and more convenient care; better quality of information; increased method choice; and improved privacy, confidentiality and trust with clients. Most clients discussed multiple FP methods with CHWs; only 1 in 10 clients reported discussion of all 9 methods. This research suggests that mobile phones can be effective tools to support CHWs with FP counseling, screening and referrals, data collection and reporting, and communication. Challenges remain to support informed contraceptive choice. Future research should focus on implementation, including scale-up and sustainability. Mobile job aids can uniquely enhance FP service provision at the community level through adherence to standard protocols, real-time feedback and technical assistance, and provision of confidential care. This study can inform future efforts to support and expand the role of CHWs in increasing FP access and informed contraceptive choice. Copyright © 2016 Elsevier Inc. All rights reserved.

Costs can influence family planning decisions.

PubMed

Barnett, B

1998-01-01

This article discusses research in Cebu, Philippines, that examines the relationship between costs and income and family planning (FP) decisions. Clients weigh the costs and benefits of obtaining FP services. Costs may include the time to purchase supplies, travel to clinics, child care, and lost work time. Women should consider the costs of having more children. Family Health International's Women's Studies Project explored couple's FP decision-making. In Cebu, women play a decisive role in household expenditure decisions. 64% of women made sole decisions about children's shoes and clothing. 43% made decisions about taking children to the doctor. Women consulted husbands for larger expenditures, such as land purchases, hiring household help, and travel outside Cebu. If conflicts arose, 82% reported a mutual final decision, while 12% accepted the husband's judgment. Only 12% of women made sole decisions about FP. About 20% of the sample of women discussed FP with adult females. 25% of the women who consulted their husbands about FP made the final decision when there was conflict. Only 7% reported that the husband's decision was final. A recent follow-up study to a 1983 study finds that price is only one among many factors that affect contraceptive decision-making. Rural women in Cebu reported that the time needed to obtain contraceptives was an important factor in determining their use. A study of 64 women in rural southern India finds that contraceptive prevalence was influenced by women's autonomy rather than income. Women's and children's ages, family size, and birth order affected women's autonomy and access to money. In another related study, Pakistani women had lower fertility rates when wives' unearned income was high. An increase by 25% in unearned income among rural women decreased fertility by one child.

Shale gas wastewater management under uncertainty.

PubMed

Zhang, Xiaodong; Sun, Alexander Y; Duncan, Ian J

2016-01-01

This work presents an optimization framework for evaluating different wastewater treatment/disposal options for water management during hydraulic fracturing (HF) operations. This framework takes into account both cost-effectiveness and system uncertainty. HF has enabled rapid development of shale gas resources. However, wastewater management has been one of the most contentious and widely publicized issues in shale gas production. The flowback and produced water (known as FP water) generated by HF may pose a serious risk to the surrounding environment and public health because this wastewater usually contains many toxic chemicals and high levels of total dissolved solids (TDS). Various treatment/disposal options are available for FP water management, such as underground injection, hazardous wastewater treatment plants, and/or reuse. In order to cost-effectively plan FP water management practices, including allocating FP water to different options and planning treatment facility capacity expansion, an optimization model named UO-FPW is developed in this study. The UO-FPW model can handle the uncertain information expressed in the form of fuzzy membership functions and probability density functions in the modeling parameters. The UO-FPW model is applied to a representative hypothetical case study to demonstrate its applicability in practice. The modeling results reflect the tradeoffs between economic objective (i.e., minimizing total-system cost) and system reliability (i.e., risk of violating fuzzy and/or random constraints, and meeting FP water treatment/disposal requirements). Using the developed optimization model, decision makers can make and adjust appropriate FP water management strategies through refining the values of feasibility degrees for fuzzy constraints and the probability levels for random constraints if the solutions are not satisfactory. The optimization model can be easily integrated into decision support systems for shale oil/gas lifecycle management. Copyright © 2015 Elsevier Ltd. All rights reserved.

Chinese women's participation in fertility discussions.

PubMed

Li, L

1993-01-01

In an attempt to better understand the process through which the family planning (FP) programs and socioeconomic developments in China affect fertility, women's participation in fertility discussions with their husbands are examined as an intermediate factor in a study based on results of a random survey of 6654 ever-married women of reproductive age from 7 cities and 30 counties of Guangdong. First, it must be noted that Chinese couples do have individual choices (albeit quite limited ones) about their fertility; they can choose to follow or ignore government policy or they can choose to remain childless. The present study has 3 major hypotheses: 1) the more a woman is involved in fertility discussions with her husband, the fewer children she will have; 2) urban women with a higher educational status will be more likely to have such discussions; and 3) women who are contacted individually by FP personnel are more likely to be involved in fertility discussions. After a discussion of data collection and variables (number of living children, education of wife and husband, age at marriage, residence, living with parents, contacted by FP personnel, and discussion with husband), the results are presented in terms of zero-order correlation coefficients indicating their relationships. The bivariate analysis supported the hypotheses. Multiple regression analysis showed that age at marriage, education of wives and husbands, FP contacts, and participation in discussions remain significant fertility determinants (but the correlation between fertility and residence becomes trivial). A further regression model indicated that a woman's educational attainment is the most significant positive indication of their participation in fertility discussions. These results imply that as women's status continues to improve in China and the deeply-rooted patriarchal tradition loses hold, increased gender equity and education will influence a fertility decline. FP personnel could also encourage women to actively participate in fertility discussions with their husbands.

Increasingly artful. Applying commercial marketing communication techniques to family planning communication.

PubMed

Williams, J R

1992-08-01

Family planning (FP) and social marketing messages must utilize the rules concerning artfulness developed in the private sector for effective communication in the mass media around the world. They have to compete for the attention of television program viewers accustomed to receiving hundreds of 30-second messages. There are some rules essential to any effective communication program: 1) Command attention. In the US over 1350 different mass media messages vie for attention every single day. FP messages are sensitive, but dullness and passivity is not a requisite. 2) Clarify the message, and keep it simple and direct. Mixed messages equal less effective communication. 3) Communicate a benefit. Consumers do not only buy products, they buy expectations of benefits. 4) Consistency counts. The central message should remain consistent to allow the evaluation of its effectiveness, but execution should vary from time to time and medium to medium. 5) Cater to the heart and the head. Effective communication offers real emotional values. 6) Create trust. Words, graphics, sounds, and casting in the campaign should support 1 central key promise to a single prime prospect. 7) Call for action. Both commercial and social marketing campaigns can calculate results by quantifiable measurement of sales (of condoms) transactions (the number of IUD insertions), floor traffic (clinic visits), attitude shifts, and behavior change. The PRO-PATER Vasectomy Campaign of 1988 in Sao Paulo, Brazil successfully used the above rules for effective communication. During the 1st 2 months of the campaign, phone calls increased by over 300%, new clients by 97%, and actual vasectomies performed by 79%.

FP-180 Water Motor AFFF Proportioner First Article Procedure and Evaluation

DTIC Science & Technology

1989-07-20

concentrates. The first fluorocarbon-based Aqueous Film Forming Foam ( AFFF ) concentrate fully suitable for use with ocean water was FC -195, which had a...Fil E W Y. . Naval Research Laboratory Washington, DC 20375-500 NRL Memorandum Report 6507 FP-180 Water Motor AFFF Proportioner First Article...NUMBERS PROGRAM :PROJECT TASK WORK UNIT ELEMENT NO NO NO ACCESSION NO 11 TITLE (Include Security Classification) FP-180 Water Motor AFFF Proportioner

Mammography Clinical Image Quality and the False Positive Rate in a Canadian Breast Cancer Screening Program.

PubMed

Guertin, Marie-Hélène; Théberge, Isabelle; Zomahoun, Hervé Tchala Vignon; Dufresne, Michel-Pierre; Pelletier, Éric; Brisson, Jacques

2018-05-01

The study sought to determine if mammography quality is associated with the false positive (FP) rate in the Quebec breast cancer screening program in 2004 and 2005. Mammography quality of a random sample of screen-film mammograms was evaluated by an expert radiologist following the criteria of the Canadian Association of Radiologists. For each screening examination, scores ranging from 1 (poor quality) to 5 (excellent quality) were attributed for positioning, compression, contrast, exposure level, sharpness, and artifacts. A final overall quality score (lower or higher) was also given. Poisson regression models with robust estimation of variance and adjusted for potential confounding factors were used to assess associations of mammography quality with the FP rate. Among 1,209 women without cancer, there were 104 (8.6%) FPs. Lower overall mammography quality is associated with an increase in the FP rate (risk ratio [RR], 1.4; 95% confidence interval [CI], 1.0-2.1; P = .07) but this increase was not statistically significant. Artifacts were associated with an increase in the FP rate (RR, 2.1; 95% CI, 1.3-3.3; P = .01) whereas lower quality of exposure level was related to a reduction of the FP rate (RR, 0.4; 95% CI, 0.1-1.0; P = .01). Lower quality scores for all other quality attributes were related to a nonstatistically significant increase in the FP rate of 10%-30%. Artifacts can have a substantial effect on the FP rate. The effect of overall mammography quality on the FP rate may also be substantial and needs to be clarified. Copyright © 2017 Canadian Association of Radiologists. Published by Elsevier Inc. All rights reserved.

The role of family planning in achieving safe pregnancy for serodiscordant couples: commentary from the United States government’s interagency task force on family planning and HIV service integration

PubMed Central

Mason, Jennifer; Medley, Amy; Yeiser, Sarah; Nightingale, Vienna R.; Mani, Nithya; Sripipatana, Tabitha; Abutu, Andrew; Johnston, Beverly; Watts, D. Heather

2017-01-01

Abstract Introduction: People living with HIV (PLHIV) have the right to exercise voluntary choices about their health, including their reproductive health. This commentary discusses the integral role that family planning (FP) plays in helping PLHIV, including those in serodiscordant relationships, achieve conception safely. The United States (US) President’s Emergency Plan for AIDS Relief (PEPFAR) is committed to meeting the reproductive health needs of PLHIV by improving their access to voluntary FP counselling and services, including prevention of unintended pregnancy and counselling for safer conception. Discussion: Inclusion of preconception care and counselling (PCC) as part of routine HIV services is critical to preventing unintended pregnancies and perinatal infections among PLHIV. PLHIV not desiring a current pregnancy should be provided with information and counselling on all available FP methods and then either given the method onsite or through a facilitated referral process. PLHIV, who desire children should be offered risk reduction counselling, support for HIV status disclosure and partner testing, information on safer conception options to reduce the risk of HIV transmission to the partner and the importance of adhering to antiretroviral treatment during pregnancy and breastfeeding to reduce the risk of vertical transmission to the infant. Integration of PCC, HIV and FP services at the same location is recommended to improve access to these services for PLHIV. Other considerations to be addressed include the social and structural context, the health system capacity to offer these services, and stigma and discrimination of providers. Conclusion: Evaluation of innovative service delivery models for delivering PCC services is needed, including provision in community-based settings. The US Government will continue to partner with local organizations, Ministries of Health, the private sector, civil society, multilateral and bilateral donors, and other key stakeholders to strengthen both the policy and programme environment to ensure that all PLHIV and serodiscordant couples have access to FP services, including prevention of unintended pregnancy and safer conception counselling. PMID:28361500

Does Integrating Family Planning into HIV Services Improve Gender Equitable Attitudes? Results from a Cluster Randomized Trial in Nyanza, Kenya.

PubMed

Newmann, Sara J; Rocca, Corinne H; Zakaras, Jennifer M; Onono, Maricianah; Bukusi, Elizabeth A; Grossman, Daniel; Cohen, Craig R

2016-09-01

This study investigated whether integrating family planning (FP) services into HIV care was associated with gender equitable attitudes among HIV-positive adults in western Kenya. Surveys were conducted with 480 women and 480 men obtaining HIV services from 18 clinics 1 year after the sites were randomized to integrated FP/HIV services (N = 12) or standard referral for FP (N = 6). We used multivariable regression, with generalized estimating equations to account for clustering, to assess whether gender attitudes (range 0-12) were associated with integrated care and with contraceptive use. Men at intervention sites had stronger gender equitable attitudes than those at control sites (adjusted mean difference in scores = 0.89, 95 % CI 0.03-1.74). Among women, attitudes did not differ by study arm. Gender equitable attitudes were not associated with contraceptive use among men (AOR = 1.06, 95 % CI 0.93-1.21) or women (AOR = 1.03, 95 % CI 0.94-1.13). Further work is needed to understand how integrating FP into HIV care affects gender relations, and how improved gender equity among men might be leveraged to improve contraceptive use and other reproductive health outcomes.

Circular on family planning, 1988.

PubMed

1988-01-01

This Hubei, China, Circular, issued near the end of 1988, provides the following: "The population growth situation in our country is grim. Since 1986, the natural population growth rate has risen continuously. To draw the prompt attention of the whole party and the entire people to the issue of our population, all localities must seriously unfold the activities of publicizing family planning (FP) this winter and next spring, in coordination with education in current affairs. It is necessary to publicize FP in an all-around way and with accuracy, and the activities of publicizing must be carried out effectively in a solid and deep-going way. In the rural areas, stress must be placed on areas where FP work is not carried out well and where there is a prevailing tendency toward early marriage, early child-bearing, and extra-budgetary births. In cities, publicity and education must be conducted especially among the transient population, individual households, and jobless households. During the period of publicity, large-scale street-corner publicity activities must be carried out in cities and towns so as to create strong public opinion and to combine the endeavor to publicize current affairs and policies with the effort to popularize knowledge about contraception and birth-control, to execute measures of contraception and birth control, and to establish FP associations in the countryside." full text

Maternal mortality in the Islamic countries of the Eastern Mediterranean Region of WHO.

PubMed

El-haffez, G

1990-07-01

Maternal mortality in Islamic countries is high. Some reasons for high maternal mortality here include low average age of marriage, illiteracy, lack of prenatal care, and obstetric complications. In at least 3 Islamic countries it stands 50/10,000, but ranges from 20-49 in most Islamic countries. These figures are based on only a few studies in hospitals, however. In fact, 70-90% of deliveries do not take place in hospitals, particularly in rural areas. Moreover, traditional birth attendants (TBAs) deliver most infants. In addition, poor health information systems exist. WHO's Regional Office of the Eastern Mediterranean promotes maternal health projects designed to reduce maternal mortality. Specifically, it supports scientific inquiries into maternal deaths which can include talking to husbands about wives' deaths or having TBAs record infant and maternal events. WHO promotes self care by having mothers complete record cards. These cards are used in Yemen, Egypt, Pakistan, Syria, and Somalia. It also encourages maternal and child health/family planning (MCH/FP) programs to adopt a risk approach to expedite early referral care of high risk pregnant females. In fact, WHO sponsors workshops on risk approach in MCH/FP for physicians. It also fosters improvement of managerial and technical skills. WHO collaborates with medical, nursing, and paramedical schools in curriculum development for training students in MCH/FP. Similarly, it provides training for practicing obstetricians. Further, it promotes training of TBAs. WHO encourages each country to monitor and evaluate MCH/FP activities, to conduct health system research, and address unmet needs in maternal care. In conclusion, education is needed to dispel harmful traditional practices and countries should increase the role of the media to inform the public.

Nepal CRS project incorporates.

PubMed

1983-01-01

The Nepal Contraceptive Retail Sales (CRS) Project, 5 years after lauching product sales in June 1978, incorporated as a private, nonprofit company under Nepalese management. The transition was finalized in August 1983. The Company will work through a cooperative agreement with USAID/Kathmandu to complement the national family planning goals as the program continues to provide comtraceptives through retail channels at subsidized prices. Company objectives include: increase contraceptive sales by at least 15% per year; make CRS cost effective and move towards self sufficiency; and explore the possibility of marketing noncontraceptive health products to improve primary health care. After only5 years the program can point to some impressive successes. The number of retial shops selling family planning products increased from 100 in 1978 to over 8000, extending CRS product availability to 66 of the country's 75 districts. Retail sales have climbed dramatically in the 5-year period, from Rs 46,817 in 1978 to Rs 271,039 in 1982. Sales in terms of couple year protection CYP) have grown to 24,451 CYP(1982), a 36% increase over 1980 CYP. Since the beginning of the CRS marketing program, total distribution of contraceptives--through both CRS and the Family Planning Maternal and Child Haelth (FP/MCH) Project--has been increasing. While the FP/MCH program remains the largest distributor,contribution of CRS Products is increasing, indicating that CRS is creating new product acceptors. CRS market share in 1982 was 43% for condoms and 16% for oral contraceptives (OCs). CRS markets 5 products which are subsidized in order to be affordable to consumers as well as attractive to sellers. The initial products launched in June 1978 were Gulaf standard dose OCs and Dhaal lubricated colored condoms. A less expensive lubricates, plain Suki-Dhaal condom was introduced in June 1980 in an attempt to reach poorer rural populations, but rural distribution costs are excessive and Suki-Dhaal sales have never been high. In 1982 2 additional products were introduced--Nilocan (Norminest) low does OCs and Kamal Neo Sampoon foaming tablets. The CRS program recruited and trained its own sales representatives who work shop to shop, promoting products and educating retailers and consumers. An important part of the communication starategy includes consumer and retailer education. Advertising messages were developed to increase brand awareness, create demand, educate consumers about side effects of OCs, and to identify contraceptives as a means of adequately space children.

Are Hemorrhoids Associated with False-Positive Fecal Immunochemical Test Results?

PubMed

Kim, Nam Hee; Park, Jung Ho; Park, Dong Il; Sohn, Chong Il; Choi, Kyuyong; Jung, Yoon Suk

2017-01-01

False-positive (FP) results of fecal immunochemical tests (FITs) conducted in colorectal cancer (CRC) screening could lead to performing unnecessary colonoscopies. Hemorrhoids are a possible cause of FP FIT results; however, studies on this topic are extremely rare. We investigated whether hemorrhoids are associated with FP FIT results. A retrospective study was conducted at a university hospital in Korea from June 2013 to May 2015. Of the 34547 individuals who underwent FITs, 3946 aged ≥50 years who underwent colonoscopies were analyzed. Logistic regression analysis was performed to determine factors associated with FP FIT results. Among 3946 participants, 704 (17.8%) showed positive FIT results and 1303 (33.0%) had hemorrhoids. Of the 704 participants with positive FIT results, 165 had advanced colorectal neoplasia (ACRN) and 539 had no ACRN (FP results). Of the 1303 participants with hemorrhoids, 291 showed FP results, of whom 81 showed FP results because of hemorrhoids only. Participants with hemorrhoids had a higher rate of FP results than those without hemorrhoids (291/1176, 24.7% vs. 248/2361, 10.5%; p<0.001). Additionally, the participants with hemorrhoids as the only abnormality had a higher rate of FP results than those experiencing no such abnormalities (81/531, 15.3% vs. 38/1173, 3.2%; p<0.001). In multivariate analysis, the presence of hemorrhoids was identified as an independent predictor of FP results (adjusted odds ratio, 2.76; 95% confidence interval, 2.24-3.40; p<0.001). Hemorrhoids are significantly associated with FP FIT results. Their presence seemed to be a non-negligible contributor of FP results in FIT-based CRC screening programs.

Traditional food: a better compatibility with industry requirements.

PubMed

Cotillon, Christophe; Guyot, Anne-Clothilde; Rossi, Daniel; Notarfonso, Maurizio

2013-11-01

The objective of this article is to summarise the main results of the TRUEFOOD Integrated project, which is supported by the European Commission in the European Framework Program 6 (FP6). This project started in 2006 and ended in 2010. TRUEFOOD aimed to improve quality and safety and introduce innovation into Traditional European Food production systems through research, demonstration, dissemination and training activities. It focuses on increasing value to both consumers and producers and on supporting the development of realistic business plans for all components of the food chain, using a farm-to-fork approach. © 2013 Society of Chemical Industry.

Development of a marker assisted selection program for cacao.

PubMed

Schnell, R J; Kuhn, D N; Brown, J S; Olano, C T; Phillips-Mora, W; Amores, F M; Motamayor, J C

2007-12-01

ABSTRACT Production of cacao in tropical America has been severely affected by fungal pathogens causing diseases known as witches' broom (WB, caused by Moniliophthora perniciosa), frosty pod (FP, caused by M. roreri) and black pod (BP, caused by Phytophthora spp.). BP is pan-tropical and causes losses in all producing areas. WB is found in South America and parts of the Caribbean, while FP is found in Central America and parts of South America. Together, these diseases were responsible for over 700 million US dollars in losses in 2001 (4). Commercial cacao production in West Africa and South Asia are not yet affected by WB and FP, but cacao grown in these regions is susceptible to both. With the goal of providing new disease resistant cultivars the USDA-ARS and Mars, Inc. have developed a marker assisted selection (MAS) program. Quantitative trait loci have been identified for resistance to WB, FP, and BP. The potential usefulness of these markers in identifying resistant individuals has been confirmed in an experimental F(1) family in Ecuador.

Can Family Planning Service Statistics Be Used to Track Population-Level Outcomes?

PubMed

Magnani, Robert J; Ross, John; Williamson, Jessica; Weinberger, Michelle

2018-03-21

The need for annual family planning program tracking data under the Family Planning 2020 (FP2020) initiative has contributed to renewed interest in family planning service statistics as a potential data source for annual estimates of the modern contraceptive prevalence rate (mCPR). We sought to assess (1) how well a set of commonly recorded data elements in routine service statistics systems could, with some fairly simple adjustments, track key population-level outcome indicators, and (2) whether some data elements performed better than others. We used data from 22 countries in Africa and Asia to analyze 3 data elements collected from service statistics: (1) number of contraceptive commodities distributed to clients, (2) number of family planning service visits, and (3) number of current contraceptive users. Data quality was assessed via analysis of mean square errors, using the United Nations Population Division World Contraceptive Use annual mCPR estimates as the "gold standard." We also examined the magnitude of several components of measurement error: (1) variance, (2) level bias, and (3) slope (or trend) bias. Our results indicate modest levels of tracking error for data on commodities to clients (7%) and service visits (10%), and somewhat higher error rates for data on current users (19%). Variance and slope bias were relatively small for all data elements. Level bias was by far the largest contributor to tracking error. Paired comparisons of data elements in countries that collected at least 2 of the 3 data elements indicated a modest advantage of data on commodities to clients. None of the data elements considered was sufficiently accurate to be used to produce reliable stand-alone annual estimates of mCPR. However, the relatively low levels of variance and slope bias indicate that trends calculated from these 3 data elements can be productively used in conjunction with the Family Planning Estimation Tool (FPET) currently used to produce annual mCPR tracking estimates for FP2020. © Magnani et al.

osFP: a web server for predicting the oligomeric states of fluorescent proteins.

PubMed

Simeon, Saw; Shoombuatong, Watshara; Anuwongcharoen, Nuttapat; Preeyanon, Likit; Prachayasittikul, Virapong; Wikberg, Jarl E S; Nantasenamat, Chanin

2016-01-01

Currently, monomeric fluorescent proteins (FP) are ideal markers for protein tagging. The prediction of oligomeric states is helpful for enhancing live biomedical imaging. Computational prediction of FP oligomeric states can accelerate the effort of protein engineering efforts of creating monomeric FPs. To the best of our knowledge, this study represents the first computational model for predicting and analyzing FP oligomerization directly from the amino acid sequence. After data curation, an exhaustive data set consisting of 397 non-redundant FP oligomeric states was compiled from the literature. Results from benchmarking of the protein descriptors revealed that the model built with amino acid composition descriptors was the top performing model with accuracy, sensitivity and specificity in excess of 80% and MCC greater than 0.6 for all three data subsets (e.g. training, tenfold cross-validation and external sets). The model provided insights on the important residues governing the oligomerization of FP. To maximize the benefit of the generated predictive model, it was implemented as a web server under the R programming environment. osFP affords a user-friendly interface that can be used to predict the oligomeric state of FP using the protein sequence. The advantage of osFP is that it is platform-independent meaning that it can be accessed via a web browser on any operating system and device. osFP is freely accessible at http://codes.bio/osfp/ while the source code and data set is provided on GitHub at https://github.com/chaninn/osFP/.Graphical Abstract.

Are Hemorrhoids Associated with False-Positive Fecal Immunochemical Test Results?

PubMed Central

Kim, Nam Hee; Park, Jung Ho; Park, Dong Il; Sohn, Chong Il; Choi, Kyuyong

2017-01-01

Purpose False-positive (FP) results of fecal immunochemical tests (FITs) conducted in colorectal cancer (CRC) screening could lead to performing unnecessary colonoscopies. Hemorrhoids are a possible cause of FP FIT results; however, studies on this topic are extremely rare. We investigated whether hemorrhoids are associated with FP FIT results. Materials and Methods A retrospective study was conducted at a university hospital in Korea from June 2013 to May 2015. Of the 34547 individuals who underwent FITs, 3946 aged ≥50 years who underwent colonoscopies were analyzed. Logistic regression analysis was performed to determine factors associated with FP FIT results. Results Among 3946 participants, 704 (17.8%) showed positive FIT results and 1303 (33.0%) had hemorrhoids. Of the 704 participants with positive FIT results, 165 had advanced colorectal neoplasia (ACRN) and 539 had no ACRN (FP results). Of the 1303 participants with hemorrhoids, 291 showed FP results, of whom 81 showed FP results because of hemorrhoids only. Participants with hemorrhoids had a higher rate of FP results than those without hemorrhoids (291/1176, 24.7% vs. 248/2361, 10.5%; p<0.001). Additionally, the participants with hemorrhoids as the only abnormality had a higher rate of FP results than those experiencing no such abnormalities (81/531, 15.3% vs. 38/1173, 3.2%; p<0.001). In multivariate analysis, the presence of hemorrhoids was identified as an independent predictor of FP results (adjusted odds ratio, 2.76; 95% confidence interval, 2.24–3.40; p<0.001). Conclusion Hemorrhoids are significantly associated with FP FIT results. Their presence seemed to be a non-negligible contributor of FP results in FIT-based CRC screening programs. PMID:27873508

Fertility preservation in pediatric and adolescent cancer patients in Switzerland: A qualitative cross-sectional survey.

PubMed

Diesch, Tamara; von der Weid, Nicolas Xavier; Szinnai, Gabor; Schaedelin, Sabine; De Geyter, Christian; Rovó, Alicia

2016-10-01

Fertility preservation (FP) is an important topic of discussion in the field of oncology, particularly in pediatric oncology. Despite the awareness of severe impact of infertility on quality of life and different guidelines available in this area, the options in FP are not routinely discussed with the pediatric cancer patients and their parents. To the best of our knowledge, this is the first survey report concerned to FP counseling and procedures in pediatric and adolescent cancer patients in Switzerland. This survey was conducted from June 2014 to October 2014 on the counseling and procedures performed between 2009 and 2013; the questionnaire was completed by one of the professional from hematology/oncology centers in Switzerland. Currently, only four out of nine centers have a program for FP. In 2013, 45/301 (15%) patients received FP counseling and 36/301 (12%) underwent an FP procedure. The most commonly performed procedures from 2009 to 2013 were administration of gonadotropin releasing hormone agonist (3%) and cryopreservation of ovarian tissue in females (3%) and cryopreservation of sperms in males (6%); the most frequently cited reason for the absence of FP counseling was lack of time (55%). Therefore, this survey should help to develop and harmonize practices with respect to FP counseling and procedures in Switzerland, and to establish FP as a standard of care during cancer treatment. Copyright © 2016. Published by Elsevier Ltd.

Motivating women. Bangladesh.

PubMed

1996-08-01

The Integrated Family Development Program (IFDP) in Bangladesh is expanding from the original project areas in Panchdona Union and Dhalian Union into four neighboring unions under the initiative of the Family Planning Association of Bangladesh (FPAB). The JOICFP-executed project entered its second cycle this year as part of the UNFPA-supported regional Capacity Building for Sustainable Community-based Reproductive Health/Family Planning (FP) Project Emphasizing Quality of Care. The community-based project has won wide acceptance from people at the grass roots who have helped fuel its expansion into other villages. In particular, villagers have welcomed the comprehensive approach of the project which integrates a range of components such as reproductive health including FP/maternal and child health (MCH), income-generating activities, skills and literacy education for women and children and primary health care including parasite control. The success of the project also convinced the Japanese Embassy in Bangladesh to extend funding under the Japanese government's Grant Assistance for Grass Roots Cooperation Projects. With the funds, FPAB will establish a Women's Multipurpose Training Center in Panchdona Union. The sum of US$68,157 was officially handed over to FPAB on March 29 by Japanese Ambassador Yoshikazu Kaneko. The center, which is to open within this year, will contribute to improving reproductive health and promoting the empowerment of women. Once completed, it will be used for such activities as training in health care, literacy and skills for income generation for women's empowerment. full text

Fractional Programming for Communication Systems—Part I: Power Control and Beamforming

NASA Astrophysics Data System (ADS)

Shen, Kaiming; Yu, Wei

2018-05-01

This two-part paper explores the use of FP in the design and optimization of communication systems. Part I of this paper focuses on FP theory and on solving continuous problems. The main theoretical contribution is a novel quadratic transform technique for tackling the multiple-ratio concave-convex FP problem--in contrast to conventional FP techniques that mostly can only deal with the single-ratio or the max-min-ratio case. Multiple-ratio FP problems are important for the optimization of communication networks, because system-level design often involves multiple signal-to-interference-plus-noise ratio terms. This paper considers the applications of FP to solving continuous problems in communication system design, particularly for power control, beamforming, and energy efficiency maximization. These application cases illustrate that the proposed quadratic transform can greatly facilitate the optimization involving ratios by recasting the original nonconvex problem as a sequence of convex problems. This FP-based problem reformulation gives rise to an efficient iterative optimization algorithm with provable convergence to a stationary point. The paper further demonstrates close connections between the proposed FP approach and other well-known algorithms in the literature, such as the fixed-point iteration and the weighted minimum mean-square-error beamforming. The optimization of discrete problems is discussed in Part II of this paper.

Young People’s Preferences for Family Planning Service Providers in Rural Malawi: A Discrete Choice Experiment

PubMed Central

Michaels-Igbokwe, Christine; Terris-Prestholt, Fern; Lagarde, Mylene; Chipeta, Effie; Cairns, John

2015-01-01

Objective To quantify the impact of service provider characteristics on young people’s choice of family planning (FP) service provider in rural Malawi in order to identify strategies for increasing access and uptake of FP among youth. Methods and Findings A discrete choice experiment was developed to assess the relative impact of service characteristics on preferences for FP service providers among young people (aged 15–24). Four alternative providers were included (government facility, private facility, outreach and community based distribution of FP) and described by six attributes (the distance between participants’ home and the service delivery point, frequency of service delivery, waiting time at the facility, service providers’ attitude, availability of FP commodities and price). A random parameters logit model was used to estimate preferences for service providers and the likely uptake of services following the expansion of outreach and community based distribution (CBDA) services. In the choice experiment young people were twice as likely to choose a friendly provider (government service odds ratio [OR] = 2.45, p<0.01; private service OR = 1.99, p<0.01; CBDA OR = 1.88, p<0.01) and more than two to three times more likely to choose a provider with an adequate supply of FP commodities (government service OR = 2.48, p<0.01; private service OR = 2.33, p<0.01; CBDA = 3.85, p<0.01). Uptake of community based services was greater than facility based services across a variety of simulated service scenarios indicating that such services may be an effective means of expanding access for youth in rural areas and an important tool for increasing service uptake among youth. Conclusions Ensuring that services are acceptable to young people may require additional training for service providers in order to ensure that all providers are friendly and non-judgemental when dealing with younger clients and to ensure that supplies are consistently available. PMID:26630492

Changes in sexual behavior and contraceptive use after HIV acquisition and factors associated with risky sexual practices among people living with HIV in selected Indian cities.

PubMed

Joshi, Beena; Chauhan, Sanjay; Das, Hiranya; Luaia, Rosangluaia; Sunil, Nitya

2016-01-01

Sexual behavior and contraceptive use among HIV-infected persons are a neglected issue in public health programs. To understand sexual practices and contraceptive use of people living with HIV (PLHIV) before and after being diagnosed with the infection and assess the providers' perspectives on provision of contraceptives to PLHIV, the quality of services provided and linkages between reproductive health and HIV services. A mix method design study using a purposive sampling was undertaken enrolling PLHIV from ART centers and PLHIV networks across three cities in India. Doctors and counselors providing HIV services at public hospitals were also interviewed. Use of condoms increased from 35% to 81% after being diagnosed with HIV. Consistent condom use was 69% compared to only 8.7% before being diagnosed with HIV. Nearly 41% (297) of participants indulged in one or more forms of risky sexual behaviors. Significant correlates of risky sexual practices were: participants who were middle-aged (25-33 years), formerly married, currently not on antiretroviral therapy, and received negligible information on contraception from service providers leading to poor knowledge on safe sex and dual protection. Information from service providers reveals a lack of specific program guidelines to comprehensively address family planning (FP) issues through HIV programs. The study throws light on missed opportunities to address contraceptive needs of PLHIV and recommends training service providers and operationalizing a strategy to link HIV and FP services.

Reproductive health service use and social determinants among the floating population: a quantitative comparative study in Guangzhou City.

PubMed

Liu, Huan; Wang, Qi; Lu, Zuxun; Liu, Junan

2014-10-30

The World Health Assembly has pledged to achieve universal reproductive health (RH) coverage by 2015. Therefore, China has been vigorously promoting the equalisation of basic public health services (i.e. RH services). The floating population (FP) is the largest special group of internal migrants in China and constitutes the current national focus. However, gaps exist in the access of this group to RH services in China. A total of 453 members of the FP and 794 members of the residential population (RP) aged 18 to 50 years from five urban districts in Guangzhou City were recruited to participate in a cross-sectional survey in 2009. Information on demographics and socioeconomic status (SES) were collected from these two groups to evaluate the utilisation of RH knowledge and skills and family planning services (FPS), and to identify social determinants. The proportion of individuals with low SES in the FP (19.2%) was higher than that in the RP (6.3%) (P <0.001). Of the FP, 9.7% to 35.8% had no knowledge of at least one skill, a proportion higher than the counterpart values (6.2% to 27.5%) for the RP (P <0.05). The frequency of FPS use among the FP and RP was low. However, FPS use was higher among the FP than among the RP (3.51 vs. 2.99) (P =0.050). Logistic regression analysis was used to analyse the social determinants that influence FPS use in the FP and RP. The factors that affect FPS utilisation of the RP included SES (OR =4.652, 95% CI =1.751, 12.362), whereas those of the FP excluded SES. The FPS use of the FP in Guangzhou City was higher under equalised public health services. However, a need still exists to help the FP with low SES to improve their RH knowledge and skills through access to public RH services.

Health condition of juvenile Chelonia mydas related to fibropapillomatosis in southeast Brazil

USGS Publications Warehouse

Renan de Deus Santos, Marcello; Silva Martins, Agnaldo; Baptistotte, Cecília; Work, Thierry M.

2015-01-01

Packed cell volume (PCV), plasma biochemistry, visual body condition (BC), and calculated body condition index (BCI) were evaluated in 170 wild juvenile green sea turtles Chelonia mydas from an aggregation in the effluent canal of a steel mill in Brazil. Occurrence of cutaneous fibropapillomatosis (FP) was observed in 44.1% of the animals examined. BCI alone did not differ significantly between healthy animals and those afflicted with FP. However, all turtles with low BCI were severely afflicted and were uremic, hypoglycemic, and anemic in relation to healthy animals. Severe FP was not always reflected by a poor health condition of the individual. Clinical evaluation and plasma biochemistry indicated that most animals afflicted with FP were in good health condition. Differences in FP manifestations and associated health conditions in different geographic regions must be assessed by long-term health monitoring programs to help define priorities for conservation efforts.

Decision No. 162 Concerning a Number of Population and Family Planning Policies.

PubMed

1989-01-01

This document contains a January 1989 decision of the Council of Ministers of Viet Nam "Concerning a Number of Population and Family Planning [FP] Policies" adopted to reduce the growth rate to 1.7% by 1990. The policies hold that FP is the responsibility of male as well as female citizens and provide categories of people who are permitted to have two children and those who may have three. The child-bearing age of families residing in municipalities, cities, and industrial zones is at least 22 for women and 24 for men. In other areas, the child-bearing age is at least 19 for women and 21 for men. A second child, if any, must be spaced 3-5 years from a first child unless the mother is over 30 when the spacing can be reduced to 2-3 years. Further provisions concern registration and record-keeping, measures for promoting population control and FP through population education and service provision, incentives for having no more than two children, and penalties to be applied to larger families. The policies include provisions to provide treatment for infertile women.

Adjunctive stent use during endovascular intervention to the femoropopliteal artery with drug coated balloons: Insights from the XLPAD registry.

PubMed

Kokkinidis, Damianos G; Jeon-Slaughter, Haekyung; Khalili, Houman; Brilakis, Emmanouil S; Shammas, Nicolas W; Banerjee, Subhash; Armstrong, Ehrin J

2018-06-01

With growing use of drug-coated balloons (DCB) for femoropopliteal (FP) artery interventions, there is limited information on rates of real-world adjunctive stent use and its association with short and long-term outcomes. We report on 225 DCB treated FP lesions in 224 patients from the Excellence in Peripheral Artery Disease (XLPAD) registry (NCT01904851) between 2014 and 2016. Cochran-Mantel-Haenszel and Wilcoxon rank sum statistics were used to compare stented (planned or 'bail-out') versus non-stented DCB treated lesions. Stents were implanted in 31% of FP DCB interventions. Among the 70 stents implanted, 46% were for 'bail-out' indications and 54% were planned. Lesions treated with stents were longer (mean 150 mm vs 100 mm; p < 0.001) and less likely to be in-stent restenosis lesions (10% vs 28%; p=0.003). Stenting was significantly more frequent in complex FP lesions, including chronic total occlusions (66% vs 34%; p < 0.001). For bail-out stenting, interwoven nitinol stents were the most common type (50%) followed by drug-eluting stents (34%) and bare-metal stents (22%). There were no differences in peri-procedural complication rates or 12-month target limb revascularization rates (18.6% vs 11.6%; p=0.162) or 12-month amputation rates (11.4% vs 11%; p=0.92) between lesions where adjunctive stenting was used versus lesions without adjunctive stenting, respectively. In conclusion, in a contemporary 'real-world' adjudicated multicenter US registry, adjunctive stenting was necessary in nearly a third of the lesions, primarily for the treatment of more complex FP lesions, with similar short and intermediate-term clinical outcomes compared with non-stented lesions.

A diagnostic study of the DOH health volunteer workers program.

PubMed

Lacuesta, M C; Sarangani, S T; Amoyen, N D

1993-01-01

A 1993 study in the Philippines sought to 1) examine the characteristics of the Barangay (village) Health Workers (BHWs), 2) describe their recruitment and training, 3) reveal what their work entailed and how they felt about it, 4) identify the factors affecting their ability to deliver FP services, and 5) determine clients' attitudes towards them. Data were collected from structured interviews with 100 active BHWs and 150 clients in each of two regions. Most of the BHWs were women who had at least some high school education. They were longterm residents of their villages, were not gainfully employed, and their family incomes were below the poverty level. They were in favor of FP but considered three or more children ideal. Most had been BHWs for at least six years after being recruited (most often by a midwife). Most BHWs spent an average of 1.7 days assisting in the health centers and 2.0 days in the field. Their FP training was sketchy and largely centered on the use of various methods. The BHWs expressed a desire to learn more about natural FP, the IUD, and newer methods. Most received some monetary or other incentive for their work and were supervised directly by local midwives. FP service delivery was positively associated with education, experience, acquaintance with local residents, and cultural homogeneity with the clients. About half of the clients reported that they had consulted a BHW about FP, but an additional third were not familiar with the BHW program. The image of the BHW in the community was of a friendly, well-intentioned but not terribly knowledgeable person. The BHWs tended to provide follow-up services but often failed to refer clients to the health centers in the first place. Clients also reported that the BHWs gave them no choice about which method to use. This study points out the shortcomings in the BHW program. Improvement in outreach objectives could be reached by improved recruitment and training activities, the provision of more generous incentives, and improved logistics (such as contraceptive supply). The FP record-keeping system should also be improved.

Improving the quality of life.

PubMed

Suyono, H

1993-12-01

It is encouraging that most developing countries now have population policies, but it is discouraging that some countries have been unable to implement their policies. Therefore, Indonesia believes technical cooperation should be strengthened among developing countries. International cooperation is working in 108 developing countries, but the desired impact has yet to be reached, and the quality of life in many countries is still unacceptable. For example, life expectancy at birth in developing countries is 14-17 years shorter for females and 10-13 years shorter for males as compared to developed countries which have superior health and welfare systems. The speed of population growth is also hindering efforts to help improve living conditions, and the biggest increase in growth will occur in Asia and Africa. This will increase the numbers of poor, hungry, and illiterate in developing countries and will lead to a lack of arable land, deterioration in education, and increase in unsafe sanitation. In order to slow population growth, quality family planning (FP) services must be provided to those who want them. By the year 2000, developed countries and donors should be ready to provide half of the required US$10.5 billion to FP services in developing countries. In Indonesia, population programs and policies have been governed by the National FP Coordinating Board as well as by the State Ministry for Population and the Environment, which was divided into two ministries in 1993 in order to deal with the enormity and seriousness of the two issues.

Modern contraceptive use, unmet need, and demand satisfied among women of reproductive age who are married or in a union in the focus countries of the Family Planning 2020 initiative: a systematic analysis using the Family Planning Estimation Tool.

PubMed

Cahill, Niamh; Sonneveldt, Emily; Stover, John; Weinberger, Michelle; Williamson, Jessica; Wei, Chuchu; Brown, Win; Alkema, Leontine

2018-03-03

The London Summit on Family Planning in 2012 inspired the Family Planning 2020 (FP2020) initiative and the 120×20 goal of having an additional 120 million women and adolescent girls become users of modern contraceptives in 69 of the world's poorest countries by the year 2020. Working towards achieving 120 × 20 is crucial for ultimately achieving the Sustainable Development Goals of universal access and satisfying demand for reproductive health. Thus, a performance assessment is required to determine countries' progress. An updated version of the Family Planning Estimation Tool (FPET) was used to construct estimates and projections of the modern contraceptive prevalence rate (mCPR), unmet need for, and demand satisfied with modern methods of contraception among women of reproductive age who are married or in a union in the focus countries of the FP2020 initiative. We assessed current levels of family planning indicators and changes between 2012 and 2017. A counterfactual analysis was used to assess if recent levels of mCPR exceeded pre-FP2020 expectations. In 2017, the mCPR among women of reproductive age who are married or in a union in the FP2020 focus countries was 45·7% (95% uncertainty interval [UI] 42·4-49·1), unmet need for modern methods was 21·6% (19·7-23·9), and the demand satisfied with modern methods was 67·9% (64·4-71·1). Between 2012 and 2017 the number of women of reproductive age who are married or in a union who use modern methods increased by 28·8 million (95% UI 5·8-52·5). At the regional level, Asia has seen the mCPR among women of reproductive age who are married or in a union grow from 51·0% (95% UI 48·5-53·4) to 51·8% (47·3-56·5) between 2012 and 2017, which is slow growth, particularly when compared with a change from 23·9% (22·9-25·0) to 28·5% (26·8-30·2) across Africa. At the country level, based on a counterfactual analysis, we found that 61% of the countries that have made a commitment to FP2020 exceeded pre-FP2020 expectations for modern contraceptive use. Country success stories include rapid increases in Kenya, Mozambique, Malawi, Lesotho, Sierra Leone, Liberia, and Chad relative to what was expected in 2012. Whereas the estimate of additional users up to 2017 for women of reproductive age who are married or in a union would suggest that the 120 × 20 goal for all women is overly ambitious, the aggregate outcomes mask the diversity in progress at the country level. We identified countries with accelerated progress, that provide inspiration and guidance on how to increase the use of family planning and inform future efforts, especially in countries where progress has been poor. The Bill & Melinda Gates Foundation, through grant support to the University of Massachusetts Amherst and Avenir Health. Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.

Media Influence on Sexual Activity and Contraceptive Use: A Cross Sectional Survey among Young Women in Urban Nigeria.

PubMed

Bajoga, Ummulkhulthum A; Atagame, Ken L; Okigbo, Chinelo C

2015-09-01

This study assessed the relationship between recent exposure to family planning (FP) messages in the media (newspaper, radio, television, and mobile phones) and use of modern contraceptive methods among women aged 15-24 years living in six cities in Nigeria. Logistic regression models were used to predict recent media exposure to FP messages and its association with sexual experience and modern contraceptive method use. About 45% of our sample had ever had sex with only a quarter of them using a modern contraceptive method at the time of survey. Approximately 71% of our sample was exposed to FP messages in the media within the three months preceding the survey. The main sources of media exposure were mobile phones (48%), radio (37%), and television (29%). Controlling for relevant factors, recent media exposure to FP messages predicted both sexual experience and use of modern contraceptive methods, although there were city-level differences.

Farmácia Popular Program: pharmaceutical market analysis of antihypertensive acting on the renin-angiotensin system medicines.

PubMed

Silva, Rondineli Mendes da; Chaves, Gabriela Costa; Chaves, Luisa Arueira; Campos, Mônica Rodrigues; Luiza, Vera Lucia; Bertoldi, Andréa Dâmaso; Ross-Degnan, Dennis; Emmerick, Isabel Cristina Martins

2017-08-01

This paper aims to analyse changes in the retail pharmaceutical market following policy changes in the Farmácia Popular Program (FP), a medicines subsidy program in Brazil. The retrospective longitudinal analyses focus on therapeutic class of agents acting on the renin-angiotensin system. Data obtained from QuintilesIMS (formerly IMS Health) included private retail pharmacy sales volume (pharmaceutical units) and sales values from 2002 to 2013. Analyses evaluated changes in market share following key FP policy changes. The therapeutic class was selected due to its relevance to hypertension treatment. Market share was analysed by therapeutic sub-classes and by individual company. Losartan as a single product accounted for the highest market share among angiotensin II antagonists. National companies had higher sales volume during the study period, while multinational companies had higher sales value. Changes in pharmaceutical market share coincided with the inclusion of specific products in the list of medicines covered by FP and with increases in or exemption from patient copayment.

Fractional Programming for Communication Systems—Part II: Uplink Scheduling via Matching

NASA Astrophysics Data System (ADS)

Shen, Kaiming; Yu, Wei

2018-05-01

This two-part paper develops novel methodologies for using fractional programming (FP) techniques to design and optimize communication systems. Part I of this paper proposes a new quadratic transform for FP and treats its application for continuous optimization problems. In this Part II of the paper, we study discrete problems, such as those involving user scheduling, which are considerably more difficult to solve. Unlike the continuous problems, discrete or mixed discrete-continuous problems normally cannot be recast as convex problems. In contrast to the common heuristic of relaxing the discrete variables, this work reformulates the original problem in an FP form amenable to distributed combinatorial optimization. The paper illustrates this methodology by tackling the important and challenging problem of uplink coordinated multi-cell user scheduling in wireless cellular systems. Uplink scheduling is more challenging than downlink scheduling, because uplink user scheduling decisions significantly affect the interference pattern in nearby cells. Further, the discrete scheduling variable needs to be optimized jointly with continuous variables such as transmit power levels and beamformers. The main idea of the proposed FP approach is to decouple the interaction among the interfering links, thereby permitting a distributed and joint optimization of the discrete and continuous variables with provable convergence. The paper shows that the well-known weighted minimum mean-square-error (WMMSE) algorithm can also be derived from a particular use of FP; but our proposed FP-based method significantly outperforms WMMSE when discrete user scheduling variables are involved, both in term of run-time efficiency and optimizing results.

Cluster Randomized Controlled Trial Evaluation of a Gender Equity and Family Planning Intervention for Married Men and Couples in Rural India

PubMed Central

Raj, Anita; Ghule, Mohan; Ritter, Julie; Battala, Madhusudana; Gajanan, Velhal; Nair, Saritha; Dasgupta, Anindita; Silverman, Jay G.; Balaiah, Donta; Saggurti, Niranjan

2016-01-01

Background Despite ongoing recommendations to increase male engagement and gender-equity (GE) counseling in family planning (FP) services, few such programs have been implemented and rigorously evaluated. This study evaluates the impact of CHARM, a three-session GE+FP counseling intervention delivered by male health care providers to married men, alone (sessions 1&2) and with their wives (session 3) in India. Methods and Findings A two-armed cluster randomized controlled trial was conducted with young married couples (N = 1081 couples) recruited from 50 geographic clusters (25 clusters randomized to CHARM and a control condition, respectively) in rural Maharashtra, India. Couples were surveyed on demographics, contraceptive behaviors, and intimate partner violence (IPV) attitudes and behaviors at baseline and 9 &18-month follow-ups, with pregnancy testing at baseline and 18-month follow-up. Outcome effects on contraceptive use and incident pregnancy, and secondarily, on contraceptive communication and men’s IPV attitudes and behaviors, were assessed using logistic generalized linear mixed models. Most men recruited from CHARM communities (91.3%) received at least one CHARM intervention session; 52.5% received the couple’s session with their wife. Findings document that women from the CHARM condition, relative to controls, were more likely to report contraceptive communication at 9-month follow-up (AOR = 1.77, p = 0.04) and modern contraceptive use at 9 and 18-month follow-ups (AORs = 1.57–1.58, p = 0.05), and they were less likely to report sexual IPV at 18-month follow-up (AOR = 0.48, p = 0.01). Men in the CHARM condition were less likely than those in the control clusters to report attitudes accepting of sexual IPV at 9-month (AOR = 0.64, p = 0.03) and 18-month (AOR = 0.51, p = 0.004) follow-up, and attitudes accepting of physical IPV at 18-month follow-up (AOR = 0.64, p = 0.02). No significant effect on pregnancy was seen. Conclusions Findings demonstrate that men can be engaged in FP programming in rural India, and that such an approach inclusive of GE counseling can improve contraceptive practices and reduce sexual IPV in married couples. Trial Registration ClinicalTrials.gov NCT01593943 PMID:27167981

Enterobacterial repetitive intergenic consensus sequences and the PCR to generate fingerprints of genomic DNAs from Vibrio cholerae O1, O139, and non-O1 strains.

PubMed

Rivera, I G; Chowdhury, M A; Huq, A; Jacobs, D; Martins, M T; Colwell, R R

1995-08-01

Enterobacterial repetitive intergenic consensus (ERIC) sequence polymorphism was studied in Vibrio Cholerae strains isolated before and after the cholera epidemic in Brazil (in 1991), along with epidemic strains from Peru, Mexico, and India, by PCR. A total of 17 fingerprint patterns (FPs) were detected in the V. cholerae strains examined; 96.7% of the toxigenic V. cholerae O1 strains and 100% of the O139 serogroup strains were found to belong to the same FP group comprising four fragments (FP1). The nontoxigenic V. cholerae O1 also yielded four fragments but constituted a different FP group (FP2). A total of 15 different patterns were observed among the V. cholerae non-O1 strains. Two patterns were observed most frequently for V. cholerae non-01 strains, 25% of which have FP3, with five fragments, and 16.7% of which have FP4, with two fragments. Three fragments, 1.75, 0.79, and 0.5 kb, were found to be common to both toxigenic and nontoxigenic V. cholerae O1 strains as well as to group FP3, containing V. cholerae non-O1 strains. Two fragments of group FP3, 1.3 and 1.0 kb, were present in FP1 and FP2 respectively. The 0.5-kb fragment was common to all strains and serogroups of V. cholerae analyzed. It is concluded from the results of this study, based on DNA FPs of environmental isolates, that it is possible to detect an emerging virulent strain in a cholera-endemic region. ERIC-PCR constitutes a powerful tool for determination of the virulence potential of V. cholerae O1 strains isolated in surveillance programs and for molecular epidemiological investigations.

Knowledge, attitudes and awareness regarding fertility preservation among oncologists and clinical practitioners in Lebanon.

PubMed

Ghazeeri, Ghina; Zebian, Dina; Nassar, Anwar H; Harajly, Sally; Abdallah, Alain; Hakimian, Stephanie; Skaiff, Bassem; Abbas, Hussein A; Awwad, Johnny

2016-06-01

Fertility preservation (FP) aims to help individuals overcome the infertility associated with cancer treatments such as chemotherapy and radiation. The objective of this study was to assess the awareness, attitudes and knowledge of oncologists' and clinical practitioners' (CPs) about fertility preservation and its options in Lebanon. This was a cross-sectional study with surveys carried out between March 2012 and February 2013 on CPs at the American University of Beirut Medical Centre and Saint Jude's Children Cancer Centre as well as all registered oncologists in Lebanon. Ninety percent of CPs (n = 88) and 94% of oncologists (n = 53) agreed that fertility preservation should be discussed with patient before their cancer treatment. Our data showed a gender bias in relation to patients being informed of their FP options, as well as conflicting knowledge of FP options available in Lebanon among oncologists. The CPs were more likely to have accurate knowledge of FP options and treatment than oncologists. A proactive approach is required to: (1) increase the awareness and knowledge of FP; (2) improve attitudes towards FP; and (3) encourage its communication between CPs, oncologists and patients in Lebanon. Increased education programs, awareness campaigns and development of dedicated FP centres are needed.

Availability of family planning services and quality of counseling by faith-based organizations: a three country comparative analysis.

PubMed

Barden-O'Fallon, Janine

2017-05-08

Faith-based organizations (FBOs) have a long history of providing health services in developing countries and are important contributors to healthcare systems. Support for the wellbeing of women, children, and families is evidenced through active participation in the field of family planning (FP). However, there is little quantitative evidence on the availability or quality of FP services by FBOs. The descriptive analysis uses facility-level data collected through recent Service Provision Assessments in Malawi (2013-14), Kenya (2010), and Haiti (2012) to examine 11 indicators of FP service and method availability and nine indicators of comprehensive and quality counseling. The indicators include measures of FP service provision, method mix, method stock, the provision of accurate information, and the discussion of reproductive intentions, client's questions/concerns, prevention of sexually transmitted infections, and return visits, among others. Pearson's Chi-square test is used to assess the selected indicators by managing authority (FBO, public, and other private sector) to determine statistical equivalence. Results show that FBOs are less likely to offer FP services than other managing authorities (p < 0.05). For example, 69% of FBOs in Kenya offer FP services compared to 97% of public facilities and 83% of other private facilities. Offering long-acting or permanent methods in faith-based facilities is especially low (43% in Malawi, 29% in Kenya and 39% in Haiti). There were few statistically significant differences between the managing authorities in comprehensive and quality counseling indicators. Interestingly, Haitian FBOs often perform as well or better than public sector health facilities on counseling indicators, such as discussion of a return visit (79% of FBO providers vs. 68% of public sector providers) and discussion of client concerns/questions (52% vs. 49%, respectively). Results from this analysis indicate that there is room for improvement in the availability of FP services by FBOs in these countries. Quality of counseling should be improved by all managing authorities in the three countries, as indicated by low overall coverage for practices such as ensuring confidentiality (22% in Malawi, 47% in Kenya and 12% in Haiti), discussion of sexually transmitted infections (18%, 25%, 17%, respectively), and providing services to youth (53%, 27%, 32%, respectively).

Predicting client attendance at further treatment following drug and alcohol detoxification: Theory of Planned Behaviour and Implementation Intentions.

PubMed

Kelly, Peter J; Leung, Joanne; Deane, Frank P; Lyons, Geoffrey C B

2016-11-01

Despite clinical recommendations that further treatment is critical for successful recovery following drug and alcohol detoxification, a large proportion of clients fail to attend treatment after detoxification. In this study, individual factors and constructs based on motivational and volitional models of health behaviour were examined as predictors of post-detoxification treatment attendance. The sample consisted of 220 substance-dependent individuals participating in short-term detoxification programs provided by The Australian Salvation Army. The Theory of Planned Behaviour and Implementation Intentions were used to predict attendance at subsequent treatment. Follow-up data were collected for 177 participants (81%), with 104 (80%) of those participants reporting that they had either attended further formal treatment (e.g. residential rehabilitation programs, outpatient counselling) or mutual support groups in the 2 weeks after leaving the detoxification program. Logistic regression examined the predictors of further treatment attendance. The full model accounted for 21% of the variance in treatment attendance, with attitude and Implementation Intentions contributing significantly to the prediction. Findings from the present study would suggest that assisting clients to develop a specific treatment plan, as well as helping clients to build positive perceptions about subsequent treatment, will promote greater attendance at further treatment following detoxification. [Kelly PJ, Leung J, Deane FP, Lyons GCB. Predicting client attendance at further treatment following drug and alcohol detoxification: Theory of Planned Behaviour and Implementation Intentions. Drug Alcohol Rev 2016;35:678-685]. © 2015 Australasian Professional Society on Alcohol and other Drugs.

Impact of integration of sexual and reproductive health services on consultation duration times: results from the Integra Initiative.

PubMed

Siapka, Mariana; Obure, Carol Dayo; Mayhew, Susannah H; Sweeney, Sedona; Fenty, Justin; Vassall, Anna

2017-11-01

The lack of human resources is a key challenge in scaling up of HIV services in Africa's health care system. Integrating HIV services could potentially increase their effectiveness and optimize the use of limited resources and clinical staff time. We examined the impact of integration of provider initiated HIV counselling and testing (PITC) and family planning (FP counselling and FP provision) services on duration of consultation to assess the impact of PITC and FP integration on staff workload. This study was conducted in 24 health facilities in Kenya under the Integra Initiative, a non-randomized, pre/post intervention trial to evaluate the impact of integrated HIV and sexual and reproductive health services on health and service outcomes. We compared the time spent providing PITC-only services, FP-only services and integrated PITC/FP services. We used log-linear regression to assess the impact of plausible determinants on the duration of clients' consultation times. Median consultation duration times were highest for PITC-only services (30 min), followed by integrated services (10 min) and FP-only services (8 min). Times for PITC-only and FP-only services were 69.7% higher (95% Confidence Intervals (CIs) 35.8-112.0) and 43.9% lower (95% CIs -55.4 to - 29.6) than times spent on these services when delivered as an integrated service, respectively. The reduction in consultation times with integration suggests a potential reduction in workload. The higher consultation time for PITC-only could be because more pre- and post-counselling is provided at these stand-alone services. In integrated PITC/FP services, the duration of the visit fell below that required by HIV testing guidelines, and service mix between counselling and testing substantially changed. Integration of HIV with FP services may compromise the quality of services delivered and care must be taken to clearly specify and monitor appropriate consultation duration times and procedures during the process of integrating HIV and FP services. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

Impact of integration of sexual and reproductive health services on consultation duration times: results from the Integra Initiative

PubMed Central

Siapka, Mariana; Obure, Carol Dayo; Mayhew, Susannah H; Fenty, Justin; Initiative, Integra; Vassall, Anna

2017-01-01

Abstract The lack of human resources is a key challenge in scaling up of HIV services in Africa’s health care system. Integrating HIV services could potentially increase their effectiveness and optimize the use of limited resources and clinical staff time. We examined the impact of integration of provider initiated HIV counselling and testing (PITC) and family planning (FP counselling and FP provision) services on duration of consultation to assess the impact of PITC and FP integration on staff workload. This study was conducted in 24 health facilities in Kenya under the Integra Initiative, a non-randomized, pre/post intervention trial to evaluate the impact of integrated HIV and sexual and reproductive health services on health and service outcomes. We compared the time spent providing PITC-only services, FP-only services and integrated PITC/FP services. We used log-linear regression to assess the impact of plausible determinants on the duration of clients’ consultation times. Median consultation duration times were highest for PITC-only services (30 min), followed by integrated services (10 min) and FP-only services (8 min). Times for PITC-only and FP-only services were 69.7% higher (95% Confidence Intervals (CIs) 35.8–112.0) and 43.9% lower (95% CIs −55.4 to − 29.6) than times spent on these services when delivered as an integrated service, respectively. The reduction in consultation times with integration suggests a potential reduction in workload. The higher consultation time for PITC-only could be because more pre- and post-counselling is provided at these stand-alone services. In integrated PITC/FP services, the duration of the visit fell below that required by HIV testing guidelines, and service mix between counselling and testing substantially changed. Integration of HIV with FP services may compromise the quality of services delivered and care must be taken to clearly specify and monitor appropriate consultation duration times and procedures during the process of integrating HIV and FP services. PMID:29194545

Family planning, abortion, and HIV in Ghanaian print media: a 15-month content analysis of a national Ghanaian newspaper.

PubMed

Laar, Amos K

2010-12-01

This study assessed coverage of reproductive health (RH) issues--family planning (FP), abortion, and HIV--in the Ghanaian Daily Graphic newspaper. Using the composite week sampling technique, the researcher analyzed the contents of 62 editions of the paper. Prominence was measured using various attributes, and differences in mean coverage over time were assessed using analysis of variance. This review shows that coverage of RH issues was extraordinarily poor, less than 1 percent each for FP, abortion, and HIV. RH news that was covered was given little prominence. These findings support the popular impression that the Daily Graphic does not give priority to reproductive health issues in its coverage. RH advocates need to develop innovative means of integrating RH content into existing media outlets.

Point of view: Hillary Rodham Clinton.

PubMed

Clinton, H R

1999-04-01

During the 1994 International Conference on Population and Development (ICPD) in Cairo, 180 nations agreed for the first time that women's reproductive health and empowerment are crucial to national sustainability and growth. In the US the government has increased funding to family planning (FP) and reproductive care services nationwide, while continuing to ensure that abortion remain safe, legal, and increasingly rare. Commitments to FP must be continued in light of the nearly 600,000 annual deaths worldwide from pregnancy-related causes. Commitments to education must continue because two-thirds of the 960 million illiterate adults are women. The goals to reach by the year 2015 are for pregnancies to be planned, children to be wanted, and women to achieve their rightful place in society. Educating women means educating families, and educating families means educating societies.

[Studying the fertility peak in Beijing].

PubMed

Zhong, L

1989-07-01

Beijing, China, is experiencing a baby boom in response to 2 periods of large population increase in the mid-1950s and early 1960s. The average number of annual births was 220,000 in the first period and 269,000 in the second period. The causes of the large increase in the population in the first period were an improvement of health conditions which led to a reduction in mortality, immigration flow, and an erroneous population policy. The causes in the second period were recuperative fertility after three years of natural calamity and increased fertility among immigrants. Net migration had an important role in population growth these two periods; it also will have an important impact in future population changes. According to population projections, another baby boom is expected to occur before the end of the end of the century. During the up-coming baby boom period, 1.54 million births are expected, 190,000 per annum. The average increase in population size is expected to 127,000 per year. In the peak year, it may be around 200,000. Thanks to the family planning (FP) program the occurrence of the third baby boom in Beijing has been postponed and the duration will be shortened. From 1972 to 1982, 2.57 million births was averted due to FP, which drastically reduced pressure on the demand for resources and on the momentum of the next baby boom. Another baby booms is not expected during the early half of the 21st century, although an elevated birth rate within the range of normal fluctuation is predicted. The projection was based on the assumption of restricted migration and the enforcement of the FP program. The realization of the projected population will depend on deferred marriage, deferred child-bearing, prolonged birth spacing, the prevention of high parity fertility, the maintenance of the current population policy, and control over the reproductive behavior of the new migrant population.

Influence of Training Models at 3,900-m Altitude on the Physiological Response and Performance of a Professional Wheelchair Athlete: A Case Study.

PubMed

Sanz-Quinto, Santiago; López-Grueso, Raúl; Brizuela, Gabriel; Flatt, Andrew A; Moya-Ramón, Manuel

2018-06-20

Sanz-Quinto, S, López-Grueso, R, Brizuela, G, Flatt, AA, and Moya-Ramón, M. Influence of training models at 3,900-m altitude on the physiological response and performance of a professional wheelchair athlete: A case study. J Strength Cond Res XX(X): 000-000, 2018-This case study compared the effects of two training camps using flexible planning (FP) vs. inflexible planning (IP) at 3,860-m altitude on physiological and performance responses of an elite marathon wheelchair athlete with Charcot-Marie-Tooth disease (CMT). During IP, the athlete completed preplanned training sessions. During FP, training was adjusted based on vagally mediated heart rate variability (HRV) with specific sessions being performed when a reference HRV value was attained. The camp phases were baseline in normoxia (BN), baseline in hypoxia (BH), specific training weeks 1-4 (W1, W2, W3, W4), and Post-camp (Post). Outcome measures included the root mean square of successive R-R interval differences (rMSSD), resting heart rate (HRrest), oxygen saturation (SO2), diastolic blood pressure and systolic blood pressure, power output and a 3,000-m test. A greater impairment of normalized rMSSD (BN) was shown in IP during BH (57.30 ± 2.38% vs. 72.94 ± 11.59%, p = 0.004), W2 (63.99 ± 10.32% vs. 81.65 ± 8.87%, p = 0.005), and W4 (46.11 ± 8.61% vs. 59.35 ± 6.81%, p = 0.008). At Post, only in FP was rMSSD restored (104.47 ± 35.80%). Relative changes were shown in power output (+3 W in IP vs. +6 W in FP) and 3,000-m test (-7s in IP vs. -16s in FP). This case study demonstrated that FP resulted in less suppression and faster restoration of rMSSD and more positive changes in performance than IP in an elite wheelchair marathoner with CMT.

The role of the Standard Days Method in modern family planning services in developing countries.

PubMed

Lundgren, Rebecka I; Karra, Mihira V; Yam, Eileen A

2012-08-01

The mere availability of family planning (FP) services is not sufficient to improve reproductive health; services must also be of adequate quality. The introduction of new contraceptive methods is a means of improving quality of care. The Standard Days Method (SDM) is a new fertility-awareness-based contraceptive method that has been successfully added to reproductive health care services around the world. Framed by the Bruce-Jain quality-of-care paradigm, this paper describes how the introduction of SDM in developing country settings can improve the six elements of quality while contributing to the intrinsic variety of available methods. SDM meets the needs of women and couples who opt not to use other modern methods. SDM providers are sensitised to the potential of fertility-awareness-based contraception as an appropriate choice for these clients. SDM requires the involvement of both partners and thus offers a natural entry point for providers to further explore partner communication, intimate partner violence, condoms, and HIV/STIs. SDM introduction broadens the range of FP methods available to couples in developing countries. SDM counselling presents an opportunity for FP providers to discuss important interpersonal and reproductive health issues with potential users.

Numerical Calculation of the Peaking Factor of a Water-Cooled W/Cu Monoblock for a Divertor

NASA Astrophysics Data System (ADS)

Han, Le; Chang, Haiping; Zhang, Jingyang; Xu, Tiejun

2015-09-01

In order to accurately predict the incident critical heat flux (ICHF, the heat flux at the heated surface when CHF occurs) of a water-cooled W/Cu monoblock for a divertor, the exact knowledge of its peaking factors (fp) under one-sided heating conditions with different design parameters is a key issue. In this paper, the heat conduction in the solid domain of a water-cooled W/Cu monoblock is calculated numerically by assuming the local heat transfer coefficients (HTC) of the cooling wall to be functions of the local wall temperature, so as to obtain fp. The reliability of the calculation method is validated by an experimental example result, with the maximum error of 2.1% only. The effects of geometric and flow parameters on the fp of a water-cooled W/Cu monoblock are investigated. Within the scope of this study, it is shown that the fp increases with increasing dimensionless W/Cu monoblock width and armour thickness (the shortest distance between the heated surface and Cu layer), and the maximum increases are 43.8% and 22.4% respectively. The dimensionless W/Cu monoblock height and Cu thickness have little effect on fp. The increase of Reynolds number and Jakob number causes the increase of fp, and the maximum increases are 6.8% and 9.6% respectively. Based on the calculated results, an empirical correlation on peaking factor is obtained via regression. These results provide a valuable reference for the thermal-hydraulic design of water-cooled divertors. supported by National Magnetic Confinement Fusion Science Program of China (No. 2010GB104005) and Funding of Jiangsu Innovation Program for Graduate Education, China (CXLX12_0170), the Fundamental Research Funds for the Central Universities of China

Applying lessons learned from the USAID family planning graduation experience to the GAVI graduation process.

PubMed

Shen, Angela K; Farrell, Marguerite M; Vandenbroucke, Mary F; Fox, Elizabeth; Pablos-Mendez, Ariel

2015-07-01

As low income countries experience economic transition, characterized by rapid economic growth and increased government spending potential in health, they have increased fiscal space to support and sustain more of their own health programmes, decreasing need for donor development assistance. Phase out of external funds should be systematic and efforts towards this end should concentrate on government commitments towards country ownership and self-sustainability. The 2006 US Agency for International Development (USAID) family planning (FP) graduation strategy is one such example of a systematic phase-out approach. Triggers for graduation were based on pre-determined criteria and programme indicators. In 2011 the GAVI Alliance (formerly the Global Alliance for Vaccines and Immunizations) which primarily supports financing of new vaccines, established a graduation policy process. Countries whose gross national income per capita exceeds $1570 incrementally increase their co-financing of new vaccines over a 5-year period until they are no longer eligible to apply for new GAVI funding, although previously awarded support will continue. This article compares and contrasts the USAID and GAVI processes to apply lessons learned from the USAID FP graduation experience to the GAVI process. The findings of the review are 3-fold: (1) FP graduation plans served an important purpose by focusing on strategic needs across six graduation plan foci, facilitating graduation with pre-determined financial and technical benchmarks, (2) USAID sought to assure contraceptive security prior to graduation, phasing out of contraceptive donations first before phasing out from technical assistance in other programme areas and (3) USAID sought to sustain political support to assure financing of products and programmes continue after graduation. Improving sustainability more broadly beyond vaccine financing provides a more comprehensive approach to graduation. The USAID FP experience provides a window into understanding one approach to graduation from donor assistance. The process itself-involving transparent country-level partners well in advance of graduation-appears a valuable lesson towards success. Published by Oxford University Press 2014. This work is written by US Government employees and is in the public domain in the US.

Genetics, structure, and prevalence of FP967 (CDC Triffid) T-DNA in flax.

PubMed

Young, Lester; Hammerlindl, Joseph; Babic, Vivijan; McLeod, Jamille; Sharpe, Andrew; Matsalla, Chad; Bekkaoui, Faouzi; Marquess, Leigh; Booker, Helen M

2015-01-01

The detection of T-DNA from a genetically modified flaxseed line (FP967, formally CDC Triffid) in a shipment of Canadian flaxseed exported to Europe resulted in a large decrease in the amount of flax planted in Canada. The Canadian flaxseed industry undertook major changes to ensure the removal of FP967 from the supply chain. This study aimed to resolve the genetics and structure of the FP967 transfer DNA (T-DNA). The FP967 T-DNA is thought to be inserted in at single genomic locus. The junction between the T-DNA and genomic DNA consisted of two inverted Right Borders with no Left Border (LB) flanking genomic DNA sequences recovered. This information was used to develop an event-specific quantitative PCR (qPCR) assay. This assay and an existing assay specific to the T-DNA construct were used to determine the genetics and prevalence of the FP967 T-DNA. These data supported the hypothesis that the T-DNA is present at a single location in the genome. The FP967 T-DNA is present at a low level (between 0.01 and 0.1%) in breeder seed lots from 2009 and 2010. None of the 11,000 and 16,000 lines selected for advancement through the Flax Breeding Program in 2010 and 2011, respectively, tested positive for the FP967 T-DNA, however. Most of the FP967 T-DNA sequence was resolved via PCR cloning and next generation sequencing. A 3,720 bp duplication of an internal portion of the T-DNA (including a Right Border) was discovered between the flanking genomic DNA and the LB. An event-specific assay, SAT2-LB, was developed for the junction between this repeat and the LB.

Generating public awareness in Africa. Advocacy for reproductive health: Africa.

PubMed

Nyong'o, D

1996-01-01

In 1995 the IPPF Africa Region undertook advocacy missions to six countries in the region to sensitize national leaders about family planning (FP). This mission was governed by the six challenges laid down in the IPPF's strategic plan, Vision 2000, and the program of action of the International Conference on Population and Development (ICPD) held in Cairo in 1994. In Ethiopia, Kenya, and Tanzania the concerns were adolescent sexuality, family life education, and services to youth. In Uganda unsafe abortion; while in the Central African Republic and Guinea sexual and reproductive health, unsafe abortion, the sexuality of youth, and the empowerment of women were the main issues. Documentation packages prepared for the mission included annual reports, periodicals, conference reports, booklets, and position papers. The target audiences were political leaders, national, regional, and international organizations, religious, educational, and media leaders, and the public. Press conferences were organized and lobbying was conducted with national family planning associations to strengthen networking and coalition building. In Ethiopia the IPPF president's visit pertained to the sexuality of young people. In Kenya the mission coincided with the controversy of introducing family life education in primary schools. A seminar in Nairobi brought together 100 influential people who came to an agreement on the necessity of such education. In Tanzania the advocacy team crusaded for reproductive health services for young people. The country's president fully supported FP activities even allowing the use of hospitals and health centers for the distribution of contraceptives. There was a visit to a teenage mothers' center providing vocational training and reproductive health counseling in Dar es Salaam. In Uganda UNFPA, USAID, and national family planning association representatives met to forge closer working relations and examine the issue of tax exemption for imported contraceptives. In the Central African Republic and Guinea the mission also underscored the concerns about reproductive health, unsafe abortion, and empowerment of women.

Paying the Price at the End of Life: A Consideration of Factors that Affect the Profitability of Hospice

PubMed Central

Ettner, Susan L.; Lorenz, Karl A.

2008-01-01

Abstract Objective To evaluate factors that affect the financial performance of hospice. Methods Using the California Office of Statewide Health Planning and Development 2003 survey, we evaluated the organizational attributes, clinical care, and financial performance of 185 operational hospices. As outcomes, we evaluated revenues, costs, and profits per patient and per patient–day, the intensity and skill mix of care, and the provision of charitable and special palliative services. We evaluated regression-adjusted differences by profit status controlling for other organizational features and aggregate patient characteristics. Results Hospices reported median revenue of $6865 per patient and $138 per patient–day (for-profit-not-for profit [FP-NFP] difference −$20, p = 0.045), median cost of $6737 per patient, and $135 per patient–day (FP-NFP difference −$55, p = 0.002), and median pretax profit of $334 per patient and $6 per patient–day (FP-NFP difference $34, p = 0.026). Patients received a median of 29.9 total visits by all providers per patient (FP-NFP difference 8.8 visits, p = 0.010), but there was no difference in total visits per patient–day. A median of 50.8% of all nursing visits were registered nurse (RN) visits (FP-NFP difference −14.1%, p < 0.001). Few hospices provided charity care, and only 4% of hospices reported expenditures on chemotherapy and only 9% on radiation therapy. Conclusions Overall hospice profitability is low. Length of stay is strongly associated with financial performance, and greater FP profitability is related to lower costs. FP hospices also provide less RN care as a proportion of nursing care. Few hospices provide charitable care or special costly services. The relationship of service patterns to patient quality needs to be examined. PMID:18788962

Paying the price at the end of life: a consideration of factors that affect the profitability of hospice.

PubMed

O'Neill, Sean M; Ettner, Susan L; Lorenz, Karl A

2008-09-01

To evaluate factors that affect the financial performance of hospice. Using the California Office of Statewide Health Planning and Development 2003 survey, we evaluated the organizational attributes, clinical care, and financial performance of 185 operational hospices. As outcomes, we evaluated revenues, costs, and profits per patient and per patient-day, the intensity and skill mix of care, and the provision of charitable and special palliative services. We evaluated regression-adjusted differences by profit status controlling for other organizational features and aggregate patient characteristics. Hospices reported median revenue of $6865 per patient and $138 per patient-day (for-profit-not-for profit [FP-NFP] difference -$20, p = 0.045), median cost of $6737 per patient, and $135 per patient-day (FP-NFP difference -$55, p = 0.002), and median pretax profit of $334 per patient and $6 per patient-day (FP-NFP difference $34, p = 0.026). Patients received a median of 29.9 total visits by all providers per patient (FP-NFP difference 8.8 visits, p = 0.010), but there was no difference in total visits per patient-day. A median of 50.8% of all nursing visits were registered nurse (RN) visits (FP-NFP difference -14.1%, p < 0.001). Few hospices provided charity care, and only 4% of hospices reported expenditures on chemotherapy and only 9% on radiation therapy. Overall hospice profitability is low. Length of stay is strongly associated with financial performance, and greater FP profitability is related to lower costs. FP hospices also provide less RN care as a proportion of nursing care. Few hospices provide charitable care or special costly services. The relationship of service patterns to patient quality needs to be examined.

Measuring client satisfaction and the quality of family planning services: A comparative analysis of public and private health facilities in Tanzania, Kenya and Ghana

PubMed Central

2011-01-01

Background Public and private family planning providers face different incentive structures, which may affect overall quality and ultimately the acceptability of family planning for their intended clients. This analysis seeks to quantify differences in the quality of family planning (FP) services at public and private providers in three representative sub-Saharan African countries (Tanzania, Kenya and Ghana), to assess how these quality differentials impact upon FP clients' satisfaction, and to suggest how quality improvements can improve contraceptive continuation rates. Methods Indices of technical, structural and process measures of quality are constructed from Service Provision Assessments (SPAs) conducted in Tanzania (2006), Kenya (2004) and Ghana (2002) using direct observation of facility attributes and client-provider interactions. Marginal effects from multivariate regressions controlling for client characteristics and the multi-stage cluster sample design assess the relative importance of different measures of structural and process quality at public and private facilities on client satisfaction. Results Private health facilities appear to be of higher (interpersonal) process quality than public facilities but not necessarily higher technical quality in the three countries, though these differentials are considerably larger at lower level facilities (clinics, health centers, dispensaries) than at hospitals. Family planning client satisfaction, however, appears considerably higher at private facilities - both hospitals and clinics - most likely attributable to both process and structural factors such as shorter waiting times and fewer stockouts of methods and supplies. Conclusions Because the public sector represents the major source of family planning services in developing countries, governments and Ministries of Health should continue to implement and to encourage incentives, perhaps performance-based, to improve quality at public sector health facilities, as well as to strengthen regulatory and monitoring structures to ensure quality at both public and private facilities. In the meantime, private providers appear to be fulfilling an important gap in the provision of FP services in these countries. PMID:21864335

Measuring client satisfaction and the quality of family planning services: a comparative analysis of public and private health facilities in Tanzania, Kenya and Ghana.

PubMed

Hutchinson, Paul L; Do, Mai; Agha, Sohail

2011-08-24

Public and private family planning providers face different incentive structures, which may affect overall quality and ultimately the acceptability of family planning for their intended clients. This analysis seeks to quantify differences in the quality of family planning (FP) services at public and private providers in three representative sub-Saharan African countries (Tanzania, Kenya and Ghana), to assess how these quality differentials impact upon FP clients' satisfaction, and to suggest how quality improvements can improve contraceptive continuation rates. Indices of technical, structural and process measures of quality are constructed from Service Provision Assessments (SPAs) conducted in Tanzania (2006), Kenya (2004) and Ghana (2002) using direct observation of facility attributes and client-provider interactions. Marginal effects from multivariate regressions controlling for client characteristics and the multi-stage cluster sample design assess the relative importance of different measures of structural and process quality at public and private facilities on client satisfaction. Private health facilities appear to be of higher (interpersonal) process quality than public facilities but not necessarily higher technical quality in the three countries, though these differentials are considerably larger at lower level facilities (clinics, health centers, dispensaries) than at hospitals. Family planning client satisfaction, however, appears considerably higher at private facilities - both hospitals and clinics - most likely attributable to both process and structural factors such as shorter waiting times and fewer stockouts of methods and supplies. Because the public sector represents the major source of family planning services in developing countries, governments and Ministries of Health should continue to implement and to encourage incentives, perhaps performance-based, to improve quality at public sector health facilities, as well as to strengthen regulatory and monitoring structures to ensure quality at both public and private facilities. In the meantime, private providers appear to be fulfilling an important gap in the provision of FP services in these countries.

Population and reproductive health in National Adaptation Programmes of Action (NAPAs) for climate change in Africa.

PubMed

Mutunga, Clive; Hardee, Karen

2010-12-01

This paper reviews 44 National Adaptation Programmes of Action (NAPAs) to assess the NAPA process and identify the range of interventions included in countries' priority adaptation actions and highlight how population issues and reproductive health/family planning (RH/FP) are addressed as part of the adaptation agenda. A majority of the 44 NAPAs identify rapid population growth as a key component of vulnerability to climate change impacts. However, few chose to prioritise NAPA funds for family planning/reproductive health programmes. The paper emphasizes the need to translate the recognition of population pressure as a factor related to countries' ability to adapt to climate change into relevant project activities. Such projects should include access to RH/FP, in addition to other strategies such as girls' education and women's empowerment that lead to lower fertility. Attention to population and integrated strategies should be central and aligned to longer-term national adaptation plans and strategies.

Quality and clinical supply considerations of Paediatric Investigation Plans for IV preparations-A case study with the FP7 CloSed project.

PubMed

Hanning, Sara M; Orlu Gul, Mine; Winslade, Jackie; Baarslag, Manuel A; Neubert, Antje; Tuleu, Catherine

2016-09-25

A Paediatric Investigation Plan (PIP) is a development plan that aims to ensure that sufficient data are obtained through studies in paediatrics to support the generation of marketing authorisation of medicines for children. This paper highlights some practical considerations and challenges with respect to PIP submissions and paediatric clinical trials during the pharmaceutical development phase, using the FP7-funded Clonidine for Sedation of Paediatric Patients in the Intensive Care Unit (CloSed) project as a case study. Examples discussed include challenges and considerations regarding formulation development, blinding and randomisation, product labelling and shipment and clinical trial requirements versus requirements for marketing authorisation. A significant quantity of information is required for PIP submissions and it is hoped that future applicants may benefit from an insight into some critical considerations and challenges faced in the CloSed project. Copyright © 2016 Elsevier B.V. All rights reserved.

Implementing a Fee-for-Service Cervical Cancer Screening and Treatment Program in Cameroon: Challenges and Opportunities.

PubMed

DeGregorio, Geneva; Manga, Simon; Kiyang, Edith; Manjuh, Florence; Bradford, Leslie; Cholli, Preetam; Wamai, Richard; Ogembo, Rebecca; Sando, Zacharie; Liu, Yuxin; Sheldon, Lisa Kennedy; Nulah, Kathleen; Welty, Thomas; Welty, Edith; Ogembo, Javier Gordon

2017-07-01

Cervical cancer screening is one of the most effective cancer prevention strategies, but most women in Africa have never been screened. In 2007, the Cameroon Baptist Convention Health Services, a large faith-based health care system in Cameroon, initiated the Women's Health Program (WHP) to address this disparity. The WHP provides fee-for-service cervical cancer screening using visual inspection with acetic acid enhanced by digital cervicography (VIA-DC), prioritizing care for women living with HIV/AIDS. They also provide clinical breast examination, family planning (FP) services, and treatment for reproductive tract infection (RTI). Here, we document the strengths and challenges of the WHP screening program and the unique aspects of the WHP model, including a fee-for-service payment system and the provision of other women's health services. We retrospectively reviewed WHP medical records from women who presented for cervical cancer screening from 2007-2014. In 8 years, WHP nurses screened 44,979 women for cervical cancer. The number of women screened increased nearly every year. The WHP is sustained primarily on fees-for-service, with external funding totaling about $20,000 annually. In 2014, of 12,191 women screened for cervical cancer, 99% received clinical breast exams, 19% received FP services, and 4.7% received treatment for RTIs. We document successes, challenges, solutions implemented, and recommendations for optimizing this screening model. The WHP's experience using a fee-for-service model for cervical cancer screening demonstrates that in Cameroon VIA-DC is acceptable, feasible, and scalable and can be nearly self-sustaining. Integrating other women's health services enabled women to address additional health care needs. The Cameroon Baptist Convention Health Services Women's Health Program successfully implemented a nurse-led, fee-for-service cervical cancer screening program using visual inspection with acetic acid-enhanced by digital cervicography in the setting of a large faith-based health care system in Cameroon. It is potentially replicable in many African countries, where faith-based organizations provide a large portion of health care. The cost-recovery model and concept of offering multiple services in a single clinic rather than stand-alone "silo" cervical cancer screening could provide a model for other low-and-middle-income countries planning to roll out a new, or make an existing, cervical cancer screening services accessible, comprehensive, and sustainable. © AlphaMed Press 2017.

Family planning in Vietnam.

PubMed

Feuerstein, M T

1993-07-24

A trial of nearly 32,000 quinacrine pellet female sterilizations in Vietnam has occurred in the context of a country in transition to modernization. The main objectives of population and family planning (FP) policies are a two-child family, reduction of the infant mortality rate from 45 to 25/1000, reduction of child malnutrition rates from 50% to 25%, reduced maternal mortality from 120 to 50/100,000, increase in contraceptive use by 20% from the present rate of 33%, and reduction in the fertility rate from 4.0 to below 3 by the end of the century. Without vigorous FP, the population could double to 170 million within 30 years. The government has trebled its population and FP budget, but neighboring countries spend 6-10 times as much. The search is on to broaden the range of FP methods currently in use. In 1990, there were reported to be about 1 million abortions, another million insertions of IUDs around 223,000 oral contraceptive users, and 23,000 sterilizations. Menstrual regulation is legal, free, and available in communes where there is a three-year trained health worker. Research is in progress on injectable and implanted contraceptives. Acceptance of male sterilization is increasing. In field trials of quinacrine pellet nonsurgical female sterilization, physicians and midwives trained in IUD insertion were used. (The country is currently in the midst of a major overhaul of health manpower and health facilities.) Further research is required on the effects of insertion technique on the efficacy of quinacrine pellet sterilization and on the concentration of quinacrine in the uterine cavity in relation to placement and efficacy. The field trial also suggests that around 242 maternal deaths may have been averted during the study. It is estimated that 1300 clinicians doing 100 quinacrine pellet insertions sterilizations a month could meet vietnam's unmet need for female sterilization, thus contributing substantially to the country's FP needs.

China's family planning policy today.

PubMed

Meredith, W H

1993-01-01

This paper reviews China's family planning (FP) policy and its progress and problems in reaching state goals. Opening with a brief description of the one-child policy introduced in 1979, the paper moves backward in time to a consideration of the historical perspective and government policy. The current situation is then described in more detail. It is noted that China's population of 1.14 billion in 1990 would have been 1.3 billion without FP and that China contains 22% of the world's population with only 7% of its arable land. The state hopes to limit the growth rate to 12.5/1000 in the coming decade but a birth peak is predicted, birth control work has progressed very unevenly, marriage and pregnancy under age 18 is still common in rural areas, and life expectancy has risen. Urban compliance is very high, but the desire to have sons is still strong in rural areas. Problems with the birth rate among the migrating population are being addressed by the requirement that migrants produce "FP cards" before applying for residency permits. It is believed that female infanticide is still practiced in rural areas and that eliminating son preference would reduce the overall birth rate. While many couples rely on sterilization, the government is conducting research on new forms of the IUD (the most popular contraceptive) and vaccines and is encouraging the use of condoms. Most contraceptives are distributed free through an extensive network of FP associations. China has faced international criticism for the potential abuse to human rights implicit in its one-child policy, but China maintains that it opposes forced abortions, forbids infanticide, and that the FP policy reflects a more humane response to the reality of China's situation than would allowing couples to have large families. While China's methods would not work in a more pluralistic society which extols individualism, China's success or failure will in large measure determine the future of the world.

Oncofertility resources at NCI-designated comprehensive cancer centers.

PubMed

Clayman, Marla L; Harper, Maya M; Quinn, Gwendolyn P; Reinecke, Joyce; Shah, Shivani

2013-12-01

NCI-designated comprehensive cancer centers (CCCs) set the standard for providing exemplary patient care. Quality cancer care includes discussions about fertility and referrals to fertility specialists for patients at risk for sterility. This study sought to determine what fertility preservation (FP) resources are available in CCCs and how well those are integrated into patient care. Leaders at each CCC received a letter requesting a short telephone interview with individuals who could provide information about the institution's FP resources. A semi-structured interview guide was used and responses were audio-recorded. Data were analyzed using content and thematic analysis. Interviews were conducted with 30 of the 39 CCCs that see adult patients (77%). The remaining institutions included 4 nonresponders, 3 that referred the interviewers to childhood cancer survivorship clinics, 1 that refused, and 1 that could not identify any FP resources. Participants were primarily affiliated with reproductive endocrinology (n=15) or hematology/oncology divisions (n=10). Institutional policies regarding consistent provision of FP information were rare (n=4), although most sites (n=20) either had some services on-site or had referral programs (n=8). However, only 13 had some experimental services, such as ovarian tissue cryopreservation. Respondents reported barriers to provision of FP, including oncologists' identification of patients at risk, low referral rates, and perceptions of patient prognosis. Only 8 (27%) sites had staff with time dedicated to FP. CCCs vary widely in implementing FP-recommended practice to their patients. CCCs are positioned to provide exemplary oncofertility care, but most need to better integrate FP information and referral into practice.

Generating and executing programs for a floating point single instruction multiple data instruction set architecture

DOEpatents

Gschwind, Michael K

2013-04-16

Mechanisms for generating and executing programs for a floating point (FP) only single instruction multiple data (SIMD) instruction set architecture (ISA) are provided. A computer program product comprising a computer recordable medium having a computer readable program recorded thereon is provided. The computer readable program, when executed on a computing device, causes the computing device to receive one or more instructions and execute the one or more instructions using logic in an execution unit of the computing device. The logic implements a floating point (FP) only single instruction multiple data (SIMD) instruction set architecture (ISA), based on data stored in a vector register file of the computing device. The vector register file is configured to store both scalar and floating point values as vectors having a plurality of vector elements.

Does a dedicated program for young breast cancer patients affect the likelihood of fertility preservation discussion and referral?

PubMed

Srikanthan, Amirrtha; Amir, Eitan; Warner, Ellen

2016-06-01

To assess whether a dedicated program for young breast cancer patients, including a nurse navigator, improves the frequency of: a) fertility discussion documentation and b) fertility preservation (FP) referrals. A retrospective chart review and prospective survey were undertaken of breast cancer patients diagnosed at age 40 or younger between 2011 and 2013 who received adjuvant or neo-adjuvant chemotherapy at two academic cancer centers in Toronto, Canada. The Odette Cancer Centre (OCC) has a dedicated program for young breast cancer patients while Princess Margaret Cancer Centre (PM) does not. Patient demographics, tumor pathology, treatment and fertility discussion documentation prior to systemic chemotherapy administration were extracted from patient records. Prospective surveys were administered to the same cohort to corroborate data collected. Eighty-one patient charts were reviewed at both OCC and PM. Forty-seven and 49 at OCC and PM returned surveys for a response rate of 58% and 60% respectively. Chart reviews demonstrated no difference in the frequency of fertility discussion documentation (78% versus 75% for OCC and PM, p = 0.71); however, surveys demonstrated higher rates of recall of fertility discussion at OCC (96% versus 80%, p = 0.02). A greater proportion of women were offered FP referrals at OCC, as observed in chart reviews (56% versus 41%, p = 0.09), and surveys (73% versus 51%, p = 0.04). Time to initiation of chemotherapy did not differ between women who underwent FP and those who did not. A dedicated program for young breast cancer patients is associated with a higher frequency of FP referrals without delaying systemic therapy. Copyright © 2016 Elsevier Ltd. All rights reserved.

Who is driving continuing medical education for family medicine?

PubMed

Klein, Douglas; Allan, G Michael; Manca, Donna; Sargeant, Joan; Barnett, Carly

2009-01-01

Considerable time and money are invested in continuing medical education (CME) for family physicians (FPs) but the effectiveness is uncertain. The participation of FPs as coordinators and teachers is not well known. The goal of this project was to describe the role of FPs in organizing and teaching CME events that are accredited for FPs. Information about accredited CME events occurring in Alberta and Nova Scotia was requested from universities, provincial chapters of the College of Family Physicians of Canada, and pharmaceutical companies. Location, coordinating site, organizing committee members, teaching faculty, and format were recorded from each event. The number and proportion of FPs involved in both organizing and teaching CME events accredited for FPs were calculated and compared. A total of 314 CME events were collected, comprising a total of 1,472 hours of CME. From the CME events collected, there were 1,730 organizing committee members and 1,647 teachers. FPs constitute 59% of the organizing committees and 17% of the teachers. Significant differences in the numbers of FP planners and teachers were related to organizing group, format, location, and expected audience composition. The accreditation requirement for FPs on organizing committees likely helps preserve a reasonable proportion of FP organizers but not teachers in FP CME. The proportions of true FP planners and teachers may actually be lower than planning documents indicate. Low level of family physician teachers in CME may be due to FPs' not selecting FP teachers, the FP teaching pool's being inadequate, or the organizing committee's being unaware of FPs who are knowledgeable in particular areas.

Reconciling religious identity and reproductive practices: the Church and contraception in Poland.

PubMed

Mishtal, Joanna; Dannefer, Rachel

2010-08-01

After the fall of state socialism in Poland in 1989, a Catholic-nationalist government assumed power. The new political power of the Catholic Church resulted in severe restrictions on family planning (FP) services. Yet, Poland's fertility rate declined sharply, suggesting that women are controlling their fertility despite restrictions. This study examined the Church's influence on women's contraceptive decisions, and how women reconcile religious teachings with their contraceptive use. We conducted a mixed-methods study, including a cross-sectional survey and qualitative interviews, in Gdańsk, Poland with sexually active women aged 18-40. The quantitative sample included 418 respondents; the qualitative sample included 49 respondents. Despite restrictions on FP services, modern contraceptive use among our sample was 56%, up from 19% in 1991. Catholicism played a relatively small role in respondents' contraceptive decisions; though 94.2% of respondents were Catholic, 79% reported that the Church had little or no influence on reproductive decisions. Women's explanations for how they reconcile their reproductive practices with Catholicism included using elements of religion to support contraceptive use, prioritising responsibility for family and financial considerations over the Church's prohibitions, and challenging the Church's credibility in FP matters. Our findings underscore women's struggles under post-socialist reproductive policies that limit FP access. Despite religious, political, and economic obstacles, contraceptive use has increased dramatically, indicating that FP is a high priority for women in Poland. Policies should respond to women's needs. Comprehensive, state-sponsored FP and sex education are urgently needed and the state should legitimise such services.

"Side effects affected my daily activities a lot": a qualitative exploration of the impact of contraceptive side effects in Bangladesh.

PubMed

Jain, Aparna; Reichenbach, Laura; Ehsan, Iqbal; Rob, Ubaidur

2017-01-01

In a country like Bangladesh that has made great progress in contraceptive use with one of the lowest levels of fertility and highest levels of contraceptive use, understanding what factors influence women's decisions to discontinue a contraceptive method and not switch to a new method is critical in designing interventions and programs that will help enable Bangladesh to reach its FP2020 goals. Research on side effects has focused on physical manifestations like headaches, moodiness, abdominal pain, and menstrual irregularities. While physical effects alone may stop women from continuing a contraceptive method, less is known about how side effects influence women's daily activities and lives. The purpose of this study is to understand the ways that side effects affect Bangladeshi women's participation in different social settings. Thirty-five in-depth interviews with married women who recently discontinued or switched to a different contraceptive method were conducted in Sylhet and Khulna Divisions. Interviews explored reasons for discontinuation including experience of side effects and impact of side effects on women's lives. Key themes emerged including that side effects are not only experienced physically but are barriers to women's participation in many aspects of their lives. The spheres of life that most commonly appeared to be influenced by side effects include religion, household, and sexual intimacy irrespective of method used or residence. Family planning providers need to be aware of these additional consequences associated with contraceptive side effects to provide tailored counseling that recognizes these issues and helps women to mitigate them. For Bangladesh to achieve its FP2020 goals, understanding the broader context in which family planning decisions are made vis-à-vis side effects is critical to design programs and interventions that meet all the needs of women beyond just their fertility intentions.

Family planning and protection of human rights.

PubMed

1991-12-01

The discussion of human rights in China is based on the White Paper issued by the Information Office under the State Council on November 1, 1991. China is the most populous country in the world at 1.14 billion in 1990. Annual increases of 17 million are expected even with family planning (FP). The area of cultivated land/capita has dropped to 1.3 mu (16.5% of an acre)/capita, or 25% of the world average. Fresh water resources have also dropped similarly. The amount of grain.person is 22% of that in the US. 25% of additional income to the national income is consumed by newborns annually. Savings have been cut and reinvestment in economic development has been slowed. There are pressures on all social and economic systems. There is acknowledged success in FP. The birth rate has dropped to 21.06.1000 in 1990, the rate of natural increase to 14.39%/1000, and the fertility rate to 2.31. These figures are lower than the averages for other developing countries. The FP policy is to promote deferred marriage and childbearing, fewer but healthier births, and 1 child/couple. Rural families who are having difficulties may after an interval of several years have a 2nd child. Minority nationalities are being encouraged to adopt FP voluntarily. Han requirements are different. The policy has been understood and supported by the masses and has contributed to the drop in 3rd and higher parity births to 19.32% in 1989 from 62.21% in 1970. The government role is one of guidance and persuasion within the law, and cannot be accomplished by administrative decrees alone. The government has given priority to enlightening the masses through publicity and education that birth control has a direct impact on the nation's prosperity and people's happy family life. The China FP Association has set up 600,000 grass roots branches with 32 million members to assist in aiding the masses in self-education, self-management, and self-service. Ideological education has been combined with helping the masses solve practical problems. FP identifies contraception as protection of maternal and child health. 75% of couples of childbearing age practice contraception. Coercive abortions are resolutely opposed. Induced abortion in cases of contraceptive failure are voluntary and safe. The abortion ratio is comparable to world rates, but lower rates are targeted. Policy objectives are to control population growth and improve the quality of human resources. Maternal and child health care is provided. Law forbids infanticide. Policy conforms to item 9 of the UN Mexico City Declaration on Population and Development, 1984, and the UN World Population Plan of Action.

TBVAC2020: Advancing Tuberculosis Vaccines from Discovery to Clinical Development.

PubMed

Kaufmann, Stefan H E; Dockrell, Hazel M; Drager, Nick; Ho, Mei Mei; McShane, Helen; Neyrolles, Olivier; Ottenhoff, Tom H M; Patel, Brij; Roordink, Danielle; Spertini, François; Stenger, Steffen; Thole, Jelle; Verreck, Frank A W; Williams, Ann

2017-01-01

TBVAC2020 is a research project supported by the Horizon 2020 program of the European Commission (EC). It aims at the discovery and development of novel tuberculosis (TB) vaccines from preclinical research projects to early clinical assessment. The project builds on previous collaborations from 1998 onwards funded through the EC framework programs FP5, FP6, and FP7. It has succeeded in attracting new partners from outstanding laboratories from all over the world, now totaling 40 institutions. Next to the development of novel vaccines, TB biomarker development is also considered an important asset to facilitate rational vaccine selection and development. In addition, TBVAC2020 offers portfolio management that provides selection criteria for entry, gating, and priority settings of novel vaccines at an early developmental stage. The TBVAC2020 consortium coordinated by TBVI facilitates collaboration and early data sharing between partners with the common aim of working toward the development of an effective TB vaccine. Close links with funders and other consortia with shared interests further contribute to this goal.

TBVAC2020: Advancing Tuberculosis Vaccines from Discovery to Clinical Development

PubMed Central

Kaufmann, Stefan H. E.; Dockrell, Hazel M.; Drager, Nick; Ho, Mei Mei; McShane, Helen; Neyrolles, Olivier; Ottenhoff, Tom H. M.; Patel, Brij; Roordink, Danielle; Spertini, François; Stenger, Steffen; Thole, Jelle; Verreck, Frank A. W.; Williams, Ann; Britton, Warwick

2017-01-01

TBVAC2020 is a research project supported by the Horizon 2020 program of the European Commission (EC). It aims at the discovery and development of novel tuberculosis (TB) vaccines from preclinical research projects to early clinical assessment. The project builds on previous collaborations from 1998 onwards funded through the EC framework programs FP5, FP6, and FP7. It has succeeded in attracting new partners from outstanding laboratories from all over the world, now totaling 40 institutions. Next to the development of novel vaccines, TB biomarker development is also considered an important asset to facilitate rational vaccine selection and development. In addition, TBVAC2020 offers portfolio management that provides selection criteria for entry, gating, and priority settings of novel vaccines at an early developmental stage. The TBVAC2020 consortium coordinated by TBVI facilitates collaboration and early data sharing between partners with the common aim of working toward the development of an effective TB vaccine. Close links with funders and other consortia with shared interests further contribute to this goal. PMID:29046674

Long-term peritoneal dialysis experience: quality control supports the use of fluconazole to prevent fungal peritonitis.

PubMed

Lopes, Karina; Rocha, Ana; Rodrigues, Anabela; Carvalho, Maria João; Cabrita, António

2013-07-01

Fungal peritonitis (FP) is rare, but it is associated with high morbidity and mortality. A prospective study was conducted based on the peritonitis episodes registry to evaluate FP rate, possible risk factors, and outcomes. The impact of prophylactic intervention with oral fluconazole was evaluated. Over 24 years of experience, 417 patients underwent peritoneal dialysis (PD), followed for 956 patient-years. By the end of the study, the peritonitis rate reached 0.47 episodes per patient-year of treatment (ep/pt-y). FP was detected in 24 patients. The global rate of FP was 0.03 ep/pt-y (4.8%). Candida species accounted for 92% of the FP. Risk factors identified: recent use of antibiotics in 63% (13 episodes of bacterial peritonitis and 2 exit-site infections (ESI)) and immunosuppressive therapy in 8%. While rare, the FP proportion was still observed to increase from the beginning of the program, reaching 7.8% (0.05 ep/pt-y). A strategy of antifungal prophylaxis with oral fluconazole during peritonitis or ESI antibiotic therapy was adopted, which allowed thereafter a 4.0% falling FP proportion (by study end, rate of 0.01 ep/pt-y). Catheter removal occurred in all patients. The mortality rate was 12.5%. Reinsertion of dialysis catheter was attempted in 4 patients and PD was successfully resumed in 3 patients. FP was associated with high mortality and required early removal of the catheter in all patients. Recent use of antibiotics was a predisposing factor to PF. The quality control process determined a prophylactic strategy and reduction of PF after introduction of oral fluconazole was implemented.

Evaluation of family planning communications in El Salvador.

PubMed

Bertrand, J T; Zelaya, J D; Cisneros, R J; Morris, L

1982-01-01

During the 1970s, El Salvador had one of the most active communication programmes for family planning (FP) of any Latin American country. The current study, carried out nationwide among women of reproductive age in El Salvador, indicates that over 90% of women have been reached FP messages via mass or interpersonal channels. Levels of exposure were found to be relatively lower among women who live in rural areas, who work at home or not at all, who have little education, who are not married or live in union, and who are under 19 or over 40. The study was completed at a time of political stability in the country, and these data were to be used as a guideline for designing future communication programmes with respect to content, target population, and channels. With regard to communication research, this study yielded findings which usefully supplement those already recorded through a number of investigations of the subject.

Family planning and its effects on the lives of women in China.

PubMed

Barnett, B

1998-12-01

This report presents findings from a family planning (FP) survey of the population in 2 counties in North Anhui province and 2 counties in South Jiangsu province, China. FP views differed between the older and younger generation. About 66% viewed FP as positive. One women noted the increase in women's status. Young women and men preferred the husband's role as breadwinner and wife's role in the home. Preference for a son as a first child was expressed by 13% of men and women in South Jiangsu and 25-30% in North Anhui. Respondents from North Anhui indicated that sons were valuable for old age support and as persons to carry on the family name. Some mothers reported pressure from mothers-in-law to bear a son. Over 33% in South Jiangsu desired a stronger FP role for men, expressed in their acceptance of vasectomy. Over 50% wanted men to use condoms. In North Anhui, 60% wanted more men to undergo vasectomy; 52% wanted men to use condoms. 97% in South Jiangsu and 91% in North Anhui used contraception. Nearly 82% of contraceptive users in South Jiangsu and 31% in North Anhui used the IUD. 29% of husbands in North Anhui and under 1% in South Jiangsu had obtained a vasectomy. Nearly 20% of women in South Jiangsu and 9% in North Anhui had had a pregnancy due to contraceptive failure. Fertility was 1.3 children/woman in South Jiangsu and 1.8 in North Anhui. After focus groups, researchers recommended improvements in quality of care and services to adolescents and youth, wider choices of methods, and promotion of the value of daughters.

Providing maternal and child health-family planning services to a large rural population: results of the Bohol Project, Philippines.

PubMed Central

Williamson, N E; Parado, J P; Maturan, E G

1983-01-01

The Bohol Project (1975-1979) sought to improve maternal and child health and to increase the use of family planning among a rural Philippine population of 400,000. Research indicated that maternal and child health (MCH) services did become more available during the Project period and coverage of the priority populations improved. Family planning (FP) use, particularly of less effective methods, increased and fertility declined although some change could have been expected even without the Project. Deaths due to neonatal tetanus were almost eliminated by mortality rates did not decline for a number of reasons, including the fact that services were probably not tailored closely enough to local health problems, especially respiratory diseases. The Project showed that it was possible to increase health and family planning services by using low-cost strategies (such as setting up community drug stores) and by employing paramedical workers, in this case, midwives. Preventive MCH-FP services were not overwhelmed by curative services as had been feared. Perhaps the most significant contributions of the Project were the lessons learned about delivering health and family planning services and conducting evaluation research. In general, if developing countries could maintain well-evaluated field laboratories for working out health and family planning delivery approaches before going nationwide, it is likely that time and money would be saved in the long run. PMID:6848001

Multiple levels of social influence on adolescent sexual and reproductive health decision-making and behaviors in Ghana

PubMed Central

Challa, Sneha; Manu, Abubakar; Morhe, Emmanuel; Dalton, Vanessa K.; Loll, Dana; Dozier, Jessica; Zochowski, Melissa K.; Boakye, Andrew; Adanu, Richard; Hall, Kelli Stidham

2018-01-01

Little is known about the multilevel social determinants of adolescent sexual and reproductive health (SRH) that shape the use of family planning (FP) among young women in Africa. We conducted in-depth, semi-structured, qualitative interviews with 63 women aged 15–24 years in Accra and Kumasi, Ghana. We used purposive, stratified sampling to recruit women from community-based sites. Interviews were conducted in English or local languages, recorded, and transcribed verbatim. Grounded theory-guided thematic analysis identified salient themes. Three primary levels of influence emerged as shaping young women’s SRH experiences, decision-making, and behaviors. Interpersonal influences (peers, partners, and parents) were both supportive and unsupportive influences on sexual debut, contraceptive (non) use, and pregnancy resolution. Community influences included perceived norms about acceptability/unacceptability of adolescent sexual activity and its consequences (pregnancy, childbearing, abortion). Macro-social influences involved religion and abstinence and teachings about premarital sex, lack of comprehensive sex education, and limited access to confidential, quality SRH care. The willingness and ability of young women in our study to use FP methods and services were affected, often negatively, by factors operating within and across each level. These findings have implications for research, programs, and policies to address social determinants of adolescent SRH. PMID:28296626

Multiple levels of social influence on adolescent sexual and reproductive health decision-making and behaviors in Ghana.

PubMed

Challa, Sneha; Manu, Abubakar; Morhe, Emmanuel; Dalton, Vanessa K; Loll, Dana; Dozier, Jessica; Zochowski, Melissa K; Boakye, Andrew; Adanu, Richard; Hall, Kelli Stidham

2018-04-01

Little is known about the multilevel social determinants of adolescent sexual and reproductive health (SRH) that shape the use of family planning (FP) among young women in Africa. We conducted in-depth, semi-structured, qualitative interviews with 63 women aged 15-24 years in Accra and Kumasi, Ghana. We used purposive, stratified sampling to recruit women from community-based sites. Interviews were conducted in English or local languages, recorded, and transcribed verbatim. Grounded theory-guided thematic analysis identified salient themes. Three primary levels of influence emerged as shaping young women's SRH experiences, decision-making, and behaviors. Interpersonal influences (peers, partners, and parents) were both supportive and unsupportive influences on sexual debut, contraceptive (non) use, and pregnancy resolution. Community influences included perceived norms about acceptability/unacceptability of adolescent sexual activity and its consequences (pregnancy, childbearing, abortion). Macro-social influences involved religion and abstinence and teachings about premarital sex, lack of comprehensive sex education, and limited access to confidential, quality SRH care. The willingness and ability of young women in our study to use FP methods and services were affected, often negatively, by factors operating within and across each level. These findings have implications for research, programs, and policies to address social determinants of adolescent SRH.

Parent Experience With False-Positive Newborn Screening Results for Cystic Fibrosis.

PubMed

Hayeems, Robin Z; Miller, Fiona A; Barg, Carolyn J; Bombard, Yvonne; Kerr, Elizabeth; Tam, Karen; Carroll, June C; Potter, Beth K; Chakraborty, Pranesh; Davies, Christine; Milburn, Jennifer; Patton, Sarah; Bytautas, Jessica P; Taylor, Louise; Price, April; Gonska, Tanja; Keenan, Katherine; Ratjen, Felix; Guttmann, Astrid

2016-09-01

The risk of psychosocial harm in families of infants with false-positive (FP) newborn bloodspot screening (NBS) results for cystic fibrosis (CF) is a longstanding concern. Whether well designed retrieval and confirmatory testing systems can mitigate risks remains unknown. Using a mixed-methods cohort design, we obtained prospective self-report data from mothers of infants with FP CF NBS results 2 to 3 months after confirmatory testing at Ontario's largest follow-up center, and from a randomly selected control sample of mothers of screen negative infants from the same region. Mothers completed a questionnaire assessing experience and psychosocial response. A sample of mothers of FP infants completed qualitative interviews. One hundred thirty-four mothers of FP infants (response rate, 55%) and 411 controls (response rate, 47%) completed questionnaires; 54 mothers of FP infants were interviewed. Selected psychosocial response measures did not detect psychosocial distress in newborns or 1 year later (P > .05). Mothers recalled distress during notification of the positive result and in the follow-up testing period related to fear of chronic illness, but valued the screening system of care in mitigating concerns. Although immediate distress was reported among mothers of FP infants, selected psychometric tools did not detect these concerns. The NBS center from which mothers were recruited minimizes delay between notification and confirmatory testing and ensures trained professionals are communicating results and facilitating follow-up. These factors may explain the presence of minimal psychosocial burden. The screening system reflected herein may be a model for NBS programs working to minimize FP-related psychosocial harm. Copyright © 2016 by the American Academy of Pediatrics.

Private-Sector Social Franchising to Accelerate Family Planning Access, Choice, and Quality: Results From Marie Stopes International

PubMed Central

Munroe, Erik; Hayes, Brendan; Taft, Julia

2015-01-01

Background: To achieve the global Family Planning 2020 (FP2020) goal of reaching 120 million more women with voluntary family planning services, rapid scale-up of services is needed. Clinical social franchising, a service delivery approach used by Marie Stopes International (MSI) in which small, independent health care businesses are organized into quality-assured networks, provides an opportunity to engage the private sector in improving access to family planning and other health services. Methods: We analyzed MSI’s social franchising program against the 4 intended outputs of access, efficiency, quality, and equity. The analysis used routine service data from social franchising programs in 17 African and Asian countries (2008–2014) to estimate number of clients reached, couple-years of protection (CYPs) provided, and efficiency of services; clinical quality audits of 636 social franchisees from a subset of the 17 countries (2011–2014); and exit interviews with 4,844 clients in 14 countries (2013) to examine client satisfaction, demographics (age and poverty), and prior contraceptive use. The MSI “Impact 2” model was used to estimate population-level outcomes by converting service data into estimated health outcomes. Results: Between 2008 and 2014, an estimated 3,753,065 women cumulatively received voluntary family planning services via 17 national social franchise programs, with a sizable 68% choosing long-acting reversible contraceptives (LARCs). While the number of social franchisee outlets increased over time, efficiency also significantly improved over time, with each outlet delivering, on average, 178 CYPs in 2008 compared with 941 CYPs in 2014 (P = .02). Clinical quality audit scores also significantly improved; 39.8% of social franchisee outlets scored over 80% in 2011 compared with 84.1% in 2014. In 2013, 40.7% of the clients reported they had not been using a modern method during the 3 months prior to their visit (95% CI = 37.4, 44.0), with 46.1% (95% CI = 40.9, 51.2) of them reporting having never previously used family planning at all. Analysis of age and poverty levels of clients indicate mixed results in bridging equity gaps: 57.4% of clients lived on under US$2.50/day in 2013 (95% CI = 54.9, 60.0) and 26.1% were 15–24 years old (95% CI = 23.8, 28.4), but only 15.1% lived on less than $1.25/day (95% CI = 13.8, 16.4) and 5.0% were 15–19 years old (95% CI = 3.9, 6.1). The services provided via social franchising are estimated to avert 4,958,000 unintended pregnancies and 7,150 maternal deaths. Conclusion: Social franchising through the existing private sector has the ability to rapidly scale-up access to high-quality family planning services, including LARCs, for the general population as well as young women and the poor, providing a promising model to help achieve the global FP2020 goal. PMID:26085018

Donor funding for family planning: levels and trends between 2003 and 2013.

PubMed

Grollman, Christopher; Cavallaro, Francesca L; Duclos, Diane; Bakare, Victoria; Martínez Álvarez, Melisa; Borghi, Josephine

2018-05-01

The International Conference on Population and Development in 1994 set targets for donor funding to support family planning programmes, and recent initiatives such as FP2020 have renewed focus on the need for adequate funding to rights-based family planning. Disbursements supporting family planning disaggregated by donor, recipient country and year are not available for recent years. We estimate international donor funding for family planning in 2003-13, the period covering the introduction of reproductive health targets to the Millennium Development Goals and up to the beginning of FP2020, and compare funding to unmet need for family planning in recipient countries. We used the dataset of donor disbursements to support reproductive, maternal, newborn and child health developed by the Countdown to 2015 based on the Organization for Economic Cooperation and Development Creditor Reporting System. We assessed levels and trends in disbursements supporting family planning in the period 2003-13 and compared this to unmet need for family planning. Between 2003 and 2013, disbursements supporting family planning rose from under $400 m prior to 2008 to $886 m in 2013. More than two thirds of disbursements came from the USA. There was substantial year-on-year variation in disbursement value to some recipient countries. Disbursements have become more concentrated among recipient countries with higher national levels of unmet need for family planning. Annual disbursements of donor funding supporting family planning are far short of projected and estimated levels necessary to address unmet need for family planning. The reimposition of the US Global Gag Rule will precipitate an even greater shortfall if other donors and recipient countries do not find substantial alternative sources of funding.

Donor funding for family planning: levels and trends between 2003 and 2013

PubMed Central

Grollman, Christopher; Cavallaro, Francesca L; Duclos, Diane; Bakare, Victoria; Martínez Álvarez, Melisa; Borghi, Josephine

2018-01-01

Abstract The International Conference on Population and Development in 1994 set targets for donor funding to support family planning programmes, and recent initiatives such as FP2020 have renewed focus on the need for adequate funding to rights-based family planning. Disbursements supporting family planning disaggregated by donor, recipient country and year are not available for recent years. We estimate international donor funding for family planning in 2003–13, the period covering the introduction of reproductive health targets to the Millennium Development Goals and up to the beginning of FP2020, and compare funding to unmet need for family planning in recipient countries. We used the dataset of donor disbursements to support reproductive, maternal, newborn and child health developed by the Countdown to 2015 based on the Organization for Economic Cooperation and Development Creditor Reporting System. We assessed levels and trends in disbursements supporting family planning in the period 2003–13 and compared this to unmet need for family planning. Between 2003 and 2013, disbursements supporting family planning rose from under $400 m prior to 2008 to $886 m in 2013. More than two thirds of disbursements came from the USA. There was substantial year-on-year variation in disbursement value to some recipient countries. Disbursements have become more concentrated among recipient countries with higher national levels of unmet need for family planning. Annual disbursements of donor funding supporting family planning are far short of projected and estimated levels necessary to address unmet need for family planning. The reimposition of the US Global Gag Rule will precipitate an even greater shortfall if other donors and recipient countries do not find substantial alternative sources of funding. PMID:29534176

Use of HIV counseling and testing and family planning services among postpartum women in Kenya: a multicentre, non-randomised trial.

PubMed

Kimani, James; Warren, Charlotte E; Abuya, Timothy; Ndwiga, Charity; Mayhew, Susannah; Vassall, Anna; Mutemwa, Richard; Askew, Ian

2015-11-13

Addressing the postnatal needs of new mothers is a neglected area of care throughout sub-Saharan Africa. The study compares the effectiveness of integrating HIV and family planning (FP) services into postnatal care (PNC) with stand-alone services on postpartum women's use of HIV counseling and testing and FP services in public health facilities in Kenya. Data were derived from samples of women who had been assigned to intervention or comparison groups, had given birth within the previous 0-10 weeks and were receiving postnatal care, at baseline and 15 months later. Descriptive statistics describe the characteristics of the sample and multivariate logistic regression models assess the effect of the integrated model of care on use of provider-initiated testing and counseling (PITC) and FP services. At the 15-month follow-up interviews, more women in the intervention than comparison sites used implants (15 % vs. 3 %; p < 0.001), while injectables were the most used short-term method by women in both sites. Women who wanted to wait until later to have children (OR = 1.3; p < 0.01; 95 % CI: 1.1-1.5), women with secondary education (OR = 1.2; p < 0.05; 95 % CI: 1.0-1.4), women aged 25-34 years (OR = 1.2; p < 0.01; 95 % CI: 1.1-1.4) and women from poor households (OR = 1.6; p < 0.001; 95 % CI: 1.4-1.9) were associated with FP use. Nearly half (47 %) and about one-third (30 %) of mothers in the intervention and comparison sites, respectively, were offered PITC. Significant predictors of uptake of PITC were seeking care in a health center/dispensary relative to a hospital, having a partner who has tested for HIV and being poor. An integrated delivery approach of postnatal services is beneficial in increasing the uptake of PITC and long-acting FP services among postpartum women. Also, interventions aimed at increasing male partners HIV testing have a positive effect on the uptake of PITC and should be encouraged. ClinicalTrials.gov NCT01694862.

Taking education to the hills.

PubMed

1991-10-01

The Population and Community Development Association (PDA) of Thailand operates a health education program in 30 hilltribe villages in Chiang Rai province. The 1st village to benefit from the PDA program is Baan Huay Krai (population of 400), a Lisu village in Mae Suay district. It began with a presentation and films on primary health care and improving rice productivity shown at the public health center. The films, the presentation, and music played before the showing of the film entertained and educated the villagers. The Lisu hilltribe constitutes 5% of the tribal population in Thailand. The Lisu think that evil spirits cause illness and do not seek care from a Western medical practitioner. If they believe the illness was caused by natural causes, however, they do go to a medical practitioner. Further, they believe vampires exist where many people are ill or dying and that the vampires will bite, so they are fearful of going to a hospital. The headman of Baan Huay Krai is a PDA health care volunteer and has familiarized villagers with Western health care practices. To be such a volunteer, he attended a PDA seminar which focused on family planning (FP) in the community and on sound agricultural practices. He has since informed villagers about different FP methods: condoms, oral contraceptives, injection, IUD, and sterilization. He also educates them about personal hygiene, environmental sanitation, nutrition, infectious disease control and prevention, 1st aid, and drug abuse. PDA regional coordinators visit all volunteers' villages each month at which time the volunteers can ask any questions that arise and discuss problems and successes.

Psychosocial Training in U.S. Internal Medicine and Family Practice Residency Programs.

ERIC Educational Resources Information Center

Gaufberg, Elizabeth H.; Joseph, Robert C.; Pels, Richard J.; Wyshak, Grace; Wieman, Dow; Nadelson, Carol C.

2001-01-01

Surveyed directors of internal medicine (IM) and family practice (FP) residency programs regarding the format, content, and quantity of psychosocial training in their programs, their opinions on topics related to such training, and program demographics. Found considerable variation in content and time devoted to psychosocial training within and…

Implementing a Fee‐for‐Service Cervical Cancer Screening and Treatment Program in Cameroon: Challenges and Opportunities

PubMed Central

DeGregorio, Geneva; Manga, Simon; Kiyang, Edith; Manjuh, Florence; Bradford, Leslie; Cholli, Preetam; Wamai, Richard; Ogembo, Rebecca; Sando, Zacharie; Liu, Yuxin; Sheldon, Lisa Kennedy; Nulah, Kathleen; Welty, Thomas; Welty, Edith

2017-01-01

Abstract Background. Cervical cancer screening is one of the most effective cancer prevention strategies, but most women in Africa have never been screened. In 2007, the Cameroon Baptist Convention Health Services, a large faith‐based health care system in Cameroon, initiated the Women's Health Program (WHP) to address this disparity. The WHP provides fee‐for‐service cervical cancer screening using visual inspection with acetic acid enhanced by digital cervicography (VIA‐DC), prioritizing care for women living with HIV/AIDS. They also provide clinical breast examination, family planning (FP) services, and treatment for reproductive tract infection (RTI). Here, we document the strengths and challenges of the WHP screening program and the unique aspects of the WHP model, including a fee‐for‐service payment system and the provision of other women's health services. Methods. We retrospectively reviewed WHP medical records from women who presented for cervical cancer screening from 2007–2014. Results. In 8 years, WHP nurses screened 44,979 women for cervical cancer. The number of women screened increased nearly every year. The WHP is sustained primarily on fees‐for‐service, with external funding totaling about $20,000 annually. In 2014, of 12,191 women screened for cervical cancer, 99% received clinical breast exams, 19% received FP services, and 4.7% received treatment for RTIs. We document successes, challenges, solutions implemented, and recommendations for optimizing this screening model. Conclusion. The WHP's experience using a fee‐for‐service model for cervical cancer screening demonstrates that in Cameroon VIA‐DC is acceptable, feasible, and scalable and can be nearly self‐sustaining. Integrating other women's health services enabled women to address additional health care needs. Implication for Practice. The Cameroon Baptist Convention Health Services Women's Health Program successfully implemented a nurse‐led, fee‐for‐service cervical cancer screening program using visual inspection with acetic acid‐enhanced by digital cervicography in the setting of a large faith‐based health care system in Cameroon. It is potentially replicable in many African countries, where faith‐based organizations provide a large portion of health care. The cost‐recovery model and concept of offering multiple services in a single clinic rather than stand‐alone “silo” cervical cancer screening could provide a model for other low‐and‐middle‐income countries planning to roll out a new, or make an existing, cervical cancer screening services accessible, comprehensive, and sustainable. PMID:28536303

Frenkel pair recombinations in UO2: Importance of explicit description of polarizability in core-shell molecular dynamics simulations

NASA Astrophysics Data System (ADS)

Devynck, Fabien; Iannuzzi, Marcella; Krack, Matthias

2012-05-01

The oxygen and uranium Frenkel pair (FP) recombination mechanisms are studied in UO2 using an empirical interatomic potential accounting for the polarizability of the ions, namely a dynamical core-shell model. The results are compared to a more conventional rigid-ion model. Both model types have been implemented into the cp2k program package and thoroughly validated. The overall picture indicates that the FP recombination mechanism is a complex process involving several phenomena. The FP recombination can happen instantaneously when the distance between the interstitial and the vacancy is small or can be thermally activated at larger separation distances. However, other criteria can prevail over the interstitial-vacancy distance. The surrounding environment of the FP defect, the mechanical stiffness of the matrix, and the orientation of the migration path are shown to be major factors acting on the FP lifetime. The core-shell and rigid-ion models provide a similar qualitative description of the FP recombination mechanism. However, the FP stabilities determined by both models significantly differ in the lower temperature range considered. Indeed, the recombination time of the oxygen and uranium FPs can be up to an order of magnitude lower in the core-shell model at T=600 K and T=1800 K, respectively. These differences highlight the importance of the explicit description of polarizability on some crucial properties such as the resistance to amorphization. This refined description of the interatomic interactions would certainly affect the description of the recrystallization process following a displacement cascade. In turn, the self-healing phase would be better accounted for in the core-shell model and the misestimate inherent to the lack of polarizability in the rigid-ion model corrected.

Simple locking of infrared and ultraviolet diode lasers to a visible laser using a LabVIEW proportional-integral-derivative controller on a Fabry-Perot signal.

PubMed

Kwolek, J M; Wells, J E; Goodman, D S; Smith, W W

2016-05-01

Simultaneous laser locking of infrared (IR) and ultraviolet lasers to a visible stabilized reference laser is demonstrated via a Fabry-Perot (FP) cavity. LabVIEW is used to analyze the input, and an internal proportional-integral-derivative algorithm converts the FP signal to an analog locking feedback signal. The locking program stabilized both lasers to a long term stability of better than 9 MHz, with a custom-built IR laser undergoing significant improvement in frequency stabilization. The results of this study demonstrate the viability of a simple, computer-controlled, non-temperature-stabilized FP locking scheme for our applications, laser cooling of Ca(+) ions, and its use in other applications with similar modest frequency stabilization requirements.

A novel role for FOXA2 and SHH in organizing midbrain signaling centers.

PubMed

Bayly, Roy D; Brown, Charmaine Y; Agarwala, Seema

2012-09-01

The floor plate (FP) is a midline signaling center, known to direct ventral cell fates and axon guidance in the neural tube. The recent identification of midbrain FP as a source of dopaminergic neurons has renewed interest in its specification and organization, which remain poorly understood. In this study, we have examined the chick midbrain and spinal FP and show that both can be partitioned into medial (MFP) and lateral (LFP) subdivisions. Although Hedgehog (HH) signaling is necessary and sufficient for LFP specification, it is not sufficient for MFP induction. By contrast, the transcription factor FOXA2 can execute the full midbrain and spinal cord FP program via HH-independent and dependent mechanisms. Interestingly, although HH-independent FOXA2 activity is necessary and sufficient for inducing MFP-specific gene expression (e.g., LMX1B, BMP7), it cannot confer ventral identity to midline cells without also turning on Sonic hedgehog (SHH). We also note that the signaling centers of the midbrain, the FP, roof plate (RP) and the midbrain-hindbrain boundary (MHB) are physically contiguous, with each expressing LMX1B and BMP7. Possibly as a result, SHH or FOXA2 misexpression can transform the MHB into FP and also suppress RP induction. Conversely, HH or FOXA2 knockdown expands the endogenous RP and transforms the MFP into a RP and/or MHB fate. Finally, combined HH blockade and FOXA2 misexpression in ventral midbrain induces LMX1B expression, which triggers the specification of the RP, rather than the MFP. Thus we identify HH-independent and dependent roles for FOXA2 in specifying the FP. In addition, we elucidate for the first time, a novel role for SHH in determining whether a midbrain signaling center will become the FP, MHB or RP. Copyright © 2012 Elsevier Inc. All rights reserved.

Association between contraceptive use and socio-demographic factors of young fecund women in Bangladesh.

PubMed

Islam, Ahmed Zohirul; Rahman, Mosiur; Mostofa, Md Golam

2017-10-01

This study aimed to explore the association between socio-demographic factors and contraceptive use among fecund women under 25years old. This study utilized a cross-sectional data (n=3744) extracted from the Bangladesh Demographic and Health Survey 2011. Differences in the use of contraceptives by socio-demographic characteristics were assessed by χ 2 analyses. Binary logistic regression was used to identify the determinants of contraceptive use among young women. This study observed that 71% fecund women aged below 25years used contraceptives. Getting family planning (FP) methods from FP workers increases the likelihood of using contraceptives among young women because outreach activities by FP workers and accessibility of FP related information pave the way of using contraceptives. Husband-wife joint participation in decision making on health care increases the likelihood of using contraceptives. Participation of women in decision making on health care could be achieved by promoting higher education and gainful employment for women. Reproductive and sex education should be introduced in schools to prepare the young for healthy and responsible living. Moreover, policy makers should focus on developing negotiation skills in young women by creating educational and employment opportunities since husband-wife joint participation in decision making increases contraceptive use. Copyright © 2017 Elsevier B.V. All rights reserved.

Fall prevention modulates decisional saccadic behavior in aging.

PubMed

Coubard, Olivier A

2012-01-01

As society ages and frequency of falls increases in older adults, counteracting motor decline is a challenging issue for developed countries. Physical activity based on aerobic and strength training as well as motor activity based on skill learning both help benefit balance and reduce the risk of falls, as assessed by clinical or laboratory measures. However, how such programs influence motor control is a neglected issue. This study examined the effects of fall prevention (FP) training on saccadic control in older adults. Saccades were recorded in 12 participants aged 64-91 years before and after 2.5 months training in FP. Traditional analysis of saccade timing and dynamics was performed together with a quantitative analysis using the LATER model, enabling us to examine the underlying motor control processes. Results indicated that FP reduced the rate of anticipatory and express saccades in inappropriate directions and enhanced that of express saccades in the appropriate direction, resulting in decreased latency and higher left-right symmetry of motor responses. FP reduced within-participant variability of saccade duration, amplitude, and peak velocity. LATER analysis suggested that FP modulates decisional thresholds, extending our knowledge of motor training influence on central motor control. We introduce the Threshold Interval Modulation with Early Release-Rate of rIse Deviation with Early Release (TIMER-RIDER) model to account for the results.

Financial constraints lead to innovation by IPPF.

PubMed

1998-07-01

In this interview, the International Planned Parenthood Federation's (IPPF) Secretary General, Director of Resource and Program Development, and Special Advisor to the Secretary General commented on IPPF programming innovations being adopted in response to financial constraints. Factors that have led to a reduction in core funding for the IPPF include the fact that other nongovernmental organizations (NGOs) have become more active, that many donor countries have decentralized their funding mechanisms to the country level, and that overall overseas development assistance is being decreased, despite promises made at the 1994 International Conference on Population and Development (ICPD). New funding can be sought from foundations, from the private sector, and by successfully competing with other organizations for funds available from donor countries. Transferring skills to local Family Planning Associations (FPAs) also helps these groups develop their own resource base. The ICPD marked the first time that NGOs were considered a legitimate part of the process of creating a program of action. It will be important for NGOs to demonstrate their ability to translate the goals of the ICPD into action. The IPPF and other NGOs have been successful in helping FPAs expand FP programs to cover reproductive health needs, in dealing with adolescent sexuality, and in enhancing women's empowerment. The IPPF wishes to create stronger alliances between its FPAs and other NGOs dealing with complementary issues and foster a synthesis among the recommendations of the 5 major UN conferences of the 1990s.

Proceedings of the 2015 international summit on fibropapillomatosis: Global status, trends, and population impacts

USGS Publications Warehouse

Hargrove, Stacy A.; Work, Thierry M.; Brunson, Shandell; Foley, Allen M.; Balazs, George H.

2016-01-01

The 2015 International Summit on Fibropapillomatosis (FP) was convened in Honolulu, Hawaii June 11-14, 2015. Scientists from around the world were invited to present results from sea turtle monitoring and research programs as they relate to the global status, trends, and population impacts of FP on green turtles. The participants engaged in discussions that resulted in the following conclusions: 1.Globally, FP has long been present in wild sea turtle populations the earliest mention was in the late 1800s in the Florida Keys. 2.FP primarily affects medium-sized immature turtles in coastal foraging pastures. 3.Expression of FP differs across ocean basins and to some degree within basins. Turtles in the Southeast US, Caribbean, Brazil, and Australia rarely have oral tumors (inside the mouth cavity), whereas they are common and often severe in Hawaii. Internal tumors (on vital organs) occur in the Atlantic and Hawaii, but only rarely in Australia. Liver tumors are common in Florida but not in Hawaii. 4.Recovery from FP through natural processes, when the affliction is not severe, has been documented in wild populations globally. 5.FP causes reduced survivorship, but documented mortality rates in Australia and Hawaii are low. The mortality impact of FP is not currently exceeding population growth rates in some intensively monitored populations (e.g., Florida, Hawaii) as evidenced by increasing nesting trends despite the incidence of FP in immature foraging populations. 6.Pathogens, hosts, and potential disease and environmental cofactors have the capacity to change; while we are having success now, there needs to be continued monitoring to detect changes in the distribution, occurrence, and severity of the disease. 7.While we do not have clear evidence to provide the direct link, globally, the preponderance of sites with a high frequency of FP tumors are areas with some degree of degradation resulting from altered watersheds. Watershed management and responsible coastal development may be the best approach for reducing the spread and prevalence of the disease. 8.Future research efforts should employ a multi-factorial ecological approach (e.g., virology, parasitology, genetics, health, diet, habitat use, water quality, etc.) since there are likely several environmental cofactors involved in the expression of the disease, which is still thought to be caused by a herpesvirus. 9.Minimum FP data collection in new areas should include: individual identification (photo ID, PIT tags, etc.), standard measurements (length and weight), presence/absence of tumors, tumor severity, body condition, oral examination, method of capture, and effort

CHANGES SDSS: the development of a Spatial Decision Support System for analysing changing hydro-meteorological risk

NASA Astrophysics Data System (ADS)

van Westen, Cees; Bakker, Wim; Zhang, Kaixi; Jäger, Stefan; Assmann, Andre; Kass, Steve; Andrejchenko, Vera; Olyazadeh, Roya; Berlin, Julian; Cristal, Irina

2014-05-01

Within the framework of the EU FP7 Marie Curie Project CHANGES (www.changes-itn.eu) and the EU FP7 Copernicus project INCREO (http://www.increo-fp7.eu) a spatial decision support system is under development with the aim to analyse the effect of risk reduction planning alternatives on reducing the risk now and in the future, and support decision makers in selecting the best alternatives. The Spatial Decision Support System will be composed of a number of integrated components. The Risk Assessment component allows to carry out spatial risk analysis, with different degrees of complexity, ranging from simple exposure (overlay of hazard and assets maps) to quantitative analysis (using different hazard types, temporal scenarios and vulnerability curves) resulting into risk curves. The platform does not include a component to calculate hazard maps, and existing hazard maps are used as input data for the risk component. The second component of the SDSS is a risk reduction planning component, which forms the core of the platform. This component includes the definition of risk reduction alternatives (related to disaster response planning, risk reduction measures and spatial planning) and links back to the risk assessment module to calculate the new level of risk if the measure is implemented, and a cost-benefit (or cost-effectiveness/ Spatial Multi Criteria Evaluation) component to compare the alternatives and make decision on the optimal one. The third component of the SDSS is a temporal scenario component, which allows to define future scenarios in terms of climate change, land use change and population change, and the time periods for which these scenarios will be made. The component doesn't generate these scenarios but uses input maps for the effect of the scenarios on the hazard and assets maps. The last component is a communication and visualization component, which can compare scenarios and alternatives, not only in the form of maps, but also in other forms (risk curves, tables, graphs). The envisaged users of the platform are organizations involved in planning of risk reduction measures, and that have staff capable of visualizing and analysing spatial data at a municipal scale.

Cancer and Fertility Program Improves Patient Satisfaction With Information Received

PubMed Central

Thom, Bridgette; Benedict, Catherine; Carter, Jeanne; Corcoran, Stacie; Dickler, Maura N.; Goodman, Karyn A.; Margolies, Allison; Matasar, Matthew J.; Noy, Ariela; Goldfarb, Shari B.

2016-01-01

Purpose A cancer and fertility program was established at a large cancer center to support clinicians in discussing treatment-related fertility risks and fertility preservation (FP) options with patients and in referring patients to reproductive specialists. The program provides resources, clinician education, and fertility clinical nurse specialist consultation. This study evaluated the program’s impact on patient satisfaction with information received. Patients and Methods Retrospective cross-sectional surveys assessed satisfaction before (cohort 1 [C1]) and after (cohort 2 [C2]) program initiation. Questionnaires were investigator-designed, gender-specific, and anonymous. Results Most C1 (150 males, 271 females) and C2 (120 males, 320 females) respondents were 2 years postdiagnosis; the most frequently reported cancers were testicular, breast, and lymphoma. A significant difference in satisfaction with the amount of information received was seen between C1 and C2. For males, satisfaction with information on fertility risks was high in both cohorts but significantly greater in C2 for information on sperm banking (χ2 = 9.3, P = .01) and finding a sperm bank (χ2 = 13.3, P = .001). For females, satisfaction with information was significantly greater in C2 for information on fertility risks (χ2 = 62.1, P < .001), FP options (χ2 = 71.9, P < .001), help with decision making (χ2 = 80.2, P < .001), and finding a reproductive endocrinologist (χ2 = 60.5, P < .001). Among patients who received and read information materials, 96% of males and 99% of females found them helpful. Among C2 females, fertility clinical nurse specialist consultation was associated with significantly greater satisfaction with information on FP options (χ2 = 11.2, P = .004), help with decision making (χ2 = 10.4, P = .006), and finding a reproductive endocrinologist (χ2 = 22.6, P < .001), with 10% reporting lack of knowledge as a reason for not pursuing FP. Conclusion Improvements in patient satisfaction with information received demonstrate the potential for fertility programs in cancer care settings to improve the quality of clinician-patient discussions about fertility. PMID:27044937

General Design Memorandum, Gulfport Harbor, Mississippi. Design Memorandum Number 1. Appendix F. Regional Impact and Financial Analysis

DTIC Science & Technology

1990-03-01

District, Mobile AREA A ORK UNIT NUMBCRS Economic Analysis Sec., Planning Div. (CESAM-PD-FE) P. 0. Box 2288, Mobile , AL 36628-0001 11. CONTROLLING OPPICE...NAME AND ADDRESS It. REPORT DATE US Army Engineer District, Mobile March 1990 Plan Development Sec., Planning Div. (CESAM-PD-FP) IS. NUMBER OF PAGES P...0. Box 2288, Mobile , AL 36628-0001 114 14. MONITORING AGENCY NAMIE & AOORIESSQif EU110nt km cIOfi.IAd 011*e) VS. SECURITY CLASS. (of Wol roport

Fertility trends and prospects in East and South-East Asian countries and implications for policies and programmes.

PubMed

Leete, R

1991-01-01

Fertility trends and prospects for east and southeast Asian countries including cities in China, Taiwan, the Republic of Korea, Thailand, Indonesia, Malaysia, the Philippines, Myanmar, and Viet Nam are described. Additional discussion focuses on family planning methods, marriage patterns, fertility prospects, theories of fertility change, and policy implications for the labor supply, labor migrants, increased female participation in the labor force (LFP), human resource development, and social policy measures. Figures provide graphic descriptions of total fertility rates (TFRS) for 12 countries/areas for selected years between 1960-90, TFR for selected Chinese cities between 1955-90, the % of currently married women 15-44 years using contraception by main method for selected years and for 10 countries, actual and projected TFR and annual growth rates between 1990-2020 for Korea and Indonesia. It is noted that the 1st southeast Asian country to experience a revolution in reproductive behavior was Japan with below replacement level fertility by 1960. This was accomplished by massive postponement in age at marriage and rapid reduction in marital fertility. Fertility was controlled primarily through abortion. Thereafter every southeast Asian country experienced fertility declines. Hong Kong, Penang, Shanghai, Singapore, and Taipei and declining fertility before the major thrust of family planning (FP). Chinese fertility declines were reflected in the 1970s to the early 1980s and paralleled the longer, later, fewer campaign and policy which set ambitious targets which were strictly enforced at all levels of administration. Korea and Taiwan's declines were a result of individual decision making to restrict fertility which was encouraged by private and government programs to provide FP information and subsidized services. The context was social and economic change. Indonesia's almost replacement level fertility was achieved dramatically through the 1970s and 1980s by institutional change in ideas about families and schooling and material welfare, changes in the structure of governance, and changes in state ideology. Thailand's decline began in the 1960s and is attributed to social change, change in cultural setting, demand, and FP efforts. Modest declines characterize Malaysia and the Philippines, which have been surpassed by Myanmar and Viet Nam. The policy implications are that there are shortages in labor supply which can be remedied with labor migration, pronatalist policy, more capital intensive industries, and preparation for a changing economy.

Easy handling of tectonic data: the programs TectonicVB for Mac and TectonicsFP for Windows™

NASA Astrophysics Data System (ADS)

Ortner, Hugo; Reiter, Franz; Acs, Peter

2002-12-01

TectonicVB for Macintosh and TectonicsFP for Windows TM operating systems are two menu-driven computer programs which allow the shared use of data on these environments. The programs can produce stereographic plots of orientation data (great circles, poles, lineations). Frequently used statistical procedures like calculation of eigenvalues and eigenvectors, calculation of mean vector with concentration parameters and confidence cone can be easily performed. Fault data can be plotted in stereographic projection (Angelier and Hoeppener plots). Sorting of datasets into homogeneous subsets and rotation of tectonic data can be performed in interactive two-diagram windows. The paleostress tensor can be calculated from fault data sets using graphical (calculation of kinematic axes and right dihedra method) or mathematical methods (direct inversion or numerical dynamical analysis). The calculations can be checked in dimensionless Mohr diagrams and fluctuation histograms.

Effects of chlorpyrifos on enzymatic systems of Cydia pomonella (Lepidoptera: Tortricidae) adults.

PubMed

Parra Morales, Laura Beatriz; Alzogaray, Raúl Adolfo; Cichón, Liliana; Garrido, Silvina; Soleño, Jimena; Montagna, Cristina Mónica

2017-06-01

The control program of codling moth (Cydia pomonella L.) in the Río Negro and Neuquén Valley is intended to neonate larvae. However, adults may be subjected to sublethal pesticide concentrations generating stress which might enhance both mutation rates and activity of the detoxification system. This study assessed the exposure effects of chlorpyrifos on target enzyme and, both detoxifying and antioxidant systems of surviving adults from both a laboratory susceptible strain (LSS) and a field population (FP). The results showed that the FP was as susceptible to chlorpyrifos as the LSS and, both exhibited a similar chlorpyrifos-inhibitory concentration 50 (IC 50 ) of acetylcholinesterase (AChE). The FP displayed higher carboxylesterase (CarE) and 7-ethoxycoumarine O-deethylase (ECOD) activities than LSS. Both LSS and FP showed an increase on CarE activity after the exposure to low-chlorpyrifos concentrations, followed by enzyme inhibition at higher concentrations. There were no significant differences neither in the activities of glutathione S-transferases (GST), catalase (CAT) and superoxide dismutase (SOD) nor in the reduced glutathione (GSH) content between LSS and FP. Moreover, these enzymes were unaffected by chlorpyrifos. In conclusion, control adults from the FP exhibited higher CarE and ECOD activities than control adults from the LSS. AChE and CarE activities were the most affected by chlorpyrifos. Control strategies used for C. pomonella, such as rotations of insecticides with different modes of action, will probably delay the evolution of insecticide resistance in FPs from the study area. © 2015 Institute of Zoology, Chinese Academy of Sciences.

Private-Sector Social Franchising to Accelerate Family Planning Access, Choice, and Quality: Results From Marie Stopes International.

PubMed

Munroe, Erik; Hayes, Brendan; Taft, Julia

2015-06-17

To achieve the global Family Planning 2020 (FP2020) goal of reaching 120 million more women with voluntary family planning services, rapid scale-up of services is needed. Clinical social franchising, a service delivery approach used by Marie Stopes International (MSI) in which small, independent health care businesses are organized into quality-assured networks, provides an opportunity to engage the private sector in improving access to family planning and other health services. We analyzed MSI's social franchising program against the 4 intended outputs of access, efficiency, quality, and equity. The analysis used routine service data from social franchising programs in 17 African and Asian countries (2008-2014) to estimate number of clients reached, couple-years of protection (CYPs) provided, and efficiency of services; clinical quality audits of 636 social franchisees from a subset of the 17 countries (2011-2014); and exit interviews with 4,844 clients in 14 countries (2013) to examine client satisfaction, demographics (age and poverty), and prior contraceptive use. The MSI "Impact 2" model was used to estimate population-level outcomes by converting service data into estimated health outcomes. Between 2008 and 2014, an estimated 3,753,065 women cumulatively received voluntary family planning services via 17 national social franchise programs, with a sizable 68% choosing long-acting reversible contraceptives (LARCs). While the number of social franchisee outlets increased over time, efficiency also significantly improved over time, with each outlet delivering, on average, 178 CYPs in 2008 compared with 941 CYPs in 2014 (P = .02). Clinical quality audit scores also significantly improved; 39.8% of social franchisee outlets scored over 80% in 2011 compared with 84.1% in 2014. In 2013, 40.7% of the clients reported they had not been using a modern method during the 3 months prior to their visit (95% CI = 37.4, 44.0), with 46.1% (95% CI = 40.9, 51.2) of them reporting having never previously used family planning at all. Analysis of age and poverty levels of clients indicate mixed results in bridging equity gaps: 57.4% of clients lived on under US$2.50/day in 2013 (95% CI = 54.9, 60.0) and 26.1% were 15-24 years old (95% CI = 23.8, 28.4), but only 15.1% lived on less than $1.25/day (95% CI = 13.8, 16.4) and 5.0% were 15-19 years old (95% CI = 3.9, 6.1). The services provided via social franchising are estimated to avert 4,958,000 unintended pregnancies and 7,150 maternal deaths. Social franchising through the existing private sector has the ability to rapidly scale-up access to high-quality family planning services, including LARCs, for the general population as well as young women and the poor, providing a promising model to help achieve the global FP2020 goal. © Munroe et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly cited. To view a copy of the license, visit http://creativecommons.org/licenses/by/3.0/

Fertility intentions and contraceptive practices among clinic-users living with HIV in Kenya: a mixed methods study.

PubMed

Mayhew, Susannah H; Colombini, Manuela; Kimani, James Kelly; Tomlin, Keith; Warren, Charlotte E; Mutemwa, Richard

2017-07-05

Preventing unwanted pregnancies in Women Living with HIV (WLHIV) is a recognised HIV-prevention strategy. This study explores the fertility intentions and contraceptive practices of WLHIV using services in Kenya. Two hundred forty women self-identifying as WLHIV who attended reproductive health services in Kenya were interviewed with a structured questionnaire in 2011; 48 were also interviewed in-depth. STATA SE/13.1, Nvivo 8 and thematic analysis were used. Seventy one percent participants did not want another child; this was associated with having at least two living children and being the bread-winner. FP use was high (92%) but so were unintended pregnancies (40%) while living with HIV. 56 women reported becoming pregnant "while using FP": all were using condoms or short-term methods. Only 16% participants used effective long-acting reversible contraceptives or permanent methods (LARC-PM). Being older than 25 years and separated, widowed or divorced were significant predictors of long-term method use. Qualitative data revealed strong motivation among WLHIV to plan or prevent pregnancies to avoid negative health consequences. Few participants received good information about contraceptive choices. WLHIV need better access to FP advice and a wider range of contraceptives including LARC to enable informed choices that will protect their fertility intentions, ensure planned pregnancies and promote safe child-bearing. Integra is a non-randomised pre-post intervention trial registered with Current Controlled Trials ID: NCT01694862 .

The Design and Implementation of a Parallel Persistent Object System

DTIC Science & Technology

1992-02-01

Semantica JilP L Add descriptor (FP.L) to active pool JMPF r L If Frames, FP+r.O-0 Add descriptor (FP,L) to active pool Else Add descriptor (FP, IP+l...Syntax Semantica STARTO rl r2 Let FP’ = Frames[FP+rl] Let IP’ - Frames[FP+r2] Add (FP.IP+I) to active pool Add (FP I, P’ ) to active pool STARTI rl r2 r3...deadlock. 119 Syntaz Semantica ALLOCFRANE ri rj Let CallerFP - Frames [FP+ri] Let ResultIP - Frames [FP+ri+1] Let SignalIP = Frames [FP+ri+2] Let ResSlot

Clinical usefulness of brain-computer interface-controlled functional electrical stimulation for improving brain activity in children with spastic cerebral palsy: a pilot randomized controlled trial.

PubMed

Kim, Tae-Woo; Lee, Byoung-Hee

2016-09-01

[Purpose] Evaluating the effect of brain-computer interface (BCI)-based functional electrical stimulation (FES) training on brain activity in children with spastic cerebral palsy (CP) was the aim of this study. [Subjects and Methods] Subjects were randomized into a BCI-FES group (n=9) and a functional electrical stimulation (FES) control group (n=9). Subjects in the BCI-FES group received wrist and hand extension training with FES for 30 minutes per day, 5 times per week for 6 weeks under the BCI-based program. The FES group received wrist and hand extension training with FES for the same amount of time. Sensorimotor rhythms (SMR) and middle beta waves (M-beta) were measured in frontopolar regions 1 and 2 (Fp1, Fp2) to determine the effects of BCI-FES training. [Results] Significant improvements in the SMR and M-beta of Fp1 and Fp2 were seen in the BCI-FES group. In contrast, significant improvement was only seen in the SMR and M-beta of Fp2 in the control group. [Conclusion] The results of the present study suggest that BCI-controlled FES training may be helpful in improving brain activity in patients with cerebral palsy and may be applied as effectively as traditional FES training.

Identification of novel malarial cysteine protease inhibitors using structure-based virtual screening of a focused cysteine protease inhibitor library.

PubMed

Shah, Falgun; Mukherjee, Prasenjit; Gut, Jiri; Legac, Jennifer; Rosenthal, Philip J; Tekwani, Babu L; Avery, Mitchell A

2011-04-25

Malaria, in particular that caused by Plasmodium falciparum , is prevalent across the tropics, and its medicinal control is limited by widespread drug resistance. Cysteine proteases of P. falciparum , falcipain-2 (FP-2) and falcipain-3 (FP-3), are major hemoglobinases, validated as potential antimalarial drug targets. Structure-based virtual screening of a focused cysteine protease inhibitor library built with soft rather than hard electrophiles was performed against an X-ray crystal structure of FP-2 using the Glide docking program. An enrichment study was performed to select a suitable scoring function and to retrieve potential candidates against FP-2 from a large chemical database. Biological evaluation of 50 selected compounds identified 21 diverse nonpeptidic inhibitors of FP-2 with a hit rate of 42%. Atomic Fukui indices were used to predict the most electrophilic center and its electrophilicity in the identified hits. Comparison of predicted electrophilicity of electrophiles in identified hits with those in known irreversible inhibitors suggested the soft-nature of electrophiles in the selected target compounds. The present study highlights the importance of focused libraries and enrichment studies in structure-based virtual screening. In addition, few compounds were screened against homologous human cysteine proteases for selectivity analysis. Further evaluation of structure-activity relationships around these nonpeptidic scaffolds could help in the development of selective leads for antimalarial chemotherapy.

Missile Defense Certification: Examination of the U.S. Navy Aegis Warship and U.S. Army Patriot Crew Certification Process

DTIC Science & Technology

2008-09-01

C. Ensure FP Status indicators posted IAW SSTO : ___ (1) WCS ___ (2) DEFCON ___ (3) MOC ___ (4) Alert State ___ (5) ADW... SSTO . ___ 6. Denial and destruction plans. ___ 7. Missile hazard/misfire procedures. ___ 8. General Knowledge of TABS, Switch/Indicator

Influence of primary care professionals on early detection of breast cancer: different perception between family physicians and nursing professionals.

PubMed

Esteban-Vasallo, María D; Aerny-Perreten, Nicole; García-Riolobos, Carmen; López Rubio, Aranzazu; Domínguez-Berjón, Felicitas

2017-01-01

The aim of this study was to assess the level of self-perceived influence on early detection of breast cancer among nurses and family physicians (FP) working in primary care and to identify the factors associated with a lower perception in each group. In the Autonomous Community of Madrid, an online questionnaire on cancer prevention was sent to a random sample of primary care professionals (3586 FP and nurses). The data included sex, age, profession, years in primary care, specific postgraduate training, and opinions and attitudes toward cancer prevention. A descriptive analysis was carried out. Factors associated with a low/null self-perceived influence on early detection of breast cancer were analyzed separately for FP and nurses with multivariate logistic regression models. In all, 76.4% of the participants considered that their influence on the early detection of breast cancer was enough/high. FP attributed to themselves a higher influence than nurses (enough/high: 86.0 vs. 64.6%, P<0.01), and a lower perception was associated with a low/null perceived utility of their individual intervention [odds ratio (OR): 6.42, 95% confidence interval (CI) 2.77-14.85]. Among nurses, also associated with this low/null perceived utility [adjusted odds ratio (aOR): 2.81, 95% CI 1.37-5.77] were the absence of postgraduate training in the matter (aOR: 2.56, 95% CI 1.05-6.25), and a low/null perception of feasibility of prevention programs in their centers (aOR: 1.93, 95% CI 1.25-2.98). Primary care professionals perceive their activity in the early detection of breast cancer as relevant, especially FP. To increase knowledge of the utility of individual interventions, specific training and improvement of the feasibility of these programs could enhance this perception.

Chemical properties and sensory quality of ice cream fortified with fish protein.

PubMed

Shaviklo, Gholam Reza; Thorkelsson, Gudjon; Sveinsdottir, Kolbrun; Rafipour, Fereidon

2011-05-01

Fish protein powder is a functional ingredient that can be used for enhancing the nutritional value of food products. In this study the effect of fortification with different levels of fish protein powder (FP) on chemical properties and sensory quality of Persian ice cream with 0, 30 and 50 g kg(-1) FP during storage at - 18 °C for 4 months was investigated. Ice creams fortified with 50 and 30 g kg(-1) FP had significantly higher protein and solid-non-fat content than ice cream with 0% FP or 83, 69 and 51 g kg(-1) protein and 215, 204 and 181 g kg(-1) solid non-fat, respectively. All products had the same levels of fat, lactose, acidity and pH. They had similar sensory quality after production except for colour, but sensory properties of fortified samples changed significantly after 2 months of storage. Colour faded, cohesiveness decreased, sandiness/coarseness increased, sweetness decreased and fish flavour and off-odour increased. The control ice cream scored highest for additives odour and flavour. Development of ice cream fortified with fish protein powder could be an effective way to enhance nutritional and functional value of ice cream. But studies on storage stability, consumers' acceptance and attitudes are recommended if companies are planning to do so. Copyright © 2011 Society of Chemical Industry.

What Motivates Family Physicians to Participate in Training Programs in Shared Decision Making?

ERIC Educational Resources Information Center

Allaire, Anne-Sophie; Labrecque, Michel; Giguere, Anik; Gagnon, Marie-Pierre; Legare, France

2012-01-01

Introduction: Little is known about the factors that influence family physician (FP) participation in continuing professional development (CPD) programs in shared decision making (SDM). We sought to identify the factors that motivate FPs to participate in DECISION+, a CPD program in SDM. Methods: In 2007-2008, we collected data from 39 FPs who…

Social franchising and vouchers to promote long-term methods of family planning in rural Pakistan: a qualitative stocktaking with stakeholders.

PubMed

Azmat, Syed Khurram; Mustafa, Ghulam; Hameed, Waqas; Asghar, Jamshaid; Ahmed, Aftab; Shaikh, Babar T

2013-04-01

The overall use of modern contraception in Pakistan is quite low, especially in rural areas. Several studies have demonstrated the effectiveness of social franchising (SF) approaches in increasing access to modern contraception and improving the quality of healthcare in resource-poor areas in Asia and Africa. Drawing on best practices in SF, the Marie Stopes Society (MSS) implemented an SF model in certain rural areas of Pakistan to increase access to affordable and quality family planning (FP) services. The model was branded as Suraj (sun) and complemented with an innovative voucher scheme for intrauterine contraceptive devices (IUCDs). This paper describes the perspectives of Suraj clients, field workers mobilization (FWMs), and providers on various components of the Suraj model. A qualitative exploratory study was conducted in six randomly selected intervention districts in the Sindh and Punjab provinces. Data were collected using focus group discussions (FGDs) with clients and in-depth interviews (IDIs) with providers and FWMs. Data were manually analyzed using constant comparison and the thematic analysis approach. Clients showed positive attitudes towards modern contraceptive methods and identified Suraj FWMs and signboards as sources of information. Almost all clients reported IUCDs as effective methods as they have manageable side effects and require fewer visits to clinics. They spoke highly of voucher schemes as these enabled them to avail free IUCD services. Clients also appreciated many components of Suraj clinics, including cleanliness, privacy, confidentiality, the sterilization of instruments, and courteous Suraj providers and FWMs. Most Suraj providers said that IUCD insertion and infection-prevention training enhanced their ability to provide IUCD services and increased their standing in local communities. They reported that the role of FWMs was crucial in mobilizing the community and increasing their FP clientele. The FWMs said that attitudes towards FP were changing because of economic pressure at the household level, increases in literacy, and community mobilization efforts. The Suraj intervention influenced attitudes towards FP and modern contraception, positively. Women using IUCDs showed greater satisfaction with the method. The findings emphasize that SF approaches like Suraj, when complemented with vouchers and community mobilization efforts, can improve the utilization of long-term contraceptive methods among rural and underserved women. The study also identified the need for integrating FP, antenatal care, and safe delivery services.

Coping with changing conditions: alternative strategies for the delivery of maternal and child health and family planning services in Dhaka, Bangladesh.

PubMed Central

Routh, S.; el Arifeen, S.; Jahan, S. A.; Begum, A.; Thwin, A. A.; Baqui, A. H.

2001-01-01

The door-to-door distribution of contraceptives and information on maternal and child health and family planning (MCH-FP) services, through bimonthly visits to eligible couples by trained fieldworkers, has been instrumental in increasing the contraceptive prevalence rate and immunization coverage in Bangladesh. The doorstep delivery strategy, however, is labour-intensive and costly. More cost-effective service delivery strategies are needed, not only for family planning services but also for a broader package of reproductive and other essential health services. Against this backdrop, operations research was conducted by the Centre for Health and Population Research at the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B) from January 1996 to May 1997, in collaboration with government agencies and a leading national nongovernmental organization, with a view to developing and field-testing alternative approaches to the delivery of MCH-FP services in urban areas. Two alternative strategies featuring the withdrawal of home-based distribution and the delivery of basic health care from fixed-site facilities were tested in two areas of Dhaka. The clinic-based service delivery strategy was found to be a feasible alternative to the resource-intensive doorstep system in urban Dhaka. It did not adversely affect programme performance and it allowed the needs of clients to be addressed holistically through a package of essential health and family planning services. PMID:11242821

Law on the protection of public health, 30 June 1989.

PubMed

1989-01-01

This document contains major provisions of Viet Nam's 1989 law on the protection of public health. Chapter 1 sets out the rights of citizens to health care and health-promoting activities and environments as well as the obligations of citizens to implement the public health provisions of the law. Chapter 7 covers maternal-child health care and family planning (FP). Individuals may choose their method of birth control, and couples should have no more than two children. Coercion in the implementation of FP is forbidden. Women have the right to abortion and to reproductive health care. Abortions and IUD removals must be performed by licensed individuals. Employers of women must respect reproductive health policies dealing with pregnancy, child birth, breast feeding, and FP. Women may not be employed in arduous jobs or in jobs that are harmful to health. Health services for children will be expanded to provide necessary services, and parents must see that their children have the appropriate examinations and immunizations. The care of handicapped children will be organized by the Ministry of Health and the Minister of Labour, War Invalids, and Social Affairs.

Cost-utility analysis of the inhaled steroids available in a developing country for the management of pediatric patients with persistent asthma.

PubMed

Rodríguez-Martínez, Carlos E; Sossa-Briceño, Mónica P; Castro-Rodriguez, Jose A

2013-05-01

The choice among the different treatments available can have a great impact on the costs of asthma, The objective of this study was to estimate the incremental cost-utility ratio of three inhaled corticosteroids (ICs): budesonide (BUD), fluticasone propionate (FP), and ciclesonide, compared to beclomethasone dipropionate (BDP) (the only IC included in the Compulsory Health Insurance Plan of Colombia), A Markov-type model was developed to estimate costs and health outcomes of a simulated cohort of patients less than 18 years of age with persistent asthma treated over a 12-month period. Effectiveness parameters were obtained from a systematic review of the literature. Cost data were obtained from a hospital´s bills and from the national manual of drug prices. The study assumed the perspective of the national healthcare in Colombia. The main outcome was the variable "quality-adjusted life years" (QALY), RESULTS: While treatment with BDP was associated with the lowest cost (£106.16 average cost per patient during 12 months), treatment with FP resulted in the greatest gain in QUALYs (0.9325 QALYs). FP was associated with a greater gain in QALYs compared to BUD and ciclesonide (0.9325 vs. 0.8999 and 0.9051 QALYs, respectively) at lower costs (£231.19 vs. £309.27 and £270.15, respectively), thus leading to dominance. The incremental cost-utility ratio of FP compared to BDP was £19,835.28 per QALY, CONCLUSIONS: BDP is the most cost-effective therapy for treating pediatric patients with persistent asthma when willingness to pay (WTP) is less than £21,129.22/QALY, otherwise, FP is the most cost-effective therapy.

Tiger cubs and little flowers.

PubMed

1993-01-01

Short vignettes are related to show the conditions for girls and women in Morocco. Descriptions are given for child labor, literacy, the government's education campaign, youth group efforts to enhance family planning (FP) knowledge, the impact of FP outreach in rural areas, and unmarried mothers. In Morocco's cities, young boys can be seen hawking cigarettes and working in market stalls; in the countryside, boys herd goats or do other farm work. In rural areas girls are hidden by having them perform work around the house or on the farm primarily indoors. Women are supervised by women. 54% work as maids and 39% are apprentices in carpet factories. Parents prefer to have their daughters working and consider it protection from mischief as well as needed income. Only 60% of girls are enrolled in primary school vs. 80% of the boys. In rural areas, only 44% of girls are enrolled, and 20% stay to complete their primary education, while 76% of boys enroll and 63% complete primary school. Literacy of women has an effect on the ability to accurately take birth control pills. All ages of women gather at schools in the evening for lessons in reading and writing in a program supported by the King. Women are pleased with their success in just learning how to write their own names. Television advertisements promote sending children to school, as another part of the Ministry of Education's campaign to increase girl's educational status. There are still not enough schools; many schools are double shift, and communities are building their own schools. Youth clubs, which refer to boys as "tiger cubs" and girls as "little flowers," try to familiarize young people with some basic information about contraception. A traditional midwife relates some problems with girl's education: costs for clothing and supplies, worry about male teachers, and poor role models. In some remote areas, farm families do not send their children to school, because of the distance to schools and the need for farm workers. Husbands divorce wives for not producing children, and turn away FP workers who knock on their doors. Unmarried mothers aged 14-19 are usually illiterate and poor and cannot afford abortion. Orphanages are full. FP is practiced only by the married, after having proven their fertility.

Assessment and Control of Spacecraft Charging Risks on the International Space Station

NASA Technical Reports Server (NTRS)

Koontz, Steve; Edeen, Marybeth; Spetch, William; Dalton, Penni; Keening, Thomas

2003-01-01

Electrical interactions between the F2 region ionospheric plasma and the 160V photovoltaic (PV) electrical power system on the International Space Station (ISS) can produce floating potentials (FP) on the ISS conducting structure of greater magnitude than are usually observed on spacecraft in low-Earth orbit. Flight through the geomagnetic field also causes magnetic induction charging of ISS conducting structure. Charging processes resulting from interaction of ISS with auroral electrons may also contribute to charging albeit rarely. The magnitude and frequency of occurrence of possibly hazardous charging events depends on the ISS assembly stage (six more 160V PV arrays will be added to ISS), ISS flight configuration, ISS position (latitude and longitude), and the natural variability in the ionospheric flight environment. At present, ISS is equipped with two plasma contactors designed to control ISS FP to within 40 volts of the ambient F2 plasma. The negative-polarity grounding scheme utilized in the ISS 160V power system leads, naturally, to negative values of ISS FP. A negative ISS structural FP leads to application of electrostatic fields across the dielectrics that separate conducting structure from the ambient F2 plasma, thereby enabling dielectric breakdown and arcing. Degradation of some thermal control coatings and noise in electrical systems can result. Continued review and evaluation of the putative charging hazards, as required by the ISS Program Office, revealed that ISS charging could produce a risk of electric shock to the ISS crew during extra vehicular activity. ISS charging risks are being evaluated in ongoing ISS charging measurements and analysis campaigns. The results of ISS charging measurements are combined with a recently developed detailed model of the ISS charging process and an extensive analysis of historical ionospheric variability data, to assess ISS charging risks using Probabilistic Risk Assessment (PRA) methods. The PRA analysis (estimated frequency of occurrence and severity of the charging hazards) are then used to select the hazard control strategy that provides the best overall safety and mission success environment for ISS and the ISS crew. This paper presents: 1) a summary of ISS spacecraft charging analysis, measurements, observations made to date, 2) plans for future ISS spacecraft charging measurement campaigns, and 3) a detailed discussion of the PRA strategy used to assess ISS spacecraft charging risks and select charging hazard control strategies

Assessment and Control of International Space Station Spacecraft Charging Risks

NASA Astrophysics Data System (ADS)

Koontz, S.; Edeen, M.; Spetch, W.; Dalton, P.; Keeping, T.; Minow, J.

2003-12-01

Electrical interactions between the F2 region ionospheric plasma and the 160V photovoltaic (PV) electrical power system on the International Space Station (ISS) can produce floating potentials (FP) on ISS conducting structure of greater magnitude than are usually observed on spacecraft in low-Earth orbit. Flight through the geomagnetic field also causes magnetic induction charging of ISS conducting structure. Charging processes resulting from interaction of ISS with auroral electrons may also contribute to charging, albeit rarely. The magnitude and frequency of occurrence of possibly hazardous charging events depends on the ISS assembly stage (six more 160V PV arrays will be added to ISS), ISS flight configuration, ISS position (latitude and longitude), and the natural variability in the ionospheric flight environment. At present, ISS is equipped with two plasma contactors designed to control ISS FP to within 40 volts of the ambient F2 plasma. The negative-polarity grounding scheme utilized in the ISS 160V power system leads, naturally, to negative values of ISS FP. A negative ISS structural FP leads to application of electrostatic fields across the dielectrics that separate conducting structure from the ambient F2 plasma, thereby enabling dielectric breakdown and arcing. Degradation of some thermal control coatings and noise in electrical systems can result. Continued review and evaluation of the putative charging hazards, as required by the ISS Program Office, revealed that ISS charging could produce a risk of electric shock to the ISS crew during extra vehicular activity. ISS charging risks are being evaluated in ongoing ISS charging measurements and analysis campaigns. The results of ISS charging measurements are combined with a recently developed detailed model of the ISS charging process and an extensive analysis of historical ionospheric variability data, to assess ISS charging risks using Probabilistic Risk Assessment (PRA) methods. The PRA analysis (estimated frequency of occurrence and severity of the charging hazards) are then used to select the hazard control strategy that provides the best overall safety and mission success environment for ISS and the ISS crew. This paper presents: 1) a summary of ISS spacecraft charging analysis, measurements, observations made to date, 2) plans for future ISS spacecraft charging measurement campaigns, and 3) a detailed discussion of the PRA strategy used to assess ISS spacecraft charging risks and select charging hazard control strategies.

A functional language approach in high-speed digital simulation

NASA Technical Reports Server (NTRS)

Ercegovac, M. D.; Lu, S.-L.

1983-01-01

A functional programming approach for a multi-microprocessor architecture is presented. The language, based on Backus FP, its intermediate form and the translation process are discussed and illustrated with an example. The approach allows performance analysis to be performed at a high level as an aid in program partitioning.

Modeling of live-birth rates and cost-effectiveness of oocyte cryopreservation for cancer patients prior to high- and low-risk gonadotoxic chemotherapy.

PubMed

Lyttle Schumacher, B; Grover, N; Mesen, T; Steiner, A; Mersereau, J

2017-10-01

What is the live-birth rate (LBR) and cost-effectiveness of fertility preservation with oocyte cryopreservation (FP-OC) compared to expectant management in cancer patients age 25-40 based on estimated gonadotoxicity of treatments 5 years after cancer diagnosis? Oocyte cryopreservation prior to cancer treatment is more costly, yet more effective (producing more live births), than not undergoing oocyte cryopreservation but it is most beneficial for patients undergoing high-risk chemotherapy (HRC). The decision to undergo FP prior to treatment is multifactorial and can be costly and delay treatment. Not all treatments carry the same gonadotoxicity and patients may choose to undergo FP-OC based on the probability of premature ovarian insufficiency, predicted outcomes and cost. A comprehensive model that incorporates age at diagnosis and toxicity of treatment to help guide patients in the decision to undergo FP-OC does not yet exist. This study used a Decision Analysis Model to estimate effectiveness and cost of FP for cancer patients. Age-based estimates of LBR and cost per live birth were calculated for ages 25-40 years based on gonadotoxicity of treatment. A decision analysis model was constructed using Treeage Pro 2015 with case base probabilities derived from national registries, practice guidelines and medical records from a national network of infertility practices (IntegraMed). Compared to no FP-OC, FP-OC improved LBRs for women of all ages undergoing either low-risk chemotherapy (LRC) or HRC; however, it was most cost effective for women undergoing LRC at older ages or HRC at younger ages. Although FP-OC results in higher LBRs, it was always more costly. Using donor oocyte IVF can be a successful alternative to autologous FP-OC. Decision tree results reflect probabilities of certain events and are compiled from multiple reputable sources but are not directly derived from a recruited cohort of patients. Outcomes are based on United States estimates and should be interpreted in the broader context of individual patient diagnoses, treatment care plans and country of origin. The development of this analytic model will help guide practitioners in their counseling of women from age 25 to 40 years, who are considering FP-OC at the time of cancer diagnosis. It provides a realistic pathway from diagnosis to LB and accounts for the majority of costs and outcome possibilities. This study was partially funded by a grant from National Institute of Health (NIH)/National Institute of Child Health and Human Development (NICHD) (R01 HD67683) to A.Z.S. There are no conflicts of interest to declare. N/A. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Operating Profitability of For-Profit and Not-for-Profit Florida Community Hospitals During Medicare Policy Changes, 2000 to 2010.

PubMed

Langland-Orban, Barbara; Large, John T; Sear, Alan M; Zhang, Hanze; Zhang, Nanhua

2015-01-01

Medicare Advantage was implemented in 2004 and the Recovery Audit Contractor (RAC) program was implemented in Florida during 2005. Both increase surveillance of medical necessity and deny payments for improper admissions. The purpose of the present study was to determine their potential impact on for-profit (FP) and not-for-profit (NFP) hospital operating margins in Florida. FP hospitals were expected to be more adversely affected as admissions growth has been one strategy to improve stock performance, which is not a consideration at NFPs. This study analyzed Florida community hospitals from 2000 through 2010, assessing changes in pre-tax operating margin (PTOM). Florida Agency for Health Care Administration data were analyzed for 104 community hospitals (62 FPs and 42 NFPs). Academic, public, and small hospitals were excluded. A mixed-effects model was used to assess the association of RAC implementation, organizational and payer type variables, and ownership interaction effects on PTOM. FP hospitals began the period with a higher average PTOM, but converged with NFPs during the study period. The average Medicare Advantage effect was not significant for either ownership type. The magnitude of the RAC variable was significantly negative for average PTOM at FPs (-4.68) and positive at NFPs (0.08), meaning RAC was associated with decreasing PTOM at FP hospitals only. RAC complements other Medicare surveillance systems that detect medically unnecessary admissions, coding errors, fraud, and abuse. Since its implementation in Florida, average FP and NFP operating margins have been similar, such that the higher margins reported for FP hospitals in the 1990s are no longer evident. © The Author(s) 2015.

The Predictive Validity of the National Board of Osteopathic Medical Examiners' COMLEX-USA Examinations With Regard to Outcomes on American Board of Family Medicine Examinations.

PubMed

O'Neill, Thomas R; Peabody, Michael R; Song, Hao

2016-11-01

To examine the predictive validity of the National Board of Osteopathic Medical Examiners' Comprehensive Osteopathic Medical Licensing Examination of the United States of America (COMLEX-USA) series with regard to the American Board of Family Medicine's (ABFM's) In-Training Examination (ITE) and Maintenance of Certification for Family Physicians (MC-FP) Examination. A repeated-measures design was employed, using test scores across seven levels of training for 1,023 DOs who took the MC-FP for the first time between April 2012 and November 2014 and for whom the ABFM had ITE scores for each of their residency years. Pearson and disattenuated correlations were calculated; Fisher r to z transformation was performed; and sensitivity, specificity, and positive and negative predictive values for the COMLEX-USA Level 2-Cognitive Evaluation (CE) with regard to the MC-FP were computed. The Pearson and disattenuated correlations ranged from 0.55 to 0.69 and from 0.61 to 0.80, respectively. For MC-FP scores, only the correlation increase from the COMLEX-USA Level 2-CE to Level 3 was statistically significant (for Pearson correlations: z = 2.41, P = .008; for disattenuated correlations: z = 3.16, P < .001). The sensitivity, specificity, and positive and negative predictive values of the COMLEX-USA Level 2-CE with the MC-FP were 0.90, 0.39, 0.96, and 0.19, respectively. Evidence was found that the COMLEX-USA can assist family medicine residency program directors in predicting later resident performance on the ABFM's ITE and MC-FP, which is becoming increasingly important as graduate medical education accreditation moves toward a single aligned model.

Operating Profitability of For-Profit and Not-for-Profit Florida Community Hospitals During Medicare Policy Changes, 2000 to 2010

PubMed Central

Langland-Orban, Barbara; Large, John T.; Sear, Alan M.; Zhang, Hanze; Zhang, Nanhua

2015-01-01

Medicare Advantage was implemented in 2004 and the Recovery Audit Contractor (RAC) program was implemented in Florida during 2005. Both increase surveillance of medical necessity and deny payments for improper admissions. The purpose of the present study was to determine their potential impact on for-profit (FP) and not-for-profit (NFP) hospital operating margins in Florida. FP hospitals were expected to be more adversely affected as admissions growth has been one strategy to improve stock performance, which is not a consideration at NFPs. This study analyzed Florida community hospitals from 2000 through 2010, assessing changes in pre-tax operating margin (PTOM). Florida Agency for Health Care Administration data were analyzed for 104 community hospitals (62 FPs and 42 NFPs). Academic, public, and small hospitals were excluded. A mixed-effects model was used to assess the association of RAC implementation, organizational and payer type variables, and ownership interaction effects on PTOM. FP hospitals began the period with a higher average PTOM, but converged with NFPs during the study period. The average Medicare Advantage effect was not significant for either ownership type. The magnitude of the RAC variable was significantly negative for average PTOM at FPs (−4.68) and positive at NFPs (0.08), meaning RAC was associated with decreasing PTOM at FP hospitals only. RAC complements other Medicare surveillance systems that detect medically unnecessary admissions, coding errors, fraud, and abuse. Since its implementation in Florida, average FP and NFP operating margins have been similar, such that the higher margins reported for FP hospitals in the 1990s are no longer evident. PMID:26294267

Fault Tolerant Frequent Pattern Mining

DOE Office of Scientific and Technical Information (OSTI.GOV)

Shohdy, Sameh; Vishnu, Abhinav; Agrawal, Gagan

FP-Growth algorithm is a Frequent Pattern Mining (FPM) algorithm that has been extensively used to study correlations and patterns in large scale datasets. While several researchers have designed distributed memory FP-Growth algorithms, it is pivotal to consider fault tolerant FP-Growth, which can address the increasing fault rates in large scale systems. In this work, we propose a novel parallel, algorithm-level fault-tolerant FP-Growth algorithm. We leverage algorithmic properties and MPI advanced features to guarantee an O(1) space complexity, achieved by using the dataset memory space itself for checkpointing. We also propose a recovery algorithm that can use in-memory and disk-based checkpointing,more » though in many cases the recovery can be completed without any disk access, and incurring no memory overhead for checkpointing. We evaluate our FT algorithm on a large scale InfiniBand cluster with several large datasets using up to 2K cores. Our evaluation demonstrates excellent efficiency for checkpointing and recovery in comparison to the disk-based approach. We have also observed 20x average speed-up in comparison to Spark, establishing that a well designed algorithm can easily outperform a solution based on a general fault-tolerant programming model.« less

7 CFR 654.1 - Purpose and scope.

Code of Federal Regulations, 2014 CFR

2014-01-01

...) Federal financially-assisted projects. (i) Watershed Protection and Flood Prevention (WP&FP). See part 622...) Emergency Watershed Protection (EWP). See part 624 of this title. (4) Great Plains Conservation Program (GP...

7 CFR 654.1 - Purpose and scope.

Code of Federal Regulations, 2010 CFR

2010-01-01

...) Federal financially-assisted projects. (i) Watershed Protection and Flood Prevention (WP&FP). See part 622...) Emergency Watershed Protection (EWP). See part 624 of this title. (4) Great Plains Conservation Program (GP...

7 CFR 654.1 - Purpose and scope.

Code of Federal Regulations, 2012 CFR

2012-01-01

...) Federal financially-assisted projects. (i) Watershed Protection and Flood Prevention (WP&FP). See part 622...) Emergency Watershed Protection (EWP). See part 624 of this title. (4) Great Plains Conservation Program (GP...

7 CFR 654.1 - Purpose and scope.

Code of Federal Regulations, 2013 CFR

2013-01-01

...) Federal financially-assisted projects. (i) Watershed Protection and Flood Prevention (WP&FP). See part 622...) Emergency Watershed Protection (EWP). See part 624 of this title. (4) Great Plains Conservation Program (GP...

7 CFR 654.1 - Purpose and scope.

Code of Federal Regulations, 2011 CFR

2011-01-01

...) Federal financially-assisted projects. (i) Watershed Protection and Flood Prevention (WP&FP). See part 622...) Emergency Watershed Protection (EWP). See part 624 of this title. (4) Great Plains Conservation Program (GP...

Public Law 100-202, Joint Resolution making further continuing appropriations for the fiscal year 1988, and for other purposes, 22 December 1987.

PubMed

1988-01-01

This US Act provides the following with respect to universal access to child immunization: "The Congress calls upon the President to direct the Agency for International Development, working through the Centers for Disease Control and other appropriate Federal agencies, to work in a global effort to provide enhanced support towards achieving the goal of universal access to childhood immunization by 1990 by 1) assisting in the delivery, distribution, and use of vaccines, including a) the building of locally sustainable systems and technical capacities in developing countries to reach, by the appropriate age, not less than 80% of their annually projected target population with the full schedule of required immunizations and b) the development of a sufficient network of indigenous professionals and institutions with responsibility for developing, monitoring, and assessing immunization program and continually adapting strategies to reach the goal of preventing immunizable diseases and 2) performing, supporting, and encouraging research and development activities, in both the public and the private sector, that will be targeted at developing new vaccines and at modifying and improving existing vaccines to make them more appropriate for use in developing countries. In support of this global effort, the President should appeal to the people of the US and the US private sector to support public and private efforts to provide the resources necessary to achieve universal access to childhood immunization by 1990." The Act also does the following with respect to various forms of bilateral assistance: 1) prohibits the use of funds for an organization or program that supports coercive abortion or involuntary sterilization; 2) prohibits the use of funds for the performance of abortion as a method of family planning (FP); 3) provides that in awarding grants for natural FP under section 104 of the Foreign Assistance Act no applicant shall be discriminated against because of such applicant's religious or conscientious commitment to offer only natural FP. In addition, the Act stipulates that with respect to appropriations for the Department of Health and Human Services no funds will be used to perform abortions except where the life of the mother would be endangered if the fetus were carried to term. full text

Moving towards the goals of FP2020 - classifying contraceptives.

PubMed

Festin, Mario Philip R; Kiarie, James; Solo, Julie; Spieler, Jeffrey; Malarcher, Shawn; Van Look, Paul F A; Temmerman, Marleen

2016-10-01

With the renewed focus on family planning, a clear and transparent understanding is needed for the consistent classification of contraceptives, especially in the commonly used modern/traditional system. The World Health Organization Department of Reproductive Health and Research and the United States Agency for International Development (USAID) therefore convened a technical consultation in January 2015 to address issues related to classifying contraceptives. The consultation defined modern contraceptive methods as having a sound basis in reproductive biology, a precise protocol for correct use and evidence of efficacy under various conditions based on appropriately designed studies. Methods in country programs like Fertility Awareness Based Methods [such as Standard Days Method (SDM) and TwoDay Method], Lactational Amenorrhea Method (LAM) and emergency contraception should be reported as modern. Herbs, charms and vaginal douching are not counted as contraceptive methods as they have no scientific basis in preventing pregnancy nor are in country programs. More research is needed on defining and measuring use of emergency contraceptive methods, to reflect their contribution to reducing unmet need. The ideal contraceptive classification system should be simple, easy to use, clear and consistent, with greater parsimony. Measurement challenges remain but should not be the driving force to determine what methods are counted or reported as modern or not. Family planning programs should consider multiple attributes of contraceptive methods (e.g., level of effectiveness, need for program support, duration of labeled use, hormonal or nonhormonal) to ensure they provide a variety of methods to meet the needs of women and men. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

ASTRONET: Towards a Strategic Plan for European Astronomy

NASA Astrophysics Data System (ADS)

Gallego, J.; Torra, J.; Barcons, X.; Mas-Hesse, M.

ASTRONET is an ERA-Net financed by the European Commission FP6 under the initiative Integrating and Strengthening the European Research Area (ERA). ASTRONET was created by a group of European funding agencies in order to establish a comprehensive long-term planning for the development of European astronomy. The objective of this effort is to consolidate and reinforce the world-leading position that European astronomy has attained at the beginning of this twenty-first century. The Ministerio de Ciencia e Innovación is the Spanish representative.

The Development of a Tactical Dual-Wavelength Nephelometer.

DTIC Science & Technology

1982-11-24

Instrument Layout 50 4.5 Optical Systems 53 4.6 Electronic Systems 56 4.6.1 Transmitter System 56 4.6.2 Receiver Systems 58 5. R&D TEST AND ACCEPTANCE PLAN 61... PLAN , 136 HSS-B-086, 10 DEC1981. APPENDIX B ARVIN CALSPAN DOCUMENTATION OF 155 EXTINCTION AND PARTICLE SIZE MEASUREMENTS FOR CHAMBER TESTS OF MAY 1982. 6...121 FP’enn Aerosol Models. 8.9 Aerosol Extinction Coefficients at Two Wavelenghts 129 and their Ratio for Four Deirmendjian Aerosol Models. 10

Challenges Addressing Unmet Need for Contraception: Voices of Family Planning Service Providers in Rural Tanzania.

PubMed

Baraka, Jitihada; Rusibamayila, Asinath; Kalolella, Admirabilis; Baynes, Colin

2015-12-01

Provider perspectives have been overlooked in efforts to address the challenges of unmet need for family planning (FP). This qualitative study was undertaken in Tanzania, using 22 key informant interviews and 4 focus group discussions. The research documents perceptions of healthcare managers and providers in a rural district on the barriers to meeting latent demand for contraception. Social-ecological theory is used to interpret the findings, illustrating how service capability is determined by the social, structural and organizational environment. Providers' efforts to address unmet need for FP services are constrained by unstable reproductive preferences, low educational attainment, and misconceptions about contraceptive side effects. Societal and organizational factors--such as gender dynamics, economic conditions, religious and cultural norms, and supply chain bottlenecks, respectively--also contribute to an adverse environment for meeting needs for care. Challenges that healthcare providers face interact and produce an effect which hinders efforts to address unmet need. Interventions to address this are not sufficient unless the supply of services is combined with systems strengthening and social engagement strategies in a way that reflects the multi-layered, social institutional problems.

Application of IRTAM to Support ISS Program Safety

NASA Technical Reports Server (NTRS)

Hartman, William A.; Schmidl, William D.; Mikatarian, Ronald; Koontz, Steven; Galkin, Ivan

2017-01-01

The International Space Station (ISS) orbits near the F-peak of the ionosphere (approximately 400 km altitude). Generally, satellites orbiting at this altitude would have a floating potential (FP) of approximately -1 V due to the electron temperature (Te). However, the ISS has 8 large negatively grounded 160 V solar array wings (SAW) that collect a significant electron current from the ionosphere. This current drives the ISS FP much more negative during insolation and is highly dependent on the electron density (Ne). Also, due to the size of the ISS, magnetic inductance caused by the geomagnetic field produces a delta potential up to 40 V across the truss, possibly producing positive potentials. During Extravehicular Activity (EVA) the negative FP can lead to an arcing hazard when it exceeds -45.5 V, and the positive FP can produce a DC current high enough to stimulate the astronaut's muscles and also cause a hazard. Data collected from the Floating Potential Monitoring Unit (FPMU) have shown that the probability of either of these hazards occurring during times with quiet to moderately disturbed geomagnetic activity is low enough to no longer be considered a risk. However, a study of the ionosphere Ne during severe geomagnetic storm activity has shown that the Ne can be enhanced by a factor of 6 in the ISS orbit. As a result, the ISS Safety Review Panel (SRP) requires that ionospheric conditions be monitored using the FPMU in conjunction with the ISS Plasma Interaction Model (PIM) to determine if a severe geomagnetic storm could result in a plasma environment that could produce a hazard. A 'Real-Time' plasma hazard assessment process was developed to support ISS Program real-time decision making providing constraint relief information for EVAs planning and operations. This process incorporates 'real time' ionospheric conditions, ISS solar arrays' orientation, ISS flight attitude, and where the EVA will be performed on the ISS. This assessment requires real time data that is presently provided by the FPMU including ISS floating potential, along with ionospheric Ne and Te, in order to determine the present environment. Once the present environment conditions are known to be either above, below, or near the current IRI values, the IRI is used to forecast what the environment could become in the event of a severe geomagnetic storm. If the FPMU should fail, the Space Environments team needs another source of data which is utilized to support a short-term forecast for EVAs. The IRI Real-Time Assimilative Mapping (IRTAM) model is an ionospheric model that uses real time measurements from approximately 70 digisondes to produce foF2 and hmF2 global maps in 15 minute cadence. The Boeing Space Environments team has used the IRI coefficients produced in IRTAM to calculate the Ne along the ISS orbital track. The results of the IRTAM model have been compared to FPMU measurements and show excellent agreement (figure 1). IRTAM has been identified as a potential FPMU back-up system will be used as a backup for the FPMU to support the ISS Program following completion of an FPMU/IRTAM validation campaign.

Comparing preseason frontal and sagittal plane plyometric programs on vertical jump height in high-school basketball players.

PubMed

King, Jeffrey A; Cipriani, Daniel J

2010-08-01

The primary purpose of this study was to evaluate whether frontal plane (FP) plyometrics, which are defined as plyometrics dominated with a lateral component, would produce similar increases in vertical jump height (VJH) compared to sagittal plane (SP) Plyometrics. Thirty-two junior varsity and varsity high-school basketball players participated in 6 weeks of plyometric training. Players participated in either FP or SP plyometrics for the entire study. Vertical jump height was measured on 3 occasions: preintervention (baseline), at week 3 of preparatory training, and at week 6 of training. Descriptive statistics were calculated for VJH. A 2-way analysis of variance (ANOVA) with repeated measures was used to test the difference in mean vertical jump scores using FP and SP training modalities. Results showed a significant effect over time for vertical jump (p < 0.001). Moreover, a significant time by protocol interaction was noted (p < 0.032). A 1-way ANOVA demonstrated that only the SP group demonstrated improvements over time, in VJH, p < 0.05. The FP group did not improve statistically. The data from this study suggest that FP plyometric training did not have a significant effect on VJH and significant improvement in VJH was seen in subjects participating in SP plyometrics thus reinforcing the specificity principle of training. However, coaches should implement both types of plyometrics because both training modalities can improve power and quickness among basketball players.

Effect of interconnection between cervical vagus trunk, epicardial fat pad on sinus node function, and atrial fibrillation.

PubMed

Zhou, Qina; Zhang, Ling; Wang, Kun; Xu, Xiaoxia; Ji, Meng; Zhang, Feng; Wang, Hongli; Hou, Yuemei

2014-03-01

The epicardial fat pad (FP) integrates the autonomic innervation between the extrinsic and intrinsic cardiac autonomic nervous system and affects atrial electrophysiology and pathophysiology. Eighteen dogs were divided into two groups: sequential ablation of sinoatrial node FP (SAN-FP) and atrioventricular node FP (AVN-FP). Sinus rate (SR), atrial fibrillation (AF) inducibility, and effective refractory period (ERP) changes during electrical stimulation of the vagus trunk were detected before and after ablation. In the SAN-FP group, the SR slowing, increasing AF inducibility, and ERP shortening that induced by vagus trunk stimulation were significantly attenuated by isolated SAN-FP ablation, compared with the same group prior to ablation (all P < 0.05). Subsequent AVN-FP ablation following SAN-FP ablation almost cannot produce further attenuation during vagus trunk stimulation, compared with isolated SAN-FP ablation (P > 0.05). In the AVN-FP group, SR slowing, increasing AF inducibility, and ERP shortening that induced by vagus trunk stimulation were completely eliminated by isolated AVN-FP ablation, compared with the same group prior to ablation (all P < 0.05). Subsequent SAN-FP ablation following AVN-FP ablation produced no further attenuation, compared with isolated AVN-FP ablation (P > 0.05). A neural pathway from the cervical vagus trunk to the sinus node and atrium runs through the SAN-FP, but eventually converges at the AVN-FP and also suggested that the AVN-FP serves as an "integration center" for the SAN-FP to modulate sinus node function. The AVN-FP may play a more critical role in the initiation and maintenance of AF. ©2013 First Affilated Hospital of Xingiang Medical University Pacing and Clinical Electrophysiology ©2013 Wiley Periodicals, Inc.

Synthesis of the expert group meetings convened as part of the substantive preparations for the International Conference on Population and Development.

PubMed

1993-01-01

As part of the preparation for the 1994 International Conference on Population and Development to be sponsored by the UN in Cairo, 6 expert groups were convened to consider 1) population growth; 2) population policies and programs; 3) population, development, and the environment; 4) migration; 5) the status of women; and 6) family planning programs, health, and family well-being. Each group included 15 experts representing a full range of relevant scientific disciplines and geographic regions. Each meeting lasted 5 days and included a substantive background paper prepared by the Population Division as well as technical papers. Each meeting concluded with the drafting of between 18 and 37 recommendations (a total of 162). The meeting on population, the environment, and development focused on the implications of current trends in population and the environment for sustained economic growth and sustainable development. The meeting on population policies and programs observed that, since 1984, there has been a growing convergence of views about population growth among the nations of the world and that the stabilization of world population as soon as possible is now an internationally recognized goal. The group on population and women identified practical steps that agencies could take to empower women in order to achieve beneficial effects on health, population trends, and development. The meeting on FP, health, and family well-being reviewed policy-oriented issues emerging from the experience of FP programs. The meeting on population growth and development reviewed trends and prospects of population growth and age structure and their consequences for global sustainability. The population distribution and migration experts appraised current trends and their interrelationship with development. In nearly all of the group meetings, common issues emerged. Concern was universally voiced for sustainable development and sustained economic growth, relevance of past experience, human rights, the status of women, the family, accessibility and quality of services, the special needs of subpopulations, AIDS, the roles of governments and nongovernmental organizations, community participation, research and data collection, and international cooperation.

Physical security equipment for combating terrorism

NASA Astrophysics Data System (ADS)

Toscano, Michael

2002-08-01

The objective of the Department of Defense Physical Security Equipment (DoD PSE) RDT&E program is to provide end users within the four Services with the most efficient and productive physical security (PS) at the most reasonable cost to ensure the effective protection of DoD resources. These resources include personnel, nuclear weapons, classified information, materiel, and readiness assets. As a result of the1996 Khobar Towers terrorist bombing incident, the DoD PSE program began to receive additional funding in 1997 for Force Protection Commercial-Off-The-Shelf (FP COTS) equipment evaluation and testing. The FP COTS testing applies to all available technologies, which are considered effective for DoD use. Successive terrorist incidents occurring since Khobar Towers have resulted in increasing focus on the demonstration and validation of equipment necessary to combat the ubiquitously asymmetric terrorist threat.

Mobile dental units: leasing or buying? A dollar-cost analysis.

PubMed

Arevalo, Oscar; Saman, Daniel M; Bonaime, Alice; Skelton, Judy

2010-01-01

The decision to acquire a mobile dental unit is based on a standard capital budgeting analysis. The next step is to determine whether to obtain the use of the mobile dental unit by borrowing and purchasing or by leasing. As a financing mechanism, leases are simply another way of borrowing money to pay for the asset. To compare lease vs. debt as financial vehicles to acquiring a mobile dental unit. An estimate for a new mobile unit was obtained. Lease and loan proposals from financial lenders were collected. A cost of capital rate was chosen for comparison. Cash flows associated with borrowing and leasing vs. buying were determined fortwo different scenarios: for profit (FP) vs. not-for-profit (NFP), at 5 years. A dollar-cost analysis was utilized to determine the option with the lowest capitalized value. There was a net advantage to buying vs. leasing for both for FP and NFP organizations. Due to tax advantages, owning and leasing were substantially less expensive for FP than for NFP. Slight decreases in the monthly lease payments would make leasing competitive to the buying approach. Exploring alternative financing vehicles may allow dental programs to expand their services through the acquisition of a mobile unit. Though programs generally own assets, it is the use of the asset which is important rather than the ownership. Dental programs can find leasing an attractive alternative by offering access to capital with cash-flow advantages.

Husband-wife communication and status of women as a determinant of contraceptive use in rural Bangladesh.

PubMed

Kabir, M; Moslehuddin, M; Howlader, A A

1988-03-01

The study provides the socioeconomic status of women and factors which affect their choice of contraception using data collected from 423 working women in the Savan Upazila, Bangladesh. 72% of the sample included women under 30 years old, and 53% of the sample and attended primary school and were equal to their husbands educationally. 46.1% were employed in the garment industry, 13.8% in construction, 14/45% in services, and 17% in farm or hand craft activities. 80% lived in rural areas and did not own land. 600% were from a nuclear family. The average husband's income was Taka 1501. 18% had an affiliation with some organization. 42% were using contraceptives, and 58% discussed use of family planning (FP). 66% shared decision making with their husbands about their children's education and marriage. Logistic analysis is used to determine the probability of contraceptive use on the following independent variables: age, wife's education, membership in a society, contract with FP workers, participation in income-generating activities, visit of FP workers, visit of health workers, family type, husband's education and monthly income, and ownership of electricity. The results indicate that women working outside the house have improved their status in the family and the community, and this more equal status and the presence of good husband and wife communication are intervening variables through which economic and demographic factors effect fertility. Contract with FP workers was very closely related to use of contraceptives.

The Mexico City Policy: a "gag rule" that violates free speech and democratic values.

PubMed

Cohen, S A

1998-04-01

With the support of the Republican leadership of the US House of Representatives, Representative Chris Smith of New Jersey continues to attempt to limit provision of US family planning (FP) funding to foreign nongovernmental organizations (NGOs) who agree to enforce absolute prohibitions on engaging in abortion-related activities. Despite the fact that the House is withholding funds to meet US obligations to the UN and to support the International Monetary Fund, US President Clinton refuses to give in to pressure to enforce what amounts to a "gag rule." The Secretary of State explains that Clinton has no intention of punishing organizations engaging in free-speech protected democratic activities in foreign countries. Smith has offered a self-styled "compromise" that would allow Clinton to waive disqualification for a foreign NGO offering abortion services with its own funds in compliance with the laws of its country. This waiver would penalize the international FP program by $44 million and would not apply to the broad prohibitions against abortion lobbying (including lobbying for changes in laws, sponsoring conferences and workshops on "alleged" defects in abortion laws, and drafting and distributing materials or public statements on "alleged defects"). Smith's emphasis on the "lobbying" ban has widened the issue from a debate on abortion to a debate on democracy and free speech. Opposition to Smith's proposal is, thus, rising in many quarters. Smith also endorses withholding US contributions to the UN Population Fund because the fund has resumed work in China.

Population Activities Fund Agency (PAFA): the journey so far.

PubMed

1993-01-01

Mechanisms are needed funding Nigerian Federal efforts to implement the National Policy on Population for Development, which was approved by the Armed Forces Ruling Council in February, 1988. Subprojects of the Population Activities Fund Agency (PAFA) which were approves are: the integration of family planning (FP) into maternal and child health (MCH) the promotion of Fp through health education, tertiary centers for reproductive health, public enlightenment on population, population/family life education in primary schools, monitoring of National Population Project impact, and integration of population into planning and budgeting. The last obstacle to implementation of PAFA's activities is the signing into law the decree establishing PAFA as a parastatal. The passage is required for continued operations. The national Population for Development policy is unique in providing for quantitative targets, which has attracted the needed financial support of agencies such as the World Bank. As part of the National Population Policy, the National Population Program (NPP) is developing an effective strategy for securing funding and evaluation of subprojects that are designed and implemented b Collaborating Agencies (CAs), both private and public. NPP aims 1) to provide funds for qualified CAs through the Population Activities Fund (PAF) and Agency (PAFA); 2) to monitor PAFA, which manages PAf with the Department of Population Activities, and 3) to stimulate analysis of sociocultural constraints to fertility reduction and international comparisons, and to design innovative interventions through the Population Research Fund (PRF). PAFA funds implementing agencies at all government and nongovernment levels with approaches to population information and services. The goal of PAFA is to realize NPP objectives. The motto is "Towards an improved quality of life for every Nigerian." The mandate is to provide funding for the PAF and NPP, to monitor CAs, to provide assistance to CAs preparing Phase II subprojects, and to supervise and guide CAs on funding, procurement, and implementation.

People are satisfied with it.

PubMed

Hata, K

1992-08-01

The success of the integrated Family Planning (FP) and Parasite Control Project (IP) of Indonesia is discussed in terms of the government's view, the major characteristics of IP, the major problem, future funding sources, the purposes of community participation, obstacles encountered, and impact. Ministry policymakers consider IP effective and desirable, and suggest IP in remote areas with poor infrastructure such as Lombok in West Nusa Tenggara Province. Health is improved for parents and children initially. The project is self-reliant with small, affordable fees. Support has come from the Indonesian Planned Parenthood Association and Kusuma Buana Foundation; although external financial assistance has ceased, expansion is possible with the income generated. The Jakarta Municipal government may pick up the cost of implementing it through the public health center Pukesmas, either with existing project staff or local staff in collaboration with IP staff. The government is not ready to implement it because control of intestinal parasites is of low priority. Major problems are the uneven performance particularly in IP bases in Jakarta, which is attributed to lack of concern by managers for community health conditions. Community participation is important because people are eager to learn how to prevent the parasitic invasions after being successfully treated. When success in cleaning houses and toilets and lower incidence of infection is accomplished, then people trust and use the health services more. Obstacles have been the cost of building hygienic latrines and access to safe and potable water, particularly in slum areas of Jakarta, and changing institutional representation on the IP project National Coordinating Forum, the IP policy making group, and officials from government FP and Health and Education Departments. Government officials need to understand the intricacies of how IP operates. Evaluation is difficult with measures such as the fertility rate or infant mortality rate. Project staff are satisfied with the increase in health consciousness of clients, and the use of paid services. A study by the Forum found that FP participation among the target community increased compared with baseline data, but FP information is available from multiple sources in Jakarta and it would be presumptuous to believe that community participation was solely due to IP.

[Application of a mathematical algorithm for the detection of electroneuromyographic results in the pathogenesis study of facial dyskinesia].

PubMed

Gribova, N P; Iudel'son, Ia B; Golubev, V L; Abramenkova, I V

2003-01-01

To carry out a differential diagnosis of two facial dyskinesia (FD) models--facial hemispasm (FH) and facial paraspasm (FP), a combined program of electroneuromyographic (ENMG) examination has been created, using statistical analyses, including that for objects identification based on hybrid neural network with the application of adaptive fuzzy logic method and standard statistics programs (Wilcoxon, Student statistics). In FH, a lesion of peripheral facial neuromotor apparatus with augmentation of functions of inter-neurons in segmental and upper segmental stem levels predominated. In FP, primary afferent strengthening in mimic muscles was accompanied by increased motor neurons activity and reciprocal augmentation of inter-neurons, inhibiting motor portion of V pair. Mathematical algorithm for ENMG results recognition worked out in the study provides a precise differentiation of two FD models and opens possibilities for differential diagnosis of other facial motor disorders.

Initiating or changing to a fixed-dose combination of Fluticasone propionate/Formoterol over Fluticasone propionate/Salmeterol: A real-life effectiveness and cost impact evaluation.

PubMed

Wan Yau Ming, Simon; Haughney, John; Small, Iain; Wolfe, Stephanie; Hamill, John; Gruffydd-Jones, Kevin; Daly, Cathal; Soriano, Joan B; Gardener, Elizabeth; Skinner, Derek; Stagno d'Alcontres, Martina; Price, David B

2017-08-01

Asthma has a substantial impact on quality of life and health care resources. The identification of a more cost-effective, yet equally efficacious, treatment could positively influence the economic burden of this disease. Fluticasone propionate/Formoterol (FP/FOR) may be as effective as Fluticasone Salmeterol (FP/SAL). We evaluated non-inferiority of asthma control in terms of the proportion of patients free from exacerbations, and conducted a cost impact analysis. This historical, matched cohort database study evaluated two treatment groups in the Optimum Patient Care Research Database in the UK: 1) an FP/FOR cohort of patients initiating treatment with FP/FOR or changing from FP/SAL to FP/FOR and; 2) an FP/SAL cohort comprising patients initiating, or remaining on FP/SAL pMDI combination therapy. The main outcome evaluated non-inferiority of effectiveness (defined as prevention of severe exacerbations, lower limit of the 95% confidence interval (CI) of the mean difference between groups in patient proportions with no exacerbations is -3.5% or higher) in patients treated with FP/FOR versus FP/SAL. After matching 1:3, we studied a total of 2472 patients: 618 in the FP/FOR cohort (174 patients initiated on FP/FOR and 444 patients changed to FP/FOR) and 1854 in the FP/SAL cohort (522 patients initiated FP/SAL and 1332 continued FP/SAL). The percentage of patients prescribed FP/FOR met non-inferiority as the adjusted mean difference in proportion of no severe exacerbations (95%CI) was 0.008 (-0.032, 0.047) between the two cohorts. No other significant differences were observed except acute respiratory event rates, which were lower for patients prescribed FP/FOR (rate ratio [RR] 0.82, 95% CI 0.71, 0.94). Changing to, or initiating FP/FOR combination therapy, is associated with a non-inferior proportion of patients who are severe exacerbation-free at a lower average annual cost compared with continuing or initiating treatment with FP/SAL. Copyright © 2017 Elsevier Ltd. All rights reserved.

Glycopyrronium once-daily significantly improves lung function and health status when combined with salmeterol/fluticasone in patients with COPD: the GLISTEN study—a randomised controlled trial

PubMed Central

Frith, Peter A; Thompson, Philip J; Ratnavadivel, Rajeev; Chang, Catherina L; Bremner, Peter; Day, Peter; Frenzel, Christina; Kurstjens, Nicol

2015-01-01

Background The optimal use of various therapeutic combinations for moderate/severe chronic obstructive pulmonary disease (COPD) is unclear. The GLISTEN trial compared the efficacy of two long-acting anti-muscarinic antagonists (LAMA), when combined with an inhaled corticosteroid (ICS) and a long-acting β2 agonist (LABA). Methods This randomised, blinded, placebo-controlled trial in moderate/severe COPD patients compared once-daily glycopyrronium (GLY) 50 µg, once-daily tiotropium (TIO) 18 µg or placebo (PLA), when combined with salmeterol/fluticasone propionate (SAL/FP) 50/500 µg twice daily. The primary objective was to determine the non-inferiority of GLY+SAL/FP versus TIO+SAL/FP on trough FEV1 after 12 weeks. An important secondary objective was whether addition of GLY to SAL/FP was better than SAL/FP alone. Results 773 patients (mean FEV1 57.2% predicted) were randomised; 84.9% completed the trial. At week 12, GLY+SAL/FP demonstrated non-inferiority to TIO+SAL/FP for trough FEV1: least square mean treatment difference (LSMdiff) −7 mL (SE 17.4) with a lower limit for non-inferiority of −60 mL. There was significant increase in week 12 trough FEV1 with GLY+SAL/FP versus PLA+SAL/FP (LSMdiff 101 mL, p<0.001). At 12 weeks, GLY+SAL/FP produced significant improvement in St George's Respiratory Questionnaire total score versus PLA+SAL/FP (LSMdiff −2.154, p=0.02). GLY+SAL/FP demonstrated significant rescue medication reduction versus PLA+SAL/FP (LSMdiff −0.72 puffs/day, p<0.001). Serious adverse events were similar for GLY+SAL/FP, TIO+SAL/FP and PLA+SAL/FP with an incidence of 5.8%, 8.5% and 5.8%, respectively. Conclusions GLY+SAL/FP showed comparable improvements in lung function, health status and rescue medication to TIO+SAL/FP. Importantly, addition of GLY to SAL/FP demonstrated significant improvements in lung function, health status and rescue medication compared to SAL/FP. Trial registration number NCT01513460. PMID:25841237

Couple Characteristics and Contraceptive Use among Women and their Partners in Urban Kenya

PubMed Central

Irani, Laili; Speizer, Ilene S.; Fotso, Jean-Christophe

2014-01-01

Background Few studies have used couple data to identify individual- and relationship-level characteristics that affect contraceptive use in urban areas. Using matched couple data from urban Kenya collected in 2010, this study determines the association between relationship-level characteristics (desire for another child, communication about desired number of children and FP use) and contraceptive use and intention to use among non-users. Methods Data were collected from three Kenyan cities: Nairobi, Mombasa and Kisumu. Baseline population-based survey data from the Measurement, Learning & Evaluation Project were used to identify 883couples (weighted value=840). Multivariate regressions used the couple as the unit of analysis. Results Almost two-thirds of couples currently used contraception. Adjusting for individual- and environmental-level characteristics, couples who desired another child were less likely to use contraception than couples wanting more children. In addition, couples where both partners reported communicating with each other regarding desired number of children and FP use were more likely to use contraception compared to couples that did not communicate. Analyses testing the association of relationship-level characteristics and intention to use contraception, among non-users, resembled those of current contraceptive users. Conclusion Couple-level characteristics are associated with current contraceptive use and future intent to use. Couples that discussed their desired number of children and FP use were more likely to use contraception than couples that did not communicate with each other. FP programs should identify strategies to improve communication in FP among couples and to ensure better cooperation between partners. PMID:24733057

Hilbert-Huang Transformation Based Analyses of FP1, FP2, and Fz Electroencephalogram Signals in Alcoholism.

PubMed

Lin, Chin-Feng; Su, Jiun-Yi; Wang, Hao-Min

2015-09-01

Chronic alcoholism may damage the central nervous system, causing imbalance in the excitation-inhibition homeostasis in the cortex, which may lead to hyper-arousal of the central nervous system, and impairments in cognitive function. In this paper, we use the Hilbert-Huang transformation (HHT) method to analyze the electroencephalogram (EEG) signals from control and alcoholic observers who watched two different pictures. We examined the intrinsic mode function (IMF) based energy distribution features of FP1, FP2, and Fz EEG signals in the time and frequency domains for alcoholics. The HHT-based characteristics of the IMFs, the instantaneous frequencies, and the time-frequency-energy distributions of the IMFs of the clinical FP1, FP2, and Fz EEG signals recorded from normal and alcoholic observers who watched two different pictures were analyzed. We observed that the number of peak amplitudes of the alcoholic subjects is larger than that of the control. In addition, the Pearson correlation coefficients of the IMFs, and the energy-IMF distributions of the clinical FP1, FP2, and Fz EEG signals recorded from normal and alcoholic observers were analyzed. The analysis results show that the energy ratios of IMF4, IMF5, and IMF7 waves of the normal observers to the refereed total energy were larger than 10 %, respectively. In addition, the energy ratios of IMF3, IMF4, and IMF5 waves of the alcoholic observers to the refereed total energy were larger than 10 %. The FP1 and FP2 waves of the normal observers, the FP1 and FP2 waves of the alcoholic observers, and the FP1 and Fz waves of the alcoholic observers demonstrated extremely high correlations. On the other hand, the FP1 waves of the normal and alcoholic observers, the FP1 wave of the normal observer and the FP2 wave of the alcoholic observer, the FP1 wave of the normal observer and the Fz wave of the alcoholic observer, the FP2 waves of the normal and alcoholic FP2 observers, and the FP2 wave of the normal observer and the Fz wave of the alcoholic observer demonstrated extremely low correlations. The IMF4 of the FP1 and FP2 signals of the normal observer, and the IMF5 of the FP1 and FP2 signals of the alcoholic observer were correlated. The IMF4 of the FP1 signal of the normal observer and that of the FP2 signal of the alcoholic observer as well as the IMF5 of the FP1 signal of the normal observer and that of the FP2 signal of the alcoholic observer exhibited extremely low correlations. In this manner, our experiment leads to a better understanding of the HHT-based IMFs features of FP1, FP2, and Fz EEG signals in alcoholism. The analysis results show that the energy ratios of the wave of an alcoholic observer to its refereed total energy for IMF4, and IMF5 in the δ band for FP1, FP2, and Fz channels were larger than those of the respective waves of the normal observer. The alcoholic EEG signals constitute more than 1 % of the total energy in the δ wave, and the reaction times were 0_4, 4_8, 8_12, and 12_16 s. For normal EEG signals, more than 1 % of the total energy is distributed in the δ wave, with a reaction time 0 to 4 s. We observed that the alcoholic subject reaction times were slower than those of the normal subjects, and the alcoholic subjects could have experienced a cognitive error. This phenomenon is due to the intoxicated central nervous systems of the alcoholic subjects.

Technical efficiency of women's health prevention programs in Bucaramanga, Colombia: a four-stage analysis.

PubMed

Ruiz-Rodriguez, Myriam; Rodriguez-Villamizar, Laura A; Heredia-Pi, Ileana

2016-10-13

Primary Health Care (PHC) is an efficient strategy to improve health outcomes in populations. Nevertheless, studies of technical efficiency in health care have focused on hospitals, with very little on primary health care centers. The objective of the present study was to use the Data Envelopment Analysis to estimate the technical efficiency of three women's health promotion and disease prevention programs offered by primary care centers in Bucaramanga, Colombia. Efficiency was measured using a four-stage data envelopment analysis with a series of Tobit regressions to account for the effect of quality outcomes and context variables. Input/output information was collected from the institutions' records, chart reviews and personal interviews. Information about contextual variables was obtained from databases from the primary health program in the municipality. A jackknife analysis was used to assess the robustness of the results. The analysis was based on data from 21 public primary health care centers. The average efficiency scores, after adjusting for quality and context, were 92.4 %, 97.5 % and 86.2 % for the antenatal care (ANC), early detection of cervical cancer (EDCC) and family planning (FP) programs, respectively. On each program, 12 of the 21 (57.1 %) health centers were found to be technically efficient; having had the best-practice frontiers. Adjusting for context variables changed the scores and reference rankings of the three programs offered by the health centers. The performance of the women's health prevention programs offered by the centers was found to be heterogeneous. Adjusting for context and health care quality variables had a significant effect on the technical efficiency scores and ranking. The results can serve as a guide to strengthen management and organizational and planning processes related to local primary care services operating within a market-based model such as the one in Colombia.

Can girls also carry on the family lineage? Six contributors' views. Family planning forum.

PubMed

Gao, M; He, S; Zhang, F; Lu, C; Liao, J; Wei, L; Cheng, R

1996-06-01

This document discusses the clash between traditional concepts about fertility in China and goals which seek to reduce fertility and promote equality between the sexes. The traditional emphasis on having a son to carry on the family line and support his elders is seen as a practical necessity by many rural dwellers. During a 6-month period starting in April 1992, therefore, "China Population News" published commentaries on this subject written by people from all walks of life and all areas of China. Six of these commentaries are presented in this article. In the first, a family planning (FP) worker notes that farmers without sons currently have an economic and social disadvantage, which may be mitigated if daughters can carry on family lines and have an equal right of inheritance. Another FP worker also urges women to affirm that they can carry on the family name. A farmer, however, believes that every man should have a son to carry on their family line because daughters become members of their husband's families upon marriage. A third FP worker finds feudal ideas of male superiority still at work in small towns and feels that education and socioeconomic development will be required to encourage farmers to abandon this outmoded concept. Another farmer then relays that her family's response to having a single daughter was to have her son-in-law become a member of her family, with the first child having her surname and the second child his. The final account is from a government worker whose only brother was killed. Despair killed her mother and almost killed her father until he understood that his daughter and son-in-law would care for him in his old age. This woman's first child was given both surnames.

Impact of public programs on fertility and gender specific investment in human capital of children in rural India: cross sectional and time series analyses.

PubMed

Duraisamy, P; Malathy, R

1991-01-01

Cross sectional and time series analyses are conducted with 1971 and 1981 rural district level data for India in order to estimate variations in program impacts on household decisionmaking concerning fertility, child mortality, and schooling; to analyze how the variation in public program subsidies and services influences sex specific investments in schooling; and to examine the bias in cross sectional estimates by employing fixed effects methodology. The theory of household production uses the framework development by Rosenzweig and Wolpin. The utility function is expressed as a function of families' desired number of children, sex specific investment in human capital of children measured by schooling of males and females, and a composite consumption good. Budget constraints are characterized in terms of the biological supply of births or natural fertility, the number of births averted by fertility control, exogenous money income, the prices of number of children, contraceptives, child schooling, and consumption of goods. Demand functions are constructed from maximizing the utility function subject to the budget constraint. Data constitute 40% of the total districts and 50% of the rural population. The empirical specification of the linear model and variable description are provided. Other explanatory variables included are adult educational attainment; % of scheduled castes and tribes and % Muslim; and % rural population. Estimation methods are described and justification is provided for the use of ordinary least squares and fixed effects methods. The results of the cross sectional analysis reveal that own-program effects of family planning and primary health centers reduced family size in 1971 and 81. The increase in secondary school enrollment is evidenced in only 1971. There is a significant effect of family planning (FP) clinics on the demand for surviving children only in 1971. The presence of a seconary school in a village reduces the demand for children in both years. Primary health centers (PHC) and hospitals in a village only encourage boys and girls schooling in 1981. Doubling the number of PHCs/1000 population would reduce the total fertility rate from 4.05 to 3.85. Doubling secondary schools alone would reduce the total fertility rate to 3.75. A 12% decline in fertility or a 20% decrease in populaiton growth would be realized with this doubling. Promotion of female higher education would reduce family size and increase the schooling of females, to equalize the enrollments between the sexes. Muslim population increases fertility and reduces schooling for both sexes. The panel results suggest that the effects of hospitals are overstated cross sectionally, and the effects of FP and secondary schools are understated. Both analyses showed increases in schools to improve female educational attainment.

Reliance on condoms for contraceptive protection among HIV care and treatment clients: a mixed methods study on contraceptive choice and motivation within a generalised epidemic

PubMed Central

Church, Kathryn; Wringe, Alison; Fakudze, Phelele; Kikuvi, Joshua; Nhlabatsi, Zelda; Masuku, Rachel; Initiative, Integra; Mayhew, Susannah H

2014-01-01

Objectives To (i) describe the contraceptive practices of HIV care and treatment (HCTx) clients in Manzini, Swaziland, including their unmet needs for family planning (FP), and compare these with population-level estimates; and (ii) qualitatively explore the causal factors influencing contraceptive choice and use. Methods Mixed quantitative and qualitative methods were used. A cross-sectional survey conducted among HCTx clients (N=611) investigated FP and condom use patterns. Using descriptive statistics, findings were compared with population-level estimates derived from Swaziland Demographic and Health Survey data, weighted for clustering. In-depth interviews were conducted with HCTx providers (n=16) and clients (n=22) and analysed thematically. Results 64% of HCTx clients reported current contraceptive use; most relied on condoms alone, few practiced dual method use. Rates of condom use for FP among female HCTx clients (77%, 95% CI 71% to 82%) were higher than population-level estimates in the study region (50% HIV-positive, 95% CI 43% to 57%; 37% HIV-negative, 95% CI 31% to 43%); rates of unmet FP needs were similar when condom use consistency was accounted for (32% HCTx, 95% CI 26% to 37%; vs 35% HIV-positive, 95% CI 28% to 43%; 29% HIV-negative, 95% CI 24% to 35%). Qualitative analysis identified motivational factors influencing FP choice: fears of reinfection; a programmatic focus on condoms for people living with HIV; changing sexual behaviours before and after antiretroviral therapy (ART) initiation; failure to disclose to partners; and contraceptive side effect fears. Conclusions Fears of reinfection prevailed over consideration of pregnancy risk. Given current evidence on reinfection, HCTx services must move beyond a narrow focus on condom promotion, particularly for those in seroconcordant relationships, and consider diverse strategies to meet reproductive needs. PMID:24695990

Case descriptions of fibropapillomatosis in rehabilitating loggerhead sea turtles Caretta caretta in the southeastern USA.

PubMed

Page-Karjian, Annie; Norton, Terry M; Harms, Craig; Mader, Doug; Herbst, Larry H; Stedman, Nancy; Gottdenker, Nicole L

2015-08-20

Fibropapillomatosis (FP) is a debilitating neoplastic disease that affects all species of hard-shelled sea turtles, including loggerhead turtles Caretta caretta. FP can represent an important clinical concern in rehabilitating turtles, since managing these infectious lesions often requires special husbandry provisions including quarantine, and FP may affect clinical progression, extend rehabilitation duration, and complicate prognoses. Here we describe cases of rehabilitating loggerhead turtles with FP (designated FP+). Medical records of FP+ loggerhead cases from 3 sea turtle rehabilitation facilities in the southeastern USA were reviewed. Between 2001 and 2014, FP was observed in 8 of 818 rehabilitating loggerhead turtles (0.98% overall prevalence in admitted patients). FP+ loggerhead size classes represented were large juvenile (straight carapace length, SCL: 58.1-80 cm; n=7) and adult (SCL>87 cm; n=1). Three turtles presented with FP, and 5 developed tumors during rehabilitation within a range of 45 to 319 d. Sites of new tumor growth included the eyes, sites of trauma, neck, and glottis. FP+ turtles were scored as mildly (3/8), moderately (4/8), or heavily (1/8) afflicted. The mean total time in rehabilitation was 476±355 d (SD) (range: 52-1159 d). Six turtles were released without visible evidence of FP, 1 turtle was released with mild FP, and 1 turtle with internal FP was euthanized. Clinical decision-making for FP+ loggerhead patients can be aided by such information as time to tumor development, anatomic locations to monitor for new tumor growth, husbandry considerations, diagnostic and treatment options, and comparisons to FP in rehabilitating green turtles Chelonia mydas.

Pilot study of postoperative adjuvant chemoradiation for advanced gastric cancer: Adjuvant 5-FU/cisplatin and chemoradiation with capecitabine

PubMed Central

Lee, Hyung-Sik; Choi, Youngmin; Hur, Won-Joo; Kim, Hyo-Jin; Kwon, Hyuk-Chan; Kim, Sung-Hyun; Kim, Jae-Seok; Lee, Jong-Hoon; Jung, Ghap-Joong; Kim, Min-Chan

2006-01-01

AIM: To evaluate the efficacy and toxicity of postoperative chemoradiation using FP chemotherapy and oral capecitabine during radiation for advanced gastric cancer following curative resection. METHODS: Thirty-one patients who had underwent a potentially curative resection for Stage III and IV (M0) gastric cancer were enrolled. Therapy consists of one cycle of FP (continuous infusion of 5-FU 1000 mg/m2 on d 1 to 5 and cisplatin 60 mg/m2 on d 1) followed by 4500 cGy (180 cGy/d) with capecitabine (1650 mg/m2 daily throughout radiotherapy). Four wk after completion of the radiotherapy, patients received three additional cycles of FP every three wk. The median follow-up duration was 22.2 mo. RESULTS: The 3-year disease free and overall survival in this study were 82.7% and 83.4%, respectively. Four patients (12.9%) showed relapse during follow-up. Eight patients did not complete all planned adjuvant therapy. Grade 3/4 toxicities included neutropenia in 50.2%, anemia in 12.9%, thrombocytopenia in 3.2% and nausea/vomiting in 3.2%. Neither grade 3/4 hand foot syndrome nor treatment related febrile neutropenia or death were observed. CONCLUSION: These preliminary results suggest that this postoperative adjuvant chemoradiation regimen of FP before and after capecitabine and concurrent radiotherapy appears well tolerated and offers a comparable toxicity profile to the chemoradiation regimen utilized in INT-0116. This treatment modality allowed successful loco-regional control rate and 3-year overall survival. PMID:16489675

Barriers to Modern Contraceptive Use in Kinshasa, DRC.

PubMed

Muanda, Mbadu; Gahungu Ndongo, Parfait; Taub, Leah D; Bertrand, Jane T

2016-01-01

Recent research from Kinshasa, DRC, has shown that only one in five married women uses modern contraception; over one quarter have an unmet need for family planning; and almost 400 health facilities across Kinshasa report that they provide modern contraception. This study addresses the question: with reasonable physical access and relatively high unmet need, why is modern contraceptive prevalence so low? To this end, the research team conducted 6 focus groups of women (non-users of any method, users of traditional methods, and users of modern methods) and 4 of husbands (of users of traditional methods and in non-user unions) in health zones with relatively strong physical access to FP services. Five key barriers emerged from the focus group discussions: fear of side effects (especially sterility), costs of the method, sociocultural norms (especially the dominant position of the male in family decision-making), pressure from family members to avoid modern contraception, and lack of information/misinformation. These findings are very similar to those from 12 other studies of sociocultural barriers to family planning in sub-Saharan Africa. Moreover, they have strong programmatic implications for the training of FP workers to counsel future clients and for the content of behavior change communication interventions.

Effect of postpartum suppression of ovulation on uterine involution in dairy cows.

PubMed

Heppelmann, M; Brömmling, A; Weinert, M; Piechotta, M; Wrenzycki, C; Bollwein, H

2013-09-15

The objective of this study was to investigate the effect of time of first postpartum ovulation after calving on uterine involution in dairy cows with and without uterine puerperal disease. Transvaginal follicular puncture (FP) of follicles >6 mm suppressed ovulation and development of a CL until Day 42 after calving. Fifty-three lactating Holstein Friesian cows (3.4 ± 1.2 years old, parity 2.5 ± 1.0 [median ± mean absolute deviation]) were divided into groups on the basis of the presence (UD+) or absence (UD-) of uterine disease and whether FP was carried out (FP+) or not (FP-). Uterine disease was defined as the occurrence of retained fetal membranes and/or metritis. This resulted in the following groups: UD-FP- (n = 15), UD-FP+ (n = 13), UD+FP- (n = 13), and UD+FP+ (n = 12). A general examination, vaginoscopy, transrectal palpation, and transrectal B-mode sonography of the reproductive organs were conducted on Days 8, 11, 18, and 25 and then every 10 days until Day 65 after calving. After hormonal synchronization of ovulation (cloprostenol between Days 55 and 60 postpartum and GnRH 2 days later), cows were inseminated in the next spontaneous estrus. On average, the cows ovulated on Day 21.0 ± 6.0 (UD-FP-), 50.0 ± 4.0 (UD-FP+), 16.0 ± 3.0 (UD+FP-), and 48.0 ± 2.0 (UD+FP+) postpartum. Calving-to-conception interval and first-service conception rates were not affected by FP (P > 0.05). Healthy cows with FP had smaller (P < 0.05) uterine horn and cervical diameters assessed sonographically than cows without FP. FP reduced the prevalence of purulent vaginal discharge and uterine size assessed transrectally in UD+ cows (P < 0.05). The results showed that suppression of an early ovulation by transvaginal FP improved uterine involution in cows with and without uterine disease. Copyright © 2013 Elsevier Inc. All rights reserved.

Pharmacokinetics and pharmacodynamics of GSK961081, a novel inhaled muscarinic antagonist β2 -agonist, and fluticasone propionate administered alone, concurrently and as a combination blend formulation in healthy volunteers.

PubMed

Norris, Virginia; Ambery, Claire; Riley, Trevor

2014-07-01

To investigate the pharmacokinetics and pharmacodynamics of inhaled GSK961081 and fluticasone propionate (FP) given alone, concurrently and as a combination blend formulation. The study was double-blind, double-dummy, four-way crossover. Twenty-four healthy volunteers took single doses of the following in randomized order: (1) GSK961081 800 µg; (2) FP 500 µg; (3) GSK961081 800 µg and FP 500 µg as a blend formulation; and (4) GSK961081 800 µg and FP 500 µg concurrently via separate inhalers. The eLung breathing simulator was also used for the in vitro characterization of the formulations. There was no pharmacokinetic interaction when GSK961081 and FP were administered concurrently. Mean Cmax and AUC(0-t) of GSK961081 were lower (∼20%) and mean Cmax and AUC(0-t) of FP were higher (two fold) following GSK961081/FP blend formulation compared to concurrent or the individual components alone. There was an increase in the FP in vitro ex-throat dose for the GSK961081/FP blend from the eLung breathing simulator. Serum cortisol suppression was greater with GSK961081/FP blend, with lower (∼10%) cortisol levels than after GSK961081 + FP concurrent or FP alone. GSK961081/FP blend formulation was associated with an increase in FP systemic exposure and greater serum cortisol suppression. © 2014, The American College of Clinical Pharmacology.

The Thai Business Initiative in Rural Development (TBIRD): a new dimension in rural development.

PubMed

Viravaidya, M

1990-04-01

The Population and Community Development Association (PDA) promotes family planning (FP) throughout Thailand through a community-based approach. The Thai government actively supports rural development. In 1986, 80% of Thailand's people who lived below the poverty line were in rural areas. The poverty line in rural areas is an annual per capita income of 3823 baht, or US $153; in urban areas, it is more. Since 1984, Thailand's gross domestic product (GDP) has increased by more than 50%. Per capita GDP has risen dramatically, also, with the success of FP efforts. This economic achievement, however, has not been shared by most of the Thai population. Incomes in the agriculture sector are far below those in the nonagricultural sector. The government and the nonprofit organizations, however, do not have skills. The corporate sector does have these skills. The Thailand Business Initiative in Rural Development (TBIRD) helps companies sponsor villages and aids them in developing business skills, whereupon income levels and local living standards are improved. Companies thus help in the employment transfer from agriculture to nonagriculture. There is a "one-company-one- village" formula. Company employees have the skills needed in the villages. They are directly involved. Since 1988, PDA has been working with companies in Thailand to help villages develop business skills. In Saraburi province, PDA and Volvo Swedish Motors have been aiding villagers to grow saplings and sell them to golf course and housing developers. In Ayutthaya Province, PDA and the same company are helping the residents with needlepoint and embroidery to supply a wedding dress manufacturing operation. These programs have succeeded. PDA wants to expand the program by September 1990, to include 50 companies. It is hoped that once the companies are comfortable with their relationship to the village, they will start associations with additional villages. PDA has established the "Ten Steps to Adopt a Village."

Exploring reanalysis application for the purposes of climatological applications at regional scale

NASA Astrophysics Data System (ADS)

Kaspar, F.; Kaiser-Weiss, A.; Obregon, A.; Borsche, M.

2014-12-01

Recent advances in reanalysis methods yield new tools for climatological application. Here we use applications in Germany to discuss methodological issues at regional scale. Especially in the field of renewable energy planning and production there is a need for climatological information across all spatial scales, i.e., from climatology at a certain site to the spatial scale of national renewable energy production. Also, there is the need for the temporal resolution between the scales of a few minutes up to decadal changes. We explore the spatio-temporal scales where reanalyses can be used with benefit together with the traditional approaches which are based on station measurements only. Reanalyses can provide valuable additional information on larger scale variability, e.g. multi-annual variation over Germany. However, the change in the observing system, model errors and biases have to be carefully considered. On the other hand, the ground-based observation networks suffer from change of the station distribution, changes in instrumentation, measurements procedures and quality control as well as local changes which might modify their spatial representativity. All these effects might often been unknown or hard to characterize, although plenty of the meta-data information has been recorded for the German stations. European research activities on global and regional reanalysis are supported by the Framework Program 7 (FP7) of the European Commission as a preparation activity for the European COPERNICUS climate change service. Here we start from the user requirements for reanalyses as they were collected in the FP7 project CORE-CLIMAX. Second, we give an overview over the methods to determine whether a specific reanalysis is fit for a certain purpose (discussed in FP7 projects CORE-CLIMAX and UERRA) . Thirdly, we compare for an example application the feedback statistics from global (ERA-Interim) and regional (HErZ - COSMO) reanalyses and show which conclusion can be drawn. Finally, the wind climatologies derived from the different reanalyses (ERA-Interim, ERA-20C, HErZ-COSMO) are compared with point measurements and gridded field climatologies derived from ground-based stations, illustrating the added value of the reanalysis fields.

Community resources and reproductive behaviour in rural Bangladesh.

PubMed

Saha, T D

1994-03-01

Local community impact on contraceptive usage is illustrated in this logistic model of contraceptive behavior in 1986 in rural Bangladesh. Variables include an index of accessibility and availability of family planning (FP) at the "thana" level, age of respondent, respondent's educational level, desire to have a child, distance from the district, rural electrification, an index of agricultural wages and percentage of small farm households, and presence of a mosque. Community-level variables are found to be significant in separate equations and in equations with individual level variables. Contraceptive use is more likely to occur in a rural situation where there are commercial places such as market places and post offices. Contraceptive use is enhanced by "thana" closeness to district headquarters. Reduced contraceptive use is related to rural areas with many small farm households and a high agricultural wage rate. Access to FP provides a positive environment for improving motivation to use contraception and for improving use of modern methods. The degree of rural isolation negatively impacts on contraceptive use. Bangladesh is one of the few countries with a comprehensive development program at the sub-district level or "thana." Health centers and family welfare centers are established but are unevenly distributed spatially. Data for this study were obtained from the 1985 Bangladesh Contraceptive Prevalence Survey of 7681 rural women aged under 50 years, from the 1983 Agricultural Census on farm land, and from other statistical publications. Information was obtained on 120 "thanas." Contraceptive use status is measured as use, nonuse, modern use, traditional use, intention to use, and nonintention to use. The religious variable is negative, as expected, but not significant for contraceptive use and intention to use. The sign is positive for modern contraceptive use. Closer examination reveals that respondents with no education and with no household land are more frequent users of modern methods, including sterilization which incurs a religious moral and social stigma. Other data support the notion that religious beliefs are not an important factor in nonuse of contraceptives in Bangladesh. The FP index has a significant impact on use and intention to use but has a positive and insignificant effect on modern methods, which may indicate measurement error.

Balance assessment during squatting exercise: A comparison between laboratory grade force plate and a commercial, low-cost device.

PubMed

Mengarelli, Alessandro; Verdini, Federica; Cardarelli, Stefano; Di Nardo, Francesco; Burattini, Laura; Fioretti, Sandro

2018-04-11

Testing balance through squatting exercise is a central part of many rehabilitation programs and sports and plays also an important role in clinical evaluation of residual motor ability. The assessment of center of pressure (CoP) displacement and its parametrization is commonly used to describe and analyze squat movement and the laboratory-grade force plates (FP) are the gold standard for measuring balance performances from a dynamic view-point. However, the Nintendo Wii Balance Board (NWBB) has been recently proposed as an inexpensive and easily available device for measuring ground reaction force and CoP displacement in standing balance tasks. Thus, this study aimed to compare the NWBB-CoP data with those obtained from a laboratory FP during a dynamic motor task, such as the squat task. CoP data of forty-eight subjects were acquired simultaneously from a NWBB and a FP and the analyses were performed over the descending squatting phase. Outcomes showed a very high correlation (r) and limited root-mean-square differences between CoP trajectories in anterior-posterior (r > 0.99, 1.63 ± 1.27 mm) and medial-lateral (r > 0.98, 1.01 ± 0.75 mm) direction. Spatial parameters computed from CoP displacement and ground reaction force peak presented fixed biases between NWBB and FP. Errors showed a high consistency (standard deviation < 2.4% of the FP outcomes) and a random spread distribution around the mean difference. Mean velocity is the only parameter which exhibited a tendency towards proportional values. Findings of this study suggested the NWBB as a valid device for the assessment and parametrization of CoP displacement during squatting movement. Copyright © 2018 Elsevier Ltd. All rights reserved.

Nature versus nurture in determining athletic ability.

PubMed

Brutsaert, Tom D; Parra, Esteban J

2009-01-01

This chapter provides an overview of the truism that both nature and nurture determine human athletic ability. The major thesis developed is that environmental effects work through the process of growth and development and interact with an individual's genetic background to produce a specific adult phenotype, i.e. an athletic or nonathletic phenotype. On the nature side (genetics), a brief historical review is provided with emphasis on several areas that are likely to command future attention including the rise of genome-wide association as a mapping strategy, the problem of false positives using association approaches, as well as the relatively unknown effects of gene-gene interaction(epistasis), gene-environment interaction, and genome structure on complex trait variance. On the nurture side (environment), common environmental effects such as training-level and sports nutrition are largely ignored in favor of developmental environmental effects that are channeled through growth and development processes. Developmental effects are difficult to distinguish from genetic effects as phenotypic plasticity in response to early life environmental perturbation can produce lasting effects into adulthood. In this regard, the fetal programming (FP) hypothesis is reviewed in some detail as FP provides an excellent example of how developmental effects work and also interact with genetics. In general, FP has well-documented effects on adult body composition and the risk for adult chronic disease, but there is emerging evidence that FP affects human athletic performance as well. 2009 S. Karger AG, Basel

Cost Analysis of Fluconazole Prophylaxis for Prevention of Neonatal Invasive Candidiasis.

PubMed

Swanson, Jonathan R; Vergales, Jeff; Kaufman, David A; Sinkin, Robert A

2016-05-01

Fluconazole prophylaxis (FP) in premature infants is well studied and has been shown to decrease invasive candidiasis (ICs). IC in neonates has significant financial costs; determining the cost-benefit of FP may provide additional justification for targeting high-risk neonates. We aimed to determine the IC rate in premature infants at which FP is cost-beneficial. A decision tree cost-analysis model using cost of FP related to costs associated with IC was used. We searched PubMed for all papers that used intravenous FP and reported rates of IC in very low birth weight neonates. Average IC rates in those who received FP (2.0%; range, 0-6.1%) and in those who did not receive FP (9.2%; range, 0-20.5%) were used. Incremental hospital costs because of IC and for FP were retrieved from the literature. Sensitivity analysis was performed to determine the incremental cost of FP across the range of published IC rates. The average cost per patient attributed to IC in patients receiving FP was $785 versus $2617 in those not receiving FP. Sensitivity analysis demonstrates the rate of IC would need to be <2.8% for FP to lose its cost-benefit. In Monte Carlo simulation, targeting infants <1000 g would lead to $50,304,333 in cost savings per year in the United States. FP provides a cost-advantage across most IC rates seen in the youngest premature infants. Using a rate of 2.8% for their individual high-risk neonatal intensive care unit patients, providers can determine if FP is cost-beneficial in determining for whom to provide IC prophylaxis.

Comparison of rapid descriptive sensory methodologies: Free-Choice Profiling, Flash Profile and modified Flash Profile.

PubMed

Liu, Jing; Bredie, Wender L P; Sherman, Emma; Harbertson, James F; Heymann, Hildegarde

2018-04-01

Rapid sensory methods have been developed as alternatives to traditional sensory descriptive analysis methods. Among them, Free-Choice Profiling (FCP) and Flash Profile (FP) are two that have been known for many years. The objectives of this work were to compare the rating-based FCP and ranking-based FP method; to evaluate the impact of adding adjustments to FP approach; to investigate the influence of the number of assessors on the outcome of modified FP. To achieve these aims, a conventional descriptive analysis (DA), FCP, FP and a modified version of FP were carried out. Red wines made by different grape maturity and ethanol concentration were used for sensory testing. This study showed that DA provided a more detailed and accurate information on products through a quantitative measure of the intensity of sensory attributes than FCP and FP. However, the panel hours for conducting DA were higher than that for rapid methods, and FP was even able to separate the samples to a higher degree than DA. When comparing FCP and FP, this study showed that the ranking-based FP provided a clearer separation of samples than rating-based FCP, but the latter was an easier task for most assessors. When restricting assessors on their use of attributes in FP, the sample space became clearer and the ranking task was simplified. The FP protocol with restricted attribute sets seems to be a promising approach for efficient screening of sensory properties in wine. When increasing the number of assessors from 10 to 20 for conducting the modified FP, the outcome tended to be slightly more stable, however, one should consider the degree of panel training when deciding the optimal number of assessors for conducting FP. Copyright © 2018 Elsevier Ltd. All rights reserved.

Clear-sky irradiance simulation using GMAO products and its comparison to ground and CERES satellite observation

NASA Astrophysics Data System (ADS)

Ham, S. H.; Loeb, N. G.; Kato, S.; Rose, F. G.; Bosilovich, M. G.; Rutan, D. A.; Huang, X.; Collow, A.

2017-12-01

Global Modeling Assimilation Office (GMAO) GEOS assimilated datasets are used to describe temperature and humidity profiles in the Clouds and the Earth's Radiant Energy System (CERES) data processing. Given that advance versions of the assimilated data sets known as of Forward Processing (FP), FP Parallel (FPP), and Modern-Era Retrospective Analysis for Research and Applications version 2 (MERRA-2) datasets are available, we examine clear-sky irradiance calculation to see if accuracy is improved with these newer versions of GMAO datasets when their temperature and humidity profiles are used in computing irradiances. Two older versions, GEOS-5.2.0 and GEOS-5.4.1 are used for producing, respectively, Ed3 and Ed4 CERES data products. For the evaluation, CERES-derived TOA irradiances and observed ground-based surface irradiances are compared with the computed irradiances for clear skies identified by Moderate Resolution Imaging Spectroradiometer (MODIS). Surface type dependent spectral emissivity is taken from an observationally-based monthly gridded emissivity dataset. TOA longwave (LW) irradiances computed with GOES-5.2.0 temperature and humidity profiles are biased low, up to -5 Wm-2, compared to CERES-derived TOA longwave irradiance over tropical oceans. In contrast, computed longwave irradiances agree well with CERES observations with the biases less than 2 W m-2 when GOES-5.4.1, FP v5.13, or MERRA-2 temperature and humidity are used. The negative biases of the TOA LW irradiance computed with GOES-5.2.0 appear to be related to a wet bias at 500-850 hPa layer. This indicates that if the input of CERES algorithm switches from GOES-5.2.0 to FP v5.13 or MERRA-2, the bias in clear-sky longwave TOA fluxes over tropical oceans is expected to be smaller. At surface, downward LW irradiances computed with FP v5.13 and MERRA-2 are biased low, up to -10 Wm-2, compared to ground observations over tropical oceans. The magnitude of the bias in the longwave surface irradiances cannot be explained by uncertainties related to aerosol, which is estimated to be less than 2.5 W m-2. Therefore, the negative biases are likely caused by cold or dry biases in FP v5.13 and MERRA-2 datasets. We plan to continue the investigation with more ground sites.

Assessment of the intrinsic vulnerability of agricultural land to water and nitrogen losses: case studies in Italy and Greece

NASA Astrophysics Data System (ADS)

Aschonitis, V. G.; Mastrocicco, M.; Colombani, N.; Salemi, E.; Castaldelli, G.

2014-09-01

LOS indices (abbr. of Losses) can be used for the assessment of the intrinsic vulnerability of agricultural land to water and nitrogen losses through percolation and runoff. The indices were applied on the lowland region of Ferrara Province (FP) in Italy and the upland region of Sarigkiol Basin (SB) in Greece. The most vulnerable zones in FP were the coastal areas consisting of high permeability sandy dunes and the areas close to riverbanks and palaeochannels, and in SB were the areas characterized by high slopes and high permeability soils at high altitude and areas belonging to the upper part of the alluvial plain close to the boundaries between agricultural land and mountainous regions. The application of LOS indices highlighted the specific features of both lowland and upland regions that contribute to water and nitrogen losses and showed their ability for use as tools in designing environmental management plans.

Compensatory expressive behavior for facial paralysis: adaptation to congenital or acquired disability.

PubMed

Bogart, Kathleen R; Tickle-Degnen, Linda; Ambady, Nalini

2012-02-01

Although there has been little research on the adaptive behavior of people with congenital compared to acquired disability, there is reason to predict that people with congenital conditions may be better adapted because they have lived with their conditions for their entire lives (Smart, 2008). We examined whether people with congenital facial paralysis (FP), compared to people with acquired FP, compensate more for impoverished facial expression by using alternative channels of expression (i.e., voice and body). Participants with congenital (n = 13) and acquired (n = 14) FP were videotaped while recalling emotional events. Expressive verbal behavior was measured using the Linguistic Inquiry Word Count (Pennebaker, Booth, & Francis, 2007). Nonverbal behavior and FP severity were rated by trained coders. People with congenital FP, compared to acquired FP, used more compensatory expressive verbal and nonverbal behavior in their language, voices, and bodies. The extent of FP severity had little effect on compensatory expressivity. This study provides the first behavioral evidence that people with congenital FP use more adaptations to express themselves than people with acquired FP. These behaviors could inform social functioning interventions for people with FP.

Bacteremia in free-ranging Hawaiian green turtles, Chelonia mydas, with fibropapillomatosis

USGS Publications Warehouse

Work, Thierry M.; Balazs, G.H.; Wolcott, M.; Morris, Robert

2003-01-01

Past studies of free-ranging green turtles Chelonia mydas with fibropapillomatosis (FP) in Hawaii have shown that animals become immunosuppressed with increasing severity of this disease. Additionally, preliminary clinical examination of moribund turtles with FP revealed that some animals were also bacteraemic. We tested the hypothesis that bacteraemia in sea turtles is associated with the severity of FP. We captured free-ranging green turtles from areas in Hawaii where FP is absent, and areas where FP has been endemic since the late 1950s. Each turtle was given an FP severity score ranging from 0 (no tumours) to 3 (severely affected). A fifth category included turtles that were stranded ashore and moribund with FP. We found that the percentage of turtles with bacteraemia increased with the severity of FP, and that the majority of bacteria cultured were Vibrio spp. Turtles with severe FP were more susceptible to bactaeremia, probably in part due to immunosuppression. The pattern of bacteraemia in relation to severity of disease strengthens the hypothesis that immunosuppression is a sequel to FP.

TARDEC Update for TTCP

DTIC Science & Technology

2009-04-01

09 COL Kevin Peterson Principal Deputy Program Manager Joint MRAP Vehicle Program 17 MRAP Variant Overview FP COUGAR CAT I (FPII CAT I) MaxxPro BAE...distribution unlimited 13. SUPPLEMENTARY NOTES Presented at the TTCP LND TP3 Annual Meeting and Task Workshop Manned and Unmanned Ground Vehicle Systems, 23...28 April 2009, Suffield, Alberta, Canada, The original document contains color images. 14. ABSTRACT 15. SUBJECT TERMS 16. SECURITY

Effects of diet forage proportion on maintenance energy requirement and the efficiency of metabolizable energy use for lactation by lactating dairy cows.

PubMed

Dong, L F; Ferris, C P; McDowell, D A; Yan, T

2015-12-01

The objective of the present study was to examine the effect of dietary forage proportion (FP) on metabolizable energy (ME) requirement for maintenance (MEm) and the efficiency of ME use for lactation (kl) in lactating dairy cows. Data used were derived from 32 calorimetric chamber experiments undertaken at our institute between 1992 and 2010, including data from 818 Holstein-Friesian cows (HF), 50 Norwegian Red cows, and 62 crossbred cows (Jersey × HF or Norwegian Red × HF). Animals were offered forage-only rations (n=66) or forage and concentrate rations (n=864) with FP ranging from 18 to 100% (dry matter basis). The effect of FP was evaluated by dividing the whole data set into 4 groups according to the FP ranges, categorized as FP <30%, FP=30 to 59%, FP=60 to 99%, and FP=100%. The MEm for individual cows was calculated from heat production minus energy losses from inefficiencies of ME use for lactation, energy retention and pregnancy, and kl was obtained from milk energy output adjusted to zero energy balance (El(0)) divided by ME available for production. Increasing FP significantly reduced ME intake and milk energy output, although the differences between the 2 low FP groups were not significant. However, increasing FP significantly increased the ratio of heat production over ME intake and MEm (MJ/kg(0.75)), with the exception that the increases did not reach significance in heat production/ME intake between FP <30% and FP=30 to 59%, or in MEm between FP=60 to 99% and FP=100%. However, the FP had no significant effect on the kl values, which were similar among the 4 groups of cows. The effect of FP was also evaluated using the linear mixed regression technique relating El(0) to ME intake. The results demonstrated that with a common regression coefficient (slope), the regression constants (intercepts) taken as net energy requirement for maintenance significantly increased with increasing FP. However, the increase between the 2 high FP groups did not research significance. It is concluded that increasing diet FP had no effects on kl but significantly increased maintenance energy requirement (MJ/kg(0.75)). These results indicate that using the current energy feeding systems to ration dairy cows managed under low input systems may underestimate their nutrient requirements, because the majority of feeding systems adopted globally do not differentiate the maintenance energy requirements between low and high forage input systems. Copyright © 2015 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

A novel injection strategy of flurbiprofen axetil by inhibiting protein binding with 6-methoxy-2-naphthylacetic acid.

PubMed

Ogata, Kenji; Takamura, Norito; Tokunaga, Jin; Ikeda, Tetsuya; Setoguchi, Nao; Tanda, Kazuhiro; Yamasaki, Tetsuo; Nishio, Toyotaka; Kawai, Keiichi

2016-04-01

Flurbiprofen axetil (FPA) is an injection product and a prodrug of a non-steroidal anti-inflammatory drug (NSAID). After injection, it is rapidly hydrolyzed to the active form, flurbiprofen (FP). Since frequent injections of FPA can lead to abnormal physiology, an administration strategy is necessary to ensure there is enhancement of the analgesic efficiency of FP after a single dose and to reduce the total number of doses. FP strongly binds to site II of albumin, and thus the free (unbound) FP concentration is low. This study focused on 6-methoxy-2-naphthylacetic acid (6-MNA), the active metabolite of nabumetone (a prodrug of NSAID). We performed ultrafiltration experiments and pharmacokinetics analysis in rats to investigate whether the inhibitory effect of 6-MNA on FP binding to albumin increased the free FP concentration in vitro and in vivo. Results indicated that 6-MNA inhibited the binding of FP to albumin competitively. When 6-MNA was injected in rats, there was a significant increase in the free FP concentration and the area under concentration-time curve (AUC) calculated from the free FP concentration, while there was a significant decrease in the total (bound + free) FP concentration and the AUC calculated from the total FP concentration. These findings indicate that 6-MNA inhibits the protein binding of FP in vivo. This suggests that the frequency of FPA injections can be reduced when administered with nabumetone, as there is increase in the free FP concentration associated with pharmacological effect.

Engaging community organizations in falls prevention for older adults: Moving from research to action.

PubMed

Markle-Reid, Maureen F; Dykeman, Catherine S; Reimer, Holly D; Boratto, Lorna J; Goodall, Carol E; McGugan, Jennifer L

2015-04-29

Falls prevention (FP) evidence abounds but falls rates remain relatively unaffected. This study aimed to explore community service providers' use of evidence-based FP interventions, attitudes toward implementation, knowledge and capacity for FP engagement, collaboration in FP, and organizational readiness to implement evidence. To our knowledge, this is the first study exploring the potential for broader integration of FP throughout communities. A purposive sampling of providers (n = 84), in varied roles within diverse senior-serving community organizations (both health and non-health sectors) across disparate geographies, completed a structured survey as part of a larger mixed methods study. Nearly all (90%) reported already implementing at least one evidence-based FP practice. The majority indicated that falls were preventable (82%) and a top concern for older adults (75%), and that FP would be beneficial to their clients (75%). There were, however, notable differences between health and non-health sectors in their: confidence in providing FP activities (86% vs. 47%), desire for future collaboration (86% vs. 56%) and already knowing how best to provide FP activities (49% vs. 36%). Only some (21%) perceived that staff to a great extent had the necessary knowledge and skills, and few (10%) perceived that available resources could support FP activities. Community service providers generally supported FP, but resources limited implementation, particularly in non-health sectors. Translating FP evidence to better fit community settings, and fostering collaboration to bridge resource gaps, suggest a public health role in the broader integration of FP within and across community sectors.

Fertility preservation counselling in Dutch Oncology Practice: Are nurses ready to assist physicians?

PubMed

Krouwel, E M; Nicolai, M P J; van Steijn-van Tol, A Q M J; Putter, H; Osanto, S; Pelger, R C M; Elzevier, H W

2017-11-01

Cancer and its treatments may result in impaired fertility, which could cause long-term distress to cancer survivors. For eligible patients, fertility preservation (FP) is available to secure future reproductive potential. Many physicians, however, feel inhibited about discussing FP. Oncology nurses may serve as an initiator for discussing the subject and provide additional support. Our aim was to investigate their knowledge about FP, the way they apply this, and possible barriers to discussing FP with patients of reproductive age. A questionnaire was administered via mail, Internet and the Dutch Oncology Nursing Congress. Four hundred and twenty-one oncology nurses participated, a third of whom (31.1%) had "sufficient" knowledge of FP. Twenty-eight per cent of participants reported that they "never/hardly ever" discussed FP; 32.2% "almost always/always." FP discussions were more frequently performed by graduate nurses, academic nurses, experienced nurses and nurses with sufficient knowledge. Reasons for not discussing FP were a "lack of knowledge" (25.2%), "poor prognosis" (16.4%) and "lack of time" (10.5%). In conclusion, several obstacles may result in FP not being routinely discussed, specifically a lack of knowledge. Yet nurses feel responsible for addressing the issue, indicating that assistance with FP discussions should be encouraged. Educational training about FP is recommended. © 2016 John Wiley & Sons Ltd.

Revisiting the relationship between environmental and financial performance in Chinese industry.

PubMed

Qi, G Y; Zeng, S X; Shi, Jonathan J; Meng, X H; Lin, H; Yang, Q X

2014-12-01

The debate on the relationship between corporate or industrial environmental performance (EP) and financial performance (FP) has yet to be resolved, and studies need to examine the possible moderating effects on the EP-FP link. We argue that industrial EP has a positive effect on FP and that industrial munificence and resource slack can moderate the EP-FP link. Using a dataset from Chinese industrial firms, we examine the direct effect of industrial EP on FP and the indirect effects of industrial munificence and resource slack on the EP-FP link. Our results show that improving corporate or industrial-level EP significantly influences FP and that slack resources play a significant role on the EP-FP link. However, we found no significant moderating effect of industrial munificence on the link. Copyright © 2014 Elsevier Ltd. All rights reserved.

IMPACT OF FISSION PRODUCTS IMPURITY ON THE PLUTONIUM CONTENT IN PWR MOX FUELS

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gilles Youinou; Andrea Alfonsi

2012-03-01

This report presents the results of a neutronics analysis done in response to the charter IFCA-SAT-2 entitled 'Fuel impurity physics calculations'. This charter specifies that the separation of the fission products (FP) during the reprocessing of UOX spent nuclear fuel assemblies (UOX SNF) is not perfect and that, consequently, a certain amount of FP goes into the Pu stream used to fabricate PWR MOX fuel assemblies. Only non-gaseous FP have been considered (see the list of 176 isotopes considered in the calculations in Appendix 1). This mixture of Pu and FP is called PuFP. Note that, in this preliminary analysis,more » the FP losses are considered element-independent, i.e., for example, 1% of FP losses mean that 1% of all non-gaseous FP leak into the Pu stream.« less

Mapping of QTL for bacterial cold water disease resistance in rainbow trout

USDA-ARS?s Scientific Manuscript database

Bacterial cold water disease (BCWD) causes significant economic loss in salmonids aquaculture. We previously detected genetic variation in survival following challenge with Flavobacterium psychrophilum (Fp), the causative agent of BCWD in rainbow trout, and a family-based selection program to impro...

Compensatory Expressive Behavior for Facial Paralysis: Adaptation to Congenital or Acquired Disability

PubMed Central

Bogart, Kathleen R.; Tickle-Degnen, Linda; Ambady, Nalini

2015-01-01

Purpose/Objective Although there has been little research on the adaptive behavior of people with congenital compared to acquired disability, there is reason to predict that people with congenital conditions may be better adapted because they have lived with their conditions for their entire lives (Smart, 2008). We examined whether people with congenital facial paralysis (FP), compared to people with acquired FP, compensate more for impoverished facial expression by using alternative channels of expression (i.e. voice and body). Research Method/Design Participants with congenital (n = 13) and acquired (n = 14) FP were videotaped while recalling emotional events. Main Outcome Measures Expressive verbal behavior was measured using the Linguistic Inquiry Word Count (Pennebaker, Booth & Francis, 2007). Nonverbal behavior and FP severity were rated by trained coders. Results People with congenital FP, compared to acquired FP, used more compensatory expressive verbal and nonverbal behavior in their language, voices, and bodies. The extent of FP severity had little effect on compensatory expressivity. Conclusions/Implications This study provides the first behavioral evidence that people with congenital FP use more adaptations to express themselves than people with acquired FP. These behaviors could inform social functioning interventions for people with FP. PMID:22369116

Impact on obstetric outcome of third-trimester screening for small-for-gestational-age fetuses.

PubMed

Callec, R; Lamy, C; Perdriolle-Galet, E; Patte, C; Heude, B; Morel, O

2015-08-01

To evaluate the performance of screening for small-for-gestational-age (SGA) fetuses by ultrasound biometry at 30-35 weeks' gestation, and to determine the impact of screening on obstetric and neonatal outcomes. For this prospective cohort study, pregnant women were recruited from two French university maternity centers between 2003 and 2006. Performance measures of third-trimester biometry for the prediction of SGA, defined as estimated fetal weight < 10(th) centile, were analyzed. Obstetric outcomes and neonatal health status were compared, first, between SGA neonates diagnosed correctly at ultrasound examination (true positive (TP); n = 45) and SGA neonates that went undiagnosed (false negative (FN); n = 110) and, second, between non-SGA neonates identified as normal at ultrasound examination (true negative (TN); n = 1641) and non-SGA neonates diagnosed incorrectly as SGA (false positive (FP); n = 101). In the prediction of SGA, third-trimester ultrasound had a sensitivity of 29.0% (95% CI, 22.5-36.6%) and specificity of 94.2% (95% CI, 93.0-95.2%). Positive and negative predictive values were 30.8% (95% CI, 23.9-38.7%) and 93.7% (95% CI, 92.5-94.8%), respectively. One hundred and ten SGA neonates went undiagnosed at ultrasound. Compared to the TN neonates considered as of normal weight at ultrasound, planned preterm delivery (before 37 weeks) and elective Cesarean section for a fetal growth indication were 2.4 (P = 0.01) and 2.85 (P = 0.003) times more likely to occur, respectively, in the FP group of non-SGA neonates, diagnosed incorrectly as SGA during the antenatal period. There was no statistically significant difference in 5-min Apgar score < 7, cord blood pH at birth < 7.15 and need for neonatal resuscitation between the two subgroups (TN vs FP and TP vs FN). The performance of third-trimester ultrasound screening for SGA seems poor, as it misses the diagnosis of a large number of SGA neonates. The consequences of routine screening for SGA in a low-risk population may lead to unnecessary planned preterm deliveries and elective Cesarean sections in FP pregnancies, without improved neonatal outcome in the FN pregnancies. Copyright © 2014 ISUOG. Published by John Wiley & Sons Ltd.

What motivates family physicians to participate in training programs in shared decision making?

PubMed

Allaire, Anne-Sophie; Labrecque, Michel; Giguere, Anik; Gagnon, Marie-Pierre; Légaré, France

2012-01-01

Little is known about the factors that influence family physician (FP) participation in continuing professional development (CPD) programs in shared decision making (SDM). We sought to identify the factors that motivate FPs to participate in DECISION+, a CPD program in SDM. In 2007-2008, we collected data from 39 FPs who participated in a pilot randomized trial of DECISION+. In 2010, we collected data again from 11 of those participants and from 12 new subjects. Based on the theory of planned behavior, our questionnaire assessed FPs' intentions to participate in a CPD program in SDM and evaluated FPs' attitudes, subjective norms and perceived behavioral control. We also conducted 4 focus groups to explore FPs' salient beliefs. In 2010, FPs' mean intention to participate in a CPD program in SDM was relatively strong (2.6 ± 0.5 on a scale from -3 = "strongly disagree" to +3 = "strongly agree"). Affective attitude was the only factor significantly associated with intention (r = .51, p = .04). FPs identified the attractions of participating in a CPD program in SDM as (1) its interest, (2) the pleasure of learning, and (3) professional stimulation. Facilitators of their participation were (1) a relevant clinical topic, (2) an interactive program, (3) an accessible program, and (4) decision support tools. To attract FPs to a CPD program in SDM, CPD developers should make the program interesting, enjoyable, and professionally stimulating. They should choose a clinically relevant topic, ensure that the program is interactive and accessible, and include decision support tools. Copyright © 2012 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on CME, Association for Hospital Medical Education.

Comparative studies of lepidopteran baculovirus-specific protein FP25K: development of a novel Bombyx mori nucleopolyhedrovirus-based vector with a modified fp25K gene.

PubMed

Nakanishi, Tadashi; Goto, Chie; Kobayashi, Michihiro; Kang, Wonkyung; Suzuki, Takehiro; Dohmae, Naoshi; Matsumoto, Shogo; Shimada, Toru; Katsuma, Susumu

2010-05-01

Lepidopteran baculovirus-specific protein FP25K performs many roles during the infection cycle, including functions in the production of occlusion bodies (OBs) and budded viruses (BVs), oral infection, and postmortem host degradation. To explore the common and specific functions of FP25K proteins among lepidopteran baculoviruses, we performed comparative analyses of FP25K proteins from group I and group II nucleopolyhedroviruses (NPVs) and granulovirus (GV). Using recombinant Bombyx mori NPVs (BmNPVs), we showed that the FP25Ks from NPVs were able to eliminate all the phenotypic defects observed in an infection with a BmNPV mutant lacking functional fp25K but that FP25K from GV did not show abilities to recover oral infectivity and postmortem host degradation. We also observed that introduction of Autographa californica multiple NPV (AcMNPV) fp25K into the BmNPV genome enhanced OB and BV production. According to these results, we generated a novel BmNPV-based expression vector with AcMNPV fp25K and examined its potential in BmN cells and B. mori larvae. Our results showed that the introduction of AcMNPV fp25K significantly increases the expression of foreign gene products in cultured cells and shortens the time for obtaining the secreted recombinant proteins from larval hemolymph.

A Performance Analysis of Long-term Acute-Care Hospitals Owned by Large, Multistate Investor-Owned Companies.

PubMed

Nayar, Preethy; Liu, Xinliang; McCue, Michael J

2016-01-01

This study provides a descriptive assessment of the operating performance of for-profit long-term acute-care hospitals owned by multistate, investor-owned companies (large FP LTCHs) compared with FP LTCHs owned by smaller FP companies (small FP LTCHs) and nonprofit LTCHs (NP LTCHs). The study used the Centers for Medicare & Medicaid Services cost report data for 290 LTCHs from 2010 through 2012 to compare the financial performance of large and small FP LTCHs and NP LTCHs. The study found that the median operating profit margin for large FP LTCHs was 8.06%, which was twice as high as that of the small FP LTCHs and NP LTCHs (4.78% and 2.80%, respectively). Larger size, serving a greater proportion of private pay and more complex patients and incurring lower operating expenses, including salary expenses, may account for the higher operating margin of the large FP LTCHs.

Interview. Maria Isabal Plata, executive director of Profamilia, talks to Caroline Sweetman about the work of the organisation in Colombia.

PubMed

Sweetman, C

1996-06-01

In this interview, Maria Isabal Plata discusses the work of the nongovernmental organization Profamilia in Colombia. Since its founding in 1965, Profamilia has assumed direct and indirect responsibility for nearly 70% of family planning (FP) and reproductive health activities in the country. These activities are complemented by a legal service program, an evaluation and research program, and a documentation center. In Colombia, women gained equal rights under the law in 1974 and a constitutional prohibition on discrimination in 1991, but sex stereotypes still dictate responsibility for family chores. When women realize their economic and social rights, poverty and inequalities will diminish. Thus, it is crucial to safeguard reproductive and sexual rights and ban violence against women. The traditional concept of family forces a disregard for the rights of family members and allows societies to oppose the interests of women. The aftermath of the UN Fourth Women's Conference in Colombia will be to work towards achieving full citizenship for women and democratic societies. The experience women's groups had at the conference has created a situation in which grassroots organizations can consider beginning to work with development organizations to achieve some of these goals.

Reproductive health service utilization and associated factors among adolescents (15–19 years old) in Gondar town, Northwest Ethiopia

PubMed Central

2013-01-01

Background The utilization of reproductive health services is an important component in preventing adolescents from different sexual and reproductive health problems. It plays a vital role in safeguarding youth in Sub-Saharan African countries including Ethiopia, which accounts for a high proportion of the region’s new HIV infections as well as maternal and infant mortality ratios. Due to this, assessing adolescent reproductive health service utilization and associated factors has its own contribution in achieving the national Millennium Development Goals (MDG), especially goals 4 to 6. Methods A community based cross-sectional study was conducted from April 5–19, 2012, in 4 randomly selected administrative areas of Gondar town. A total of 1290 adolescents aged 15–19 were interviewed using a pre-tested and structured questionnaire. Data were entered in to the EPI INFO version 3.5.3 statistical software and analyzed using an adapted SPSS version 20 software package. Logistic regression was done to identify possible factors associated with family planning (FP), and voluntary counseling and testing (VCT) service utilization. Results Out of the total participants, 79.5% and 72.2% utilized FP and VCT services, respectively. In addition, among sexually experienced adolescents, 68.1% and 88.4% utilized contraceptive methods and VCT service during their first sexual encounter, respectively. Educational status, discussion with family/relatives, peer groups, sexual partners and teachers were significantly associated with FP service utilization. Also, adolescents who had a romantic sexual relationship, and those whose last sexual relationship was long-term, were about 6.5 times (Adjusted Odds Ratio [AOR] = 6.5, 95% CI: 1.23, 34.59), and about 3 times (AOR = 3, 95% CI: 1.02, 8.24) more likely to utilize FP services than adolescents who had no romantic relationship or long-term sexual relationship, respectively. In addition, the variables significantly associated with VCT service utilization were: participants who had secondary education and above, schooling attendance, co- residence with both parents, parental communication, discussion of services with peer groups, health workers, and perception of a risk of HIV/AIDS. Conclusions The majority of the adolescents were utilizing FP and VCT service in Northwest Ethiopia. But among the sexually experienced adolescents, utilization of FP at first sexual intercourse and VCT service were found to be low. Educational status, schooling attendance, discussion of services, type of sexual relationship and perception of risk were important factors affecting the utilization of FP and VCT services. Building life skill, facilitating parent to child communication, establishing and strengthening of youth centers and school reproductive health clubs are important steps to improve adolescents’ reproductive health (RH) service utilization. PMID:23915299

Fluorescent Proteins: A Cell Biologist's User Guide

PubMed Central

Snapp, Erik Lee

2009-01-01

Fluorescent Proteins (FPs) have revolutionized cell biology. The value of labeling and visualizing proteins in living cells is evident from thousands of publications since the cloning of Green Fluorescent Protein (GFP). Biologists have been flooded with a cornucopia of FPs; however, the FP toolbox has not necessarily been optimized for cell biologists. Common FP plasmids are suboptimal for FP-fusion protein construction. More problematic are commercial and investigator-constructed FP-fusion proteins that disrupt important cellular targeting information. Even when cell biologists correctly construct FP-fusion proteins, it is rarely self-evident which FP should be used. Important FP information, such as oligomer formation or photostability, is often unsearchable or anecdotal. This brief guide is offered to assist in correctly exploiting FPs in cells. PMID:19819147

Control of bromate and THM precursors using ozonation combined system.

PubMed

Xie, Shu-Guang; Shi, Dong-Wen; Wen, Dong-Hui; Wang, Rui; Xi, Dan-Li

2007-06-01

To investigate the feasibility of reducing THM precursors and controlling bromate taste and odor in drinking water taken from the Yellow River by an ozonation combined system. The appropriate ozone dosage was determined, and then the changes of TOC, UV254 and THM formation potential (THMFP) in the combined system were evaluated. One mg/L ozone could effectively remove taste and odor and meet the maximum allowable bromate level in drinking water. The pre-ozonation increased THMFP, but the conventional treatment system could effectively reduce the odor. The bio-ceramic filter could partly reduce CHCl3FP, but sometimes might increase CHCl2BrFP and CHClBr2FP. The biological activated carbon (BAC) filter could effectively reduce CHCl3FP and CHCl2BrFP, but increase CHClBr2FP. Compared with other filters, the fresh activated carbon (FAC) filter performed better in reducing THMFP and even reduced CHClBr2FP. The combined system can effectively reduce taste, odor, CHCl3FP, and CHCl2BrFP and also bring bromate under control.

Tsunami Evacuation Plan for the City of Tangier-Morocco

NASA Astrophysics Data System (ADS)

Benchekroun, Sabah; Omira, Rachid; Baptista, Maria Ana; Arbi Toto, El

2016-04-01

Tsunami evacuation plan is an important tool to mitigate the tsunami impact. It is the most efficient way to save human lives, well before the waves reach the threatened coastal area, by providing evacuation routes and appropriate shelters. In this study, we propose a tsunami evacuation plan for the city of Tangier-Morocco. This plan is designed considering the tsunami threat from the tsunamigenic sources located in the SW Iberia Margin and using the inundation maps of the worst case to define the limit of flooding area. The evacuation plan is elaborated through modelling the required time for the threatened coastal population to reach the shelters. Results of this study will be useful for decision makers and local authorities in preventing the community resiliency for tsunami hazard. This work received funding from collaborative project ASTARTE - Assessment Strategy and Risk Reduction for Tsunamis in Europe Grant 603839, FP7.

Does a voucher program improve reproductive health service delivery and access in Kenya?

PubMed

Njuki, Rebecca; Abuya, Timothy; Kimani, James; Kanya, Lucy; Korongo, Allan; Mukanya, Collins; Bracke, Piet; Bellows, Ben; Warren, Charlotte E

2015-05-23

Current assessments on Output-Based Aid (OBA) programs have paid limited attention to the experiences and perceptions of the healthcare providers and facility managers. This study examines the knowledge, attitudes, and experiences of healthcare providers and facility managers in the Kenya reproductive health output-based approach voucher program. A total of 69 in-depth interviews with healthcare providers and facility managers in 30 voucher accredited facilities were conducted. The study hypothesized that a voucher program would be associated with improvements in reproductive health service provision. Data were transcribed and analyzed by adopting a thematic framework analysis approach. A combination of inductive and deductive analysis was conducted based on previous research and project documents. Facility managers and providers viewed the RH-OBA program as a feasible system for increasing service utilization and improving quality of care. Perceived benefits of the program included stimulation of competition between facilities and capital investment in most facilities. Awareness of family planning (FP) and gender-based violence (GBV) recovery services voucher, however, remained lower than the maternal health voucher service. Relations between the voucher management agency and accredited facilities as well as existing health systems challenges affect program functions. Public and private sector healthcare providers and facility managers perceive value in the voucher program as a healthcare financing model. They recognize that it has the potential to significantly increase demand for reproductive health services, improve quality of care and reduce inequities in the use of reproductive health services. To improve program functioning going forward, there is need to ensure the benefit package and criteria for beneficiary identification are well understood and that the public facilities are permitted greater autonomy to utilize revenue generated from the voucher program.

Failure of a recombinant fowl poxvirus vaccine containing an avian influenza hemagglutinin gene to provide consistent protection against influenza in chickens preimmunized with a fowl pox vaccine.

PubMed

Swayne, D E; Beck, J R; Kinney, N

2000-01-01

Vaccines against mildly pathogenic avian influenza (AI) have been used in turkeys within the United States as part of a comprehensive control strategy. Recently, AI vaccines have been used in control programs against highly pathogenic (HP) AI of chickens in Pakistan and Mexico. A recombinant fowl pox-AI hemagglutinin subtype (H) 5 gene insert vaccine has been shown to protect specific-pathogen-free chickens from HP H5 AI virus (AIV) challenge and has been licensed by the USDA for emergency use. The ability of the recombinant fowl pox vaccine to protect chickens preimmunized against fowl pox is unknown. In the current study, broiler breeders (BB) and white leghorn (WL) pullets vaccinated with a control fowl poxvirus vaccine (FP-C) and/or a recombinant fowl poxvirus vaccine containing an H5 hemagglutinin gene insert (FP-HA) were challenged with a HP H5N2 AIV isolated from chickens in Mexico. When used alone, the FP-HA vaccine protected BB and WL chickens from lethal challenge, but when given as a secondary vaccine after a primary FP-C immunization, protection against a HP AIV challenge was inconsistent. Both vaccines protected against virulent fowl pox challenge. This lack of consistent protection against HPAI may limit use to chickens without previous fowl pox vaccinations. In addition, prior exposure to field fowl poxvirus could be expected to limit protection induced by this vaccine.

Practice of Contemporary Dance Promotes Stochastic Postural Control in Aging

PubMed Central

Ferrufino, Lena; Bril, Blandine; Dietrich, Gilles; Nonaka, Tetsushi; Coubard, Olivier A.

2011-01-01

As society ages and the frequency of falls increases, counteracting gait and posture decline is a challenging issue for countries of the developed world. Previous studies have shown that exercise and hazard management help to improve balance and/or decrease the risks for falling in normal aging. Motor activity based on motor-skill learning, particularly dance, can also benefit balance and decreases falls with age. Recent studies have suggested that older dancers have better balance, posture, or gait than non-dancers. Additionally, clinical or laboratory measures have shown improvements in some aspects of balance after dance interventions in elderly trainees. This study examined the impact of contemporary dance (CD) and of fall prevention (FP) programs on postural control of older adults. Posturography of quiet upright stance was performed in 41 participants aged 59–86 years before and after 4.4-month training in either CD or FP once a week. Though classical statistic scores failed to show any effect, dynamic analyses of the center-of-pressure displacements revealed significant changes after training. Specifically, practice of CD enhanced the critical time interval in diffusion analysis, and reduced recurrence and mathematical stability in recurrence quantification analysis, whereas practice of FP induced or tended to induce the reverse patterns. Such effects were obtained only in the eyes open condition. We suggest that CD training based on motor improvisation favored stochastic posture inducing plasticity in motor control, while FP training based on more stereotyped behaviors did not. PMID:22232582

An innovative simplified MCH score for assessing the ideal babies in well baby shows of postpartum outreach programme.

PubMed

Anandalakshmy, P N; Mittal, S

1995-01-01

In India, a simple scoring method was used to select winners at 18 well-baby shows over the last five years in low-income areas of Kotla Mubarakpur and Gautam Nagar, in the Rajeev Gandhi Resettlement Colony, in jhuggi jhopri clusters around the All Institute of Medical Sciences (AAIMS) in New Delhi, and in the Bangladeshi refugee colony (Kidwai Nagar). The parameters used to select ideal babies were parents' age at marriage and educational status, mother's age at first birth, number of living children in relation to marriage duration, immunization status of living children, birth interval, contraceptive use, and routine criteria on general health and hygiene. Winners were chosen among infants, toddlers (1-2 years), and preschool children (2-5). Health promotional activities, maternal and child health (MCH) services, and family planning (FP) services were featured at the health camps where the well-baby shows occurred. 60-90 children and 100-2000 couples participated in the well-baby shows. Health workers explained to parents of children with a poor score why their children had a poor score. At the health camps, parents adopted FP methods and had their children immunized, regardless of score, so as to improve their score for the next show and to win prizes. The well-baby scores improved over time (24.64-31.2 for Kotla Mubarakpur, 19-24.6 for Gautam Nagar, 20.9-22.4 for Rajeev Gandhi, 20.6-23.6 for AIIMS jhuggi, and 13.6-21.4 for Kidwai Nagar). A weekly clinic operating in Kotla Mubarakpur accounted for the high initial mean score. Gautam Nagar had only periodic health services. A weekly mobile health van provided services in the Rajeev Gandhi colony. Door to door contacts were conducted in the jhuggi jhopri clusters to promote MCH/FP services. The scoring method reinforced integration of MCH/FP services. It allowed local health workers to make rapid analyses and MCH decision making. It also served as a tool to monitor the efficacy of local MCH/FP services.

Phenylpyrazole insecticide fipronil induces male infertility in the estuarine meiobenthic crustacean Amphiascus tenuiremis.

PubMed

Cary, Tawnya L; Chandler, G Thomas; Volz, David C; Walse, Spencer S; Ferry, John L

2004-01-15

Copepods are the most abundant arthropods on earth and are often the most important secondary producers in estuarine/marine food webs. The new GABA (gamma-aminobutyric acid)-disrupting insecticide fipronil (FP) induces unique sex-specific reproductive dysfunction in male meiobenthic copepods, leading to trans-generational population depression at environmentally realistic concentrations (0.63 microg/L). Using a newly developed 96-well microplate lifecycle bioassay, more than 700 individual Stage-I juveniles were reared to adulthood in as short as 12 days in only 200 microL of control (CTL) or 0.63 microg-FP/L seawater solution. Individual virgin male: female pairs were then cross-mated for all possible combinations within and across rearing treatments and allowed to mate for an additional 12 days in CTL or 0.63 microg-FP/L solution. FP at 0.63 microg/L caused no significant lethality to any mating combinations but evoked 73% or 89% inhibition of reproduction when FP-reared males were mated with either a control- or FP-reared female in FP solution, respectively. In contrast, when CTL-reared males were mated with FP-reared females in FP solution, there was no difference in reproductive success compared to FP-free controls. When FP-reared males were mated with either female group in FP-free solution, these mating pairs displayed a 3-day delay in time to brood sac extrusion but ultimately did reproduce. As fipronil (1) has a high K(ow), (2) is persistent in sediments where meiobenthic copepods live, and (3) has been detected in estuarine waters >0.7 microg/L, it may pose high risk to copepod production in estuarine systems.

Factors influencing survivorship of rehabilitating green sea turtles (Chelonia mydas) with fibropapillomatosis.

PubMed

Page-Karjian, Annie; Norton, Terry M; Krimer, Paula; Groner, Maya; Nelson, Steven E; Gottdenker, Nicole L

2014-09-01

Marine turtle fibropapillomatosis (FP) is a debilitating, infectious neoplastic disease that has reached epizootic proportions in several tropical and subtropical populations of green turtles (Chelonia mydas). FP represents an important health concern in sea turtle rehabilitation facilities. The objectives of this study were to describe the observed epidemiology, biology, and survival rates of turtles affected by FP (FP+ turtles) in a rehabilitation environment; to evaluate clinical parameters as predictors of survival in affected rehabilitating turtles; and to provide information about case progression scenarios and potential outcomes for FP+ sea turtle patients. A retrospective case series analysis was performed using the medical records of the Georgia Sea Turtle Center (GSTC), Jekyll Island, Georgia, USA, during 2009-2013. Information evaluated included signalment, morphometrics, presenting complaint, time to FP onset, tumor score (0-3), co-morbid conditions, diagnostic test results, therapeutic interventions, and case outcomes. Overall, FP was present in 27/362 (7.5%) of all sea turtles admitted to the GSTC for rehabilitation, either upon admittance or during their rehabilitation. Of these, 25 were green and 2 were Kemp's ridley turtles. Of 10 turtles that had only plaque-like FP lesions, 60% had natural tumor regression, all were released, and they were significantly more likely to survive than those with classic FP (P = 0.02 [0.27-0.75, 95% CI]). Turtles without ocular FP were eight times more likely to survive than those with ocular FP (odds ratio = 8.75, P = 0.032 [1.21-63.43, 95% CI]). Laser-mediated tumor removal surgery is the treatment of choice for FP+ patients at the GSTC; number of surgeries was not significantly related to case outcome.

Eye position signals modify vestibulo- and cervico-ocular fast phases during passive yaw rotations in humans.

PubMed

Anastasopoulos, D; Mandellos, D; Kostadima, V; Pettorossi, V E

2002-08-01

We studied the amplitude, latency, and probability of occurrence of fast phases (FP) in darkness to unpredictable vestibular and/or cervical yaw stimulation in normal human subjects. The rotational stimuli were smoothed trapezoidal motion transients of 14 degrees amplitude and 1.25 s duration. Eye position before stimulus application (initial eye position, IEP) was introduced as a variable by asking the subjects to fixate a spot appearing either straight ahead or at 7 degrees eccentric positions. The recordings demonstrated that the generation of FP during vestibular stimulation was facilitated when the whole-body rotation was directed opposite the eccentric IEP. Conversely, FP were attenuated if the whole-body rotation was directed toward the eccentric IEP; i.e., the FP attenuated if they were made to further eccentric positions. Cervical stimulation-induced FP were small and variable in direction when IEP was directed straight ahead before stimulus onset. Eccentric IEPs resulted in large FP, the direction of which was essentially independent of the neck-proprioceptive stimulus. They tended to move the eye toward the primary position, both when the trunk motion under the stationary head was directed toward or away from the IEP. FP dependence on IEP was evident also during head-on-trunk rotations. No consistent interaction between vestibularly and cervically induced FP was found. We conclude that extraretinal eye position signals are able to modify vestibularly evoked reflexive FP in darkness, aiming at minimizing excursions of the eyes away from the primary position. However, neck-induced FP do not relate to specific tasks of stabilization or visual search. By keeping the eyes near the primary position, FP may permit flexibility of orienting responses to incoming stimuli. This recentering bias for both vestibularly and cervically generated FP may represent a visuomotor optimizing strategy.

Assessing psychological distress in patients with facial paralysis using the Hospital Anxiety and Depression Scale.

PubMed

Pouwels, Sjaak; Beurskens, Carien H G; Kleiss, Ingrid J; Ingels, Koen J A O

2016-08-01

Anxiety and depression are seen among patients with facial paralysis (FP), but less is known about the exact prevalence. The aim of the current study is to assess the prevalence of anxiety and depressive disorders in the FP population and to investigate possible differences between patients with left- and right-sided FP. Fifty-nine patients with FP and 59 healthy individuals were included in this study between March and December of 2014. The Hospital Anxiety and Depression Scale was used to assess the prevalence of anxiety and depression among these groups. The mean age of the patients and controls was 56 ± 15 and 40 ± 16 years, respectively. Twenty-eight patients had left-sided FP, 30 patients had right-sided FP, and one patient had bilateral FP. In the patient group, approximately 30% had anxiety and 25% had a depressive disorder. Compared with the control group, significantly more patients presented with mild anxiety (p = 0.031), mild depression (p = 0.047), and moderate depression (p = 0.006). No significant differences were found in terms of the prevalence of anxiety between left- and right-sided FP. However, significantly more patients with left-sided FP had mild depression (p = 0.018) than those with right-sided FP. This study found a significant difference in anxiety and depression between patients with FP and healthy controls. No clinically significant difference was noted in the prevalence of anxiety or depression between patients with left- and right-sided FP. Copyright © 2016 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Development and cognitive functions in Saudi pre-school children with feeding problems without underlying medical disorders.

PubMed

Hegazi, Moustafa A; Sehlo, Mohammad G; Al-Jasir, Albandari; El-Deek, Basem S

2015-09-01

This study was conducted to assess development and cognitive functions in relation to growth in Saudi pre-school children with feeding problems (FPs) without underlying medical disorders. Three hundred fifteen pre-school children with FPs (221 with normal growth (FP-N), 62 with failure to thrive (FTT) (FP-FTT), 32 with overweight (FP-OW)) and 100 healthy children (Ref group) underwent in-depth assessment by anthropometric measurements, dietetic history, Behavioral Pediatrics Feeding Assessment Scale, Denver Developmental Screening test (DDST) and Stanford Binet fifth edition intelligence scales (SB-5). The main FPs detected in Saudi children were picky eating in 85.5% of FP-N group, infantile anorexia and poor eating in more than 90% of FP-FTT group and overeating in 53% of FP-OW group. FPs were not due to evident psychosocial factors but were mostly related to unhealthy feeding behaviours. FP-N children were still having normal growth parameters, but they had significantly lower growth parameters than healthy children. Failed screening with DDST was only more significantly recorded in FP-FTT children than in Ref children (P = 0.04). The overall IQ value by SB-5 was significantly lower in FP-FTT group compared with FP-N group (P = 0.01), in FP-FTT group compared with Ref group (P < 0.001) as well as in FP-OW group compared with Ref group (P < 0.001). Persistent FPs resulted in significant negative impact not only on growth status but also on developmental milestones and cognitive functions of pre-school children. Healthy feeding habits are mandatory to prevent serious consequences of FPs on growth and development of Saudi pre-school children. © 2015 The Authors. Journal of Paediatrics and Child Health © 2015 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

Effects of inhaled fluticasone and oral prednisolone on clinical and inflammatory parameters in patients with asthma

PubMed Central

Meijer, R; Kerstjens, H; Arends, L; Kauffman, H; Koeter, G; Postma, D

1999-01-01

BACKGROUND—Guidelines state that oral and inhaled corticosteroids are the cornerstone of asthma treatment. The effect of both types of treatment can be assessed by measuring lung and systemic parameters. Treatment for two weeks with either oral prednisolone (30 mg/day), high dose fluticasone propionate (2000 µg/day, FP2000), or lower dose FP (500 µg/day, FP500), both given by a dry powder inhaler, were compared.
METHODS—One hundred and twenty patients with asthma were treated for two weeks in a double blind parallel group design. Lung function, asthma symptoms, airway hyperresponsiveness (PC20 methacholine and adenosine-5'-monophosphate), sputum eosinophil and eosinophilic cationic protein (ECP) levels were measured as lung parameters. In addition, morning serum blood cortisol, blood eosinophil, and serum ECP levels were measured as systemic parameters.
RESULTS—PC20 methacholine and adenosine-5'-monophosphate showed significantly greater improvement with FP2000 (1.99 and 4.04 doubling concentrations (DC), respectively) than prednisolone (0.90 DC, p = 0.02; 2.15 DC, p = 0.05) and marginally more than with FP500 (1.69 and 3.54 DC). Changes in sputum eosinophil and ECP concentrations showed similar trends; the decrease in ECP was significantly greater with FP2000 than with FP500. In contrast, the systemic parameters of steroid activity (cortisol, peripheral blood eosinophils, and serum ECP) decreased to a similar extent with FP2000 and prednisolone but significantly less with FP500.
CONCLUSIONS—Oral prednisolone (30 mg/day) was inferior to FP2000 in improving airway hyperresponsiveness to both methacholine and AMP, with similar trends in forced expiratory volume in one second (FEV1), sputum eosinophil and ECP concentrations. Systemic effects were similar with prednisolone and FP2000 and less with FP500.

 PMID:10491451

Florid papillomatosis of the nipple. A study of 51 patients, including nine with mammary carcinoma.

PubMed

Rosen, P P; Caicco, J A

1986-02-01

The present study was undertaken to review the pathology of florid papillomatosis (FP) of the nipple and to examine the relationship of FP to breast carcinoma. Clinical features of 49 women studied did not differ appreciably from those noted on prior reports, except that in one instance the lesion was probably congenital. Histologically, three distinct growth patterns were found: sclerosing papillomatosis (17 cases), papillomatosis (12 cases), and adenosis (3 cases). In 17 other cases, mixtures of these proliferative patterns were seen. FP with the sclerosing papillomatosis pattern more frequently had areas of focal necrosis in hyperplastic ducts and scattered mitoses, features that might be interpreted as evidence of carcinoma. No prognostic significance can be attributed to these patterns, since all types were cured by excision with follow-up that averaged 8.3 years. Seven of the 49 women had carcinoma in the same breast as FP: Two women had invasive carcinoma that appeared to arise from FP, and four women had concurrent invasive carcinomas that were separate from the FP; the seventh woman developed diffuse intraductal carcinoma 10 years after FP was excised from the same breast. Three of the seven women were also treated for contralateral breast carcinoma. Also reviewed were lesions from two men who had carcinoma arising in FP. One had intraductal carcinoma with Paget's disease and the other had invasive carcinoma. Appreciation of the diverse histological patterns of FP may be helpful in avoiding an erroneous diagnosis of carcinoma. Features indicative of carcinoma arising in FP are Paget's disease and areas of invasion. FP of the nipple is rarely the substrate for mammary carcinoma and is adequately treated by local excision. Coexistence with carcinoma elsewhere in the same or opposite breast occurs often enough to warrant thorough examination of the breasts when FP of the nipple is diagnosed. The risk of subsequent carcinoma following excision of FP appears to be low, but clinical follow-up is prudent.

Clinical Investigation Program, RCS MED-300 (R1)

DTIC Science & Technology

1987-10-31

cholesterolemai. J Fam Pract 1987; 24:54-56. Manness DL, Rogers DY: Hemorrhagic complications of varicella . Am FP Feb 1987; pp. 151-155. Madlon-Kay 0J...carotid artery occlusion. Hospital Central Militar, Mexico City, Mexico , Jun 1987, Ebert FR: Ipsilateral concomitant fractures of femoral neck and femoral

A virtual reality interface for pre-planning of surgical operations based on a customized model of the patient

NASA Astrophysics Data System (ADS)

Witkowski, Marcin; Lenar, Janusz; Sitnik, Robert; Verdonschot, Nico

2012-03-01

We present a human-computer interface that enables the operator to plan a surgical procedure on the musculoskeletal (MS) model of the patient's lower limbs, send the modified model to the bio-mechanical analysis module, and export the scenario parameters to the surgical navigation system. The interface provides the operator with tools for: importing customized MS model of the patient, cutting bones and manipulating/removal of bony fragments, repositioning muscle insertion points, muscle removal and placing implants. After planning the operator exports the modified MS model for bio-mechanical analysis of the functional outcome. If the simulation result is satisfactory the exported scenario data may be directly used during the actual surgery. The advantages of the developed interface are the possibility of installing it in various hardware configurations and coherent operation regardless of the devices used. The hardware configurations proposed to be used with the interface are: (a) a standard computer keyboard and mouse, and a 2-D display, (b) a touch screen as a single device for both input and output, or (c) a 3-D display and a haptic device for natural manipulation of 3-D objects. The interface may be utilized in two main fields. Experienced surgeons may use it to simulate their intervention plans and prepare input data for a surgical navigation system while student or novice surgeons can use it for simulating results of their hypothetical procedure. The interface has been developed in the TLEMsafe project (www.tlemsafe.eu) funded by the European Commission FP7 program.

Fluticasone propionate/formoterol for COPD management: a randomized controlled trial

PubMed Central

Papi, A; Dokic, D; Tzimas, W; Mészáros, I; Olech-Cudzik, A; Koroknai, Z; McAulay, K; Mersmann, S; Dalvi, PS; Overend, T

2017-01-01

Purpose To evaluate fluticasone propionate/formoterol (FP/FORM) in COPD. Patients and methods COPD patients with forced expiratory volume in 1 s (FEV1) ≤50% predicted and ≥1 moderate/severe COPD exacerbation in the last 12 months were randomized to FP/FORM 500/20 or 250/10 µg bid, or formoterol (FORM) 12 µg bid for 52 weeks. The primary outcome was the annualized rate of moderate/severe COPD exacerbations. Results In total, 1,765 patients were randomized. There were fewer discontinuations with FP/FORM 500/20 µg (20.6%) and 250/10 µg (24.0%) compared with FORM (26.1%). None of the two FP/FORM doses reduced the moderate/severe exacerbation rate versus FORM (rate ratios [RR]: 0.93; P≤0.402). There was a trend toward a lower moderate/severe exacerbation rate with FP/FORM 500/20 µg versus FORM in patients with ≥2 exacerbations in the preceding year (RR: 0.79; P=0.084). Pre- and post-dose FEV1 and forced vital capacity were greater with FP/FORM 500/20 µg versus FORM (P≤0.039). There was a trend toward a lower EXAcerbations of Chronic pulmonary disease Tool (EXACT) exacerbation rate with FP/FORM 500/20 µg versus FORM (RR: 0.87; P=0.077). There were more St George’s Respiratory Questionnaire for COPD (SGRQ-C) responders with FP/FORM 500/20 µg than FORM (odds ratios [OR] at weeks 6, 23 and 52 ≥1.28; P≤0.054). EXACT-respiratory symptoms total and breathlessness scores were lower with both FP/FORM 500/20 µg and 250/10 µg versus FORM (P≤0.066). Acute β2-agonist-induced effects and 24-hour Holter findings were similar for all treatments. Mean 24-hour urinary cortisol was similarly reduced with both FP/FORM doses. Radiologically confirmed pneumonia was seen in 2.4%, 3.2% and 1.5% of FP/FORM 500/20 µg, FP/FORM 250/10 µg and FORM-treated patients, respectively. Adverse events were otherwise similar across treatment groups. Conclusion FP/FORM did not reduce exacerbation rates versus FORM. Numerical benefits were observed with FP/FORM 500/20 µg versus FORM for secondary variables, including lung function, EXACT exacerbations, SGRQ-C and EXACT-respiratory symptoms total and breathlessness scores. Few efficacy differences were evident between FP/FORM 250/10 µg and FORM. Pneumonia was more frequent in FP/FORM-treated patients, although the absolute difference was low. Adverse events were otherwise similar between treatments. PMID:28740376

Fluticasone propionate/formoterol for COPD management: a randomized controlled trial.

PubMed

Papi, A; Dokic, D; Tzimas, W; Mészáros, I; Olech-Cudzik, A; Koroknai, Z; McAulay, K; Mersmann, S; Dalvi, P S; Overend, T

2017-01-01

To evaluate fluticasone propionate/formoterol (FP/FORM) in COPD. COPD patients with forced expiratory volume in 1 s (FEV 1 ) ≤50% predicted and ≥1 moderate/severe COPD exacerbation in the last 12 months were randomized to FP/FORM 500/20 or 250/10 µg bid, or formoterol (FORM) 12 µg bid for 52 weeks. The primary outcome was the annualized rate of moderate/severe COPD exacerbations. In total, 1,765 patients were randomized. There were fewer discontinuations with FP/FORM 500/20 µg (20.6%) and 250/10 µg (24.0%) compared with FORM (26.1%). None of the two FP/FORM doses reduced the moderate/severe exacerbation rate versus FORM (rate ratios [RR]: 0.93; P ≤0.402). There was a trend toward a lower moderate/severe exacerbation rate with FP/FORM 500/20 µg versus FORM in patients with ≥2 exacerbations in the preceding year (RR: 0.79; P =0.084). Pre- and post-dose FEV 1 and forced vital capacity were greater with FP/FORM 500/20 µg versus FORM ( P ≤0.039). There was a trend toward a lower EXAcerbations of Chronic pulmonary disease Tool (EXACT) exacerbation rate with FP/FORM 500/20 µg versus FORM (RR: 0.87; P =0.077). There were more St George's Respiratory Questionnaire for COPD (SGRQ-C) responders with FP/FORM 500/20 µg than FORM (odds ratios [OR] at weeks 6, 23 and 52 ≥1.28; P ≤0.054). EXACT-respiratory symptoms total and breathlessness scores were lower with both FP/FORM 500/20 µg and 250/10 µg versus FORM ( P ≤0.066). Acute β 2 -agonist-induced effects and 24-hour Holter findings were similar for all treatments. Mean 24-hour urinary cortisol was similarly reduced with both FP/FORM doses. Radiologically confirmed pneumonia was seen in 2.4%, 3.2% and 1.5% of FP/FORM 500/20 µg, FP/FORM 250/10 µg and FORM-treated patients, respectively. Adverse events were otherwise similar across treatment groups. FP/FORM did not reduce exacerbation rates versus FORM. Numerical benefits were observed with FP/FORM 500/20 µg versus FORM for secondary variables, including lung function, EXACT exacerbations, SGRQ-C and EXACT-respiratory symptoms total and breathlessness scores. Few efficacy differences were evident between FP/FORM 250/10 µg and FORM. Pneumonia was more frequent in FP/FORM-treated patients, although the absolute difference was low. Adverse events were otherwise similar between treatments.

Minimal domain of bacterial phytochrome required for chromophore binding and fluorescence

NASA Astrophysics Data System (ADS)

Rumyantsev, Konstantin A.; Shcherbakova, Daria M.; Zakharova, Natalia I.; Emelyanov, Alexander V.; Turoverov, Konstantin K.; Verkhusha, Vladislav V.

2015-12-01

Fluorescent proteins (FP) are used to study various biological processes. Recently, a series of near-infrared (NIR) FPs based on bacterial phytochromes was developed. Finding ways to improve NIR FPs is becoming progressively important. By applying rational design and molecular evolution we have engineered R. palustris bacterial phytochrome into a single-domain NIR FP of 19.6 kDa, termed GAF-FP, which is 2-fold and 1.4-fold smaller than bacterial phytochrome-based NIR FPs and GFP-like proteins, respectively. Engineering of GAF-FP involved a substitution of 15% of its amino acids and a deletion of the knot structure. GAF-FP covalently binds two tetrapyrrole chromophores, biliverdin (BV) and phycocyanobilin (PCB). With the BV chromophore GAF-FP absorbs at 635 nm and fluoresces at 670 nm. With the PCB chromophore GAF-FP becomes blue-shifted and absorbs at 625 nm and fluoresces at 657 nm. The GAF-FP structure has a high tolerance to small peptide insertions. The small size of GAF-FP and its additional absorbance band in the violet range has allowed for designing a chimeric protein with Renilla luciferase. The chimera exhibits efficient non-radiative energy transfer from luciferase to GAF-FP, resulting in NIR bioluminescence. This study opens the way for engineering of small NIR FPs and NIR luciferases from bacterial phytochromes.

Leveraging long acting reversible contraceptives to achieve FP2020 commitments in sub-Saharan Africa: The potential of implants

PubMed Central

Garfinkel, Danielle; Riley, Christina; Esch, Keith; Girma, Woldemariam; Kebede, Tadele; Kasongo, Gaby; Afolabi, Kayode; Kalamar, Amanda; Thurston, Sarah; Longfield, Kim; Bertrand, Jane; Shaw, Bryan

2018-01-01

Background In developing regions, an estimated 214 million women have an unmet need for family planning. Reaching Family Planning 2020 (FP2020) commitments will require a shift in modern contraceptive promotion, including improved access to long-acting reversible contraceptives (LARCs). Until now, a lack of market data limited understanding of the potential of LARCs to increase contraceptive access and choice. Methods From 2015, the FPwatch Project conducted representative surveys in Ethiopia, Nigeria, and Democratic Republic of Congo (DRC) using a full census approach in selected administrative areas. In these areas, every public and private sector outlet with the potential to sell or distribute modern contraceptives was approached. In outlets with modern contraceptives, product audits and provider interviews assessed contraceptive market composition, market share, availability, price, and outlet readiness to perform services. Results Fifty-four percent of outlets in Ethiopia had LARC commodities or services available at the time of the survey, versus 7% and 8% of outlets in Nigeria and DRC, respectively. When present, LARCs were usually available with at least two other methods (99%, 39%, and 84% of public health facilities in Ethiopia, Nigeria and DRC, respectively). Many public facilities had both implants and IUDs in stock (76%, 47%, and 53%, respectively). Lack of readiness to provide LARCs was mostly due to a lack of equipment, private room, or the commodity itself. Market share for implants in the public sector was 60%, 53%, and 37% of Couple Years of Protection (CYP) in Ethiopia, Nigeria, and DRC. Discussion Limited availability of LARCs in Nigeria and DRC restricts contraceptive choice and makes it difficult for women to adopt and use modern contraception consistently. Brand-specific subsidies, task shifting, and promotion of methods that require less equipment and training are promising strategies for increasing uptake. Substantial government investment is required to improve availability and affordability. Investment in implants should be prioritized to make progress towards FP2020 commitments. PMID:29630607

Does human resource management improve family planning service quality? Analysis from the Kenya Service Provision Assessment 2010.

PubMed

Thatte, Nandita; Choi, Yoonjoung

2015-04-01

Human resource (HR) management is a priority for health systems strengthening in developing countries, yet few studies have empirically examined associations with service quality. The purpose of this study was to assess the relationship between HR management and family planning (FP) service quality. Data came from the 2010 Kenya Service Provision Assessment, a nationally representative health facility assessment. In total, 912 FP consultations from 301 facilities were analysed. Four indices were created to measure quality on reproductive history taking, physical examination, sexually transmitted infections prevention and pill/injectable specific counselling. HR management variables included training in the past year, any and supportive (i.e. with feedback, technical updates and discussion) in-person supervision in the past 6 months and having a written job description. Multivariate linear regression analyses were conducted to estimate coefficients of HR management variables on each of the four quality indices, adjusting for background characteristics of clients, provider and facilities. The level of service quality ranged from 16 to 53 out of a maximum score of 100 across the indices. Fifty-two per cent of consultations were done by providers who received supportive in-person supervision in the previous 6 months. In 23% and 38% of consultations, the provider was trained in the past year and had a written job description, respectively. Multivariate analyses indicated that having a written job description was associated with higher service quality in history taking, physical examination and the pill/injectable specific counselling. Other HR management variables were not significantly associated with service quality. Having a written job description was significantly associated with higher service quality and may be a useful tool for strengthening management practices. The details of such job descriptions and the quality of other management indicators should be explored to better understand the relationship between HR management and FP service quality. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

FP core carrier technique: thermoplasticized gutta-percha root canal obturation technique using polypropylene core.

PubMed

Kato, Hiroshi; Nakagawa, Kan-Ichi

2010-01-01

Core carrier techniques are unique among the various root canal filling techniques for delivering and compacting gutta-percha in the prepared root canal system. Thermafil (TF), considered the major core carrier device, is provided as an obturator consisting of a master core coated with thermoplasticized gutta-percha. We have devised a thermoplasticized gutta-percha filling technique using a polypropylene core, FlexPoint® NEO (FP), which was developed as a canal filling material that can be sterilized in an autoclave. Therefore, FP can be coated onto thermoplasticized gutta-percha and inserted into the prepared canal as a core carrier. The FP core carrier technique offers many advantages over the TF system: the core can be tested in the root canal and verified radiographically; the core can be adjusted to fit and surplus material easily removed; furthermore the core can be easily removed for retreatment. The clinical procedure of the FP core carrier technique is simple, and similar that with the TF system. Thermoplasticized gutta-percha in a syringe is heated in an oven and extruded onto the FP core carrier after a trial insertion. The FP core carrier is inserted into the root canal to the working length. Excess FP is then removed with a red-hot plastic instrument at the orifice of the root canal. The FP core carrier technique incorporates the clinical advantages of the existing TF system while minimizing the disadvantages. Hence the FP core carrier technique is very useful in clinical practice. This paper describes the FP core carrier technique as a new core based method.

The independent effects of speed and propulsive force on joint power generation in walking

PubMed Central

Browne, Michael G.; Franz, Jason R.

2017-01-01

Walking speed is modulated using propulsive forces (FP) during push-off and both preferred speed and FP decrease with aging. However, even prior to walking slower, reduced FP may be accompanied by potentially unfavorable changes in joint power generation. For example, compared to young adults, older adults exhibit a redistribution of mechanical power generation from the propulsive plantarflexor muscles to more proximal muscles acting across the knee and hip. Here, we used visual biofeedback based on real-time FP measurements to decouple and investigate the interaction between joint-level coordination, whole-body FP, and walking speed. 12 healthy young subjects walked on a dual-belt instrumented treadmill at a range of speeds (0.9 – 1.3 m/s). We immediately calculated the average FP from each speed. Subjects then walked at 1.3 m/s while completing a series of biofeedback trials with instructions to match their instantaneous FP to their averaged FP from slower speeds. Walking slower decreased FP and total positive joint work with little effect on relative joint-level contributions. Conversely, subjects walked at a constant speed with reduced FP, not by reducing total positive joint work, but by redistributing the mechanical demands of each step from the plantarflexor muscles during push-off to more proximal leg muscles during single support. Interestingly, these naturally emergent joint- and limb-level biomechanical changes, in the absence of neuromuscular constraints, resemble those due to aging. Our findings provide important reference data to understand the presumably complex interactions between joint power generation, whole-body FP, and walking speed in our aging population. PMID:28262285

Structure-Related Roles for the Conservation of the HIV-1 Fusion Peptide Sequence Revealed by Nuclear Magnetic Resonance.

PubMed

Serrano, Soraya; Huarte, Nerea; Rujas, Edurne; Andreu, David; Nieva, José L; Jiménez, María Angeles

2017-10-17

Despite extensive characterization of the human immunodeficiency virus type 1 (HIV-1) hydrophobic fusion peptide (FP), the structure-function relationships underlying its extraordinary degree of conservation remain poorly understood. Specifically, the fact that the tandem repeat of the FLGFLG tripeptide is absolutely conserved suggests that high hydrophobicity may not suffice to unleash FP function. Here, we have compared the nuclear magnetic resonance (NMR) structures adopted in nonpolar media by two FP surrogates, wtFP-tag and scrFP-tag, which had equal hydrophobicity but contained wild-type and scrambled core sequences LFLGFLG and FGLLGFL, respectively. In addition, these peptides were tagged at their C-termini with an epitope sequence that folded independently, thereby allowing Western blot detection without interfering with FP structure. We observed similar α-helical FP conformations for both specimens dissolved in the low-polarity medium 25% (v/v) 1,1,1,3,3,3-hexafluoro-2-propanol (HFIP), but important differences in contact with micelles of the membrane mimetic dodecylphosphocholine (DPC). Thus, whereas wtFP-tag preserved a helix displaying a Gly-rich ridge, the scrambled sequence lost in great part the helical structure upon being solubilized in DPC. Western blot analyses further revealed the capacity of wtFP-tag to assemble trimers in membranes, whereas membrane oligomers were not observed in the case of the scrFP-tag sequence. We conclude that, beyond hydrophobicity, preserving sequence order is an important feature for defining the secondary structures and oligomeric states adopted by the HIV FP in membranes.

Standard curves of placental weight and fetal/placental weight ratio in Japanese population: difference according to the delivery mode, fetal sex, or maternal parity.

PubMed

Ogawa, Masaki; Matsuda, Yoshio; Nakai, Akihito; Hayashi, Masako; Sato, Shoji; Matsubara, Shigeki

2016-11-01

Placental weight (PW) and fetal/placental weight ratio (F/P) have been considered to be useful parameters for understanding the pathophysiology of fetal growth. However, there have been no standard data on PW and F/P in Asian populations. This study was conducted to establish nomograms of PW and F/P in the Japanese population and to clarify characteristics of PW and F/P in this population. Included in the study were 79,590 Japanese cases: 58,871 vaginal and 20,719 cesarean deliveries at obstetrical facilities (2001-2002) and registered to the Japan Society of Obstetrics and Gynecology Database. Multiple pregnancies, stillbirths, and fetal anomalies were excluded. Nomograms of PW and F/P were created by spline methods in groups categorized by fetal sex (male or female) and maternal parity (primipara or multipara). Standard curves of PW and F/P were established, which indicated that PW and F/P were lower in cesarean deliveries than vaginal deliveries, especially during preterm period. PW differed depending on fetal sex and maternal parity. F/P differed according to fetal sex. We for the first time established standard curves of PW and F/P in the Japanese population with statistically sufficient data, which showed that PW and F/P were lower in cesarean deliveries. PW and F/P were also affected by fetal sex. These data might be useful to understand the pathophysiology between the fetus and placenta in utero. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Snowballing movement. Legislators are now active advocates regarding population and development.

PubMed

De Leon, B D

1992-08-01

Newly industrializing economies (NIEs) in East Asia have demonstrated that the population programs were part of their economic success, such as in Thailand and Indonesia where family planning (FP) was made a way of life. The population growth in the Philippines has put pressure on the environment by migration to uplands where slash-and-burn agriculture adds to deforestation. The Global Committee of Parliamentarians of Population and Development headquartered in New York serves as a liaison for 56 legislative groups sponsoring meetings and seminars. In October 1981 the Asian Conference on Parliamentarians on Population and Development was held in Beijing with the participation of legislators from 19 countries. It set up the Asian Forum for Parliamentarians on Population and Development to contribute and promote activities that facilitate population and development, and to improve the living standards and welfare of people in Asia. The Secretariat is located in Bangkok, Thailand. In October 1987 in Beijing and in October 1990 follow-up regional conferences were organized. The latter was attended by 21 Asian parliamentarians who endorsed the stabilization of population growth to achieve a 1% growth rate for Asia by 2000. The Philippine population numbered 63.9 million in mid-1992 with an annual growth rate of 2.3%. The Philippine House of Representatives started an inquiry about the disturbing demographic trends with implications on economic growth. In 1987 a movement commenced that hosted the Philippine Parliamentarians Conference on Human Survival, Population and Development (PARLCON '88) in Manila. It focused on sustainable development, the conditions of women and children, the environment, and the promotion of FP which was adopted by the House and involved a major segment of legislators.

Ecological surveillance of small mammals at Firing Points 10 and 60, Gyeonggi Province, Republic of Korea, 2001-2005.

PubMed

O'Guinn, Monica L; Klein, Terry A; Lee, John S; Kim, Heung-Chul; Baek, Luck-Ju; Chong, Sung-Tae; Turell, Michael J; Burkett, Douglas A; Schuster, Anthony; Lee, In-Yong; Yi, Suk-Hee; Sames, William J; Song, Ki-Joon; Song, Jin-Won

2008-12-01

Throughout Korea, small mammals are hosts to a number of disease-causing agents that pose a health threat to U.S. and Korean military forces while they conduct field-training exercises. A seasonal rodent-borne disease surveillance program was established at two firing points (FP), FP-10, and FP-60, and conducted over five years from 2001 through 2005 in response to hantavirus cases among U.S. soldiers. The ecology of these sites consisted primarily of tall grasses associated with semi-permanent and temporary water sources (drainage ditches and a small stream) and dry-land agriculture farming. Eight species of rodents and one species of insectivore were collected, including Apodemus agrarius, Micromys minutus, Mus musculus, Rattus norvegicus, Tscherskia triton, Microtus fortis, Myodes regulus, and Crocidura lasiura. The striped field mouse, A. agrarius, (primary reservoir for Hantaan virus, the causative agent of Korean hemorrhagic fever), was the most frequently collected, representing 90.6% of the 1,288 small mammals captured at both sites. Reported herein are the ecological parameters, seasonal population densities, and seasonal population characteristics associated with small mammals collected at two military training sites in the Republic of Korea.

Civil forensic psychiatry - Part 2: specific issues.

PubMed

Samuels, Anthony H

2018-06-01

This paper describes the main areas of civil forensic psychiatry (FP) and the skills required by psychiatric experts. Some specific areas of civil FP are discussed, including tort law reform, reliability of psychiatric evidence, contentious psychiatric disorders, and the many domains of civil FP. Civil FP is an important sub-specialty component of forensic psychiatry that requires greater emphasis in the training and continuing education of psychiatrists. A process of accrediting psychiatrists as having competency in advanced civil FP may be of value.

Is traditional contraceptive use in Moldova associated with poverty and isolation?

PubMed

Lyons-Amos, Mark J; Durrant, Gabriele B; Padmadas, Sabu S

2011-05-01

This study investigates the correlates of traditional contraceptive use in Moldova, a poor country in Europe with one of the highest proportions of traditional contraceptive method users. The high reliance on traditional methods, particularly in the context of sub-replacement level fertility rate, has not been systematically evaluated in demographic research. Using cross-sectional data on a sub-sample of 6039 sexually experienced women from the 2005 Moldovan Demographic and Health Survey, this study hypothesizes that (a) economic and spatial disadvantages increase the likelihood of traditional method use, and (b) high exposure to family planning/reproductive health (FP/RH) programmes increases the propensity to modern method use. Multilevel multinomial models are used to examine the correlates of traditional method use controlling for exposure to sexual activity, socioeconomic and demographic characteristics and data structure. The results show that economic disadvantage increases the probability of traditional method use, but the overall effect is small. Although higher family planning media exposure decreases the reliance on traditional methods among younger women, it has only a marginal effect in increasing modern method use among older women. Family planning programmes designed to encourage women to switch from traditional to modern methods have some success--although the effect is considerably reduced in regions outside of the capital Chisinau. The study concludes that FP/RH efforts directed towards the poorest may have limited impact, but interventions targeted at older women could reduce the burden of unwanted pregnancies and abortions. Addressing differentials in accessing modern methods could improve uptake in rural areas.

Pregnancy termination in Matlab, Bangladesh: maternal mortality risks associated with menstrual regulation and abortion.

PubMed

Rahman, Mizanur; DaVanzo, Julie; Razzaque, Abdur

2014-09-01

In Bangladesh, both menstrual regulation (MR), which is thought to be a relatively safe method, and abortion, which in this setting is often performed using unsafe methods, are used to terminate pregnancies (known or suspected). However, little is known about changes over time in the use of these methods or their relative mortality risks. Data from the Demographic Surveillance System in Matlab, Bangladesh, on 110,152 pregnancy outcomes between 1989 and 2008 were used to assess changes in mortality risks associated with MR (and a small number of dilation and curettage procedures), abortion and live birth. Tabulation and logistic regression analyses were used to compare outcomes in two areas of Matlab--the comparison area, which receives standard government health and family planning services, and the Maternal and Child Health-Family Planning (MCH-FP) area, which receives enhanced health and family planning services. In Matlab as a whole, the proportion of pregnancies ending in MR increased from 1.9% in 1989-1999 to 4.2% in 2000-2008, while the proportion ending in abortion decreased from 1.6% to 1.1%. The odds of mortality from MR were 4.1 times those from live birth in 1989-1999, but were no longer elevated in 2000-2008. The odds of mortality from abortion were 12.0 and 4.9 times those of live birth in 1989-1999 and 2000-2008, respectively. Reduction in mortality risk was greater in the MCH-FP area than the comparison area (90% vs. 75%). MR is no longer associated with higher mortality risk than live birth in Bangladesh, but abortion is.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Nishi, Shohei; Taguchi, Dai; Manaka, Takaaki

By using electric-field-induced optical second-harmonic generation measurement coupled with the conventional current-voltage (I-V) measurement, we studied the carrier transport of organic double-layer diodes with a Au/pentacene/fluorine polymer (FP)/indium zinc oxide (IZO) structure. The rectifying I-V characteristics were converted into the I-E characteristics of the FP and pentacene layers. Results suggest a model in which Schottky-type electron injection from the IZO electrode to the FP layer governs the forward electrical conduction (V > 0), where the space charge electric field produced in the FP layer by accumulated holes at the pentacene/FP interface makes a significant contribution. On the other hand, Schottky-type injection bymore » accumulated interface electrons from the pentacene layer to the FP layer governs the backward electrical conduction (V < 0). The electroluminescence generated from the pentacene layer in the region V > 0 verifies the electron transport across the FP layer, and supports the above suggested model.« less

Developmental Dissociations of Preparation over Time: Deconstructing the Variable Foreperiod Phenomena

ERIC Educational Resources Information Center

Vallesi, Antonino; Shallice, Tim

2007-01-01

In a variable foreperiod (FP) paradigm, reaction times (RTs) decrease as a function of FP on trial n (FP effect) but increase with FP on trial n = 1 (sequential effects). These phenomena have traditionally been ascribed to different strategic preparation processes. According to an alternative explanation, common conditioning laws underlie both…

Galaxy Properties Across and Through the 6dFGS Fundamental Plane

NASA Astrophysics Data System (ADS)

Springob, Chris M.; Magoulas, C.; Proctor, R.; Colless, M.; Jones, D. H.; Kobayashi, C.; Campbell, L.; Lucey, J.; Mould, J.; Merson, A.

2011-05-01

The 6dF Galaxy Survey (6dFGS) is an all southern sky galaxy survey, including 125,000 redshifts and a Fundamental Plane (FP) subsample of 10,000 peculiar velocities, making it the largest peculiar velocity sample to date. We have developed a robust procedure for fitting the FP, performing a maximum likelihood fit to a tri-variate Gaussian. We have subsequently examined the variation of a variety of properties across and through the FP, including environment, morphology, metallicity, alpha-enhancement, and stellar age. We find little variation in the FP with global environment. Some variation of morphology is found along the plane, though this is likely a consequence of selection effects. Elemental abundances are found to vary both across and through the FP. The parameter that varies most directly through the FP is stellar age. We find that galaxies with stellar populations with average ages older than 3 Gyr occupy a thinner FP than those younger than 3 Gyr. Thus, a modest improvement in distance errors is realized if one divides the sample into subsamples segregated by age, and fits the FP of each subsample independently.

Pediatric oncology nurses' attitudes related to discussing fertility preservation with pediatric cancer patients and their families.

PubMed

Vadaparampil, Susan T; Clayton, Heather; Quinn, Gwendolyn P; King, Lindsey M; Nieder, Michael; Wilson, Crystal

2007-01-01

This study explores nurses' attitudes toward the discussion of fertility preservation (FP) with pediatric cancer patients and their families. A cross-sectional survey was administered to attendees of a pediatric oncology conference. Of the 115 nurses who responded and comprised the study sample, most reported discussing risks of infertility or FP

Infusion of oxytocin induces successful delivery in prostanoid FP-receptor-deficient mice.

PubMed

Kawamata, Masaki; Yoshida, Masahide; Sugimoto, Yukihiko; Kimura, Tadashi; Tonomura, Yutaka; Takayanagi, Yuki; Yanagisawa, Teruyuki; Nishimori, Katsuhiko

2008-02-13

The dramatic increase of oxytocin (OT) receptor (OTR) in the myometrium as well as circulating progesterone withdrawal has been thought to be the most important factor in the induction and accomplishment of parturition since delivery fails in prostaglandin F2alpha receptor (FP) knockout (FP KO) mice. The expression levels of OTR mRNA/protein were not dramatically increased in the near-term uteri of FP KO mice. However, OT-induced myometrial contractions and the concentration-response curves in FP KO in vitro were almost similar to those in wild-type (WT) mice. OT-infusion (0.3 U/day) enabled FP KO mice to experience successful delivery, and furthermore the duration until the onset was hastened by a higher dose of OT (3 U/day). The plasma progesterone levels of FP KO females were maintained at high levels, but decreased during labor by OT-infusion (3 U/day). These results suggest that OT has potentials to induce strong myometrial contractions in uterus with low expression levels of OTR and luteolysis in ovary, which enabled FP KO females to undergo successful delivery.

Direct observation of trapped charges under field-plate in p-GaN gate AlGaN/GaN high electron mobility transistors by electric field-induced optical second-harmonic generation

NASA Astrophysics Data System (ADS)

Katsuno, Takashi; Manaka, Takaaki; Soejima, Narumasa; Iwamoto, Mitsumasa

2017-02-01

Trapped charges underneath the field-plate (FP) in a p-gallium nitride (GaN) gate AlGaN/ GaN high electron mobility transistor device were visualized by using electric field-induced optical second-harmonic generation imaging. Second-harmonic (SH) signals in the off-state of the device with FP indicated that the electric field decreased at the p-GaN gate edge and concentrated at the FP edge. Nevertheless, SH signals originating from trapped charges were slightly observed at the p-GaN gate edge and were not observed at the FP edge in the on-state. Compared with the device without FP, reduction of trapped charges at the p-GaN gate edge of the device with FP is attributed to attenuation of the electric field with the aid of the FP. Negligible trapped charges at the FP edge is owing to lower trap density of the SiO2/AlGaN interface at the FP edge compared with that of the SiO2/p-GaN sidewall interface at the p-GaN gate edge and attenuated electric field by the thickness of the SiO2 passivation layer on the AlGaN surface.

Time Frame and Justice Motive: Future Perspective Moderates the Adaptive Function of General Belief in a Just World

PubMed Central

Wu, Michael Shengtao; Sutton, Robbie M.; Yan, Xiaodan; Zhou, Chan; Chen, Yiwen; Zhu, Zhuohong; Han, Buxin

2013-01-01

Background The human ability to envision the future, that is, to take a future perspective (FP), plays a key role in the justice motive and its function in transcending disadvantages and misfortunes. The present research investigated whether individual (Study 1) and situational (Study 2) differences in FP moderated the association of general belief in a just world (GBJW) with psychological resilience. Methodology/Principal Findings We investigated FP, GBJW, and resilience in sample of adolescents (n = 223) and disaster survivors (n = 218) in China. In Study 1, adolescents revealed stronger GBJW than PBJW, and GBJW uniquely predicted resilience in the daily lives of those with high FP (but not those with low FP). In Study 2, natural priming of FP (vs. no FP) facilitated the association of GBJW with resilience after disaster. Conclusions/Significance Supporting predictions, participants endorsed GBJW more strongly than PBJW. Further, GBJW interacted with FP in both studies, such that there was an association between GBJW and resilience at high but not low levels of FP. The results corroborate recent findings suggesting that GBJW may be more psychologically adaptive than PBJW among some populations. They also confirm that focusing on the future is an important aspect of the adaptive function of just-world beliefs. PMID:24312235

Prostaglandin F2α receptor silencing attenuates vascular remodeling in rats with type 2 diabetes.

PubMed

Li, Ya; Han, Lu; Ding, Wen-Yuan; Ti, Yun; Li, Yi-Hui; Tang, Meng-Xiong; Wang, Zhi-Hao; Zhang, Yun; Zhang, Wei; Zhong, Ming

2015-12-01

Vascular remodeling is an important feature of diabetic macrovascular complications. The prostaglandin F2α receptor (FP), the expression of which is upregulated by insulin resistance and diabetes, is reportedly involved in myocardial remodeling. In this study, we aimed to investigate whether the FP receptor is implicated in diabetes-induced vascular remodeling. A type 2 diabetic rat model was induced through a high-fat diet and low-dose streptozotocin (STZ). Thirty-two rats were randomized into four groups: control, diabetes, diabetes treated with empty virus and diabetes treated with FP receptor-shRNA. Then, we evaluated the metabolic index, FP receptor expression and vascular remodeling. We used FP receptor gene silencing in vivo to investigate the role that the FP receptor plays in the pathophysiologic features of vascular remodeling. Diabetic rats displayed increased levels of blood glucose, cholesterol, and triglycerides, as well as severe insulin resistance and FP receptor overexpression. In addition, increased medial thickness, excessive collagen deposition and diminished elastic fibers were observed in the diabetic rats, resulting in vascular remodeling. In the FP receptor-shRNA group, the medial thickness, collagen content, elastin/collagen ratio, and collagen I/collagen III content ratio were markedly decreased. Additionally, with FP receptor gene silencing, the JNK phosphorylation level was markedly decreased. Silencing of the FP receptor exerts a protective effect on diabetes-induced vascular remodeling, thereby suggesting a new therapeutic target for vascular remodeling in diabetes. Copyright © 2015 Elsevier Inc. All rights reserved.

Toward a Model-Based Approach to Flight System Fault Protection

NASA Technical Reports Server (NTRS)

Day, John; Murray, Alex; Meakin, Peter

2012-01-01

Fault Protection (FP) is a distinct and separate systems engineering sub-discipline that is concerned with the off-nominal behavior of a system. Flight system fault protection is an important part of the overall flight system systems engineering effort, with its own products and processes. As with other aspects of systems engineering, the FP domain is highly amenable to expression and management in models. However, while there are standards and guidelines for performing FP related analyses, there are not standards or guidelines for formally relating the FP analyses to each other or to the system hardware and software design. As a result, the material generated for these analyses are effectively creating separate models that are only loosely-related to the system being designed. Development of approaches that enable modeling of FP concerns in the same model as the system hardware and software design enables establishment of formal relationships that has great potential for improving the efficiency, correctness, and verification of the implementation of flight system FP. This paper begins with an overview of the FP domain, and then continues with a presentation of a SysML/UML model of the FP domain and the particular analyses that it contains, by way of showing a potential model-based approach to flight system fault protection, and an exposition of the use of the FP models in FSW engineering. The analyses are small examples, inspired by current real-project examples of FP analyses.

Long-Term Safety of Letrozole and Gonadotropin Stimulation for Fertility Preservation in Women With Breast Cancer

PubMed Central

Kim, Jayeon; Turan, Volkan

2016-01-01

Context and Objective: There has been increased attention to the issue of fertility preservation (FP). We aimed to investigate the long-term safety of FP via controlled ovarian stimulation with letrozole supplementation (COSTLES) prior to breast cancer treatment. Design, Setting, and Participants: This is a prospective, nonrandomized, controlled study conducted between the years 2002 and 2014. A total of 337 women diagnosed with stage 3 or less invasive breast cancer were enrolled during a FP consultation before chemotherapy. Of those, 120 elected to undergo COSTLES for FP prior to chemotherapy (FP group). The remaining 217 patients did not undergo any FP procedure and served as the controls. Main Outcome Measure: The primary end point was cancer recurrence defined as the detection of locoregional tumor (chest wall, regional nodal disease), distant metastases, or contralateral invasive breast cancer. Results: The baseline characteristics at enrollment were similar between the FP and control groups except for the less frequent lymph node involvement (P = .02) in the former. The mean follow-up after diagnosis was 5.0 years in the FP group and 6.9 years in the control group. In the FP group, the hazard ratio for recurrence after ovarian stimulation was 0.77 (95% confidence interval 0.28–2.13), and the survival was not compromised compared with controls (P = .61). Neither BRCA gene mutation status (P = .57) nor undergoing FP before or after breast surgery (P = .44) affected survival outcomes in the FP group. Likewise, none of the tumor characteristics including the estrogen receptor status affected the survival rates after the COSTLES. Conclusion: COSTLES is unlikely to cause a substantially increased recurrence risk in breast cancer during the 5 years after diagnosis. PMID:26751194

Traditional GFP-type cyclization and unexpected fragmentation site in a purple chromoprotein from Anemonia sulcata, asFP595.

PubMed

Zagranichny, Vasily E; Rudenko, Natalia V; Gorokhovatsky, Andrey Yu; Zakharov, Mikhail V; Balashova, Tamara A; Arseniev, Alexander S

2004-10-26

The purple chromoprotein (asFP595) from Anemonia sulcata belongs to the family of green fluorescent protein (GFP). Absorption and emission spectra of asFP595 are similar to those of a number of recently cloned GFP-like red proteins of the DsRed subfamily. The earlier proposed asFP595 chromophore structure [Martynov, V. I.; et al. (2001) J. Biol. Chem. 276, 21012-21016] was postulated to result from an "alternative cyclization" giving rise to a pyrazine-type six-membered heterocycle. Here we report that the asFP595 chromophore is actually very close in chemical structure to that of zFP538, a yellow fluorescent protein [Zagranichny, V. E.; et al. (2004) Biochemistry 43, 4764-4772]. NMR spectroscopic studies of four chromophore-containing peptides (chromopeptides) isolated under mild conditions from enzymatic digests of asFP595 and one chromopeptide obtained from DsRed revealed that all of them contain a p-hydroxybenzylideneimidazolinone moiety formed by Met-65/Gln-66, Tyr-66/67, and Gly-67/68 of asFP595/DsRed, respectively. Two asFP595 chromopeptides are proteolysis products of an isolated full-length polypeptide containing a GFP-type chromophore already formed and arrested at an earlier stage of maturation. The two other asFP595 chromopeptides were isolated as proteolysis products of the purified chromophore-containing C-terminal fragment. One of these has an oxo group at Met-65 C(alpha) and is a hydrolysis product of another one, with the imino group at Met-65 C(alpha). The N-unsubstituted imino moiety of the latter is generated by spontaneous polypeptide chain cleavage at a very unexpected site, the former peptide bond between Cys-64 C' and Met-65 N(alpha). Our data strongly suggest that both zFP538 and asFP595 could be attributed to the DsRed subfamily of GFP-like proteins.

A BCWD-resistant line of rainbow trout exhibits higher abundance of IgT+ B cells and heavy chain tau transcripts compared to a susceptible line following challenge with Flavobacterium psychrophilum.

PubMed

Zwollo, Patty; Hennessey, Erin; Moore, Catherine; Marancik, David P; Wiens, Gregory D; Epp, Lidia

2017-09-01

Bacterial Cold Water Disease (BCWD) is a common, chronic disease in rainbow trout, and is caused by the gram-negative bacterium Flavobacterium psychrophilum (Fp). Through selective breeding, the National Center for Cool and Cold Water Aquaculture has generated a genetic line that is highly resistant to Fp challenge, designated ARS-Fp-R (or R-line), as well as a susceptible "control" line, ARS-Fp-S (S-line). In previous studies, resistance to Fp had been shown to correlate with naive animal spleen size, and further, naïve R-line trout had been shown to have a lower abundance of IgM + and IgM ++ cells compared to S-line fish. Here we wished to first determine whether the abundance of IgT + and/or IgT ++ cells differed between the two lines in naïve fish, and if so, how these patterns differed after in vivo challenge with Fp. Fp challenge was by intramuscular injection of live Fp and tissue collections were on days 5, 6, and/or 28 post-challenge, in two independent challenge experiments. Flow cytometric and gene expression analyses revealed that naïve R-line fish had a higher abundance of IgT + B cells in their anterior kidney, spleen, and blood, compared to S line fish. Further, that after Fp challenge, this difference was maintained between the two lines. Lastly, abundance of IgT + B cells and expression of secHCtau correlated with lower Fp pathogen loads in challenged fish. In the anterior kidney, IgM + B cell abundance correlated with increased Fp loads. Together, these results suggest that IgT + B lineage cells may have a protective function in the immune response to Fp. Copyright © 2017 Elsevier Ltd. All rights reserved.

Enhancing the biophysical properties of mRFP1 through incorporation of fluoroproline

DOE Office of Scientific and Technical Information (OSTI.GOV)

Deepankumar, Kanagavel; Nadarajan, Saravanan Prabhu; Ayyadurai, Niraikulam

2013-11-01

Graphical abstract: Enhancing the biophysical properties of mRFP1 through incorporation of (2S, 4R)-4-fluoroproline at proline residues after mutating non-permissive site Pro63 into Ala. -- Highlights: •We incorporate (4S)-FP into mRFP1 led to insoluble protein. •Whereas, incorporation of (4R)-FP resulted in soluble but lost its fluorescence. •mRFP1-P63A mutant accommodate (4R)-FP and gave soluble protein with fluorescence. •Moreover mRFP1-P63A[(4R)-FP] showed enhanced biophysical properties of protein. -- Abstract: Here we enhanced the stability and biophysical properties of mRFP1 through a combination of canonical and non-canonical amino acid mutagenesis. The global replacement of proline residue with (2S, 4R)-4-fluoroproline [(4R)-FP] into mRFP1 led to solublemore » protein but lost its fluorescence, whereas (2S, 4S)-4-fluoroproline [(4S)-FP] incorporation resulted in insoluble protein. The bioinformatics analysis revealed that (4R)-FP incorporation at Pro63 caused fluorescence loss due to the steric hindrance of fluorine atom of (4R)-FP with the chromophore. Therefore, Pro63 residue was mutated with the smallest amino acid Ala to maintain non coplanar conformation of the chromophore and helps to retain its fluorescence with (4R)-FP incorporation. The incorporation of (4R)-FP into mRFP1-P63A showed about 2–3-fold enhancement in thermal and chemical stability. The rate of maturation is also greatly accelerated over the presence of (4R)-FP into mRFP1-P63A. Our study showed that a successful enhancement in the biophysical property of mRFP1-P63A[(4R)-FP] using non-canonical amino acid mutagenesis after mutating non-permissive site Pro63 into Ala.« less

FP-receptor gene silencing ameliorates myocardial fibrosis and protects from diabetic cardiomyopathy.

PubMed

Ding, Wen-yuan; Liu, Lin; Wang, Zhi-hao; Tang, Meng-xiong; Ti, Yun; Han, Lu; Zhang, Lei; Zhang, Yun; Zhong, Ming; Zhang, Wei

2014-06-01

Prostaglandin F2(α)-F-prostanoid (PGF2(α)-FP) receptor is closely related to insulin resistance, which plays a causal role in the pathogenesis of diabetic cardiomyopathy (DCM). We sought to reveal whether PGF2(α)-FP receptor plays an important part in modulating DCM and the mechanisms involved. We established the type 2 diabetes rat model by high-fat diet and low-dose streptozotocin (STZ) and then evaluated its characteristics by metabolite tests, Western blot analysis for FP-receptor expression, histopathologic analyses of cardiomyocyte density and fibrosis area. Next, we used gene silencing to investigate the role of FP receptor in the pathophysiologic features of DCM. Our study showed elevated cholesterol, triglyceride, glucose, and insulin levels, severe insulin resistance, and FP-receptor overexpression in diabetic rats. The collagen volume fraction (CVF) and perivascular collagen area/luminal area (PVCA/LA) were higher in the diabetic group than the control group (CVF% 10.99 ± 0.99 vs 1.59 ± 0.18, P < 0.05; PVCA/LA% 17.07 ± 2.61 vs 2.86 ± 0.69, P < 0.05). We found that the silencing of FP receptor decreased cholesterol, triglyceride, glucose, and insulin levels and ameliorated insulin resistance. The CVF and PVCF/LA were significantly downregulated in FP-receptor short hairpin RNA (shRNA) treatment group (FP-receptor shRNA group vs vehicle group: CVF% 5.59 ± 0.92 vs 10.97 ± 1.33, P < 0.05, PVCA/LA% 4.74 ± 1.57 vs 14.79 ± 2.22, P < 0.05; FP-receptor shRNA + PGF2(α) group vs vehicle group : CVF% 5.19 ± 0.79 vs 10.97 ± 1.33, P < 0.05, PVCA/LA% 5.96 ± 1.15 vs 14.79 ± 2.22, P < 0.05, respectively). Furthermore, with FP-receptor gene silencing, the activated protein kinase C (PKC) and Rho kinase were significantly decreased, and the blunted phosphorylation of Akt was restored. FP-receptor gene silencing may exert a protective effect on DCM by improving myocardial fibrosis, suggesting a new therapeutic approach for human DCM. FP-receptor gene silencing improves glucose tolerance and insulin resistance in type 2 diabetes (T2D). FP-receptor gene silencing modulates the activities of PKC/Rho and Akt signaling pathways in T2D. FP-receptor gene silencing decreases collagen expression and ameliorates myocardial fibrosis in T2D. FP-receptor gene silencing protects from diabetic cardiomyopathy in T2D.

Newborn Screening for Glutaric Aciduria-II: The New England Experience.

PubMed

Sahai, I; Garganta, C L; Bailey, J; James, P; Levy, H L; Martin, M; Neilan, E; Phornphutkul, C; Sweetser, D A; Zytkovicz, T H; Eaton, R B

2014-01-01

Newborn screening (NBS) using tandem mass spectrometry (MS/MS) permits detection of neonates with Glutaric Aciduria-Type II (GA-II). We report follow-up of positive GA-II screens by the New England Newborn Screening Program. 1.5 million infants were screened for GA-II (Feb 1999-Dec 2012). Specialist consult was suggested for infants with two or more acylcarnitine elevations suggestive of GA-II. 82 neonates screened positive for GA-II, 21 weighing > 1.5 kg and 61 weighing ≤ 1.5 kg. Seven (one weighing < 1.5 kg), were confirmed with GA-II. Four of these had the severe form (died < 1 week). The other three have a milder form and were identified because of newborn screening. Two (ages > 5 years) have a G-Tube in place, had multiple hospitalizations and are slightly hypotonic. The third infant remains asymptomatic (9 months old). Two GA-II carriers were also identified. The remaining positive screens were classified as false positives (FP). Six infants (> 1.5 kg) classified as FP had limited diagnostic work-up. Characteristics and outcomes of all specimens and neonates with a positive screen were reviewed, and marker profiles of the cases and FP were compared to identify characteristic profiles. In addition to the severe form of GA-II, milder forms of GA-II and some GA-II carriers are identified by newborn screening. Some positive screens classified as FP may be affected with a milder form of the disorder. Characteristic GA-II profiles, quantified as GA-II indexes, may be utilized to predict probability of disorder and direct urgency of intervention for positive screens.

Measles elimination – review of event notifications sent to National IHR Focal Point between 2010 and 2016

PubMed

Izdebski, Radosław; Henszel, Łukasz; Janiec, Janusz; Radziszewski, Franciszek

The Member States of the World Health Organization (WHO) in accordance with International Health Regulations (2005) were obliged to appoint National IHR Focal Points (N IHR FP), of which tasks include obtaining information concerning public health emergencies of international concern which occurred abroad or within the country. The aim of this work is the review of WHO, ECDC, National IHR Focal Points from the WHO Member States and The State Sanitary Inspection notifications related to measles received by National IHR Focal Point in Poland in the period from 2010 to 2016. During this period N IHR FP was informed about 79 events related to measles. These events include: 36 related to the outbreaks in different countries, 27 concerning individual cases, 14 related to the exposure in contact with a measles case during air travel and two concerning the implementation of the MMR vaccination programs. Despite the progress in implementing the measures included in the elimination of measles programs in Europe, there was a significant increase in the number of measles cases and outbreaks particularly in years 2010-2011.

Impacts of prenatal nutrition on animal production and performance: a focus on growth and metabolic and endocrine function in sheep.

PubMed

Khanal, Prabhat; Nielsen, Mette Olaf

2017-01-01

The concept of foetal programming (FP) originated from human epidemiological studies, where foetal life nutrition was linked to health and disease status later in life. Since the proposal of this phenomenon, it has been evaluated in various animal models to gain further insights into the mechanisms underlying the foetal origins of health and disease in humans. In FP research, the sheep has been quite extensively used as a model for humans. In this paper we will review findings mainly from our Copenhagen sheep model, on the implications of late gestation malnutrition for growth, development, and metabolic and endocrine functions later in life, and discuss how these implications may depend on the diet fed to the animal in early postnatal life. Our results have indicated that negative implications of foetal malnutrition, both as a result of overnutrition and, particularly, late gestation undernutrition, can impair a wide range of endocrine functions regulating growth and presumably also reproductive traits. These implications are not readily observable early in postnatal life, but are increasingly manifested as the animal approaches adulthood. No intervention or cure is known that can reverse this programming in postnatal life. Our findings suggest that close to normal growth and slaughter results can be obtained at least until puberty in animals which have undergone adverse programming in foetal life, but manifestation of programming effects becomes increasingly evident in adult animals. Due to the risk of transfer of the adverse programming effects to future generations, it is therefore recommended that animals that are suspected to have undergone adverse FP are not used for reproduction. Unfortunately, no reliable biomarkers have as yet been identified that allow accurate identification of adversely programmed offspring at birth, except for very low or high birth weights, and, in pigs, characteristic changes in head shape (dolphin head). Future efforts should be therefore dedicated to identify reliable biomarkers and evaluate their effectiveness for alleviation/reversal of the adverse programming in postnatal life. Our sheep studies have shown that the adverse impacts of an extreme, high-fat diet in early postnatal life, but not prenatal undernutrition, can be largely reversed by dietary correction later in life. Thus, birth (at term) appears to be a critical set point for permanent programming in animals born precocial, such as sheep. Appropriate attention to the nutrition of the late pregnant dam should therefore be a priority in animal production systems.

Hemorrhoids detected at colonoscopy: an infrequent cause of false-positive fecal immunochemical test results.

PubMed

van Turenhout, Sietze T; Oort, Frank A; Terhaar sive Droste, Jochim S; Coupé, Veerle M H; van der Hulst, Rene W; Loffeld, Ruud J; Scholten, Pieter; Depla, Annekatrien C T M; Bouman, Anneke A; Meijer, Gerrit A; Mulder, Chris J J; van Rossum, Leo G M

2012-07-01

Colorectal cancer screening by fecal immunochemical tests (FITs) is hampered by frequent false-positive (FP) results and thereby the risk of complications and strain on colonoscopy capacity. Hemorrhoids might be a plausible cause of FP results. To determine the contribution of hemorrhoids to the frequency of FP FIT results. Retrospective analysis from prospective cohort study. Five large teaching hospitals, including 1 academic hospital. All subjects scheduled for elective colonoscopy. FIT before bowel preparation. Frequency of FP FIT results in subjects with hemorrhoids as the only relevant abnormality compared with FP FIT results in subjects with no relevant abnormalities. Logistic regression analysis to determine colonic abnormalities influencing FP results. In 2855 patients, 434 had positive FIT results: 213 had advanced neoplasia and 221 had FP results. In 9 individuals (4.1%; 95% CI, 1.4-6.8) with an FP FIT result, hemorrhoids were the only abnormality. In univariate unadjusted analysis, subjects with hemorrhoids as the only abnormality did not have more positive results (9/134; 6.7%) compared with subjects without any abnormalities (43/886; 4.9%; P = .396). Logistic regression identified hemorrhoids, nonadvanced polyps, and a group of miscellaneous abnormalities, all significantly influencing false positivity. Of 1000 subjects with hemorrhoids, 67 would have FP results, of whom 18 would have FP results because of hemorrhoids only. Potential underreporting of hemorrhoids; high-risk individuals. Hemorrhoids in individuals participating in colorectal cancer screening will probably not lead to a substantial number of false-positive test results. Copyright © 2012 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.

Use of Lactobacillus plantarum fermentation products in bread-making to prevent Bacillus subtilis ropy spoilage.

PubMed

Valerio, Francesca; De Bellis, Palmira; Lonigro, Stella L; Visconti, Angelo; Lavermicocca, Paola

2008-03-20

Four fermentation products (FPs) of the lactic acid bacterium Lactobacillus plantarum ITM21B were screened for their anti-Bacillus activity in vitro and in bread-making trials. Results of the storage tests performed with loaves prepared with an FP or calcium propionate demonstrated that after 3 days at 30 degrees C, gross spoilage was evident in only the control loaves, which contained Bacillus subtilis at numbers of about 10(9) cfu/g. The highest inhibitory activity was shown by DM-FP obtained by growing L. plantarum in a defined medium (DM). Significantly, this medium contained an amino acceptor of the aminoacid transamination, namely alpha-ketoglutaric acid, and an aminoacid pool. With loaves prepared using the DM-acid mixture which simulated the DM-FP composition, the same reduction of ropy spoilage as with DM-FP was obtained after 3 days, while the efficacy of the mixture decreased after 7 days. This result suggests the potential involvement of some unknown metabolites in the inhibitory activity of DM-FP. In baked products made with flour based media (M1-FP, M2-FP, M3-FP), no ropy symptoms were noticeable after 3 days storage although a considerable Bacillus count was detected. DM-FP was as effective as calcium propionate (0.3% w/w, based on flour mass) in prolonging the Bacillus free-shelf life of yeast-leavened bread for 7 days.

Modulus, strength and thermal exposure studies of FP-Al2O3/aluminum and FP-Al2O3/magnesium composites

NASA Technical Reports Server (NTRS)

Bhatt, R. T.

1981-01-01

The mechanical properties of FP-Al2O3 fiber reinforced composites prepared by liquid infiltration techniques are improved. A strengthening addition, magnesium, was incorporated with the aluminum-lithium matrix alloy usually selected for these composites because of its good wetting characteristics. This ternary composite, FP-Al2O3/Al-(2-3)Li-(3-5)Mg, showed improved transverse strength compared with FP-Al2O3/Al-(2-3)Li composites. The lower axial strengths found for the FP-Al2O3/Al-(2-3)Li-(3-5)Mg composites were attributed to fabrication related defects. Another technique was the use of Ti/B coated FP-Al2O3 fibers in the composites. This coating is readily wet by molten aluminum and permitted the use of more conventional aluminum alloys in the composites. However, the anticipated improvements in the axial and transverse strengths were not obtained due to poor bonding between the fiber coating and the matrix. A third approach studied to improve the strengths of FP-Al2O3 reinforced composites was the use of magnesium alloys as matrix materials. While these alloys wet fibers satisfactorily, the result indicated that the magnesium alloy composites used offered no axial strength or modulus advantage over FP-Al2O3/Al-(2-3)Li composites.

Remedial Investigation/Feasibility Study/Interim Response Actions

DTIC Science & Technology

1988-03-25

organosulfur compounds (CC/FP), organophosphorus compounds (CC/FPD), hydrocarbons (CC/FID), volatile aromatic compounds (GC/ PID ), volatile halogenated...ICP metals, mercury and arsenic (AA). Water samples are being analyzed for volatile halogenated organics (GC/CON), volatile aromatic organics (GC/ PID ...Feb Mar Apr May Jun Jul Aug SepSI - I I I I I • .. I I I ----+----- 685 27-90 so ONSITE DISPOSAL FACILITY .i * 686 27-01 Prep FLUE Plan Fz=m8u> 6e7

Malaysia: where big is still better. For Malays, large families are part of the plan.

PubMed

1993-11-03

The benefits of various-sized families in Malaysia were discussed by several women and supplemented with official statements on family planning (FP). The Director of the National Population and Family Development, Dr. Raj Karim, advised that maternal health is jeopardized when women have more than five children. About 30% of reproductive age women in Malaysia have five or more children. A Federation of FP Associations spokesperson agreed that women should be advised of the dangers of bearing over five children, of the importance of spacing births two to four years apart, and of the ideal age of childbearing (21-39 years). The government lacks an official policy on family size. The government position is, however, compatible with Islamic teachings on spacing in order to protect the health of the mother and child. Islamic law does not permit sterilization or abortion. The "fatwas" of Islamic teaching may have been misconstrued by those not using any form of contraception. Dr. Karim, who has five children, reported that having a large family can be difficult for a woman with a job, a career, and a husband or when both parents work. Most Malays desire large families. The average Malay family size was 4.1 children in 1990; Malaysian Chinese have fertility of 2.3 children and Malaysian Indians have 2.6 children. People say that the benefits outweigh the hardships of a large family.

Facultative parthenogenesis discovered in wild vertebrates.

PubMed

Booth, Warren; Smith, Charles F; Eskridge, Pamela H; Hoss, Shannon K; Mendelson, Joseph R; Schuett, Gordon W

2012-12-23

Facultative parthenogenesis (FP)-asexual reproduction by bisexual species-has been documented in a variety of multi-cellular organisms but only recently in snakes, varanid lizards, birds and sharks. Unlike the approximately 80 taxa of unisexual reptiles, amphibians and fishes that exist in nature, FP has yet to be documented in the wild. Based on captive documentation, it appears that FP is widespread in squamate reptiles (snakes, lizards and amphisbaenians), and its occurrence in nature seems inevitable, yet the task of detecting FP in wild individuals has been deemed formidable. Here we show, using microsatellite DNA genotyping and litter characteristics, the first cases of FP in wild-collected pregnant females and their offspring of two closely related species of North American pitviper snakes-the copperhead (Agkistrodon contortrix) and cottonmouth (Agkistrodon piscivorus). Our findings support the view that non-hybrid origins of parthenogenesis, such as FP, are more common in squamates than previously thought. With this confirmation, FP can no longer be viewed as a rare curiosity outside the mainstream of vertebrate evolution. Future research on FP in squamate reptiles related to proximate control of induction, reproductive competence of parthenogens and population genetics modelling is warranted.

Facultative parthenogenesis discovered in wild vertebrates

PubMed Central

Booth, Warren; Smith, Charles F.; Eskridge, Pamela H.; Hoss, Shannon K.; Mendelson, Joseph R.; Schuett, Gordon W.

2012-01-01

Facultative parthenogenesis (FP)—asexual reproduction by bisexual species—has been documented in a variety of multi-cellular organisms but only recently in snakes, varanid lizards, birds and sharks. Unlike the approximately 80 taxa of unisexual reptiles, amphibians and fishes that exist in nature, FP has yet to be documented in the wild. Based on captive documentation, it appears that FP is widespread in squamate reptiles (snakes, lizards and amphisbaenians), and its occurrence in nature seems inevitable, yet the task of detecting FP in wild individuals has been deemed formidable. Here we show, using microsatellite DNA genotyping and litter characteristics, the first cases of FP in wild-collected pregnant females and their offspring of two closely related species of North American pitviper snakes—the copperhead (Agkistrodon contortrix) and cottonmouth (Agkistrodon piscivorus). Our findings support the view that non-hybrid origins of parthenogenesis, such as FP, are more common in squamates than previously thought. With this confirmation, FP can no longer be viewed as a rare curiosity outside the mainstream of vertebrate evolution. Future research on FP in squamate reptiles related to proximate control of induction, reproductive competence of parthenogens and population genetics modelling is warranted. PMID:22977071

Tunable single frequency fiber laser based on FP-LD injection locking.

PubMed

Zhang, Aiqin; Feng, Xinhuan; Wan, Minggui; Li, Zhaohui; Guan, Bai-ou

2013-05-20

We propose and demonstrate a tunable single frequency fiber laser based on Fabry Pérot laser diode (FP-LD) injection locking. The single frequency operation principle is based on the fact that the output from a FP-LD injection locked by a multi-longitudinal-mode (MLM) light can have fewer longitudinal-modes number and narrower linewidth. By inserting a FP-LD in a fiber ring laser cavity, single frequency operation can be possibly achieved when stable laser oscillation established after many roundtrips through the FP-LD. Wavelength switchable single frequency lasing can be achieved by adjusting the tunable optical filter (TOF) in the cavity to coincide with different mode of the FP-LD. By adjustment of the drive current of the FP-LD, the lasing modes would shift and wavelength tunable operation can be obtained. In experiment, a wavelength tunable range of 32.4 nm has been obtained by adjustment of the drive current of the FP-LD and a tunable filter in the ring cavity. Each wavelength has a side-mode suppression ratio (SMSR) of at least 41 dB and a linewidth of about 13 kHz.

Specificity and false positive rates of the Test of Memory Malingering, Rey 15-item Test, and Rey Word Recognition Test among forensic inpatients with intellectual disabilities.

PubMed

Love, Christopher M; Glassmire, David M; Zanolini, Shanna Jordan; Wolf, Amanda

2014-10-01

This study evaluated the specificity and false positive (FP) rates of the Rey 15-Item Test (FIT), Word Recognition Test (WRT), and Test of Memory Malingering (TOMM) in a sample of 21 forensic inpatients with mild intellectual disability (ID). The FIT demonstrated an FP rate of 23.8% with the standard quantitative cutoff score. Certain qualitative error types on the FIT showed promise and had low FP rates. The WRT obtained an FP rate of 0.0% with previously reported cutoff scores. Finally, the TOMM demonstrated low FP rates of 4.8% and 0.0% on Trial 2 and the Retention Trial, respectively, when applying the standard cutoff score. FP rates are reported for a range of cutoff scores and compared with published research on individuals diagnosed with ID. Results indicated that although the quantitative variables on the FIT had unacceptably high FP rates, the TOMM and WRT had low FP rates, increasing the confidence clinicians can place in scores reflecting poor effort on these measures during ID evaluations. © The Author(s) 2014.

Addition of topical pimecrolimus to once-daily mid-potent steroid confers no short-term therapeutic benefit in the treatment of severe atopic dermatitis; a randomized controlled trial.

PubMed

Spergel, J M; Boguniewicz, M; Paller, A S; Hebert, A A; Gallagher, P R; McCormick, C; Parneix-Spake, A; Hultsch, T

2007-08-01

Combination therapy with pimecrolimus cream 1%, a topical calcineurin inhibitor (TCI), and fluticasone propionate cream 0.05% (FP), a mid-potency topical corticosteroid, may have a synergistic effect for treatment of atopic dermatitis (AD) because their mechanism of action differs. To assess the efficacy of concomitant pimecrolimus twice daily/FP once daily vs. vehicle twice daily/FP once daily in patients with severe AD. An exploratory, 2-week, double-blind, randomized, within-patient study was conducted (n = 45). Two target areas of similar severity, size and location were assessed. Assessments included the modified Eczema Area and Severity Index (0-12 scale) (primary variable), localized investigator global assessment (0-4 scale) and Patients' Self-Assessment of Disease Severity (0-4 scale). Data for all variables were similar for the TCI/FP and vehicle/FP treatments. The efficacy observed for treatment of severe AD flares with this TCI/FP combination regimen was equivalent to that of vehicle/FP.

Fall Prevention Knowledge, Attitude, and Practices of Community Stakeholders and Older Adults

PubMed Central

Laing, Sharon S.; Silver, Ilene F.; York, Sally; Phelan, Elizabeth A.

2011-01-01

We assessed knowledge, attitude, and provision of recommended fall prevention (FP) practices by employees of senior-serving organization and participation in FP practices by at-risk elders. The Washington State Department of Health administered structured telephone surveys to 50 employees and 101 elders in Washington State. Only 38% of employees felt “very knowledgeable” about FP, and a majority of their organizations did not regularly offer FP services. Almost half (48%) of seniors sustained a fall within the past 12 months; however, one-third perceived falling to be among their least important health concerns, and most had minimal working knowledge of proven FP practices. Seniors who perceived avoiding falls as important to their well-being were more likely to participate in practices about which they had the least knowledge (risk assessment, medication management). Increased awareness and availability of FP services might help engage older adults in FP practices and reduce the adverse effects of falls. PMID:21915377

Fertility Preservation for Transgender Adolescents.

PubMed

Chen, Diane; Simons, Lisa; Johnson, Emilie K; Lockart, Barbara A; Finlayson, Courtney

2017-07-01

To describe fertility preservation (FP) utilization by transgender adolescents within a pediatric gender clinic between July 2013 and July 2016. A retrospective chart review was conducted to abstract demographic and clinical information among adolescents initiating gender-affirming hormones, including patient age at initial FP consultation, birth-assigned sex, race/ethnicity, and outcome of FP consultation. In our sample of 105 transgender adolescents, a total of 13 (seven transgender men and six transgender women) between the age of 14.2 and 20.6 years were seen in formal consultation for FP before initiating hormones. Of these adolescents, four completed sperm cryopreservation and one completed oocyte cryopreservation. Rates of FP utilization among transgender youth were low, which is consistent with a recently published report of FP utilization among transgender youth at another pediatric institution. Identified barriers to FP in our sample included cost, invasiveness of procedures, and desire not to delay medical transition. Copyright © 2017 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

SU-F-T-258: Efficacy of Exit Fluence-Based Dose Calculation for Prostate Radiation Therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Siebers, J; Gardner, J; Neal, B

Purpose: To investigate the efficacy of exit-fluence-based dose computation for prostate radiotherapy by determining if it estimates true dose more accurately than the original planning dose. Methods: Virtual exit-fluencebased dose computation was performed for 19 patients, each with 9–12 repeat CT images. For each patient, a 78 Gy treatment plan was created utilizing 5 mm CTV-to-PTV and OAR-to-PRV margins. A Monte Carlo framework was used to compute dose and exit-fluence images for the planning image and for each repeat CT image based on boney-anatomyaligned and prostate-centroid-aligned CTs. Identical source particles were used for the MC dose-computations on the planning andmore » repeat CTs to maximize correlation. The exit-fluence-based dose and image were computed by multiplying source particle weights by FC(x,y)=FP(x,y)/FT(x,y), where (x,y) are the source particle coordinates projected to the exit-fluence plane and we denote the dose/fluence from the plan by (DP,FP), from the repeat-CT as (DT,FT), and the exit-fluence computation by (DFC,FFC). DFC mimics exit-fluence backprojection through the planning image as FT=FFC. Dose estimates were intercompared to judge the efficacy of exit-fluence-based dose computation. Results: Boney- and prostate-centroid aligned results are combined as there is no statistical difference between them, yielding 420 dose comparisons per dose-volume metric. DFC is more accurate than DP for 46%, 33%, and 44% of cases in estimating CTV D98, D50, and D2 respectively. DFC improved rectum D50 and D2 estimates 54% and 49% respectively and bladder D50 and D2 47 and 49% respectively. While averaged over all patients and images DFC and DP were within 3.1% of DT, they differed from DT by as much as 22% for GTV D98, 71% for the Bladder D50, 17% for Bladder D2, 19% for Rectum D2. Conclusion: Exit-fluence based dose computations infrequently improve CTV or OAR dose estimates and should be used with caution. Research supported in part by Varian Medical Systems.« less

Isolation and characterization of a cysteine protease of freesia corms.

PubMed

Uchikoba, Tetsuya; Okubo, Michiko; Arima, Kazunari; Yonezawa, Hiroo

2002-02-01

A protease, freesia protease (FP)-A, was purified to electrophoretic homogeneity from regular freesia (Freesia reflacta) corms in harvest time. The Mr of FP-A was estimated to be 24 k by SDS-PAGE. The optimum pH of the enzyme was 8.0 using a casein substrate. These enzymes were strongly inhibited by p-chloromercuribenzoic acid but not by phenylmethane-sulfonylfluoride and EDTA. These results indicate that FP-A belongs to the cysteine proteases. The amino terminal sequence of FP-A was similar to that of papain, and the sequences was regarded to the conservative residues of cysteine protease. From the hydrolysis of peptidyl-p-NAs, the specificity of FP-A was found to be broad. It was thought that FP-A was a new protease from freesia corms.

Cost-effectiveness of a National Telemedicine Diabetic Retinopathy Screening Program in Singapore.

PubMed

Nguyen, Hai V; Tan, Gavin Siew Wei; Tapp, Robyn Jennifer; Mital, Shweta; Ting, Daniel Shu Wei; Wong, Hon Tym; Tan, Colin S; Laude, Augustinus; Tai, E Shyong; Tan, Ngiap Chuan; Finkelstein, Eric A; Wong, Tien Yin; Lamoureux, Ecosse L

2016-12-01

To determine the incremental cost-effectiveness of a new telemedicine technician-based assessment relative to an existing model of family physician (FP)-based assessment of diabetic retinopathy (DR) in Singapore from the health system and societal perspectives. Model-based, cost-effectiveness analysis of the Singapore Integrated Diabetic Retinopathy Program (SiDRP). A hypothetical cohort of patients aged 55 years with type 2 diabetes previously not screened for DR. The SiDRP is a new telemedicine-based DR screening program using trained technicians to assess retinal photographs. We compared the cost-effectiveness of SiDRP with the existing model in which FPs assess photographs. We developed a hybrid decision tree/Markov model to simulate the costs, effectiveness, and incremental cost-effectiveness ratio (ICER) of SiDRP relative to FP-based DR screening over a lifetime horizon. We estimated the costs from the health system and societal perspectives. Effectiveness was measured in terms of quality-adjusted life-years (QALYs). Result robustness was calculated using deterministic and probabilistic sensitivity analyses. The ICER. From the societal perspective that takes into account all costs and effects, the telemedicine-based DR screening model had significantly lower costs (total cost savings of S$173 per person) while generating similar QALYs compared with the physician-based model (i.e., 13.1 QALYs). From the health system perspective that includes only direct medical costs, the cost savings are S$144 per person. By extrapolating these data to approximately 170 000 patients with diabetes currently being screened yearly for DR in Singapore's primary care polyclinics, the present value of future cost savings associated with the telemedicine-based model is estimated to be S$29.4 million over a lifetime horizon. While generating similar health outcomes, the telemedicine-based DR screening using technicians in the primary care setting saves costs for Singapore compared with the FP model. Our data provide a strong economic rationale to expand the telemedicine-based DR screening program in Singapore and elsewhere. Copyright © 2016 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Non-Mydriatic Fundus Retinography in Screening for Diabetic Retinopathy: Agreement Between Family Physicians, General Ophthalmologists, and a Retinal Specialist.

PubMed

Cunha, Leonardo Provetti; Figueiredo, Evelyn Alvernaz; Araújo, Henrique Pereira; Costa-Cunha, Luciana Virgínia Ferreira; Costa, Carolina Ferreira; Neto, José de Melo Costa; Matos, Aline Mota Freitas; de Oliveira, Marise Machado; Bastos, Marcus Gomes; Monteiro, Mário Luiz Ribeiro

2018-01-01

To determine the level of agreement between trained family physicians (FPs), general ophthalmologists (GOs), and a retinal specialist (RS) in the assessment of non-mydriatic fundus retinography in screening for diabetic retinopathy (DR) in the primary health-care setting. 200 Diabetic patients were submitted to two-field non-mydriatic digital fundus camera. The images were examined by four trained FPs, two GOs, and one RS with regard to the diagnosis and severity of DR and the diagnosis of macular edema. The RS served as gold standard. Reliability and accuracy were determined with the kappa test and diagnostic measures. A total of 397 eyes of 200 patients were included. The mean age was 55.1 (±11.7) years, and 182 (91%) had type 2 diabetes. The mean levels of serum glucose and glycosylated hemoglobin A1c were 195.6 (±87.3) mg/dL and 8.9% (±2.1), respectively. DR was diagnosed in 166 eyes by the RS and in 114 and 182 eyes by GO 1 and GO 2 , respectively. For severity, DR was graded as proliferative in 8 eyes by the RS vs. 15 and 9 eyes by GO 1 and GO 2 , respectively. The agreement between the RS and the GOs was substantial for both DR diagnosis (GO 1 k  = 0.65; GO 2 k  = 0.74) and severity (GO 1 k  = 0.60; GO 2 k  = 0.71), and fair or moderate for macular edema (GO 1 k  = 0.27; GO 2 k  = 0.43). FP 1 , FP 2 , FP 3 , and FP 4 diagnosed DR in 108, 119, 163, and 117 eyes, respectively. The agreement between the RS and the FPs with regard to DR diagnosis was substantial (FP 2 k  = 0.69; FP 3 k  = 0.73; FP 4 k  = 0.71) or moderate (FP 1 k  = 0.56). As for DR severity, the agreement between the FPs and the RS was substantial (FP 2 k  = 0.66; FP 3 k  = 069; FP 4 k  = 0.64) or moderate (FP 1 k  = 0.51). Agreement between the FPs and the RS with regard to macular edema was fair (FP 1 k  = 0.33; FP 2 k  = 0.39; FP 3 k  = 0.37) or moderate (FP 4 k  = 0.51). Non-mydriatic fundus retinography was shown to be useful in DR screening in the primary health-care setting. FPs made assessments with good levels of agreement with an RS. Non-mydriatic fundus retinography associated with appropriate general physicians training is essential for the DR screening.

Impacts of Electric Propulsion Systems on Submarine Design

DTIC Science & Technology

1989-06-01

in oersteds D = the density of the steel in grams per cubic centimeter p = the elec" .,; al resistivity of the steel in microohm-centimeters N = the...Condition Al (Sum W1-W7) 4138.64 144.09 15.24 Lead Ballast 413.86 142.50 13.70 Condition A 4552.50 143.95 15.1 Variable Load Weights 209.53 87.46 9.86...fscanf(fp, "%lf", &lr); fscanf(fp, *W%lf?, &vol); fscanf(fp, "%lf", &wt.); fac~ azif (f p, "%lf" &ph); fscant (fp, "%If, &pe); fscanf(fp, "%lf" &i2r

Family Presence During Pediatric Tracheal Intubations.

PubMed

Sanders, Ronald C; Nett, Sholeen T; Davis, Katherine Finn; Parker, Margaret M; Bysani, G Kris; Adu-Darko, Michelle; Bird, Geoffrey L; Cheifetz, Ira M; Derbyshire, Ashley T; Emeriaud, Guillaume; Giuliano, John S; Graciano, Ana Lia; Hagiwara, Yusuke; Hefley, Glenda; Ikeyama, Takanari; Jarvis, J Dean; Kamat, Pradip; Krishna, Ashwin S; Lee, Anthony; Lee, Jan Hau; Li, Simon; Meyer, Keith; Montgomery, Vicki L; Nagai, Yuki; Pinto, Matthew; Rehder, Kyle J; Saito, Osamu; Shenoi, Asha N; Taekema, Hester Christianne; Tarquinio, Keiko M; Thompson, Ann E; Turner, David A; Nadkarni, Vinay M; Nishisaki, Akira

2016-03-01

Family-centered care, which supports family presence (FP) during procedures, is now a widely accepted standard at health care facilities that care for children. However, there is a paucity of data regarding the practice of FP during tracheal intubation (TI) in pediatric intensive care units (PICUs). Family presence during procedures in PICUs has been advocated. To describe the current practice of FP during TI and evaluate the association with procedural and clinician (including physician, respiratory therapist, and nurse practitioner) outcomes across multiple PICUs. Prospective cohort study in which all TIs from July 2010 to March 2014 in the multicenter TI database (National Emergency Airway Registry for Children [NEAR4KIDS]) were analyzed. Family presence was defined as a family member present during TI. This study included all TIs in patients younger than 18 years in 22 international PICUs. Family presence and no FP during TI in the PICU. The percentage of FP during TIs. First attempt success rate, adverse TI-associated events, multiple attempts (≥ 3), oxygen desaturation (oxygen saturation as measured by pulse oximetry <80%), and self-reported team stress level. A total of 4969 TI encounters were reported. Among those, 81% (n = 4030) of TIs had documented FP status (with/without). The median age of participants with FP was 2 years and 1 year for those without FP. The average percentage of TIs with FP was 19% and varied widely across sites (0%-43%; P < .001). Tracheal intubations with FP (vs without FP) were associated with older patients (median, 2 years vs 1 year; P = .04), lower Paediatric Index of Mortality 2 score, and pediatric resident as the first airway clinician (23%, n = 179 vs 18%, n = 584; odds ratio [OR], 1.4; 95% CI, 1.2-1.7). Tracheal intubations with FP and without FP were no different in the first attempt success rate (OR, 1.00; 95% CI, 0.85-1.18), adverse TI-associated events (any events: OR, 1.06; 95% CI, 0.85-1.30 and severe events: OR, 1.04; 95% CI, 0.75-1.43), multiple attempts (≥ 3) (OR, 1.03; 95% CI, 0.82-1.28), oxygen desaturation (oxygen saturation <80%) (OR, 0.97; 95% CI, 0.80-1.18), or self-reported team stress level (OR, 1.09; 95% CI, 0.92-1.31). This result persisted after adjusting for patient and clinician confounders. Wide variability exists in FP during TIs across PICUs. Family presence was not associated with first attempt success, adverse TI-associated events, oxygen desaturation (<80%), or higher team stress level. Our data suggest that FP during TI can safely be implemented as part of a family-centered care model in the PICU.

Which family physician should I choose? The analytic hierarchy process approach for ranking of criteria in the selection of a family physician.

PubMed

Kuruoglu, Emel; Guldal, Dilek; Mevsim, Vildan; Gunvar, Tolga

2015-08-05

Choosing the most appropriate family physician (FP) for the individual, plays a fundamental role in primary care. The aim of this study is to determine the selection criteria for the patients in choosing their family doctors and priority ranking of these criteria by using the multi-criteria decision-making method of the Analytic Hierarchy Process (AHP) model. The study was planned and conducted in two phases. In the first phase, factors affecting the patients' decisions were revealed with a qualitative research. In the next phase, the priorities of FP selection criteria were determined by using AHP model. Criteria were compared in pairs. 96 patient were asked to fill the information forms which contains comparison scores in the Family Health Centres. According to the analysis of focus group discussions FP selection criteria were congregated in to five groups: Individual Characteristics, Patient-Doctor relationship, Professional characteristics, the Setting, and Ethical Characteristics. For each of the 96 participants, comparison matrixes were formed based on the scores of their information forms. Of these, models of only 5 (5.2 %) of the participants were consistent, in other words, they have been able to score consistent ranking. The consistency ratios (CR) were found to be smaller than 0.10. Therefore the comparison matrix of this new model, which was formed based on the medians of scores only given by these 5 participants, was consistent (CR = 0.06 < 0.10). According to comparison results; with a 0.467 value-weight, the most important criterion for choosing a family physician is his/her 'Professional characteristics'. Selection criteria for choosing a FP were put in a priority order by using AHP model. These criteria can be used as measures for selecting alternative FPs in further researches.

Integration Assessment of Visiting Vehicle Induced Electrical Charging of the International Space Station Structure

NASA Technical Reports Server (NTRS)

Kramer, Leonard; Kerslake, Thomas W.; Galofaro, Joel T.

2010-01-01

The International Space Station (ISS) undergoes electrical charging in low Earth orbit (LEO) due to positively biased, exposed conductors on solar arrays that collect electrical charges from the space plasma. Exposed solar array conductors predominately collect negatively charged electrons and thus drive the metal ISS structure electrical ground to a negative floating potential (FP) relative to plasma. This FP is variable in location and time as a result of local ionospheric conditions. ISS motion through Earth s magnetic field creates an addition inductive voltage up to 20 positive and negative volts across ISS structure depending on its attitude and location in orbit. ISS Visiting Vehicles (VVs), such as the planned Orion crew exploration vehicle, contribute to the ISS plasma charging processes. Upon physical contact with ISS, the current collection properties of VVs combine with ISS. This is an ISS integration concern as FP must be controlled to minimize arcing of ISS surfaces and ensure proper management of extra vehicular activity crewman shock hazards. This report is an assessment of ISS induced charging from docked Orion vehicles employing negatively grounded, 130 volt class, UltraFlex (ATK Space Systems) solar arrays. To assess plasma electron current collection characteristics, Orion solar cell test coupons were constructed and subjected to plasma chamber current collection measurements. During these tests, coupon solar cells were biased between 0 and 120 V while immersed in a simulated LEO plasma. Tests were performed using several different simulated LEO plasma densities and temperatures. These data and associated theoretical scaling of plasma properties, were combined in a numerical model which was integrated into the Boeing Plasma Interaction Model. It was found that the solar array design for Orion will not affect the ISS FP by more than about 2 V during worst case charging conditions. This assessment also motivated a trade study to determine acceptable plasma electron current levels that can be collected by a single or combined fleet of ISS-docked VVs.

Asthma control using fluticasone propionate/salmeterol in Asian and non-Asian populations: a post hoc analysis of the GOAL study.

PubMed

Bousquet, Jean; Barnes, Neil; Gibbs, Michael; Gul, Nadeem; Tomkins, Susan A; Zhou, Xin; Cho, Young-Joo; Park, Hae-Sim; Busse, William; Zhong, Nanshan

2017-04-28

To analyse the efficacy of fluticasone propionate (FP) alone and combined with salmeterol (SAL) in achieving guideline-defined asthma control in Asian patients. A post hoc analysis of the GOAL study in which patients were stratified by prior-medication use into inhaled corticosteroid (ICS)-naïve (Stratum [S] 1), low-dose ICS (S2), and medium-dose ICS (S3), and randomised to receive FP/SAL or FP. Doses were stepped-up every 12 weeks until Totally Controlled asthma or maximum dose was reached (PhI) and then maintained until study end (PhII). The primary endpoint was the proportion of patients achieving Well-Controlled asthma during PhI. Additional endpoints included Total Control and adverse events. Asian and non-Asian patients were analysed separately. In Asian patients in PhI, 74% (n = 87/118) in S1 achieved Well-Controlled asthma with FP/SAL versus 74% (n = 89/121) with FP alone (p = 0.839); corresponding values were 76% (n = 81/107) versus 60% (n = 62/104; p = 0.005) in S2, and 58% (n = 59/102) versus 43% (n = 41/95; p = 0.015) in S3. More patients in all three strata achieved Totally Controlled asthma with FP/SAL versus FP alone. Control was achieved more rapidly and with lower ICS doses with FP/SAL versus FP. A high proportion of patients who achieved control during PhI maintained control during PhII. Similar trends were found in non-Asian patients. No new safety concerns were identified. A greater proportion of Asian patients (S2 and S3, for Well-Controlled; all strata, for Totally Controlled) achieved guideline-defined asthma control with FP/SAL versus FP alone. High proportions of Asian patients in S1 achieved Well-Controlled asthma in both treatment groups.

Cat iris sphincter smooth-muscle contraction: comparison of FP-class prostaglandin analog agonist activities.

PubMed

Sharif, Najam A; Kaddour-Djebbar, Ismail; Abdel-Latif, Ata A

2008-04-01

The pharmacologic characteristics of a number of FP-class prostaglandin (PG) analogs were determined by using the cat iris sphincter smooth-muscle-contraction assay. Cumulative concentration-response curves were generated for each compound. The relative agonist potencies (EC(50)) of the compounds were: cloprostenol (0.0012 +/- 0.0004 nM) > travoprost acid (0.46 +/- 0.13 nM) = bimatoprost acid (0.99 +/- 0.19 nM) > (+/-)-fluprostenol (15.8 +/- 2.6 nM) = PGF(2alpha) (18.6 +/- 1.8 nM) > latanoprost acid (29.9 +/- 1.6 nM) > bimatoprost (140 +/- 45 nM) > S-1033 (588 +/- 39 nM) > unoprostone (UF-021; 1280 +/- 50 nM; n = 4-14). The maximum response induced by travoprost acid (122% +/- 2.3% maximum response relative to PGF(2alpha)) was significantly greater than that induced by all the other PG compounds (P < 0.001 - P < 0.02). Interestingly, the FP-receptor antagonist, AL-8810, behaved as a moderate efficacy partial agonist (EC(50) = 2140 +/- 190 nM; 63 +/- 4.3% maximum response relative to PGF(2alpha)), indicating that the cat iris contains an extremely well-coupled FP-receptor population, and/or the tissue contains an extremely high density of the FP-receptor and/or spare receptors. The cat iris contraction data were well correlated with other FP-receptor-mediated signal-transduction processes, including FP-receptor binding in bovine corpus luteum (r = 0.86), FP-receptor binding in human iris (r = 0.61), phosphoinositide (PI) hydrolysis in human ciliary muscle and trabecular meshwork cells (r = 0.77 - 0.86), PI turnover in rat and mouse cells (r = 0.73 - 0.76) and via cloned human FP-receptor (r = 0.9), and rat uterus contraction (r = 0.84). These data confirm the presence of functional FP-receptors in the cat iris sphincter, which are exquisitely well coupled and which respond to a variety of FP-class PG analogs with differing potencies.

The context and limitations of female sterilization services in Pakistan.

PubMed

Khan, Adnan Ahmad; Khan, Ayesha; Abbas, Khadija; Tirmizi, Syed Farhan Ali; ul Islam, Zia

2013-04-01

Female sterilization has long been the most popular method of family planning (FP) in Pakistan, and yet most public health experts feel it contributes little to controlling family size or to population welfare. We used Pakistan Demographic Health Survey (PDHS) data to understand the role female sterilization plays in the overall context of FP in Pakistan. We performed a secondary analysis of data from the PDHS 1990-1 and 2006-7 to study factors that lead to sterilization and trends in the use of the procedure. In addition, census data were multiplied by proportions from PDHS data to estimate the number of women availing sterilization services. Around 1.9 million women in Pakistan are currently sterilized--up from 0.55 million in 1990-1, and around 173,867 undergo the procedure, annually. Women usually receive sterilization after 30 years of age (mean = 39) and after six children. The probability of sterilization increases with age, family size, and urban residence, and is unaffected by poverty, province of residence, or the woman or her husband's education. Most sterilizationis conducted in public sector facilities. Sterilization in Pakistan may be common, but occurs too late to have any significant effect on family size or benefit public health. Future avenues to make this option more useful to women and society would be to improve the repertoire and access and quality of FP services that are available, and to address governance issues that limit the performance and utility of government facilities.

Systems Harmonization and Convergence - the GIGAS Approach

NASA Astrophysics Data System (ADS)

Marchetti, P. G.; Biancalana, A.; Coene, Y.; Uslander, T.

2009-04-01

0.1 Background The GIGAS1 Support Action promotes the coherent and interoperable development of the GMES, INSPIRE and GEOSS initiatives through their concerted adoption of standards, protocols, and open architectures. 0.2 Preparing for Coordinated Data Access The GMES Coordinated Data Access System is under design and implementation2. This objective has motivated the definition of the interoperability standards between the contributing missions. The following elements have been addressed with associated papers submitted to OGC: The EO Product Metadata has been based on the OGC Geographic Markup Language, addressing sensor characteristics for optical, radar and atmospheric products. Collection and service discovery: an ISO extension package for CSW ebRim has been proposed. Catalogue Service (CSW): an Earth Observation extension package of the CSW ebRim has been proposed. Feasibility Analysis and Order: an Order interface control document and an Earth Observation profile of the Sensor Planning Service have been proposed. Online Data Access: an Earth Observation profile of the Web Map Services (WMS) for visualization and evaluation purposes has been proposed. Identity (user) management: the objective in the long term is to allow for a single sign-on to the Coordinated Data Access system by users registered in the various Earth Observation ground segments by providing a federated identity across participating ground segments, exploiting OASIS standards. 0.3 The GIGAS proposed harmonization approach The approach proposed by GIGAS is based on three elements: Technology watch Comparative analysis Shaping of initiatives and standards This paper concentrates on the methodology for technology watch and comparative analysis. The complexity of the GIGAS scenario involving huge systems (i.e. GEOSS, INSPIRE, GMES etc.) entails the interaction with different heterogeneous partners, each with a specific competence, expertise and know-how. 0.3.1 Technology watch The methodology proposed is based on an RM-ODP based study supported by interoperability use cases and scenarios used to derive requirements. GIGAS will monitor the INSPIRE, GMES and GEOSS evolution and analyze the requirements, the standards, the services and the architecture, the models, the processes and the consensus mechanisms with the same elements of the other systems under analysis. activities in the fields of standard development that are part of the three initiatives. This task will provide the basis for how these three initiatives will strategically support consensus and efficient standards development going forward. architecture, specifications, innovative concepts and software developments of past or ongoing FP6/FP7 research topics. The use of an RM-ODP approach is selected as: most of the architectural approaches to be compared are based on RM-ODP, it supports distributed processing, it aims at fostering interoperability across heterogeneous systems, it tries to hide distribution to systems developers. However, as most of the systems to be considered have the characteristic of a loosely-coupled network of systems and services instead of a "distributed processing system based on interacting objects", the RM-ODP concepts are tailored for the GIGAS needs. The usage of RM-ODP for GIGAS Requirements and Technology Watch is two-fold: Architectural analysis: It is performed for all projects and initiatives. Its purpose is to identify possibilities but also major obstacles for interoperability. Furthermore, it identifies the major use cases to be analysed in more detail. Use Case Implementation Analysis: It is used to describe how selected use cases of the projects and initiatives are implemented in the different architectures. Its purpose is to identify technological gaps and concrete problems of interoperability. It is performed only for selected use cases. The output of the Technology Watch is an RM-ODP based report containing parallel analysis on the same aspects on the three initiatives integrated by analysis of relevant FP6-FP7 projects and standardization activities. 0.3.2 Comparative Analysis Based on the outcomes of the previous monitoring tasks, GIGAS undertakes a comparative analysis on solutions, requirements, architecture, models, processes and consensus mechanisms used by INSPIRE, GMES and GEOSS, taking into account the inputs from the monitoring of FP6/FP7 research projects and the ongoing standardization activities. Initiative Contact Points will insure that the overall policy framework and schedules for each of the three initiatives will be factored in. The result of the Comparative Analysis includes: A list of recommendations to GEOSS, INSPIRE and GMES to be expanded and processed in depth in the following shaping phase The identification of technological gaps to be explored in the following shaping phase. Guidelines and objectives for the architectural approach within GIGAS Analysis on the schedules of the three initiatives and on the FP6/FP7 programs and standardization activities, with identification of key milestones or intervention points.

Comparison of the Outcome of Silicone Ahmed Glaucoma Valve Implantation with a Surface Area between 96 and 184 mm2 in Adult Eyes

PubMed Central

Koh, Kyung Min; Hwang, Young Hoon; Jung, Jong Jin; Sohn, Yong Ho

2013-01-01

Purpose To compare the success rates, complications, and visual outcomes between silicone Ahmed glaucoma valve (AGV) implantation with 96 mm2 (FP8) or 184 mm2 (FP7) surface areas. Methods This study is a retrospective review of the records from 132 adult patients (134 eyes) that underwent silicone AGV implant surgery. Among them, the outcomes of 24 eyes from 24 patients with refractory glaucoma who underwent FP8 AGV implantation were compared with 76 eyes from 76 patients who underwent FP7 AGV implantation. Preoperative and postoperative data, including intraocular pressure (IOP), visual acuity, number of medications, and complications were compared between the 2 groups. Results There were no significant differences in baseline characteristics between the 2 groups (p > 0.05). The postoperative visual acuity of the patients in the FP8 group was better than that of the patients in the FP7 group in some early postoperative periods (p < 0.05); however, after 10 postoperative months, visual acuity was not significantly different through the 3-year follow-up period (p > 0.05). Postoperative IOP was not significantly different between the 2 groups (p > 0.05) except for IOP on postoperative day 1 (11.42 mmHg for the FP7 group and 7.42 mmHg for the FP8 group; p = 0.031). There was no statistical difference in success rates, final IOP, number of medications, or complication rates between the 2 groups (p > 0.05). Conclusions The FP7 and FP8 AGV implants showed no difference in terms of vision preservation, IOP reduction, and number of glaucoma medications required. PMID:24082774

Halobacillus alkaliphilus sp. nov., a halophilic bacterium isolated from a salt lake in Fuente de Piedra, southern Spain.

PubMed

Romano, Ida; Finore, Ilaria; Nicolaus, Giancarlo; Huertas, F Javier; Lama, Licia; Nicolaus, Barbara; Poli, Annarita

2008-04-01

A Gram-positive, spore-forming, halophilic bacterial strain, FP5T, was isolated from a salt lake in southern Spain and subjected to a polyphasic taxonomic study. Strain FP5T was strictly aerobic. Cells were coccoidal, occurring singly or in clusters. The cell-wall peptidoglycan type of strain FP5T was A4 beta based on l-Orn-d-Asp. Strain FP5T was characterized chemotaxonomically by having MK-7 as the major menaquinone and anteiso-C15 : 0, anteiso-C17 : 0, iso-C15 : 0 and iso-C16 : 0 as the main fatty acids. The isolate grew optimally at 37 degrees C and in presence of 10 % NaCl; no growth was observed in the absence of NaCl. The DNA G+C content was 43.5 mol%. Phylogenetic analyses based on 16S rRNA gene sequences showed that strain FP5T falls within the evolutionary radiation of species of the genus Halobacillus. Levels of 16S rRNA gene sequence similarity between strain FP5T and the type strains of nine recognized Halobacillus species were in the range 97.0-99.0 %. Levels of DNA-DNA relatedness indicated that strain FP5T represents a genomic species that is distinct from recognized Halobacillus species. Strain FP5T could be differentiated from recognized Halobacillus species based on several phenotypic characteristics. On the basis of phenotypic, phylogenetic and genomic data, strain FP5T is considered to represent a novel species of the genus Halobacillus, for which the name Halobacillus alkaliphilus sp. nov. is proposed. The type strain is FP5T (=DSM 18525T =ATCC BAA-1361T).

Challenges in Evaluating the Severity of Fibropapillomatosis: A Proposal for Objective Index and Score System for Green Sea Turtles (Chelonia mydas) in Brazil

PubMed Central

Rossi, Silmara; Sánchez-Sarmiento, Angélica María; Vanstreels, Ralph Eric Thijl; dos Santos, Robson Guimarães; Prioste, Fabiola Eloisa Setim; Gattamorta, Marco Aurélio; Grisi-Filho, José Henrique Hildebrand; Matushima, Eliana Reiko

2016-01-01

Fibropapillomatosis (FP) is a neoplastic disease that affects marine turtles worldwide, especially green sea turtles (Chelonia mydas). FP tumors can develop on the body surface of marine turtles and also internally in the oral cavity and viscera. Depending on their quantity, size and anatomical distribution, these tumors can interfere with hydrodynamics and the ability to feed, hence scoring systems have been proposed in an attempt to quantify the clinical manifestation of FP. In order to establish a new scoring system adapted to geographic regions, we examined 214 juvenile green sea turtles with FP caught or rescued at Brazilian feeding areas, counted their 7466 tumors and classified them in relation to their size and anatomical distribution. The patterns in quantity, size and distribution of tumors revealed interesting aspects in the clinical manifestation of FP in specimens studied in Brazil, and that FP scoring systems developed for other areas might not perform adequately when applied to sea turtles on the Southwest Atlantic Ocean. We therefore propose a novel method to evaluate the clinical manifestation of FP: fibropapillomatosis index (FPI) that provides the Southwest Atlantic fibropapillomatosis score (FPSSWA). In combination, these indexing and scoring systems allow for a more objective, rapid and detailed evaluation of the severity of FP in green sea turtles. While primarily designed for the clinical manifestation of FP currently witnessed in our dataset, this index and the score system can be adapted for other areas and compare the characteristics of the disease across regions. In conclusion, scoring systems to classify the severity of FP can assist our understanding on the environmental factors that modulate its development and its impacts on the individual and population health of green sea turtles. PMID:27936118

Challenges in Evaluating the Severity of Fibropapillomatosis: A Proposal for Objective Index and Score System for Green Sea Turtles (Chelonia mydas) in Brazil.

PubMed

Rossi, Silmara; Sánchez-Sarmiento, Angélica María; Vanstreels, Ralph Eric Thijl; Dos Santos, Robson Guimarães; Prioste, Fabiola Eloisa Setim; Gattamorta, Marco Aurélio; Grisi-Filho, José Henrique Hildebrand; Matushima, Eliana Reiko

2016-01-01

Fibropapillomatosis (FP) is a neoplastic disease that affects marine turtles worldwide, especially green sea turtles (Chelonia mydas). FP tumors can develop on the body surface of marine turtles and also internally in the oral cavity and viscera. Depending on their quantity, size and anatomical distribution, these tumors can interfere with hydrodynamics and the ability to feed, hence scoring systems have been proposed in an attempt to quantify the clinical manifestation of FP. In order to establish a new scoring system adapted to geographic regions, we examined 214 juvenile green sea turtles with FP caught or rescued at Brazilian feeding areas, counted their 7466 tumors and classified them in relation to their size and anatomical distribution. The patterns in quantity, size and distribution of tumors revealed interesting aspects in the clinical manifestation of FP in specimens studied in Brazil, and that FP scoring systems developed for other areas might not perform adequately when applied to sea turtles on the Southwest Atlantic Ocean. We therefore propose a novel method to evaluate the clinical manifestation of FP: fibropapillomatosis index (FPI) that provides the Southwest Atlantic fibropapillomatosis score (FPSSWA). In combination, these indexing and scoring systems allow for a more objective, rapid and detailed evaluation of the severity of FP in green sea turtles. While primarily designed for the clinical manifestation of FP currently witnessed in our dataset, this index and the score system can be adapted for other areas and compare the characteristics of the disease across regions. In conclusion, scoring systems to classify the severity of FP can assist our understanding on the environmental factors that modulate its development and its impacts on the individual and population health of green sea turtles.

Integrated fingerprint and high wavenumber confocal Raman spectroscopy for in vivo diagnosis of cervical precancer

NASA Astrophysics Data System (ADS)

Duraipandian, Shiyamala; Zheng, Wei; Ng, Joseph; Low, Jeffrey J. H.; Ilancheran, A.; Huang, Zhiwei

2013-03-01

Raman spectroscopy is a vibrational spectroscopic technique capable of optically probing the compositional, conformational, and structural changes in the tissue associated with disease progression. The main goal of this work is to develop an integrated fingerprint (FP) and high wavenumber (HW) in vivo confocal Raman spectroscopy for simultaneous FP/HW tissue Raman spectral measurements. This work further explores the potential of integrated FP/HW Raman spectroscopy developed as a diagnostic tool for in vivo detection of cervical precancer. A total of 473 in vivo integrated FP/HW Raman spectra (340 normal and 133 precancer) were acquired from 35 patients within 1 s during clinical colposcopy. The major tissue Raman peaks are noticed around 854, 937, 1001, 1095, 1253, 1313, 1445, 1654, 2946 and 3400 cm-1, related to the molecular changes (e.g., proteins, lipids, glycogen, nucleic acids, water, etc.) that accompany the dysplastic transformation of tissue. The FP (800 - 1800 cm-1), HW (2800 - 3800 cm-1) and the integrated FP/HW Raman spectra were analyzed using partial least squares-discriminant analysis (PLS-DA) together with the leave-one patient-out, cross-validation. The developed PLS-DA classification models and receiver operating characteristics (ROC) curves for the FP, HW and integrated FP/HW spectroscopy further discloses that the performance of integrated FP/HW Raman spectroscopy is superior to that of all others in discriminating the dysplastic cervix. The results of this work indicate that the co-contributions of underlying rich biochemical information revealed by the complementary spectral modalities (FP and HW Raman) can improve the in vivo early diagnosis of cervical precancer at clinical colposcopy

Engaging with community-based public and private mid-level providers for promoting the use of modern contraceptive methods in rural Pakistan: results from two innovative birth spacing interventions.

PubMed

Azmat, Syed Khurram; Hameed, Waqas; Hamza, Hasan Bin; Mustafa, Ghulam; Ishaque, Muhammad; Abbas, Ghazunfer; Khan, Omar Farooq; Asghar, Jamshaid; Munroe, Erik; Ali, Safdar; Hussain, Wajahat; Ali, Sajid; Ahmed, Aftab; Ali, Moazzam; Temmerman, Marleen

2016-03-17

Family planning (FP) interventions aimed at reducing population growth have negligible during the last two decades in Pakistan. Innovative FP interventions that help reduce the growing population burden are the need of the hour. Marie Stopes Society--Pakistan implemented an operational research project--'Evidence for Innovating to Save Lives', to explore effective and viable intervention models that can promote healthy timing and spacing of pregnancy in rural and under-served communities of Sindh, Punjab and Khyber Pakhtunkhwa provinces of Pakistan. We conducted a quasi-experimental (pre- and post-intervention with control arm) study to assess the effectiveness of each of the two intervention models, (1) Suraj model (meaning 'Sun' in English), which uses social franchises (SF) along with a demand-side financing (DSF) approach using free vouchers, and (2) Community Midwife (CMW) model, in promoting the use of modern contraceptive methods compared to respective controls. Baseline and endline cross-sectional household surveys were conducted, 24 months apart, by recruiting 5566 and 6316 married women of reproductive age (MWRA) respectively. We used Stata version 8 to report the net effect of interventions on outcome indicators using difference-in-differences analysis. Multivariate Cox proportional hazard regression analysis was used to assess the net effect of the intervention on current contraceptive use, keeping time constant and adjusting for other variables in the model. The Suraj model was effective in significantly increasing awareness about FP methods among MWRA by 14% percentage points, current contraceptive use by 5% percentage points and long term modern method--intrauterine device (IUD) use by 6% percentage points. The CMW model significantly increased contraceptive awareness by 28% percentage points, ever use of contraceptives by 7% percentage points and, IUD use by 3% percentage points. Additionally the Suraj intervention led to a 35% greater prevalence (prevalence ratio: 1.35, 95% CI: 1.22-1.50) of contraceptive use among MWRA. Suraj intervention highlights the importance of embedding subsidized FP services within the communities of the beneficiaries. The outcomes of the CMW intervention also improved the use of long-term contraceptives. These findings indicate the necessity of designing and implementing FP initiatives involving local mid-level providers to expand contraceptive coverage in under-served areas.

The imperative of functional integration for achievement of MDGs.

PubMed

Mohamud, Khalif Bile

2009-09-01

Pakistan launched its Maternal, Neonatal and Child Health (MNCH) programme in 2006 in collaboration with the World Health Organization (WHO) and other partners to bridge gaps and upscale interventions aimed at reducing mortality and achieving the Millennium Development Goals (MDGs). The country will have an uphill task in meeting by 2020, the 2015 targets set for attainment of MDGs 4 and 5. The current Contraceptive Prevalence Rate (CPR) level of 30% is considerably below the 60% target set for 2020 and the current Total Fertility Rate (TFR), estimated at 4, is significantly higher than the set target of 2.1. Similarly, the Infant Mortality Rate (IMR) of 78 per 1,000 live births is lagging behind the MDG target of 40 per 1,000 live births, while the Maternal Mortality Ratio (MMR) of 276 per 105 live births is higher than the MDG target of 140 per 105 live births. With the rural population at an added disadvantage by reporting 82% and 40% higher MMR and IMR respectively-relative to the population of urban and major cities-reducing the current population growth rate of about 1.7% to 1.3% in the envisaged limited timeframe appears challenging. To overcome these programmatic impediments, the existing fragmentation in implementation of MNCH/Reproductive Health (RH) and Family Planning (FP) services needs to be urgently addressed. To respond to this call, the ministries of Health and Population made a joint commitment at the end of 2008 to bring about functional integration by delivering the MNCH/RH/FP services in a unified manner and by setting up effective institutional, strategic and operational mechanisms that can enhance the implementation process. To significantly reduce IMR and MMR and improve RH/FP outcomes, the two ministries must challenge the status quo and promote the coordination of health and population policies, improve MNCH/RF and FP management practices including monitoring and supervision, deploy, train and motivate the health workforce and strengthen the health system. Functional integration must also aim at ensuring use of appropriate technologies and uninterrupted provision of supplies and equipment. This viewpoint, which is related to the Heartfile Report, aims at diagnosing outstanding challenges at the field level, as well as factors contributing to successful implementation of MNCH/RH and FP and their progress towards achieving Millennium Development Goals (MDGs) 4 and 5.

Research Progress on F-P Interference—Based Fiber-Optic Sensors

PubMed Central

Huang, Yi Wen; Tao, Jin; Huang, Xu Guang

2016-01-01

We review our works on Fabry-Perot (F-P) interferometric fiber-optic sensors with various applications. We give a general model of F-P interferometric optical fiber sensors including diffraction loss caused by the beam divergence and the Gouy phase shift. Based on different structures of an F-P cavity formed on the end of a single-mode fiber, the F-P interferometric optical sensor has been extended to measurements of the refractive index (RI) of liquids and solids, temperature as well as small displacement. The RI of liquids and solids can be obtained by monitoring the fringe contrast related to Fresnel reflections, while the ambient temperature and small displacement can be obtained by monitoring the wavelength shift of the interference fringes. The F-P interferometric fiber-optic sensors can be used for many scientific and technological applications. PMID:27598173

ESMN in Memoriam (1998 -- 2006)

NASA Astrophysics Data System (ADS)

Rutten, R. J.

2007-05-01

The EC-FP5 European Solar Magnetism Network (ESMN) was terminated during this conference. Together with its FP4 predecessor, the European Solar Magnetometry Network (ESMN), it funded 22 postdoc and 9 graduate-student appointments at nine solar physics groups in Western Europe, it enhanced Europe-wide collaboration in solar physics, and it contributed to the integration of East-European groups in West-European enterprises. Its unfortunate demise results from lack of further fortune in the FP6 lottery. The FP6-funded Utrecht-Stockholm-Oslo graduate school in solar physics represents offspring, the FP6 Solaire network is a partial replacement, and the EAST undertaking and pledge to build an EST is a most worthy FP7 stake. The EC's policy shifts from postdoc to predoc funding and from requiring (too) small to requiring (too) large consortia are criticized.

Drug-in-cyclodextrin-in-liposomes: A novel drug delivery system for flurbiprofen.

PubMed

Zhang, Lina; Zhang, Qi; Wang, Xin; Zhang, Wenji; Lin, Congcong; Chen, Fen; Yang, Xinggang; Pan, Weisan

2015-08-15

A novel delivery system based on drug-cyclodextrin (CD) complexation and liposomes has been developed to improve therapeutic effect. Three different means, i.e., co-evaporation (COE), co-ground (GR) and co-lyophilization (COL) and three different CDs (β-CD, HP-β-CD and SBE-β-CD) were contrasted to investigate the characteristics of the end products. FP/FP-CD loaded liposomes were obtained by thin layer evaporation technique. Size, zeta potential and encapsulation efficiency were investigated by light scattering analysis and minicolumn centrifugation. Differential scanning calorimetry (DSC) and transmission electron microscopy (TEM) showed the amorphous form of complexes and spherical morphology of FP-HP-β-CD COE loaded liposomes. The pH 7.4 phosphate buffer solution (PBS) was selected as the medium for the in vitro release. Wistar rats were put into use to study the pharmacokinetic behavior in vivo. FP-HP-β-CD COE loaded liposomes showed the better physicochemical characters that followed the average particle size, polydispersity index, zeta potential and mean encapsulation efficiency 158±10 nm, 0.19±0.1, -12.4±0.1 mW and 56.1±0.5%, separately. The relative bioavailability of FP-HP-β-CD COE loaded liposomes was 420%, 201% and 402% compared with FP solution, FP-HP-β-CD and FP-liposomes, respectively. In conclusion, the novel delivery system improved the relative bioavailability of FP significantly and provided a perspective way for delivery of insoluble drugs. Copyright © 2015 Elsevier B.V. All rights reserved.

Association between the number of fungiform papillae on the tip of the tongue and sensory taste perception in children.

PubMed

Jilani, Hannah; Ahrens, Wohlfgang; Buchecker, Kirsten; Russo, Paola; Hebestreit, Antje

2017-01-01

Background : To measure sensory taste perception in children with an accurate and reproducible method is challenging and objective measurement methods are scarce. Objective : Aim was to characterize sensory taste perception, by measuring the number of fungiform papillae (FP) and to investigate whether the number of FP is associated with sensitivity for bitter taste and with taste preferences for sweet, salty, fatty or umami in children between 8 and 11 years of age. Design : Number of FP was measured with a digital camera in 83 children in a German subsample of the IDEFICS study. Among those 56 children performed a taste threshold test for bitter and taste preference tests for sweet, salty, fatty and umami. The association between the number of FP and sensory taste perception was analysed. Results : There is a tendency towards a lower number of FP in children with a higher fat preference (30 vs. 25 papillae, p=0.06). Results show no association between the number of FP and neither the bitter taste thresholds nor taste preferences for sweet, salty and umami. Conclusion : Bitter taste threshold might be independent of the number of FP, while the perception of fat was associated with the number of FP.

Aging Alters Functionally Human Dermal Papillary Fibroblasts but Not Reticular Fibroblasts: A New View of Skin Morphogenesis and Aging

PubMed Central

Mine, Solène; Fortunel, Nicolas O.; Pageon, Hervé; Asselineau, Daniel

2008-01-01

Understanding the contribution of the dermis in skin aging is a key question, since this tissue is particularly important for skin integrity, and because its properties can affect the epidermis. Characteristics of matched pairs of dermal papillary and reticular fibroblasts (Fp and Fr) were investigated throughout aging, comparing morphology, secretion of cytokines, MMPs/TIMPs, growth potential, and interaction with epidermal keratinocytes. We observed that Fp populations were characterized by a higher proportion of small cells with low granularity and a higher growth potential than Fr populations. However, these differences became less marked with increasing age of donors. Aging was also associated with changes in the secretion activity of both Fp and Fr. Using a reconstructed skin model, we evidenced that Fp and Fr cells do not possess equivalent capacities to sustain keratinopoiesis. Comparing Fp and Fr from young donors, we noticed that dermal equivalents containing Fp were more potent to promote epidermal morphogenesis than those containing Fr. These data emphasize the complexity of dermal fibroblast biology and document the specific functional properties of Fp and Fr. Our results suggest a new model of skin aging in which marked alterations of Fp may affect the histological characteristics of skin. PMID:19115004

Are family physicians good for you? Endogenous doctor supply and individual health.

PubMed

Gravelle, Hugh; Morris, Stephen; Sutton, Matt

2008-08-01

To investigate the impact of family physician (FP) supply on individual health, adjusting for factors that affect both health and FPs' choice of location. A total of 49,541 individuals in 351 English local authorities (LAs). Data on individual health and personal characteristics from three rounds (1998, 1999, and 2000) of the Health Survey for England were linked to LA data on FP supply. Three methods for analyzing self-reported health were used. FP supply, instrumented by house prices and by age-weighted capitation payments for patients on FP lists, was included in individual-level health regressions along with individual and LA covariates. When no instruments are used FPs have a positive but statistically insignificant effect on health. When FP supply is instrumented by age-related capitation it has markedly larger and statistically significant effects. A 10 percent increase in FP supply increases the probability of reporting very good health by 6 percent. After allowing for endogeneity, an increase in FP supply has a significant positive effect on self-reported individual health.

Nanostructured lipid carriers-based flurbiprofen gel after topical administration: acute skin irritation, pharmacodynamics, and percutaneous absorption mechanism.

PubMed

Song, Aihua; Su, Zhen; Li, Sanming; Han, Fei

2015-01-01

In order to assess the preliminary safety and effectiveness of nanostructured lipid carriers-based flurbiprofen gel (FP NLC-gel), the acute irritation test, in vivo pharmacodynamics evaluation and pharmacokinetic study were investigated after topical application. No dropsy and erythema were observed after continuous dosing 7 d of FP NLC-gel on the rabbit skin, and the xylene-induced ear drossy could be inhibited by FP NLC-gel at different dosages. The maximum concentration of FP in rats muscle was 2.03 μg/g and 1.55 μg/g after oral and topical administration, respectively. While the peak concentration in untreated muscle after topical administration was only 0.37 μg/mL. And at any time, following topical administration the mean muscle-plasma concentration ratio Cmuscle/CPlasma was obviously higher than that following oral administration. Results indicated that FP could directly penetrate into the subcutaneous muscle tissue from the administration site. Thus, the developed FP NLC-gel could be a safe and effective vehicle for topical delivery of FP.

Identification of Chelonid herpesvirus 5 (ChHV5) in endangered green turtles (Chelonia mydas) with fibropapillomatosis in Asia

USGS Publications Warehouse

Li, Tsung-Hsien; Hsu, Wei-Li; Lan, Yu-Ching; Balazs, George H.; Work, Thierry M.; Tseng, Cheng-Tsung; Chang, Chao-Chin

2017-01-01

Fibropapillomatosis (FP), a debilitating tumor disease of sea turtles, was first identified in green turtles [Chelonia mydas (Linnaeus, 1758)] in Florida in 1938. In recent decades, FP has been observed globally and is an emerging panzootic disease in sea turtles. However, few reports of FP in Asia exist. Here, we provide the first evidence of Chelonid herpesvirus 5 (ChHV5) DNA associated with FP in endangered green turtles from Taiwan, through molecular characterization, phylogenetic analysis, and histopathological examination. In our study, ChHV5 was successfully detected by PCR in the FP tumor lesions of green turtles. The sequences were found to be consistent with those of tumor-inducing viruses shown to affect sea turtles in the other parts of the world. ChHV5 RNA from the FP tissues was further detected by RT-PCR, indicating active replication of the viruses inside FP tumors. In addition to the molecular evidence of ChHV5 in FP, epidermal intranuclear inclusions were identified in tumor lesions upon histopathological examination. This further suggests that ChHV5 should be in a transcriptionally active (i.e., non-latent) state in FP tumors of affected green turtles. The phylogenetic tree revealed that ChHV5 from the green turtles in Taiwan were closest to the ChHV5 from Hawaii, Puerto Rico, and Sao Tome. For conservation of endangered sea turtles, ChHV5 should be considered an emerging virus, which threatens sea turtles in marine waters in Asia.

Synergistic anticancer effect of curcumin and chemotherapy regimen FP in human gastric cancer MGC-803 cells.

PubMed

He, Bin; Wei, Wen; Liu, Ji; Xu, Yundan; Zhao, Gang

2017-09-01

Curcumin is an anticancer compound that exerts anti-proliferative and apoptotic effects via multiple molecular targets. The purpose of the present study was to investigate the anticancer effects of curcumin in combination with 5-fluorouracil plus cisplatin (FP) on the MGC-803 human gastric cancer cell line. Following treatment with curcumin and/or FP for 24, 48 and 72 h, cell viability, cell cycle progression and the apoptosis rate were evaluated using an MTT assay, flow cytometry and dual acridine orange/ethidium bromide staining, respectively. In addition, colony formation, Transwell migration and caspase-3/caspase-8 activity assays were performed. The expression of the apoptosis regulator B-cell lymphoma-2 (Bcl-2) and Bcl-2-associated X protein (Bax) were detected by western blotting analysis. Following treatment with curcumin and/or FP, cell viability, colony formation and cell migration were significantly reduced compared with the untreated control group. The rate of apoptosis, caspase-3/caspase-8 activity and the expression of Bax were significantly increased, whereas Bcl-2 expression was significantly reduced following treatment with curcumin and/or FP, compared with the untreated control group. The efficacy of curcumin combined with low-dose FP was significantly increased, compared with that of curcumin combined with high-dose FP (P<0.05). Therefore, curcumin may enhance the anticancer effects of FP chemotherapy in MGC-803 cells through the promotion of apoptosis via the caspase-3/caspase-8, Bcl-2 and Bax signaling pathways. These results suggest that curcumin may serve as a synergistic drug with chemotherapy regimen FP for the treatment of gastric cancer.

[Cost of family planning care in 10-19 years old teenagers].

PubMed

Martínez-Ramírez, E A; Villarreal-Ríos, E; Vargas-Daza, E R; Galicia-Rodríguez, L; Martínez-González, L

2016-09-01

To identify the costs of family planning care in adolescents. Longitudinal study of the cost of care for family planning carried out in 2015 in a group of individuals with age limits of 10 and 19 years in a unit first level of health care in the state of Queretaro, Mexico. The profile of use of family planning (FP) was created for the teen was performed services through counseling, provision of contraception and review of intrauterine device (IUD) in a year; cost projections for the population of adolescents and different coverage scenarios between 5 and 100% were made. The average annual cost was 228.84 Mexican pesos. Ideally the identified cost was 2,708.94 pesos. The projection with 20 % coverage was 207,251,330 pesos. The average annual family planning consultations was 0.9. The most commonly used method was with medroxyprogesterone-estradiol at doses of 25 and 5 mg. The cost of planning in adolescents is low, taking into account the costs that the care of high-risk pregnancies and associated comorbidities.

A novel fiber Bragg grating wavelength demodulation system based on F-P etalon

NASA Astrophysics Data System (ADS)

Yang, Gang; Guo, Jinghong; Xu, Guoliang; Lv, Lidong; Tu, Guojie; Xia, Lan

2014-10-01

This paper designs and implies a high precision FBG demodulation system which based on F-P etalon. In order to reduce the influence of the temperature drift effect, the peristaltic effect, and the nonlinear effect of F-P filter in traditional tunable filter method, F-P etalon is added as dynamical calibration and wavelength reference. Meanwhile segmentation demodulation which uses ASE spectral characteristics is applied to achieve high accuracy of the center wavelength of FBG. The experiment shows that the stability, resolution are 0.65pm, 0.23pm, respectively. Key words: fiber optics; fiber Bragg grating sensor system; tunable Fabry-Perot filter; F-P etalon; spectrum segmentation demodulation

Decision-making in female fertility preservation is balancing the expected burden of fertility preservation treatment and the wish to conceive.

PubMed

Baysal, Ö; Bastings, L; Beerendonk, C C M; Postma, S A E; IntHout, J; Verhaak, C M; Braat, D D M; Nelen, W L D M

2015-07-01

What are the decisive factors in fertility preservation (FP) decision-making in young women scheduled for gonadotoxic therapy? FP decision-making in young women scheduled for gonadotoxic therapy is mainly based on weighing two issues: the intensity of the wish to conceive a child in the future and the expected burden of undergoing FP treatment. Future fertility is of importance for young cancer patients whose reproductive function is being threatened by oncological therapy. To prevent or reduce severe psychological effects of infertility as well as feelings of regret about their FP decision after cancer treatment, the quality of fertility preservation counselling (FPC) should be improved. To improve care, those issues forming a decisive factor in FP decision-making for patients should be clarified, as these issues deserve extensive discussion during FPC. Until now, decisive factors have not been isolated from the complex interplay of all aspects of FP that women contemplate during FP decision-making. By using a mixed methods methodology, a questionnaire developed after qualitative research involving a selected group of five women who previously received FPC was retrospectively sent to eligible patients (n = 143) who had received FPC (1999 - July 2013) and to whom at least one FP option was offered. Patients had received FPC at a university hospital in the Netherlands, in a setting where financial factors do not play a role in FP. They were aged ≥16 years and were scheduled for gonadotoxic treatment. The relationship between patients' baseline characteristics, their attributed importance to 28 relevant importance items and their FP choices was investigated. After five interviews, 28 importance items for FP decision-making were identified and included in our questionnaire. Of these 28 importance items, 24 items could be clustered into seven importance themes. A total of 87 patients (61%) responded to our questionnaire. After performing a multivariable logistic regression analysis, proceeding with FP was related to higher attributed importance during FP decision-making to the theme 'Wish to conceive (in the future)' (odds ratio (OR) 10.8, 95% confidence interval (CI) 3.5-34.4) and the item 'Having a stable partner relationship' (OR 2.0, 95% CI 1.0-4.1), while higher attributed importance to the theme 'Expected burden of FP' during FP decision-making (OR 0.08, 95% CI 0.02-0.3) more often resulted in refraining from treatment. Besides possible recall and selection bias, the fact that this study was performed in Dutch patients aged ≥16 years counselled in a single centre, where finance was not an additional consideration, possibly limits the generalizability of our results to a broader European population of cancer patients. Furthermore, we are not able to draw conclusions about the causality of the associations observed in our study. The wish to conceive and the expected burden of FP treatment should be discussed carefully with patients during FP decision-making, either by the referring healthcare provider or by reproductive medicine specialist. Prospective research is needed to explore the causality of the associations found in this study. Furthermore, in order to deliver high quality patient-centred care, the development of tools to explore patients' wish to conceive (for example in different age categories) and tools to provide clear information about the burden of FP treatments (using the preferred information channels suggested by patients) is needed. This work was supported by the Radboud Institute for Health Sciences (research school affiliated to the Radboud university medical center). The authors have declared no conflicts of interest with respect to this work. © The Author 2015. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Evaluation of hemoglobin A1c measurement from filter paper using high-performance liquid chromatography and immunoturbidimetric assay.

PubMed

Wu, Yonghua; Yang, Xu; Wang, Haining; Li, Zhenrong; Wang, Tiancheng

2017-04-01

Glycated hemoglobin (HbA 1c ) measurement from whole blood (WB) samples is inconvenient for epidemic surveillance and self-monitoring of glycemic level. We evaluated HbA 1c measurement from WB blotted on filter paper (FP), which can be easily transported to central laboratories, with high-performance liquid chromatography (HPLC) and immunoturbidimetric assay (ITA). WB was applied to Whatman filter paper. By using HPLC and WB samples as reference methods, these FP samples were evaluated on HPLC and ITA. Inter- and intra-assay variation, WB vs. FP agreement and sample stability at 20-25 °C and -70 °C were assessed by statistical analysis. Results showed that the coefficient of variation (CV, %) of FP samples for HPLC and ITA were 0.44-1.02% and 1.47-2.72%, respectively (intra-assay); 2.13-3.56% and 3.21-4.82%, respectively (inter-assay). The correlation of WB HPLC with FP analyzed using HPLC and ITA are both significant (p < 0.001). Sample stability showed that FP method up to 5 days at 20-25 °C and 5 weeks at -70 °C is accurate and reproducible. In conclusion, FP samples analyzed by HPLC and ITA can both provide an alternative to WB for HbA 1c measurement, supporting the use of FP method in epidemic surveillance and healthcare units.

Automated detection of pulmonary nodules in PET/CT images: Ensemble false-positive reduction using a convolutional neural network technique

DOE Office of Scientific and Technical Information (OSTI.GOV)

Teramoto, Atsushi, E-mail: teramoto@fujita-hu.ac.jp; Fujita, Hiroshi; Yamamuro, Osamu

Purpose: Automated detection of solitary pulmonary nodules using positron emission tomography (PET) and computed tomography (CT) images shows good sensitivity; however, it is difficult to detect nodules in contact with normal organs, and additional efforts are needed so that the number of false positives (FPs) can be further reduced. In this paper, the authors propose an improved FP-reduction method for the detection of pulmonary nodules in PET/CT images by means of convolutional neural networks (CNNs). Methods: The overall scheme detects pulmonary nodules using both CT and PET images. In the CT images, a massive region is first detected using anmore » active contour filter, which is a type of contrast enhancement filter that has a deformable kernel shape. Subsequently, high-uptake regions detected by the PET images are merged with the regions detected by the CT images. FP candidates are eliminated using an ensemble method; it consists of two feature extractions, one by shape/metabolic feature analysis and the other by a CNN, followed by a two-step classifier, one step being rule based and the other being based on support vector machines. Results: The authors evaluated the detection performance using 104 PET/CT images collected by a cancer-screening program. The sensitivity in detecting candidates at an initial stage was 97.2%, with 72.8 FPs/case. After performing the proposed FP-reduction method, the sensitivity of detection was 90.1%, with 4.9 FPs/case; the proposed method eliminated approximately half the FPs existing in the previous study. Conclusions: An improved FP-reduction scheme using CNN technique has been developed for the detection of pulmonary nodules in PET/CT images. The authors’ ensemble FP-reduction method eliminated 93% of the FPs; their proposed method using CNN technique eliminates approximately half the FPs existing in the previous study. These results indicate that their method may be useful in the computer-aided detection of pulmonary nodules using PET/CT images.« less

Contrast and Intensity upgrades to the Texas Petawatt laser for hadron generation and non-linear QED experiments

NASA Astrophysics Data System (ADS)

Hegelich, Bjorn M.; Arefiev, Alexey; Ditmire, Todd; Donovan, Michael E.; Dyer, Gillis; Gaul, Erhard; Labun, Lance; Luedtke, Scott; Martinez, Mikael; McCarry, Edward; Stark, David; Pomerantz, Ishay; Tiwari, Ganesh; Toncian, Toma

2015-11-01

Advances in laser-based hadron generation, especially with respect to particle energy, as well as reaching the new regime of radiation dominated plasmas and non-linear QED, require laser fields of Petavolts per meter that preferably interact with very high density, overcritical plasmas. To achieve these conditions we are upgrading the Texas Petawatt Laser both respect to on-target laser intensity and laser-contrast, aiming to reach intensities of ~ 5x1022 W/cm2 and pulse contrast parameters allowing the interaction with overcritical, yet ultrathin, sub-micron targets. We will report on the planned experiments aimed at ion acceleration, neutron generation and the first experimental measurement of radiation reactions to motivate the chosen upgrade parameters. We will further report on the technical changes to the laser and present first measurements of the achieved intensity and contrast parameters. This work was supported by NNSA cooperative agreement DE-NA0002008, the Defense Advanced Research Projects Agency's PULSE program (12-63-PULSE-FP014), the Air Force Office of Scientific Research (FA9550-14-1-0045) and the National Institute of Health SBIR.

The Effect of Low Ambient Relative Humidity on Physical Performance and Perceptual Responses during Load Carriage.

PubMed

Mekjavic, Igor B; Ciuha, Ursa; Grönkvist, Mikael; Eiken, Ola

2017-01-01

Introduction: The study evaluated the effect of low ambient relative humidity on physical performance and perceptual responses during load carriage in a hot environment. Methods: Ten heat-unacclimatized male subjects participated in three 130-min trials, during which they walked on a treadmill, carrying a load of ~35 kg, at a speed of 3.2 km.h -1 , with an incident wind at the same velocity and ambient temperature at 45°C. Each trial commenced with a 10-min baseline at 20°C and 50% relative humidity (RH), the subjects transferred to a climatic chamber and commenced their simulated hike, comprising two 50-min walks separated by a 20-min rest period. In two, full protective equipment (FP) trials, RH was 10% (partial pressure of water vapor, p H 2 O = 7.2 mmHg) in one (FP10), and 20% (p H 2 O = 14.4 mmHg; FP20) in the other. In the control trial, subjects were semi-nude (SN) and carried the equipment in their backpacks; RH was 20%. Measurements included oxygen uptake, ventilation, heart rate, rectal and skin temperatures, heat flux, temperature perception, and thermal comfort. Results: In FP20, four subjects terminated the trial prematurely due to signs of heat exhaustion; there were no such signs in FP10 or SN. Upon completion of the trials, pulmonary ventilation, heart rate, and rectal temperature were lower in FP10 (33 ± 5 l/min; 128 ± 21 bpm; 38.2 ± 0.4°C) and SN (34 ± 4 l/min; 113 ± 18 bpm; 38.1 ± 0.4°C than in FP20 (39 ± 8 l/min; 145 ± 12 bpm; 38.6 ± 0.4°C). Evaporation was significantly greater in the SN compared to FP10 and FP20 trials. FP10 was rated thermally more comfortable than FP20. Conclusion: A lower ambient partial pressure of water vapor, reflected in a lower ambient relative humidity, improved cardiorespiratory, thermoregulatory, and perceptual responses during load carriage.

The Effect of Low Ambient Relative Humidity on Physical Performance and Perceptual Responses during Load Carriage

PubMed Central

Mekjavic, Igor B.; Ciuha, Ursa; Grönkvist, Mikael; Eiken, Ola

2017-01-01

Introduction: The study evaluated the effect of low ambient relative humidity on physical performance and perceptual responses during load carriage in a hot environment. Methods: Ten heat-unacclimatized male subjects participated in three 130-min trials, during which they walked on a treadmill, carrying a load of ~35 kg, at a speed of 3.2 km.h−1, with an incident wind at the same velocity and ambient temperature at 45°C. Each trial commenced with a 10-min baseline at 20°C and 50% relative humidity (RH), the subjects transferred to a climatic chamber and commenced their simulated hike, comprising two 50-min walks separated by a 20-min rest period. In two, full protective equipment (FP) trials, RH was 10% (partial pressure of water vapor, pH2O = 7.2 mmHg) in one (FP10), and 20% (pH2O = 14.4 mmHg; FP20) in the other. In the control trial, subjects were semi-nude (SN) and carried the equipment in their backpacks; RH was 20%. Measurements included oxygen uptake, ventilation, heart rate, rectal and skin temperatures, heat flux, temperature perception, and thermal comfort. Results: In FP20, four subjects terminated the trial prematurely due to signs of heat exhaustion; there were no such signs in FP10 or SN. Upon completion of the trials, pulmonary ventilation, heart rate, and rectal temperature were lower in FP10 (33 ± 5 l/min; 128 ± 21 bpm; 38.2 ± 0.4°C) and SN (34 ± 4 l/min; 113 ± 18 bpm; 38.1 ± 0.4°C than in FP20 (39 ± 8 l/min; 145 ± 12 bpm; 38.6 ± 0.4°C). Evaporation was significantly greater in the SN compared to FP10 and FP20 trials. FP10 was rated thermally more comfortable than FP20. Conclusion: A lower ambient partial pressure of water vapor, reflected in a lower ambient relative humidity, improved cardiorespiratory, thermoregulatory, and perceptual responses during load carriage. PMID:28729839

Spectrum and prevalence of FP/TMEM127 gene mutations in pheochromocytomas and paragangliomas.

PubMed

Yao, Li; Schiavi, Francesca; Cascon, Alberto; Qin, Yuejuan; Inglada-Pérez, Lucia; King, Elizabeth E; Toledo, Rodrigo A; Ercolino, Tonino; Rapizzi, Elena; Ricketts, Christopher J; Mori, Luigi; Giacchè, Mara; Mendola, Antonella; Taschin, Elisa; Boaretto, Francesca; Loli, Paola; Iacobone, Maurizio; Rossi, Gian-Paolo; Biondi, Bernadette; Lima-Junior, José Viana; Kater, Claudio E; Bex, Marie; Vikkula, Miikka; Grossman, Ashley B; Gruber, Stephen B; Barontini, Marta; Persu, Alexandre; Castellano, Maurizio; Toledo, Sergio P A; Maher, Eamonn R; Mannelli, Massimo; Opocher, Giuseppe; Robledo, Mercedes; Dahia, Patricia L M

2010-12-15

Pheochromocytomas and paragangliomas are genetically heterogeneous neural crest-derived neoplasms. We recently identified germline mutations of the novel transmembrane-encoding gene FP/TMEM127 in familial and sporadic pheochromocytomas consistent with a tumor suppressor effect. To examine the prevalence and spectrum of FP/TMEM127 mutations in pheochromocytomas and paragangliomas and to test the effect of mutations in vitro. We sequenced the FP/TMEM127 gene in 990 individuals with pheochromocytomas and/or paragangliomas, including 898 previously unreported cases without mutations in other susceptibility genes from 8 independent worldwide referral centers between January 2009 and June 2010. A multiplex polymerase chain reaction-based method was developed to screen for large gene deletions in 545 of these samples. Confocal microscopy of 5 transfected mutant proteins was used to determine their subcellular localization. The frequency and type of FP/TMEM127 mutation or deletion was assessed and correlated with clinical variables; the subcellular localization of 5 overexpressed mutants was compared with wild-type FP/TMEM127 protein. We identified 19 potentially pathogenic FP/TMEM127 germline mutations in 20 independent families, but no large deletions were detected. All mutation carriers had adrenal tumors, including 7 bilateral (P = 2.7 × 10(-4)) and/or with familial disease (5 of 20 samples; P = .005). The median age at disease onset in the FP/TMEM127 mutation group was similar to that of patients without a mutation (41.5 vs 45 years, respectively; P = .54). The most common presentation was that of a single benign adrenal tumor in patients older than 40 years. Malignancy was seen in 1 mutation carrier (5%). Expression of 5 novel FP/TMEM127 mutations in cell lines revealed diffuse localization of the mutant proteins in contrast with the discrete multiorganelle distribution of wild-type TMEM127. Germline mutations of FP/TMEM127 were associated with pheochromocytoma but not paraganglioma and occurred in an age group frequently excluded from genetic screening algorithms. Disease-associated mutations disrupt intracellular distribution of the FP/TMEM127 protein.

A pilot study of S-1 plus cisplatin versus 5-fluorouracil plus cisplatin for postoperative chemotherapy in histological stage IIIB-IV (M0) gastric cancer.

PubMed

Lee, Sung Sook; Jeung, Hei-Cheul; Chung, Hyun Cheol; Noh, Sung Hoon; Hyung, Woo Jin; Ahn, Ji Yeong; Rha, Sun Young

2012-02-01

Although its efficacy is unproven, 5-fluorouracil plus cisplatin (FP) is used to prevent postoperative relapse in gastric cancer. We investigated the safety and feasibility of S-1 plus cisplatin (SP) vs. FP for stage IIIB-IV (M0) gastric cancer. Following curative resection, 41 stage IIIB-IV (M0) gastric cancer patients were assigned to SP (eight 14-day cycles of S-1 [40 mg/m(2) twice daily] plus cisplatin [60 mg/m(2) day 1] administered every 3 weeks) or FP (six 3-day cycles of FU [1 g/m(2) per day] plus cisplatin [80 mg/m(2) day 1] every 4 weeks). Doses were reduced based on predefined criteria. Patient characteristics were balanced between the two arms. In total, 124 cycles of SP (N = 20, median = 7, range 1-8) and 113 cycles of FP (N = 21, median 6, range 1-6) were administered. The median relative dose intensity per patient was 75% (49.99-100%) for S-1, 100% (75-100%) for cisplatin in SP, and 100% (64-100%) for 5-FU, 100% (60-100%) for cisplatin in FP. The relative dose intensity of FP was stable, while that of SP decreased during treatment. After median follow-up of 7.9 months (3.8-14.55), the median RFS was not reached. Relapse occurred in two (10%) patients on SP and five (23.8%) in the FP arm (P = 0.24). The incidence of grade 3-4 granulocytopenia was 36.8% with SP and 14.3% with FP. Grade 3-4 non-hematologic toxicities included fatigue (5.2% with SP vs. 4.8% with FP), vomiting (10.5% with SP vs. 0% with FP), and infection (5.2% with SP vs. 0% FP). S-1 plus cisplatin was feasible and tolerable as adjuvant treatment for stage IIIB-IV (M0) gastric cancer. However, because of decreased relative dose intensity during treatment, further study is warranted to determine optimal dosage and combination.

The Yucatan Minipig Temporomandibular Joint Disc Structure-Function Relationships Support Its Suitability for Human Comparative Studies.

PubMed

Vapniarsky, Natalia; Aryaei, Ashkan; Arzi, Boaz; Hatcher, David C; Hu, Jerry C; Athanasiou, Kyriacos A

2017-11-01

Frequent involvement of the disc in temporomandibular joint (TMJ) disorders warrants attempts to tissue engineer TMJ disc replacements. Physiologically, a great degree of similarity is seen between humans and farm pigs (FPs), but the pig's rapid growth confers a significant challenge for in vivo experiments. Minipigs have a slower growth rate and are smaller than FPs, but minipig TMJ discs have yet to be fully characterized. The objective of this study was to determine the suitability of the minipig for TMJ studies by extensive structural and functional characterization. The properties of minipig TMJ discs closely reproduced previously reported morphological, biochemical, and biomechanical values of human and FP discs. The width/length dimension ratio of the minipig TMJ disc was 1.95 (1.69 for human and 1.94 for FP). The biochemical evaluation revealed, on average per wet weight, 24.3% collagen (22.8% for human and 24.9% for FP); 0.8% glycosaminoglycan (GAG; 0.5% for human and 0.4% for FP); and 0.03% DNA (0.008% for human and 0.02% for FP). Biomechanical testing revealed, on average, compressive relaxation modulus of 50 kPa (37 kPa for human and 32 kPa for FP), compressive instantaneous modulus of 1121 kPa (1315 kPa for human and 1134 kPa for FP), and coefficient of viscosity of 13 MPa·s (9 MPa·s for human and 3 MPa·s for FP) at 20% strain. These properties also varied topographically in accordance to those of human and FP TMJ discs. Anisotropy, quantified by bidirectional tensile testing and histology, again was analogous among minipig, human, and FP TMJ discs. The minipig TMJ's ginglymoarthrodial nature was verified through cone beam computer tomography. Collectively, the similarities between minipig and human TMJ discs support the use of minipig as a relevant model for TMJ research; considering the practical advantages conferred by its growth rate and size, the minipig may be a preferred model over FP.

Sociodemographic Factors on Contraceptive Use among Ever-Married Women of Reproductive Age: Evidence from Three Demographic and Health Surveys in Bangladesh.

PubMed

Haq, Iqramul; Sakib, Saifullah; Talukder, Ashis

2017-12-06

Contraceptive use among married women of reproductive age has showed a substantial progress over the last few decades in Bangladesh. This study explores the sociodemographic factors associated with contraceptive use among ever-married women of reproductive age in Bangladesh by utilizing the information extracted from three of the Bangladesh Demographic and Health Surveys (BDHSs) in 1993-1994, 2004 and 2014. Bivariate analysis was conducted by performing chi-squared test of independence to explore the relationship between selected sociodemographic factors and dependent variables. To know the adjusted effects of covariates, a popular binary logistic regression model was considered. Respondents' current age, place residence, division religion, education, age at first marriage, family planning (FP) media exposure, ideal number of children and fertility preferences are the significant determinants according to the most recent survey, BDHS 2014. However, wealth index and a respondent's current working status were found to be significant factors only in BDHS 2004. The results of the study strongly recommend efforts to increase the education level among poor people, particularly among women in Bangladesh. Program interventions, including health behavior education and family planning services and counselling, are especially needed for some categories of the population, including those living in rural areas, Sylhet, Chittagong and Dhaka divisions, as well as illiterate and Muslim ever-married women.

Bias estimates used in lieu of validation of fission products and minor actinides in MCNP K eff calculations for PWR burnup credit casks

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mueller, Don E.; Marshall, William J.; Wagner, John C.

The U.S. Nuclear Regulatory Commission (NRC) Division of Spent Fuel Storage and Transportation recently issued Interim Staff Guidance (ISG) 8, Revision 3. This ISG provides guidance for burnup credit (BUC) analyses supporting transport and storage of PWR pressurized water reactor (PWR) fuel in casks. Revision 3 includes guidance for addressing validation of criticality (k eff) calculations crediting the presence of a limited set of fission products and minor actinides (FP&MA). Based on previous work documented in NUREG/CR-7109, recommendation 4 of ISG-8, Rev. 3, includes a recommendation to use 1.5 or 3% of the FP&MA worth to conservatively cover the biasmore » due to the specified FP&MAs. This bias is supplementary to the bias and bias uncertainty resulting from validation of k eff calculations for the major actinides in SNF and does not address extension to actinides and fission products beyond those identified herein. The work described in this report involves comparison of FP&MA worths calculated using SCALE and MCNP with ENDF/B-V, -VI, and -VII based nuclear data and supports use of the 1.5% FP&MA worth bias when either SCALE or MCNP codes are used for criticality calculations, provided the other conditions of the recommendation 4 are met. The method used in this report may also be applied to demonstrate the applicability of the 1.5% FP&MA worth bias to other codes using ENDF/B V, VI or VII based nuclear data. The method involves use of the applicant s computational method to generate FP&MA worths for a reference SNF cask model using specified spent fuel compositions. The applicant s FP&MA worths are then compared to reference values provided in this report. The applicants FP&MA worths should not exceed the reference results by more than 1.5% of the reference FP&MA worths.« less

The SARS-CoV Fusion Peptide Forms an Extended Bipartite Fusion Platform that Perturbs Membrane Order in a Calcium-Dependent Manner.

PubMed

Lai, Alex L; Millet, Jean K; Daniel, Susan; Freed, Jack H; Whittaker, Gary R

2017-12-08

Coronaviruses (CoVs) are a major infectious disease threat and include the pathogenic human pathogens of zoonotic origin: severe acute respiratory syndrome CoV (SARS-CoV) and Middle East respiratory syndrome CoV (MERS-CoV). Entry of CoVs into host cells is mediated by the viral spike (S) protein, which is structurally categorized as a class I viral fusion protein, within the same group as influenza virus and HIV. However, S proteins have two distinct cleavage sites that can be activated by a much wider range of proteases. The exact location of the CoV fusion peptide (FP) has been disputed. However, most evidence suggests that the domain immediately downstream of the S2' cleavage site is the FP (amino acids 798-818 SFIEDLLFNKVTLADAGFMKQY for SARS-CoV, FP1). In our previous electron spin resonance spectroscopic studies, the membrane-ordering effect of influenza virus, HIV, and Dengue virus FPs has been consistently observed. In this study, we used this effect as a criterion to identify and characterize the bona fide SARS-CoV FP. Our results indicate that both FP1 and the region immediately downstream (amino acids 816-835 KQYGECLGDINARDLICAQKF, FP2) induce significant membrane ordering. Furthermore, their effects are calcium dependent, which is consistent with in vivo data showing that calcium is required for SARS-CoV S-mediated fusion. Isothermal titration calorimetry showed a direct interaction between calcium cations and both FPs. This Ca 2+ -dependency membrane ordering was not observed with influenza FP, indicating that the CoV FP exhibits a mechanistically different behavior. Membrane-ordering effects are greater and penetrate deeper into membranes when FP1 and FP2 act in a concerted manner, suggesting that they form an extended fusion "platform." Copyright © 2017 Elsevier Ltd. All rights reserved.

Blood collected on filter paper for wildlife serology: detecting antibodies to Neospora caninum, West Nile virus, and five bovine viruses in reindeer.

PubMed

Curry, Patricia S; Ribble, Carl; Sears, William C; Hutchins, Wendy; Orsel, Karin; Godson, Dale; Lindsay, Robbin; Dibernardo, Antonia; Kutz, Susan J

2014-04-01

We compared Nobuto filter paper (FP) whole-blood samples to serum for detecting antibodies to seven pathogens in reindeer (Rangifer tarandus tarandus). Serum and FP samples were collected from captive reindeer in 2008-2009. Sample pairs (serum and FP eluates) were assayed in duplicate at diagnostic laboratories with the use of competitive enzyme-linked immunosorbent assays (cELISAs) for Neospora caninum and West Nile virus (WNV); indirect ELISA (iELISAs) for bovine herpesvirus type 1 (BHV-1), parainfluenza virus type 3 (PI-3), and bovine respiratory syncytial virus (BRSV); and virus neutralization (VN) for bovine viral diarrhea virus (BVDV) types I and II. Assay thresholds were evidence-based values employed by each laboratory. Comparable performance to serum was defined as FP sensitivity and specificity ≥ 80%. Filter-paper specificity estimates ranged from 92% in the cELISAs for N. caninum and WNV to 98% in the iELISAs for PI-3 and BRSV. Sensitivity was >85% for five tests (most ≥ 95%) but was insufficient (71-82%) for the PI-3 and BRSV iELISAs. Lowering the threshold for FP samples in these two ELISAs raised sensitivity to ≥ 87% and reduced specificity slightly (≥ 90% in three of the four test runs). Sample size limited the precision of some performance estimates. Based on the criteria of sensitivity and specificity ≥ 80%, and using adjusted FP thresholds for PI-3 and BRSV, FP sensitivity and specificity were comparable to serum in all seven assays. A potential limitation of FP is reduced sensitivity in tests that require undiluted serum (i.e., N. caninum cELISA and BVDV VNs). Possible toxicity to the assay cell layer in VN requires investigation. Results suggested that cELISA is superior to iELISA for detecting antibodies in FP samples from reindeer and other Rangifer tarandus subspecies. Our findings expand the potential utility of FP sampling from wildlife.

Falcipain inhibitors as potential therapeutics for resistant strains of malaria: a patent review.

PubMed

Mane, Uttam Rajaram; Gupta, Ramesh C; Nadkarni, Sunil Sadanand; Giridhar, Rajani R; Naik, Prashant Prakash; Yadav, Mange R

2013-02-01

There is an urgent need to discover new antimalarial drugs due to emergence of resistance in the parasite to the existing drugs. Malarial cysteine proteases falcipin-2 (FP-2) and falcipain-3 (FP-3) are attractive targets for antimalarial chemotherapy. The structures and functions of FP-2/3, their binding domains and their interactions with small- and macro-molecules are well studied. These studies could provide important insight into rational designing of FP inhibitors as potential antimalarial drugs. This review is focused on a selection of interesting patents published during 1999 - 2011 on peptidic and nonpeptidic chemotypes of the FP-2/FP-3 inhibitors. It is a known fact that malaria is a serious health problem worldwide due to the emergence of resistant strains. Hence, development of novel, potent and affordable antimalarial drugs devoid of side effects is of great significance and in great demand. FPs, the malarial cysteine proteases are potential targets for development of new antimalarial drugs. Assessing the available literature on FP-2/3 and their inhibitors it could be speculated that these inhibitors have the potential to enter the clinical stages of development for the treatment of malaria in the years to come.

A Reconciliation for the Future of Psychiatry: Both Folk Psychology and Cognitive Science.

PubMed

Hutto, Daniel D

2016-01-01

Philosophy of psychiatry faces a tough choice between two competing ways of understanding mental disorders. The folk psychology (FP) view puts our everyday normative conceptual scheme in the driver's seat - on the assumption that it, and it only, tells us what mental disorders are (1). Opposing this, the scientific image (SI) view (2, 3) holds that our understanding of mental disorders must come, wholly and solely, from the sciences of the mind, unfettered by FP. This paper argues that the FP view is problematic because it is too limited: there is more to the mind than FP allows; hence, we must look beyond FP for properly deep and illuminating explanations of mental disorders. SI promises just this. But when cast in its standard cognitivist formulations, SI is unnecessarily and unjustifiably neurocentric. After rejecting both the FP view, in its pure form, and SI view, in its popular cognitivist renderings, this paper concludes that a more liberal version of SI can accommodate what is best in both views - once SI is so formulated and the FP view properly edited and significantly revised, the two views can be reconciled and combined to provide a sound philosophical basis for a future psychiatry.

The use of reproductive healthcare at commune health stations in a changing health system in Vietnam.

PubMed

Ngo, Anh D; Hill, Peter S

2011-09-27

With health sector reform in Vietnam moving towards greater pluralism, commune health stations (CHSs) have been subject to growing competition from private health services and increasing numbers of patients bypassing CHSs for higher-level health facilities. This study describes the pattern of reproductive health (RH) and family planning (FP) service utilization among women at CHSs and other health facilities, and explores socio-demographic determinants of RH service utilization at the CHS level. This study was based on a cross-sectional survey conducted in Thua Thien Hue and Vinh Long provinces, using a multi-stage cluster sampling technique. Questionnaire-based interviews with 978 ever-married women at reproductive age provided data on socio-demographic characteristics, current use of FP methods, history of RH service use, and the health facility attended for their most recent services. Multiple logistic regression analyses were used to identify socio-demographic determinants of their use of CHS RH services. Eighty nine percent of ever-married women reported current use of birth control with 49% choosing intra-uterine device (IUD). Eighty nine percent of pregnant women attended facility-based antenatal care (ANC) with 62% having at least 3 check-ups during their latest pregnancy. Ninety one percent of mothers had their last delivery in a health facility. Seventy-one percent of respondents used CHS for IUD insertion, 55% for antenatal check-ups, and 77% gynecological examination. District and provincial/central hospitals dominated the provision of delivery service, used by 57% of mothers for their latest delivery. The percentage of women opting for private ANC services was reported at 35%, though the use of private delivery services was low (11%). Women who were farmers, earning a lower income, having more than 2 children, and living in a rural area were more likely than others to use ANC, delivery, and/or gynecological check-up services at the CHS. Women choice of providers for FP and RH services that help them plan and protect their pregnancies is driven by socio-economic factors. While the CHS retains significant utilization rates, it is under challenge by preferences for hospital-based delivery and the growing use of private ANC services.

The low-dose (1 microg) cosyntropin test (LDT) for primary adrenocortical insufficiency: Defining the normal cortisol response and report on first patients with Addison disease confirmed with LDT.

PubMed

Pura, M; Kreze, A; Kentos, P; Vanuga, P

2010-03-01

The validity of low-dose 1 microg cosyntropin test (LDT) is reported mainly for the assessment of secondary adrenocortical insufficiency (AI). Likewise the hypothalamic-pituitary disorders, early diagnosis of the initial or partial stages of primary AI has an important role. The aim of study was to: 1) establish the normal cut-off level at which the stimulated plasma cortisol (FP) in LDT excludes primary AI; 2) compare the results in elderly subjects to those in younger ones; 3) compare the results between normal and obese subjects; and 4) verify the established cut-off values on the sample of patients suspected to have primary AI. 110 subjects (99 women and 11 men, aged 19-80 years, mean 46.2+/-16.1 years, without suspicion for impairment of the hypothalamo-pituitary-adrenal axis were recruited to undergo the LDT in standard conditions. Control group consists of 30 patients (22 women and 8 men, aged 7-58 years, mean 38.4+/-10.6 years) evaluated in whom for suspicion of primary AI as suggested by LDT was confirmed by supplemental investigations (elevated ACTH levels, positive autoantibodies against 21-hydroxylase, mutational analysis of corresponding genes). The mean peak FP level at 30 min (FP (30)) of the subjects was 675+/-85 nmol/L (95% CI=659 to 691 nmol/L), thus reference values expressed as mean+/-2 SD were 505-845 nmol/L. There was a significant negative correlation between basal FP values (FP (0)) (434+/-105 nmol/L) and the absolute FP incremental (FP (Delta)) response varying from 52 to 553 nmol/L (median 230 nmol/L) (r=-0.71; P<0.001). FP (30) was higher in elderly subjects (n=27) in comparison to younger subjects (n=25) (689+/-88 nmol/L vs. 642+/-63 nmol/L, u=2.11, P<0.05) due to higher FP (Delta) (274+/-116 nmol/L vs. 175+/-112 nmol/L; u=4.02, P<0.01) ; FP (30) levels in obese subjects (n=27) did not differ from those with normal BMI (n=33) (694+/-100 nmol/L vs. 667+/-65 nmol/L, u=1.31, P>0.05). We did not find any correlation between body weight or body surface area and FP (0), FP (30) or FP (Delta). Post-stimulation FP (30) levels in the control group varied from 0 to 354 nmol/L with median 64 nmol/L (25 (th) percentile 10 nmol/L; 75 (th) percentile 165 nmol/L) and were entirely distinctive from those of the subjects without adrenal impairment ( P<0.001). Taking the mean -2 SD result as a threshold, FP value of 500 nmol/L can be consider as cut-off at 30 min in the LDT for defining the intact adrenocortical function, independently of age and body weight, body surface area. J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart * New York.

Levels, trends and correlates of unmet need for family planning among postpartum women in Indonesia: 2007-2015.

PubMed

Wilopo, Siswanto Agus; Setyawan, Althaf; Pinandari, Anggriyani Wahyu; Prihyugiarto, Titut; Juliaan, Flourisa; Magnani, Robert J

2017-11-28

Although Indonesia has relatively high contraceptive prevalence, postpartum family planning (PP-FP) has not been a particular point of emphasis. This article reports the results of analyses undertaken in order to (1) better understand levels and trends in unmet need for family planning among postpartum women, (2) assess the extent to which unmet need is concentrated among particular population sub-groups, and (3) assess the policy priority that PP-FP should have in relation to other interventions. The analyses were based on data from the 2007 and 2012 Indonesia Demographic and Health Surveys (IDHS) and the 2015 PMA2020 survey. Postpartum contraceptive use and unmet need were analyzed for fecund women who had given birth in the 3-5 years of preceding the respective surveys who were in the extended postpartum period at the time of the respective surveys. Factors associated with contraceptive use and unmet were assessed via multivariable logistic regressions using merged data from all three surveys. A wide range of biologic, demographic, socio-economic, geographic and programmatic factors were considered. Contraceptive use during the extended postpartum period is high in Indonesia, with more than 74% of post-partum women reporting currently using a family planning method in the 2015 PMA2020 survey. This is up from 68% in 2007 and 70% in 2012. Total unmet need was 28% in 2007, falling slightly to 23% in 2012 and 24% in 2015. However, the timing of contraceptive initiation is less than optimal. By six months postpartum, only 50% of mothers had begun contraceptive use. Unmet need was highest among older women, women with 4+ children, with limited knowledge of contraceptive methods, making fewer ANC visits, from poor families and residents of islands other than Java and Bali. Unmet need for family planning among postpartum women in Indonesia is low in comparison with other low- and middle-income countries. However, because of limited durations of exclusive breastfeeding, many Indonesian women do not initiate contraception early enough after delivering children. Given already high contraceptive prevalence, targeting postpartum women for increased programmatic attention would seem strategically prudent.

zFP538, a yellow fluorescent protein from coral, belongs to the DsRed subfamily of GFP-like proteins but possesses the unexpected site of fragmentation.

PubMed

Zagranichny, Vasily E; Rudenko, Natalia V; Gorokhovatsky, Andrey Yu; Zakharov, Mikhail V; Shenkarev, Zakhar O; Balashova, Tamara A; Arseniev, Alexander S

2004-04-27

The yellow fluorescent protein (zFP538) from coral Zoanthus sp. belongs to a family of green fluorescent protein (GFP). Absorption and emission spectra of zFP538 show an intermediate bathochromic shift as compared with a number of recently cloned GFP-like red fluorescent and nonfluorescent chromoproteins of the DsRed subfamily. Here we report that the zFP538 chromophore is very close, if not identical, in chemical structure to that of DsRed. To gain insight into the mechanism of zFP538 fluorescence and chromophore structure and chemistry, we studied three chromophore-containing peptides isolated from enzymatic digests of zFP538. Like GFP and DsRed chromophores, these contain a p-hydroxybenzylideneimidazolinone moiety formed by Lys-66, Tyr-67, and Gly-68 of zFP538. One of the peptides studied, the hexapeptide FKYGDR derivative, is a proteolysis product of the zFP538 full-length polypeptide containing a GFP-type chromophore already formed and arrested at an earlier stage of maturation. The two other peptides are the derivatives of the pentapeptide KYGDR resulted from the protein in which the chromophore maturation process had been completed. One of these has an oxogroup at Lys-66 C(alpha) and is a hydrolysis product of another one, with the imino group at Lys-66 C(alpha). The N-unsubstituted imino moiety of the latter is generated by spontaneous polypeptide chain fragmentation at a very unexpected site, the former peptide bond between Phe-65 C' and Lys-66 N(alpha). Also observed in the entire protein under mild denaturing conditions, this fragmentation is likely the feature of native zFP538 chromophore that distinguishes it chemically from the DsRed chromophore.

Fetal/Placental weight ratio in term Japanese pregnancy: its difference among gender, parity, and infant growth.

PubMed

Matsuda, Yoshio; Ogawa, Masaki; Nakai, Akihito; Hayashi, Masako; Satoh, Shoji; Matsubara, Shigeki

2015-01-01

The "inappropriately heavy placenta" has been considered to be associated with various pregnancy disorders; however, data is scarce what factors affect it. To determine whether the following three affect it; (1) infant gender and mother's parity, (2) growth restriction, and (3) preeclampsia. We employed fetal/placental weight ratio (F/P). Subjects consisted of 53,650 infants and their placentas from women who vaginally delivered singleton live term infants. First, we examined whether F/P differs among the infant's gender or mother's parity. We classified the population into 4 categories according to gender and parity: male, nulliparous (n=7,431), male, multiparous (n=7,859), female, nulliparous (n=7,559), female, multiparous (n=7,800), and, compared F/P among the four groups. Next, we determined whether F/P differs in "small" or "large" for gestational age (SGA or LGA) infants, compared with appropriate for gestational age infants. Last, we determined whether preeclampsia (representative disorder of SGA) affects F/P. (1) F/P significantly differed according to infant gender and parity: female and nulliparity had significantly smaller F/P. F/P was significantly smaller in (2) SGA infants, and (3) infants from preeclamptic mothers. We for the first time showed that in Japanese term vaginally-delivered singleton population, the following three had significantly smaller F/P than controls thus had "inappropriately heavy placenta": (1) female gender and nulliparity, (2) SGA infants, and (3) infants from preeclamptic mothers. We recommend that these factors should be taken into account in evaluating placental weight. These data may also be useful for further clarifying the fetal-placental pathophysiology in these conditions.

Methodological concerns for determining power output in the jump squat.

PubMed

Cormie, Prue; Deane, Russell; McBride, Jeffrey M

2007-05-01

The purpose of this study was to investigate the validity of power measurement techniques during the jump squat (JS) utilizing various combinations of a force plate and linear position transducer (LPT) devices. Nine men with at least 6 months of prior resistance training experience participated in this acute investigation. One repetition maximums (1RM) in the squat were determined, followed by JS testing under 2 loading conditions (30% of 1RM [JS30] and 90% of 1RM [JS90]). Three different techniques were used simultaneously in data collection: (a) 1 linear position transducer (1-LPT); (b) 1 linear position transducer and a force plate (1-LPT + FP); and (c) 2 linear position transducers and a force place (2-LPT + FP). Vertical velocity-, force-, and power-time curves were calculated for each lift using these methodologies and were compared. Peak force and peak power were overestimated by 1-LPT in both JS30 and JS90 compared with 2-LPT + FP and 1-LPT + FP (p

Analysis of the tunable asymmetric fiber F-P cavity for fiber strain sensor edge-filter demodulation

NASA Astrophysics Data System (ADS)

Chen, Haotao; Liang, Youcheng

2014-12-01

An asymmetric fiber (Fabry-Pérot, F-P) interferometric cavity with the good linearity and wide dynamic range was successfully designed based on the optical thin film characteristic matrix theory; by adjusting the material of two different thin metallic layers, the asymmetric fiber F-P interferometric cavity was fabricated by depositing the multi-layer thin films on the optical fiber's end face. The asymmetric F-P cavity has the extensive potential application. In this paper, the demodulation method for the wavelength shift of the fiber Bragg grating (FBG) sensor based on the F-P cavity is demonstrated, and a theoretical formula is obtained. And the experimental results coincide well with the computational results obtained from the theoretical model.

Growth of electron plasma waves above and below f(p) in the electron foreshock

NASA Technical Reports Server (NTRS)

Cairns, Iver H.; Fung, Shing F.

1988-01-01

This paper investigates the conditions required for electron beams to drive wave growth significantly above and below the electron plasma frequency, f(p), by numerically solving the linear dispersion equation. It is shown that kinetic growth well below f(p) may occur over a broad range of frequencies due to the beam instability, when the electron beam is slow, dilute, and relatively cold. Alternatively, a cold or sharp feature at low parallel velocities in the distribution function may drive kinetic growth significantly below f(p). Kinetic broadband growth significantly above f(p) is explained in terms of faster warmer beams. A unified qualitative theory for the narrow-band and broad-band waves is proposed.

'False-positive' self-reported psychotic experiences in the general population: an investigation of outcome, predictive factors and clinical relevance.

PubMed

van der Steen, Y; Myin-Germeys, I; van Nierop, M; Ten Have, M; de Graaf, R; van Dorsselaer, S; van Os, J; van Winkel, R

2018-04-16

Self-reported psychotic experiences (SRPE) by individuals from the general population are often unconfirmed by clinical interview and referred to as 'false-positive' (FP) SRPE. FP SRPE have been suggested to represent the mildest form of risk along the extended psychosis continuum. However, little is known about their (clinical) outcome and evolution over time. Aims of this study were to prospectively examine, in individuals with FP SRPE, (1) the prevalence of remission, persistence and transition to validated PE at 3-year follow-up; (2) potential baseline psychopathological and psychosocial predictors of persistence of FP SRPE and transition to validated PE; and (3) whether those with persistent FP SRPE and validated PE already differed on psychopathology and psychosocial factors at baseline. We tested the hypotheses that (i) individuals with FP SRPE would be more likely to have SRPE and validated PE at follow-up; and (ii) that FP SRPE would be predictive of lower functioning and more psychopathology and help-seeking behaviour at follow-up. Baseline (n = 6646) and 3-year follow-up (n = 5303) data of the second the Netherlands Mental Health Survey and Incidence Study (NEMESIS-2), a general population research project on prevalence, incidence, course and consequences of psychiatric disorders was used. Self-report of PE was followed by clinical interview to determine clinical validity. The presence of mood, anxiety and substance use disorders, childhood adversity, help-seeking and functioning as well as PE characteristics (number, frequency, distress and impact) were used in the analyses which included only individuals with complete data for both assessments waves (n = 4683). At baseline, 454 participants had any FP SRPE; of these 372 participants had complete follow-up data available. Those with baseline FP SRPE were significantly more likely to report SRPE (OR = 3.58; 95% CI 2.38-5.40, p < 0.001) and validated PE (OR = 6.26; 95% CI 3.91-10.02, p < 0.001) at follow-up. Baseline FP SRPE also predicted the presence of mood and anxiety disorders, reduced functioning and help-seeking at follow-up. Several baseline psychopathological, psychosocial and PE characteristics were predictive for the persistence of SRPE. These factors also differentiated groups with FP SRPE or validated PE from those with remitted FP SRPE at follow-up.Conclusions.'FP SRPE' are not truly 'false' as they index risk for the development of clinically relevant psychotic symptoms, development of mood and anxiety disorders and reduced functioning. Self-reported PE, even unconfirmed, warrant 'watchful waiting' and follow-up over time, especially when they are reported by individuals with reduced psychosocial functioning and general psychiatric problems.

Communication at pediatric rapid response events: a survey of health care providers.

PubMed

McCrory, Michael C; Aboumatar, Hanan A; Hunt, Elizabeth A

2015-06-01

The objective of this study was to explore perceptions of communication quality at pediatric rapid response events and to determine whether these perceptions differed between rapid response team (RRT) members (RRTm) and floor providers (FP). This survey study was conducted of clinical providers involved in RRT events at a tertiary care children's hospital. Perceptions of RRT communication were assessed by using a 5-point Likert scale, and qualitative comments were collected. Responses were compared between RRTm (responder nurses and intensive care fellows) and FP (floor nurses and resident physicians). Survey response was 64% (18 of 28) for RRTm and 70% (194 of 278) for FP. RRTm gave lower ratings than FP for communication of: (1) the purpose of the call; (2) airway and breathing; (3) circulation; (4) background information; and (5) possible diagnosis and treatment. RRTm were more likely than FP to indicate that description of background information delayed communication of critical management problems ("often": RRTm, 7 of 17 [41%]; FP, 23 of 175 [13%]; "always": RRTm, 2 of 18 [12%]; FP, 19 of 175 [11%]; P=.001 for overall comparison). A structured approach for communication was generally supported, although less strongly among floor nurses. Themes from qualitative responses included role confusion, fractured room entry, and a dismissive attitude by RRTm. A disconnect in perceived quality of communication was observed between RRTm and FP at pediatric rapid response events. A structured approach with well-defined roles may improve communication quality. Copyright © 2015 by the American Academy of Pediatrics.

Structural and Functional Properties of Peptides Based on the N-terminus of HIV-1 gp41 and the C-terminus of the Amyloid-Beta Protein

PubMed Central

Gordon, Larry M.; Nisthal, Alex; Lee, Andy B.; Eskandari, Sepehr; Ruchala, Piotr; Jung, Chun-Ling; Waring, Alan J.; Mobley, Patrick W.

2008-01-01

Given their high alanine and glycine levels, plaque formation, α-helix to β-sheet interconversion and fusogenicity, FP (i.e., the N-terminal fusion peptide of HIV-1 gp41; 23 residues) and amyloids were proposed as belonging to the same protein superfamily. Here, we further test whether FP may exhibit ‘amyloid-like’ characteristics, by contrasting its structural and functional properties with those of Aβ(26–42), a 17-residue peptide from the C-terminus of the amyloid-beta protein responsible for Alzheimer’s. FTIR spectroscopy, electron microscopy, light scattering and predicted amyloid structure aggregation (PASTA) indicated that aqueous FP and Aβ(26–42) formed similar networked β-sheet fibrils, although the FP fibril interactions were weaker. FP and Aβ(26–42) both lysed and aggregated human erythrocytes, with the hemolysis-onsets correlated with the conversion of α-helix to β-sheet for each peptide in liposomes. Congo red (CR), a marker of amyloid plaques in situ, similarly inhibited either FP- or Aβ(26–42)-induced hemolysis, and surface plasmon resonance indicated that this may be due to direct CR-peptide binding. These findings suggest that membrane-bound β-sheets of FP may contribute to the cytopathicity of HIV in vivo through an amyloid-type mechanism, and support the classification of HIV-1 FP as an ‘amyloid homolog’ (or ‘amylog’). PMID:18515070

Nickel nanoparticles-chitosan composite coated cellulose filter paper: An efficient and easily recoverable dip-catalyst for pollutants degradation.

PubMed

Kamal, Tahseen; Khan, Sher Bahadar; Asiri, Abdullah M

2016-11-01

In this report, we used cellulose filter paper (FP) as high surface area catalyst supporting green substrate for the synthesis of nickel (Ni) nanoparticles in thin chitosan (CS) coating layer and their easy separation was demonstrated for next use. In this work, FP was coated with a 1 wt% CS solution onto cellulose FP to prepare CS-FP as an economical and environment friendly host material. CS-FP was put into 0.2 M NiCl 2 aqueous solution for the adsorption of Ni 2+ ions by CS coating layer. The Ni 2+ adsorbed CS-FP was treated with 0.1 M NaBH 4 aqueous solution to convert the ions into nanoparticles. Thus, we achieved Ni nanoparticles-CS composite through water based in-situ preparation process. Successful Ni nanoparticles formations was assessed by FESEM and EDX analyses. FTIR used to track the interactions between nanoparticles and host material. Furthermore, we demonstrated that the nanocomposite displays an excellent catalytic activity and reusability in three reduction reactions of toxic compounds i.e. conversion of 4-nitrophenol to 4-aminophenol, 2-nitrophenol to 2-aminophenol, and methyl orange dye reduction by NaBH 4 . Such a fabrication process of Ni/CS-FP may be applicable for the immobilization of other metal nanoparticles onto FP for various applications in catalysis, sensing, and environmental sciences. Copyright © 2016 Elsevier Ltd. All rights reserved.

Fertility desires of married Tibetan women of childbearing age in Tibet.

PubMed

Chen, H

1997-08-01

This article presents findings from a 1995 survey of fertility intentions, among married women of childbearing age, in urban and rural Tibet Autonomous Region, China. The survey was conducted by the Population Research Institute of the University of Tibet. The sample included 857 women, of whom 59.2% were aged 20-34 years. Women desired 2-3 births. About 55% desired 2 children, 10% desired 1 child, 23% desired 3 children, and 11% desired 4 or more children. Tibetan women still believe that children are important for supporting aging parents and to continue the family line. A few still believe in the traditional view that God decides the number of children. Educational status was associated with average current births. Women with higher education had fewer births. Herdsmen, with an average annual income per capita of 400 yuan, had the highest average number of children of 2.71. Government employees, who had an annual per capita income of 2000 yuan, had the lowest average number of children of 1.70. 569 women said that the sex of the child was not an issue. 250 women preferred boys to girls due to the harsh local natural environment and finances. 72.23% of women hoped that their children would receive higher education and be useful to society. 89% of women were satisfied with the present family planning (FP) policy in Tibet. The interviewers recommend that the government give FP policy publicity priority and improve the quality of FP services. Improvements should include stronger health institutions, training of health care providers, quality technical services, and better natural environment and socioeconomic conditions.

Modulus, Strength and Thermal Exposure Studies of FP-Al2O3/Aluminum and FP-Al2O3/Magnesium Composites.

DTIC Science & Technology

1981-01-01

for the ~AUG18IS~ 1W Symposium on Comites and Advanced Materials*M sponsored by the American Ceramic Society Coco Beach, Florida, January 18424, 1981E...properties of cFP-A203 fiber reinforced composites prepared by liquid metal infiltration f a techniques. The first approach was the incorporation of a...coated FP-A1203 fibers in the composites. This coating is readily wet by molten aluminum and permitted the use of more conventional aluminum alloys

Floor plate chemoattracts crossed axons and chemorepels uncrossed axons in the vertebrate brain.

PubMed

Tamada, A; Shirasaki, R; Murakami, F

1995-05-01

In the bilaterally symmetrical vertebrate CNS, all developing axons must choose between remaining on the same side of the midline or growing across it. The mechanism underlying this axonal pathfinding is, however, poorly understood. Here we demonstrate that the ventral midline floor plate (FP) chemorepels two types of ipsilaterally projecting axons, one from the alar plate and another from the basal plate in the mesencephalon. We further demonstrate that the FP chemoattracts contralaterally projecting myelencephalic as well as metencephalic axons. The FP at all axial levels displayed both chemoattractive and chemorepellent activities, suggesting that FP chemoattraction and chemorepulsion may be at work throughout the neuraxis. Chemotropic guidance by the FP may therefore play a key role in the establishment of neuronal projection laterality.

Anti-mitochondrial flavoprotein autoantibodies of patients with myocarditis and dilated cardiomyopathy (anti-M7): interaction with flavin-carrying proteins, effect of vitamin B2 and epitope mapping

PubMed Central

Stähle, I; Brizzio, C; Barile, M; Brandsch, R

1999-01-01

Vitamin B2 and flavin cofactors are transported tightly bound to immunoglobulin in human serum. We reasoned that anti-mitochondrial flavoprotein autoantibodies (αFp-AB) present in the serum of patients with myocarditis and cardiomyopathy of unknown aetiology may form immunoglobulin aggregates with these serum proteins. However, immunodiffusion and Western blot assays demonstrated that the flavin-carrying proteins were not recognized by αFp-AB. Apparently the flavin moiety in the native protein conformation was inaccessible to αFp-AB. This conclusion was supported by the absence of an immunoreaction between the riboflavin-binding protein from egg white and αFP-AB. Intravenous application of vitamin B2 to rabbits immunized with 6-hydroxy-d-nicotine oxidase, a bacterial protein carrying covalently attached FAD, did not neutralize αFp-AB which had been raised in the serum of the animals. FAD-carrying peptides generated from 6-hydroxy-d-nicotine oxidase by trypsin and chymotrypsin treatment were not recognized by the αFp-AB, but those generated by endopeptidase Lys were. This demonstrates that the epitope recognized by αFp-AB comprises, besides the flavin moiety, protein secondary structure elements. PMID:10193410

Investigating FP Tau’s protoplanetary disk structure through modeling

NASA Astrophysics Data System (ADS)

Brinjikji, Marah; Espaillat, Catherine

2017-01-01

This project presents a study aiming to understand the structure of the protoplanetary disk around FP Tau, a very young, very low mass star in the Taurus star-forming region. We have gathered existing optical, Spitzer, Herschel and submillimeter observations to construct the spectral energy distribution (SED) of FP Tau. We have used the D’Alessio et al (2006) physically self-consistent irradiated accretion disk model including dust settling to model the disk of FP Tau. Using this method, the best fit for the SED of FP Tau is a model that includes a gap located 10-20 AU away from the star. This gap is filled with optically thin dust that separates the optically thick dust in the outer disk from the optically thick dust in the inner disk. These characteristics indicate that FP Tau’s protostellar system is best classified as a pre-transitional disk. Near-infrared interferometry in the K-Band from Willson et al 2016 indicates that FP Tau has a small gap located 10-20 AU from the star, which is consistent with the model we produced, lending further support to the pre-transitional disk interpretation. The most likely explanation for the existence of a gap in the disk is a forming planet.

Assessing trihalomethanes (THMs) and N-nitrosodimethylamine (NDMA) formation potentials in drinking water treatment plants using fluorescence spectroscopy and parallel factor analysis.

PubMed

Yang, Liyang; Kim, Daekyun; Uzun, Habibullah; Karanfil, Tanju; Hur, Jin

2015-02-01

The formation of disinfection byproducts (DBPs) is a major challenge in drinking water treatments. This study explored the applicability of fluorescence excitation-emission matrices and parallel factor analysis (EEM-PARAFAC) for assessing the formation potentials (FPs) of trihalomethanes (THMs) and N-nitrosodimethylamine (NDMA), and the treatability of THM and NDMA precursors in nine drinking water treatment plants. Two humic-like and one tryptophan-like components were identified for the samples using PARAFAC. The total THM FP (TTHM FP) correlated strongly with humic-like component C2 (r=0.874), while NDMA FP showed a moderate and significant correlation with the tryptophan-like component C3 (r=0.628). The reduction by conventional treatment was more effective for C2 than C3, and for TTHM FP than NDMA FP. The treatability of DOM and TTHM FP correlated negatively with the absorption spectral slope (S275-295) and biological index (BIX) of the raw water, but it correlated positively with humification index (HIX). Our results demonstrated that PARAFAC components were valuable for assessing DBPs FP in drinking water treatments, and also that the raw water quality could affect the treatment efficiency. Copyright © 2014 Elsevier Ltd. All rights reserved.

The principle of finiteness - a guideline for physical laws

NASA Astrophysics Data System (ADS)

Sternlieb, Abraham

2013-04-01

I propose a new principle in physics-the principle of finiteness (FP). It stems from the definition of physics as a science that deals with measurable dimensional physical quantities. Since measurement results including their errors, are always finite, FP postulates that the mathematical formulation of legitimate laws in physics should prevent exactly zero or infinite solutions. I propose finiteness as a postulate, as opposed to a statement whose validity has to be corroborated by, or derived theoretically or experimentally from other facts, theories or principles. Some consequences of FP are discussed, first in general, and then more specifically in the fields of special relativity, quantum mechanics, and quantum gravity. The corrected Lorentz transformations include an additional translation term depending on the minimum length epsilon. The relativistic gamma is replaced by a corrected gamma, that is finite for v=c. To comply with FP, physical laws should include the relevant extremum finite values in their mathematical formulation. An important prediction of FP is that there is a maximum attainable relativistic mass/energy which is the same for all subatomic particles, meaning that there is a maximum theoretical value for cosmic rays energy. The Generalized Uncertainty Principle required by Quantum Gravity is actually a necessary consequence of FP at Planck's scale. Therefore, FP may possibly contribute to the axiomatic foundation of Quantum Gravity.

A Moisture Function of Soil Heterotrophic Respiration Derived from Pore-scale Mechanisms

NASA Astrophysics Data System (ADS)

Yan, Z.; Todd-Brown, K. E.; Bond-Lamberty, B. P.; Bailey, V.; Liu, C.

2017-12-01

Soil heterotrophic respiration (HR) is an important process controlling carbon (C) flux, but its response to changes in soil water content (θ) is poorly understood. Earth system models (ESMs) use empirical moisture functions developed from specific sites to describe the HR-θ relationship in soils, introducing significant uncertainty. Generalized models derived from mechanisms that control substrate availability and microbial respiration are thus urgently needed. Here we derive, present, and test a novel moisture function fp developed from pore-scale mechanisms. This fp encapsulates primary physicochemical and biological processes controlling HR response to moisture variation in soils. We tested fp against a wide range of published data for different soil types, and found that fp reliably predicted diverse HR- relationships. The mathematical relationship between the parameters in fp and macroscopic soil properties such as porosity and organic C content was also established, enabling to estimate fp using soil properties. Compared with empirical moisture functions used in ESMs, this derived fp could reduce uncertainty in predicting the response of soil organic C stock to climate changes. In addition, this work is one of the first studies to upscale a mechanistic soil HR model based on pore-scale processes, thus linking the pore-scale mechanisms with macroscale observations.

Identification of JAK2 as a Mediator of FIP1L1-PDGFRA-Induced Eosinophil Growth and Function in CEL

PubMed Central

Li, Bin; Zhang, Guangsen; Li, Cui; He, Dan; Li, Xinying; Zhang, Chunfang; Tang, Faqing; Deng, Xiyun; Lu, Jingchen; Tang, Youhong; Li, Ruijuan; Chen, Zhuchu; Duan, Chaojun

2012-01-01

The Fip1-like1 (FIP1L1)-platelet-derived growth factor receptor alpha fusion gene (F/P) arising in the pluripotent hematopoietic stem cell (HSC),causes 14% to 60% of patients with hypereosinophilia syndrome (HES). These patients, classified as having F/P (+) chronic eosinophilic leukemia (CEL), present with clonal eosinophilia and display a more aggressive disease phenotype than patients with F/P (–) HES patients. The mechanisms underlying predominant eosinophil lineage targeting and the cytotoxicity of eosinophils in this leukemia remain unclear. Given that the Janus tyrosine kinase (JAK)/signal transducers and activators of transcription (Stat) signaling pathway is key to cytokine receptor-mediated eosinophil development and activated Stat3 and Stat5 regulate the expression of genes involved in F/P malignant transformation, we investigated whether and how JAK proteins were involved in the pathogenesis of F/P-induced CEL. F/P activation of JAK2, Stat3 and Stat5, were confirmed in all the 11 F/P (+) CEL patients examined. In vitro inhibition of JAK2 in EOL-1, primary F/P(+) CEL cells (PC) and T674I F/P Imatinib resistant cells(IR) by either JAK2-specific short interfering RNA (siRNA) or the tryphostin derivative AG490(AG490), significantly reduced cellular proliferation and induced cellular apoptosis. The F/P can enhance the IL-5-induced JAK2 activation, and further results indicated that JAK2 inhibition blocked IL-5-induced cellular migration and activation of the EOL-1 and PC cells in vitro. F/P-stimulation of the JAK2 suppressed cells led to a significantly reduction in Stat3 activation, but relatively normal induction of Stat5 activation. Interestingly, JAK2 inhibition also reduced PI3K, Akt and NF-κB activity in a dose-dependent manner, and suppressed expression levels of c-Myc and Survivin. These results strongly suggest that JAK2 is activated by F/P and is required for F/P stimulation of cellular proliferation and infiltration, possibly through induction of c-Myc and Survivin expression via activation of multiple signaling pathways, including NF-κB, Stat3, and PI3K/Akt. PMID:22523564

Transgender men's experiences of fertility preservation: a qualitative study.

PubMed

Armuand, G; Dhejne, C; Olofsson, J I; Rodriguez-Wallberg, K A

2017-02-01

How do transgender men experience fertility preservation (FP) by cryopreservation of oocytes? The procedures required prior to oocyte cryopreservation, such as hormonal ovarian stimulation and transvaginal ultrasound (TVS), have a negative impact on gender dysphoria as they are closely linked to the men's female assigned sex at birth, which is incompatible with their current status. Transgender persons often have high dissatisfaction with assigned sex-specific body features, such as the genital organs and androgen/oestrogen-responsive features. Thus, undergoing FP that requires genital-specific examinations, aimed at obtaining oocytes to cryopreserve, could be distressing. As no previous studies have investigated transgender men's experiences of FP involving cryopreservation of oocytes, little is known about their experience of the procedures. This is a prospective study among adult transgender men referred for FP between March 2014 and December 2015. Individual in-depth qualitative interviews were conducted shortly after FP treatment. The interviews lasted between 62 and 111 min (mean 81 min) and were digitally recorded and transcribed verbatim. Participants were recruited on their first visit to the assisted reproduction clinic for reproductive counseling. There were 15 men, scheduled for FP, who chose to participate in the study (age 19-35); none had given birth and eight had a partner. Data were analyzed by thematic content analysis. The analysis resulted in three main categories: the journey to FP, reactions to the FP proceedings and strategies for coping. The referral for FP was an important part of the assessment and diagnosis and sometimes lined with frustrating waits and doubts. The reaction to the FP proceedings revealed that the genital examinations and the physical changes associated with discontinuation of testosterone or hormonal stimulation treatment triggered gender incongruence and dysphoria. However, for some, the negative expectations were not met. The participants used several coping strategies in order to manage the procedure, such as focusing on their reasons for undergoing FP, reaching out to friends and family for support and the cognitive approaches of not hating their body or using non-gendered names for their body parts. The results demonstrate the importance of contextual sensitivity during FP procedures. The authors have strived to be reflective about their pre-understanding of the phenomenon. The majority of the participants resided in large urban areas; it is possible that transgender men living in rural areas have different experiences. As the results are based on qualitative data from 15 transgender men, the results cannot readily be generalized to larger populations. However, the results are suggested to be applicable to other transgender men who want to undergo FP by cryopreservation of oocytes. The results show that transgender men's experience of FP places may elicit gender incongruence and gender dysphoria. However, health care personnel can alleviate distress by using a gender-neutral language and the preferred pronoun. Also, reassuringly, the men also have coping strategies of how to handle the situation. This knowledge is important to ensure adequate professional support for patients with gender dysphoria during FP. Swedish Society of Medicine, Stockholm County Council and Karolinska Institutet (to K.A.R.-W.). N/A. © The Author 2016. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Early type galaxies: Mapping out the two-dimensional space of galaxy star formation histories

NASA Astrophysics Data System (ADS)

Graves, Genevieve J.

Early type galaxies form a multi-parameter family, as evidenced by the two- dimensional (2-D) Fundamental Plane relationship. However, their star formation histories are often treated as a one-dimensional mass sequence. This dissertation presents a systematic study of the relationship between the multi- parameter structural properties of early type galaxies and their star formation histoires. We demonstrate that the stellar populations of early type galaxies span a 2-D space, which means that their star formation histories form a two- parameter family. This 2-D family is then mapped onto several familiar early type galaxy scaling relations, including the color-magnitude relation, the Fundamental Plane, and a cross-section through the Fundamental Plane. We find that the stellar population properties, and therefore the star formation histories of early type galaxies depend most strongly on galaxy velocity dispersion (s), rather than on luminosity ( L ), stellar mass ( M [low *] ), or dynamical mass ( M dyn ). Interestingly, stellar populations are independent of the radius ( R e ) of the galaxies. At fixed s, they show correlated residuals through the thickness of the Fundamental Plane (FP) in the surface-brightness ( I e ) dimension, such that low-surface-brightness galaxies are older, less metal-enriched, and more enhanced in Mg relative to Fe than their counterparts at the same s and R e on the FP midplane. Similarly, high- surface-brightness galaxies are younger, more metal-rich, and less Mg-enhanced than their counterparts on the FP midplane. These differences suggest that the duration of star formation varies through the thickness of the FP. If the dynamical mass-to-light ratios of early type galaxies ( M dyn /L ) were constant for all such galaxies, the FP would be equivalent to the plane predicted by the virial relation. However, the observed FP does not exactly match the virial plane. The FP is tilted from the virial plane, indicating that M dyn /L varies systematically across it. Furthermore the FP relation, although relatively tight, shows more scatter in surface brightness (at fixed s and R e ) than is predicted by observational errors. This finite thickness indicates that M dyn /L also varies at a fixed point on the FP. We observe that the stellar populations of early type galaxies vary through the thickness of the FP. These differences translate into variations in the stellar mass-to-light ratio ( M [low *] /L ) that contribute to both the tilt and the thickness of the FP. However, the mass-to-light variations due to stellar population differences are too small to explain either the tilt of the FP or its thickness. This implies that the tilt and thickness of the FP are driven by systematic variations in either the central dark matter fraction in galaxies or in the IMF with which they form stars. Furthermore, because star formation histories can be mapped onto locations in FP-space, the variations in central dark matter fraction or IMF differences must be correlated with differences in the galaxies' star formation histories.

Prevalence and correlates of intimate partner violence among family planning clients in Conakry, Guinea.

PubMed

Delamou, Alexandre; Samandari, Ghazaleh; Camara, Bienvenu Salim; Traore, Pernamou; Diallo, Fatoumata Guilinty; Millimono, Sita; Wane, Defa; Toliver, Maimouna; Laffe, Kira; Verani, Fabio

2015-12-23

Intimate partner violence (IPV) is a global public health problem that affects women's physical, mental, sexual and reproductive health. Very little data on IPV experience and FP use is available in resource-poor settings, such as in West Africa. The aim of this study was to describe the prevalence, patterns and correlates of IPV among clients of an adult Family Planning clinic in Conakry, Guinea. The study data was collected for four months (March to June 2014) from women's family planning charts and from an IPV screening form at the Adult Family Planning and Reproductive Health Clinic of "Association Guinéenne pour le Bien-Etre Familial", a non-profit organization in Conakry, Guinea. 232 women out of 245 women who attended the clinic for services during the study period were screened for IPV and were included in this study. Of the 232 women screened, 213 (92%) experienced IPV in one form or another at some point in their lifetime. 169 women reported psychological violence (79.3%), 145 reported sexual violence (68.1%) and 103 reported physical violence (48.4%). Nearly a quarter of women reported joint occurrence of the three forms of violence(24%).Half of the IPV positive women were current users of family planning (51.2%) and of these, 77.9% preferred injectable contraceptives. The odds of experiencing IPV was higher in women with secondary or vocational level of education than those with higher level of education (AOR: 8.4; 95% CI 1.2-58.5). Women residing in other communes of Conakry (AOR: 5.6; 95% CI 1.4-22.9) and those preferring injectable FP methods (AOR: 4.5; 95% CI 1.2-16.8) were more likely to experience lifetime IPV. IPV is prevalent among family planning clients in Conakry, Guinea where nine out of ten women screened in the AGBEF adult clinic reported having experienced one or another type of IPV. A holistic approach that includes promotion of women's rights and gender equality, existence of laws and policies is needed to prevent and respond to IPV, effective implementation of policies and laws, and access to quality IPV services in Guinea and countries with higher rates of IPV.

Baseline Hazardous Waste Stream Characterization Survey at the 21st Tactical Fighter Wing Elmendorf AFB, Alaska

DTIC Science & Technology

1991-11-01

CES/DEEV). The Defense Reutilization and Marketing Office (DRMO) is responsible for contractual removal of hazardous waste. BES supports the program...RGNT HOSP ELMEŕDORFGGEPB Test Results ~ Utnit- "-R~one LCL ucg L wosnLCL uq L FP in LCL mci L irwtn Ter~rrn ride LLL miYL 9.1 crot -ne LF mqzL

An update on the clinical diagnostic value of β-hCG and αFP for intracranial germ cell tumors.

PubMed

Hu, Mingming; Guan, Hongzhi; Lau, Ching C; Terashima, Keita; Jin, Zimeng; Cui, Liying; Wang, Yuzhou; Li, Guilin; Yao, Yong; Guo, Yi; Li, Yan Michael; Zhong, Dingrong; Xiao, Juan; Wan, Xirun; Lian, Xin; Feng, Feng; Ren, Haitao; Zhao, Yanhuan; Cheng, Xinqi; Gu, Feng

2016-03-12

Pathological examination combined with tumor markers has become a standard for the diagnosis of intracranial germ cell tumors (ICGCTs), but the current concept of 'secreting germ cell tumors' and three empirically highly specific diagnostic criteria (β-hCG ≥ 50 IU/L or αFP ≥ 10 ng/mL; β-hCG ≥ 100 IU/L or αFP ≥ 50 ng/mL; β-hCG > 50 IU/L or αFP > 25 ng/mL) are not based upon pathology examination or CSF cytology. Further investigation is needed to re-evaluate their value. A multidisciplinary diagnostic team was created. Valid β-hCG/αFP data were collected from cases of ICGCTs confirmed by pathology and CSF cytology (n = 58) between 1991 and 2012, and from suspected ICGCTs cases (n = 17) between 2011 and 2012 as controls [Langerhans cell histiocytosis (LCH), n = 12; and other intracranial tumor (ICT), n = 5]. The cut-off points for β-hCG and αFP were calculated using receiver operating characteristic (ROC) curves. This study clarifies the relative rationality of one criteria (β-hCG > 50 IU/L and αFP > 25 ng/mL); confirms new β-hCG diagnostic cut-off points: CSF β-hCG ≥ 8.2 IU/L and serum β-hCG ≥ 2.5 IU/L (sensitivity of 47 and 34%, respectively, specificity of 100%, both; P < 0.05); and empirically adjusts the criteria for αFP to ≥ 3.8 ng/mL in CSF and to ≥ 25 ng/mL in serum. The total diagnostic sensitivity for ICGCTs finally increased from 34.6 to 65.4% (P < 0.05, diagnostic value of CSF β-hCG exceeds 90%). Subtype diagnosis improved with αFP in 16.7% of non-geminomatous germ cell tumor cases. New evidence-based criteria of β-hCG and αFP can help improving early and formal diagnosis of ICGCTs, and is of great clinical significance.

Family physician workloads and access to care in Winnipeg: 1991 to 2001.

PubMed

Watson, Diane E; Katz, Alan; Reid, Robert J; Bogdanovic, Bogdan; Roos, Noralou; Heppner, Petra

2004-08-17

Current perceptions of family physician (FP) shortages in Canada have prompted policies to expand medical schools. Our objective was to assess how FP supply, workloads and access to care have changed over the past decade. We used an anonymized physician and population registry and administrative health service data from Winnipeg for the period 1991/92 to 2000/01. We calculated the following measures of supply and workload: ratios of FPs to population, of population to FPs and of FP full-time equivalents (FTEs) to population, as well as FP activity ratios (sum of FTEs/number of FPs), annual number of visits per FP and visits per FP per full-time day of work. Trends in FP remuneration were analyzed by age and sex. We also measured standardized visit rates and stratified the analysis by populations deemed at risk of needing FP services. In 2000/01 FPs between 30 and 49 years of age (64% of the workforce) provided 20% fewer visits per year than their same-age peers did 10 years previously. Conversely, FPs 60 to 69 years of age (11% of the workforce) provided 33% more visits per year than the corresponding group a decade earlier. On a per capita basis, the number of FPs declined by 5%, from 97 per 100 000 population in 1991/92 to 92 per 100 000 population in 2000/01, which paralleled changes in national estimates of FP supply. Per capita visit rates among Winnipeg citizens (3.5 per year in 2000/01) and average workloads among FPs (4193 visits per year in 2000/01) were stable over the decade. Despite relative homeostasis in aggregate FP supply and use, there have been substantial temporal shifts in the volume of services provided by FPs of different age groups. Younger FPs are providing many fewer visits and older FPs are providing many more visits than their same-age predecessors did 10 years ago, a finding that was independent of physician sex. Given these data, the perpetual focus of policy-makers and care providers on increasing numbers of FPs will not help in diagnosing or treating issues of supply, workloads and access to care.

Addressing Fission Product Validation in MCNP Burnup Credit Criticality Calculations

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mueller, Don; Bowen, Douglas G; Marshall, William BJ J

2015-01-01

The US Nuclear Regulatory Commission (NRC) Division of Spent Fuel Storage and Transportation issued Interim Staff Guidance (ISG) 8, Revision 3 in September 2012. This ISG provides guidance for NRC staff members’ review of burnup credit (BUC) analyses supporting transport and dry storage of pressurized water reactor spent nuclear fuel (SNF) in casks. The ISG includes guidance for addressing validation of criticality (k eff) calculations crediting the presence of a limited set of fission products and minor actinides (FP&MAs). Based on previous work documented in NRC Regulatory Guide (NUREG) Contractor Report (CR)-7109, the ISG recommends that NRC staff members acceptmore » the use of either 1.5 or 3% of the FP&MA worth—in addition to bias and bias uncertainty resulting from validation of k eff calculations for the major actinides in SNF—to conservatively account for the bias and bias uncertainty associated with the specified unvalidated FP&MAs. The ISG recommends (1) use of 1.5% of the FP&MA worth if a modern version of SCALE and its nuclear data are used and (2) 3% of the FP&MA worth for well qualified, industry standard code systems other than SCALE with the Evaluated Nuclear Data Files, Part B (ENDF/B),-V, ENDF/B-VI, or ENDF/B-VII cross sections libraries. The work presented in this paper provides a basis for extending the use of the 1.5% of the FP&MA worth bias to BUC criticality calculations performed using the Monte Carlo N-Particle (MCNP) code. The extended use of the 1.5% FP&MA worth bias is shown to be acceptable by comparison of FP&MA worths calculated using SCALE and MCNP with ENDF/B-V, -VI, and -VII–based nuclear data. The comparison supports use of the 1.5% FP&MA worth bias when the MCNP code is used for criticality calculations, provided that the cask design is similar to the hypothetical generic BUC-32 cask model and that the credited FP&MA worth is no more than 0.1 Δk eff (ISG-8, Rev. 3, Recommendation 4).« less

Uncompensated care provided by for-profit, not-for-profit, and government owned hospitals.

PubMed

Cram, Peter; Bayman, Levent; Popescu, Ioana; Vaughan-Sarrazin, Mary S; Cai, Xueya; Rosenthal, Gary E

2010-04-07

There is growing concern certain not-for-profit hospitals are not providing enough uncompensated care to justify their tax exempt status. Our objective was to compare the amount of uncompensated care provided by not-for-profit (NFP), for-profit (FP) and government owned hospitals. We used 2005 state inpatient data (SID) for 10 states to identify patients hospitalized for three common conditions: acute myocardial infarction (AMI), coronary artery bypass grafting (CABG), or childbirth. Uncompensated care was measured as the proportion of each hospital's total admissions for each condition that were classified as being uninsured. Hospitals were categorized as NFP, FP, or government owned based upon data obtained from the American Hospital Association. We used bivariate methods to compare the proportion of uninsured patients admitted to NFP, FP and government hospitals for each diagnosis. We then used generalized linear mixed models to compare the percentage of uninsured in each category of hospital after adjusting for the socioeconomic status of the markets each hospital served. Our cohort consisted of 188,117 patients (1,054 hospitals) hospitalized for AMI, 82,261 patients (245 hospitals) for CABG, and 1,091,220 patients for childbirth (793 hospitals). The percentage of admissions classified as uninsured was lower in NFP hospitals than in FP or government hospitals for AMI (4.6% NFP; 6.0% FP; 9.5% government; P < .001), CABG (2.6% NFP; 3.3% FP; 7.0% government; P < .001), and childbirth (3.1% NFP; 4.2% FP; 11.8% government; P < .001). In adjusted analyses, the mean percentage of AMI patients classified as uninsured was similar in NFP and FP hospitals (4.4% vs. 4.3%; P = 0.71), and higher for government hospitals (6.0%; P < .001 for NFP vs. government). Likewise, results demonstrated similar proportions of uninsured patients in NFP and FP hospitals and higher levels of uninsured in government hospitals for both CABG and childbirth. For the three conditions studied NFP and FP hospitals appear to provide a similar amount of uncompensated care while government hospitals provide significantly more. Concerns about the amount of uncompensated care provided by NFP hospitals appear warranted.

The influence of secondary processing on the structural relaxation dynamics of fluticasone propionate.

PubMed

Depasquale, Roberto; Lee, Sau L; Saluja, Bhawana; Shur, Jagdeep; Price, Robert

2015-06-01

This study investigated the structural relaxation of micronized fluticasone propionate (FP) under different lagering conditions and its influence on aerodynamic particle size distribution (APSD) of binary and tertiary carrier-based dry powder inhaler (DPI) formulations. Micronized FP was lagered under low humidity (LH 25 C, 33% RH [relative humidity]), high humidity (HH 25°C, 75% RH) for 30, 60, and 90 days, respectively, and high temperature (HT 60°C, 44% RH) for 14 days. Physicochemical, surface interfacial properties via cohesive-adhesive balance (CAB) measurements and amorphous disorder levels of the FP samples were characterized. Particle size, surface area, and rugosity suggested minimal morphological changes of the lagered FP samples, with the exception of the 90-day HH (HH90) sample. HH90 FP samples appeared to undergo surface reconstruction with a reduction in surface rugosity. LH and HH lagering reduced the levels of amorphous content over 90-day exposure, which influenced the CAB measurements with lactose monohydrate and salmeterol xinafoate (SX). CAB analysis suggested that LH and HH lagering led to different interfacial interactions with lactose monohydrate but an increasing adhesive affinity with SX. HT lagering led to no detectable levels of the amorphous disorder, resulting in an increase in the adhesive interaction with lactose monohydrate. APSD analysis suggested that the fine particle mass of FP and SX was affected by the lagering of the FP. In conclusion, environmental conditions during the lagering of FP may have a profound effect on physicochemical and interfacial properties as well as product performance of binary and tertiary carrier-based DPI formulations.

Determinants of Access to Fertility Preservation in Women with Breast Cancer

PubMed Central

Lee, Sanghoon; Heytens, Elke; Moy, Fred; Ozkavukcu, Sinan; Oktay, Kutluk

2012-01-01

OBJECTIVE Evaluation of socio-economic, demographic, and medical factors that influence the referral pattern either before cancer treatment to fertility preservation (FP, early referral) or post-chemotherapy to assisted reproduction (PCART, delayed referral). DESIGN Secondary analysis. SETTING Academic medical centers. PATIENT(S) Three hundred fourteen patients with breast cancer who were counseled for FP (n=218) or PCART (n=96) from June 1999 to July 2009. INTERVENTION(S) None MAIN OUTCOME MEASURE(S) Factors favoring early referrals RESULT(S) Mean age at diagnosis was higher in FP vs PCART (35.3±4.5 vs 33.9±4.7, p<0.01). Ninety percent presented with cancer stage 1 or 2. From 2000 to 2009 the proportion of referrals for FP increased continually. In 2009, nearly all (95.5%) were for FP. The majority (63.8%) was referred from an academic center. Patients with a family history of breast cancer were more likely to consult for FP (75.2% vs 64.3% without, p=0.04). There was no association with occupation, income, race, ethnicity, obstetrical history, and prior infertility treatment. Only 22.9% of those counseled in PCART compared to 45.0% in the FP group proceeded with a procedure (p<0.001). CONCLUSION(S) There has been an increasing trend within the last 10 years for early referral of breast cancer patients to FP. Factors favoring early referrals are older age, early stage cancer, family history of breast cancer, and an academic center involvement. Those seen before cancer treatment are more likely to receive an intervention. PMID:21371704

An evaluation of fundus photography and fundus autofluorescence in the diagnosis of cuticular drusen.

PubMed

Høeg, Tracy B; Moldow, Birgitte; Klein, Ronald; La Cour, Morten; Klemp, Kristian; Erngaard, Ditte; Ellervik, Christina; Buch, Helena

2016-03-01

To examine non-mydriatic fundus photography (FP) and fundus autofluorescence (FAF) as alternative non-invasive imaging modalities to fluorescein angiography (FA) in the detection of cuticular drusen (CD). Among 2953 adults from the Danish Rural Eye Study (DRES) with gradable FP, three study groups were selected: (1) All those with suspected CD without age-related macular degeneration (AMD) on FP, (2) all those with suspected CD with AMD on FP and (3) a randomly selected group with early AMD. Groups 1, 2 and 3 underwent FA and FAF and group 4 underwent FAF only as part of DRES CD substudy. Main outcome measures included percentage of correct positive and correct negative diagnoses, Cohen's κ and prevalence-adjusted and bias-adjusted κ (PABAK) coefficients of test and grader reliability. CD was correctly identified on FP 88.9% of the time and correctly identified as not being present 83.3% of the time. CD was correctly identified on FAF 62.0% of the time and correctly identified as not being present 100.0% of the time. Compared with FA, FP has a PABAK of 0.75 (0.60 to 1.5) and FAF a PABAK of 0.44 (0.23 to 0.95). FP is a promising, non-invasive substitute for FA in the diagnosis of CD. FAF was less reliable than FP to detect CD. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Optimization of sampling pattern and the design of Fourier ptychographic illuminator.

PubMed

Guo, Kaikai; Dong, Siyuan; Nanda, Pariksheet; Zheng, Guoan

2015-03-09

Fourier ptychography (FP) is a recently developed imaging approach that facilitates high-resolution imaging beyond the cutoff frequency of the employed optics. In the original FP approach, a periodic LED array is used for sample illumination, and therefore, the scanning pattern is a uniform grid in the Fourier space. Such a uniform sampling scheme leads to 3 major problems for FP, namely: 1) it requires a large number of raw images, 2) it introduces the raster grid artefacts in the reconstruction process, and 3) it requires a high-dynamic-range detector. Here, we investigate scanning sequences and sampling patterns to optimize the FP approach. For most biological samples, signal energy is concentrated at low-frequency region, and as such, we can perform non-uniform Fourier sampling in FP by considering the signal structure. In contrast, conventional ptychography perform uniform sampling over the entire real space. To implement the non-uniform Fourier sampling scheme in FP, we have designed and built an illuminator using LEDs mounted on a 3D-printed plastic case. The advantages of this illuminator are threefold in that: 1) it reduces the number of image acquisitions by at least 50% (68 raw images versus 137 in the original FP setup), 2) it departs from the translational symmetry of sampling to solve the raster grid artifact problem, and 3) it reduces the dynamic range of the captured images 6 fold. The results reported in this paper significantly shortened acquisition time and improved quality of FP reconstructions. It may provide new insights for developing Fourier ptychographic imaging platforms and find important applications in digital pathology.

Enhanced Neutralization Potency of Botulinum Neurotoxin Antibodies Using a Red Blood Cell-Targeting Fusion Protein

PubMed Central

Adekar, Sharad P.; Segan, Andrew T.; Chen, Cindy; Bermudez, Rodney; Elias, M. D.; Selling, Bernard H.; Kapadnis, B. P.; Simpson, Lance L.; Simon, Paul M.; Dessain, Scott K.

2011-01-01

Botulinum neurotoxin (BoNT) potently inhibits cholinergic signaling at the neuromuscular junction. The ideal countermeasures for BoNT exposure are monoclonal antibodies or BoNT antisera, which form BoNT-containing immune complexes that are rapidly cleared from the general circulation. Clearance of opsonized toxins may involve complement receptor-mediated immunoadherence to red blood cells (RBC) in primates or to platelets in rodents. Methods of enhancing immunoadherence of BoNT-specific antibodies may increase their potency in vivo. We designed a novel fusion protein (FP) to link biotinylated molecules to glycophorin A (GPA) on the RBC surface. The FP consists of an scFv specific for murine GPA fused to streptavidin. FP:mAb:BoNT complexes bound specifically to the RBC surface in vitro. In a mouse model of BoNT neutralization, the FP increased the potency of single and double antibody combinations in BoNT neutralization. A combination of two antibodies with the FP gave complete neutralization of 5,000 LD50 BoNT in mice. Neutralization in vivo was dependent on biotinylation of both antibodies and correlated with a reduction of plasma BoNT levels. In a post-exposure model of intoxication, FP:mAb complexes gave complete protection from a lethal BoNT/A1 dose when administered within 2 hours of toxin exposure. In a pre-exposure prophylaxis model, mice were fully protected for 72 hours following administration of the FP:mAb complex. These results demonstrate that RBC-targeted immunoadherence through the FP is a potent enhancer of BoNT neutralization by antibodies in vivo. PMID:21399689

Artificial Intelligence -- Research and Applications.

DTIC Science & Technology

1976-06-01

Determination of Minimum Cost Paths," IEEE Trans. Sys . Sci. Cybernetics, Vol. 4, No. 2, pp. 100-107. Hendrix, G. (1975), "Expanding the Utility of Semantic...PLANS E , IN, 7979 IZ)’. TE.R ATE RECOGNITION LASEHTAED LOCATION SENP PARTS ANO AAlYI CONIP E TELOMPL T FP NET SSTEMCOMPRS SY -STy 7974 ’T S ST7p -TO...EXTNDE 1: OUBLE -ETNE %AT,,RAL ~C’v LA ~t PB IV P6 TO T4 %~ ’ F" _______________________________________ SY ~STEM 7’j NTJt, E EPAk AAII IJ Aii SASSEVELY

Cellulose-Derived Supercapacitors from the Carbonisation of Filter Paper.

PubMed

Jiang, Luyun; Nelson, Geoffrey W; Kim, Heeyeon; Sim, I N; Han, Seong Ok; Foord, John S

2015-10-01

Advanced carbon materials are important for the next-generation of energy storage apparatus, such as electrochemical capacitors. Here, the physical and electrochemical properties of carbonised filter paper (FP) were investigated. FP is comprised of pure cellulose and is a standardised material. After carbonisation at temperatures ranging from 600 to 1700 °C, FP was contaminant-free, containing only carbon and some oxygenated species, and its primary fibre structure was retained (diameter ≈20-40 μm). The observed enhancement in conductivity of the carbonised FP was correlated with the carbonisation temperature. Electrochemical capacitance in the range of ≈1.8-117 F g(-1) was achieved, with FP carbonised at 1500 °C showing the best performance. This high capacitance was stable with >87 % retained after 3000 charge-discharge cycles. These results show that carbonised FP, without the addition of composite materials, exhibits good supercapacitance performance, which competes well with existing electrodes made of carbon-based materials. Furthermore, given the lower cost and renewable source, cellulose-based materials are the more eco-friendly option for energy storage applications.

Cellulose-Derived Supercapacitors from the Carbonisation of Filter Paper

PubMed Central

Jiang, Luyun; Nelson, Geoffrey W; Kim, Heeyeon; Sim, I N; Han, Seong Ok; Foord, John S

2015-01-01

Advanced carbon materials are important for the next-generation of energy storage apparatus, such as electrochemical capacitors. Here, the physical and electrochemical properties of carbonised filter paper (FP) were investigated. FP is comprised of pure cellulose and is a standardised material. After carbonisation at temperatures ranging from 600 to 1700 °C, FP was contaminant-free, containing only carbon and some oxygenated species, and its primary fibre structure was retained (diameter ≈20–40 μm). The observed enhancement in conductivity of the carbonised FP was correlated with the carbonisation temperature. Electrochemical capacitance in the range of ≈1.8–117 F g−1 was achieved, with FP carbonised at 1500 °C showing the best performance. This high capacitance was stable with >87 % retained after 3000 charge–discharge cycles. These results show that carbonised FP, without the addition of composite materials, exhibits good supercapacitance performance, which competes well with existing electrodes made of carbon-based materials. Furthermore, given the lower cost and renewable source, cellulose-based materials are the more eco-friendly option for energy storage applications. PMID:26491636

Florid papillomatosis of the nipple: a rare presentation and review of the literature.

PubMed

Salemis, Nikolaos S

2015-01-01

Florid papillomatosis (FP) of the nipple, or nipple adenoma, is a rare benign proliferative lesion originating from the lactiferous ducts of the nipple. It most commonly affects women in their fourth and fifth decades of life. Clinically, in most cases FP presents with serous or serosanguinous nipple discharge while in many cases an erythematoid or eroded lesion, a nodule or a swelling of the nipple may coexist thus resembling Paget's disease. We describe a case of FP with a very unusual clinical presentation. Diagnostic evaluation and management of the patient are discussed along with a review of the relevant literature. We conclude that FP should be always considered in the differential diagnosis of patients presenting with a rapidly enlarging nipple nodule even in the absence of any skin lesions or nipple discharge. Early diagnosis and prompt treatment are essential. Simple complete excision in order to eliminate the risk of recurrence is the treatment of choice for FP. Although in rare cases a coincidental ipsilateral or contralateral breast cancer has been reported, FP is considered as an entirely benign clinical entity associated with excellent prognosis.

An automated real-time free phenytoin assay to replace the obsolete Abbott TDx method.

PubMed

Williams, Christopher; Jones, Richard; Akl, Pascale; Blick, Kenneth

2014-01-01

Phenytoin is a commonly used anticonvulsant that is highly protein bound with a narrow therapeutic range. The unbound fraction, free phenytoin (FP), is responsible for pharmacologic effects; therefore, it is essential to measure both FP and total serum phenytoin levels. Historically, the Abbott TDx method has been widely used for the measurement of FP and was the method used in our laboratory. However, the FP TDx assay was recently discontinued by the manufacturer, so we had to develop an alternative methodology. We evaluated the Beckman-Coulter DxC800 based FP method for linearity, analytical sensitivity, and precision. The analytical measurement range of the method was 0.41 to 5.30 microg/mL. Within-run and between-run precision studies yielded CVs of 3.8% and 5.5%, respectively. The method compared favorably with the TDx method, yielding the following regression equation: DxC800 = 0.9**TDx + 0.10; r2 = 0.97 (n = 97). The new FP assay appears to be an acceptable alternative to the TDx method.

Oncology nurses' perceptions of barriers to discussion of fertility preservation with patients with cancer.

PubMed

King, Lindsey; Quinn, Gwendolyn P; Vadaparampil, Susan T; Gwede, Clement K; Miree, Cheryl A; Wilson, Crystal; Clayton, Heather; Perrin, Karen

2008-06-01

Infertility is a common result of cancer treatment; however, opportunities exist for patients to preserve fertility prior to treatment. Recent evidence suggests that healthcare providers, including nurses, do not consistently discuss fertility preservation (FP) with patients. This qualitative, cross-sectional pilot study used a focus group and in-depth interviews to explore knowledge, attitudes, and practice behaviors related to nurses' discussion of FP with patients with cancer. Results indicate that only half of the nurses discuss FP methods with patients, even though most believe that having discussions with patients about fertility is part of their role. Factors associated with the discussion of FP among nurses included (a) knowledge (FP procedures, fertility institutes and clinics, resources for patients, and practice guidelines), (b) attitudes (difficulty finding facilities, time constraints, role, comfort level, ethical issues, financial considerations, and patient characteristics), and (c) behaviors (patient initiation, physician behaviors, patient characteristics, and timing). Discussion should be stimulated among nurses about the role of nurses in the FP discussion, and educational interventions and practice guidelines should be developed that are aimed at oncology nurses to help facilitate discussions with patients.

[Spectral characteristics of refractive index based on nanocoated optical fiber F-P sensor].

PubMed

Jiang, Ming-Shun; Li, Qiu-Shun; Sui, Qing-Mei; Jia, Lei; Peng, Peng

2013-01-01

An optical fiber Fabry-Perot (F-P) interferometer end surface was modified using layer-by-layer assembly and chemical covalent cross linking method, and the refractive index (RI) response characteristics of coated optical fiber F-P sensor were experimentally studied. Poly diallyldimethylammonium chloride (PDDA) and sodium polystyrene sulfonate (PSS) were chosen as nano-film materials. With the numbers of layers increasing, the reflection spectral contrast of optical fiber F-P sensor presents from high to low, then to high regularity. And the reflection spectral contrast has good temperature stability. The reflection spectra of the optical F-P sensor coated with 20 bilayers for a series of concentration of sucrose and inorganic solution were measured. Experimental results show that the inflection point extends from 1.457 to 1.462 3, and the reflection spectral contrast sensitivity to low RI material and high RI material is 24.53 and 3.60 dB x RI(-1), respectively, with good linearity. The results demonstrate that the functional coated optical F-P sensor provides a new method for biology and chemical material test.

Economic development with limited supplies of family labor: Chinese peasant families in balancing demographic and economic requisites.

PubMed

Chang, K S

1991-07-01

Family planning (FP) in rural China, particularly the ramifications of the 1-child policy, has profound implications and ramifications for family-centered social and economic life in addition to demographic control. Under a constitutionally endorsed policy of strict birth control, favorable economic opportunities coexisted with the problem of familial labor shortages. Recent reform policies have led to a more relaxed FP environment. The Chinese state is in a dilemma between the need to allow peasant's autonomy in determining the familial work situation and the population pressure on the limited cultivated land. The Chinese experience of rural reform is examined in terms of the complex relationship between population change and economic development which are influenced by the production and welfare activities of the peasant family. The theoretical argument is that a family reliant strategy of economic reform undercuts the effectiveness of population control programs. The ultimate solution lies with sustained industrialization with high labor absorption. National trends and the Dahe People's Commune/Township experience are analyzed. Discussion is focused on the dilemma of FP and family production, old and new evidence of family size and economic performance, welfare outcome of family size, the role of the state in altering the demographic balance sheet, and the strategic response of peasant families to bring families of old designs back and urban migration and proletarianization. It is concluded that there is growing understanding that the causal relationships between population growth and economic development do not clearly support universal population control. Human social organization, not the man/land ratio, shapes the consequences of population growth. The implications for the Malthusian vs. Marxian debate for developing countries are that the resources/population imbalance needs to consider more carefully the human organizational factors. Mao's notions that a revolutionary transformation of the social organization of production in China would resolve overpopulation have since been rectified by opposing ideological positions: changing the basic mode of production through institutional decollectivization and checking population growth with the 1-child policy. This dilemma in rural areas translates to greater productivity and diversification with Chinese families having abundant adult labor and secured by the number of sons. It is difficult to substantiate the benefit of small families for peasants theoretically. Political rewards have been curtailed by economic declines. The peasant family has adapted by reconstituting old family forms and kin networks and by out-migration and nonagricultural employment.

Exploring the Feasibility of Service Integration in a Low-Income Setting: A Mixed Methods Investigation into Different Models of Reproductive Health and HIV Care in Swaziland

PubMed Central

Church, Kathryn; Wringe, Alison; Lewin, Simon; Ploubidis, George B.; Fakudze, Phelele; Mayhew, Susannah H.

2015-01-01

Integrating reproductive health (RH) with HIV care is a policy priority in high HIV prevalence settings, despite doubts surrounding its feasibility and varying evidence of effects on health outcomes. The process and outcomes of integrated RH-HIV care were investigated in Swaziland, through a comparative case study of four service models, ranging from fully integrated to fully stand-alone HIV services, selected purposively within one town. A client exit survey (n=602) measured integrated care received and unmet family planning (FP) needs. Descriptive statistics were used to assess the degree of integration per clinic and client demand for services. Logistic regression modelling was used to test the hypothesis that clients at more integrated sites had lower unmet FP needs than clients in a stand-alone site. Qualitative methods included in-depth interviews with clients and providers to explore contextual factors influencing the feasibility of integrated RH-HIV care delivery; data were analysed thematically, combining deductive and inductive approaches. Results demonstrated that clinic models were not as integrated in practice as had been claimed. Fragmentation of HIV care was common. Services accessed per provider were no higher at the more integrated clinics compared to stand-alone models (p>0.05), despite reported demand. While women at more integrated sites received more FP and pregnancy counselling than stand-alone models, they received condoms (a method of choice) less often, and there was no statistical evidence of difference in unmet FP needs by model of care. Multiple contextual factors influenced integration practices, including provider de-skilling within sub-specialist roles; norms of task-oriented routinised HIV care; perceptions of heavy client loads; imbalanced client-provider interactions hindering articulation of RH needs; and provider motivation challenges. Thus, despite institutional support, factors related to the social context of care inhibited provision of fully integrated RH-HIV services in these clinics. Programmes should move beyond simplistic training and equipment provision if integrated care interventions are to be sustained. PMID:25978632

IL4-10 fusion protein has chondroprotective, anti-inflammatory and potentially analgesic effects in the treatment of osteoarthritis.

PubMed

Steen-Louws, C; Popov-Celeketic, J; Mastbergen, S C; Coeleveld, K; Hack, C E; Eijkelkamp, N; Tryfonidou, M; Spruijt, S; van Roon, J A G; Lafeber, F P J G

2018-05-26

Effective disease-modifying drugs for osteoarthritis (DMOAD) should preferably have chondroprotective, anti-inflammatory, and analgesic activity combined in a single molecule. We developed a fusion protein of IL4 and IL10 (IL4-10 FP), in which the biological activity of both cytokines is preserved. The present study evaluates the chondroprotective, anti-inflammatory, and analgesic activity of IL4-10 FP in in vitro and in vivo models of osteoarthritis. Human osteoarthritic cartilage tissue and synovial tissue were cultured with IL4-10 FP. Cartilage proteoglycan turnover and release of pro-inflammatory, catabolic, and pain mediators by cartilage and synovial tissue were measured. The analgesic effect of intra-articularly injected IL4-10 FP was evaluated in a canine model of osteoarthritis by force-plate analysis. IL4-10 FP increased synthesis (P = 0.018) and decreased release (P = 0.018) of proteoglycans by osteoarthritic cartilage. Release of pro-inflammatory IL6 and IL8 by cartilage and synovial tissue was reduced in the presence of IL4-10 FP (all P < 0.05). The release of MMP3 by osteoarthritic cartilage and synovial tissue was decreased (P = 0.018 and 0.028) whereas TIMP1 production was not significantly changed. Furthermore, IL4-10 FP protected cartilage against destructive properties of synovial tissue mediators shown by the increased cartilage proteoglycan synthesis (P = 0.0235) and reduced proteoglycan release (P = 0.0163). Finally, intra-articular injection of IL4-10 FP improved the deficient joint loading in dogs with experimentally induced osteoarthritis. The results of current preliminary study suggest that IL4-10 FP has DMOAD potentials since it shows chondroprotective and anti-inflammatory effects in vitro, as well as potentially analgesic effect in a canine in vivo model of osteoarthritis. Copyright © 2018 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

Dietary flavonoids from modified apple reduce inflammation markers and modulate gut microbiota in mice.

PubMed

Espley, Richard V; Butts, Christine A; Laing, William A; Martell, Sheridan; Smith, Hannah; McGhie, Tony K; Zhang, Jingli; Paturi, Gunaranjan; Hedderley, Duncan; Bovy, Arnaud; Schouten, Henk J; Putterill, Joanna; Allan, Andrew C; Hellens, Roger P

2014-02-01

Apples are rich in polyphenols, which provide antioxidant properties, mediation of cellular processes such as inflammation, and modulation of gut microbiota. In this study we compared genetically engineered apples with increased flavonoids [myeloblastis transcription factor 10 (MYB10)] with nontransformed apples from the same genotype, "Royal Gala" (RG), and a control diet with no apple. Compared with the RG diet, the MYB10 diet contained elevated concentrations of the flavonoid subclasses anthocyanins, flavanol monomers (epicatechin) and oligomers (procyanidin B2), and flavonols (quercetin glycosides), but other plant secondary metabolites were largely unaltered. We used these apples to investigate the effects of dietary flavonoids on inflammation and gut microbiota in 2 mouse feeding trials. In trial 1, male mice were fed a control diet or diets supplemented with 20% MYB10 apple flesh and peel (MYB-FP) or RG apple flesh and peel (RG-FP) for 7 d. In trial 2, male mice were fed MYB-FP or RG-FP diets or diets supplemented with 20% MYB10 apple flesh or RG apple flesh for 7 or 21 d. In trial 1, the transcription levels of inflammation-linked genes in mice showed decreases of >2-fold for interleukin-2 receptor (Il2rb), chemokine receptor 2 (Ccr2), chemokine ligand 10 (Cxcl10), and chemokine receptor 10 (Ccr10) at 7 d for the MYB-FP diet compared with the RG-FP diet (P < 0.05). In trial 2, the inflammation marker prostaglandin E(2) (PGE(2)) in the plasma of mice fed the MYB-FP diet at 21 d was reduced by 10-fold (P < 0.01) compared with the RG-FP diet. In colonic microbiota, the number of total bacteria for mice fed the MYB-FP diet was 6% higher than for mice fed the control diet at 21 d (P = 0.01). In summary, high-flavonoid apple was associated with decreases in some inflammation markers and changes in gut microbiota when fed to healthy mice.

Autopsy validation of 123I-FP-CIT dopaminergic neuroimaging for the diagnosis of DLB.

PubMed

Thomas, Alan J; Attems, Johannes; Colloby, Sean J; O'Brien, John T; McKeith, Ian; Walker, Rodney; Lee, Lean; Burn, David; Lett, Debra J; Walker, Zuzana

2017-01-17

To conduct a validation study of 123 I-N-fluoropropyl-2b-carbomethoxy-3b-(4-iodophenyl) nortropane ( 123 I-FP-CIT) SPECT dopaminergic imaging in the clinical diagnosis of dementia with Lewy bodies (DLB) with autopsy as the gold standard. Patients >60 years of age with dementia who had undergone 123 I-FP-CIT imaging in research studies and who had donated their brain tissue to the Newcastle Brain Tissue Resource were included. All had structured clinical research assessments, and clinical diagnoses were applied by consensus panels using international diagnostic criteria. All underwent 123 I-FP-CIT imaging at baseline, and scans were rated as normal or abnormal by blinded raters. Patients were reviewed in prospective studies and after death underwent detailed autopsy assessment, and neuropathologic diagnoses were applied with the use of standard international criteria. Fifty-five patients (33 with DLB and 22 with Alzheimer disease) were included. Against autopsy diagnosis, 123 I-FP-CIT had a balanced diagnostic accuracy of 86% (sensitivity 80%, specificity 92%) compared with clinical diagnosis, which had an accuracy of 79% (sensitivity 87%, specificity 72%). Among patients with DLB, 10% (3 patients) met pathologic criteria for Lewy body disease but had normal 123 I-FP-CIT imaging. This large autopsy analysis of 123 I-FP-CIT imaging in dementia demonstrates that it is a valid and accurate biomarker for DLB, and the high specificity compared with clinical diagnosis (20% higher) is clinically important. The results need to be replicated with patients recruited from a wider range of settings, including movement disorder clinics and general practice. While an abnormal 123 I-FP-CIT scan strongly supports Lewy body disease, a normal scan does not exclude DLB with minimal brainstem involvement. This study provides Class I evidence that 123 I-FP-CIT dopaminergic neuroimaging accurately identifies patients with DLB. Copyright © 2016 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.

Simultaneous fingerprint and high-wavenumber confocal Raman spectroscopy enhances early detection of cervical precancer in vivo.

PubMed

Duraipandian, Shiyamala; Zheng, Wei; Ng, Joseph; Low, Jeffrey J H; Ilancheran, A; Huang, Zhiwei

2012-07-17

Raman spectroscopy is a vibrational spectroscopic technique capable of nondestructively probing endogenous biomolecules and their changes associated with dysplastic transformation in the tissue. The main objectives of this study are (i) to develop a simultaneous fingerprint (FP) and high-wavenumber (HW) confocal Raman spectroscopy and (ii) to investigate its diagnostic utility for improving in vivo diagnosis of cervical precancer (dysplasia). We have successfully developed an integrated FP/HW confocal Raman diagnostic system with a ball-lens Raman probe for simultaneous acquistion of FP/HW Raman signals of the cervix in vivo within 1 s. A total of 476 in vivo FP/HW Raman spectra (356 normal and 120 precancer) are acquired from 44 patients at clinical colposcopy. The distinctive Raman spectral differences between normal and dysplastic cervical tissue are observed at ~854, 937, 1001, 1095, 1253, 1313, 1445, 1654, 2946, and 3400 cm(-1) mainly related to proteins, lipids, glycogen, nucleic acids and water content in tissue. Multivariate diagnostic algorithms developed based on partial least-squares-discriminant analysis (PLS-DA) together with the leave-one-patient-out, cross-validation yield the diagnostic sensitivities of 84.2%, 76.7%, and 85.0%, respectively; specificities of 78.9%, 73.3%, and 81.7%, respectively; and overall diagnostic accuracies of 80.3%, 74.2%, and 82.6%, respectively, using FP, HW, and integrated FP/HW Raman spectroscopic techniques for in vivo diagnosis of cervical precancer. Receiver operating characteristic (ROC) analysis further confirms the best performance of the integrated FP/HW confocal Raman technique, compared to FP or HW Raman spectroscopy alone. This work demonstrates, for the first time, that the simultaneous FP/HW confocal Raman spectroscopy has the potential to be a clinically powerful tool for improving early diagnosis and detection of cervical precancer in vivo during clinical colposcopic examination.

An assessment of false positive rates for malaria rapid diagnostic tests caused by non-Plasmodium infectious agents and immunological factors.

PubMed

Gatton, Michelle L; Ciketic, Sadmir; Barnwell, John W; Cheng, Qin; Chiodini, Peter L; Incardona, Sandra; Bell, David; Cunningham, Jane; González, Iveth J

2018-01-01

Malaria rapid diagnostic tests (RDTs) can produce false positive (FP) results in patients with human African trypanosomiasis and rheumatoid factor (RF), but specificity against other infectious agents and immunological factors is largely unknown. Low diagnostic specificity caused by cross-reactivity may lead to over-estimates of the number of malaria cases and over-use of antimalarial drugs, at the cost of not diagnosing and treating the true underlying condition. Data from the WHO Malaria RDT Product Testing Programme was analysed to assess FP rates of 221 RDTs against four infectious agents (Chagas, dengue, Leishmaniasis and Schistosomiasis) and four immunological factors (anti-nuclear antibody, human anti-mouse antibody (HAMA), RF and rapid plasma regain). Only RDTs with a FP rate against clean negative samples less than 10% were included. Paired t-tests were used to compare product-specific FP rates on clean negative samples and samples containing non-Plasmodium infectious agents and immunological factors. Forty (18%) RDTs showed no FP results against any tested infectious agent or immunological factor. In the remaining RDTs significant and clinically relevant increases in FP rates were observed for samples containing HAMA and RF (P<0.001). There were significant correlations between product-matched FP rates for RF and HAMA on all RDT test bands (P<0.001), and FP rates for each infectious agent and immunological factor were also correlated between test bands of combination RDTs (P≤0.002). False positive results against non-Plasmodium infectious agents and immunological factors does not appear to be a universal property of malaria RDTs. However, since many malaria RDTs have elevated FP rates against HAMA and RF positive samples practitioners may need to consider the possibility of false positive results for malaria in patients with conditions that stimulate HAMA or RF.

One of 50: Challenger, the University of Colorado Boulder QB50 Constellation Satellite

NASA Astrophysics Data System (ADS)

Palo, S. E.; Rainville, N.; Dahir, A.; Rouleau, C.; Stark, J.; Nell, N.; Fukushima, J.; Antunes de Sa, A.

2015-12-01

QB50 is a bold project lead by the Von Karman Institute of Fluid Dynamics as part of the European Union FP7 program to launch fifty cubesats from a single launch vehicle. With a planned deployment altitude of 380km, the QB50 constellation will stay below the space station and deorbit within 9-12 months, depending upon solar conditions. Forty of the QB50 satellites are flying specified scientific sensors which include an ion-neutral mass spectrometer, a Langmuir probe or a FIPEX oxygen sensor. This constellation of cubesats will yield an unprecedented set of distributed measurements of the lower-thermosphere. The University of Colorado Boulder was selected as part of a four team consortium of US cubesat providers to participate in the QB50 mission and is supported by the National Science Foundation. The Challenger cubesat, designed and built by a multidisciplinary team of students at the University of Colorado Boulder will carry the ion-neutral mass spectrometer as a science instrument and has heritage from the Colorado Student Space Weather Experiment (CSSWE) and Miniature X-Ray Spectrometer (MinXSS) cubesats. Many of the cubesat subsystems were designed, built and tested by students in the Space Technology Integration (STIg) lab. This paper will provide an overview and a status update of the QB50 program in addition to details of the Challenger cubesat.

Communicating without the Face: Holistic Perception of Emotions of People with Facial Paralysis

PubMed Central

Bogart, Kathleen; Tickle-Degnen, Linda; Ambady, Nalini

2015-01-01

People with facial paralysis (FP) report social difficulties, but some attempt to compensate by increasing expressivity in their bodies and voices. We examined perceivers’ emotion judgments of videos of people with FP to understand how they interpret the combination of an inexpressive face with an expressive body and voice. Results suggest perceivers form less favorable impressions of people with severe FP, but compensatory expression is effective in improving impressions. Perceivers seemed to form holistic impressions when rating happiness and possibly sadness. Findings have implications for basic emotion research and social functioning interventions for people with FP. PMID:26412919

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wang, Yin; Wang, Wen; Wysocki, Gerard, E-mail: gwysocki@princeton.edu

In this Letter, we present a method of performing broadband mid-infrared spectroscopy with conventional, free-running, continuous wave Fabry-Perot quantum cascade lasers (FP-QCLs). The measurement method is based on multi-heterodyne down-conversion of optical signals. The sample transmission spectrum probed by one multi-mode FP-QCL is down-converted to the radio-frequency domain through an optical multi-heterodyne process using a second FP-QCL as the local oscillator. Both a broadband multi-mode spectral measurement as well as high-resolution (∼15 MHz) spectroscopy of molecular absorption are demonstrated and show great potential for development of high performance FP-laser-based spectrometers for chemical sensing.

Identification and characterization of naturally occurring inhibitors against UDP-glucuronosyltransferase 1A1 in Fructus Psoraleae (Bu-gu-zhi)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wang, Xin-Xin; Laboratory of Pharmaceutical Resource Discovery, Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Dalian 116023; Lv, Xia

As an edible traditional Chinese herb, Fructus psoraleae (FP) has been widely used in Asia for the treatment of vitiligo, bone fracture and osteoporosis. Several cases on markedly elevated bilirubin and acute liver injury following administration of FP and its related proprietary medicine have been reported, but the mechanism in FP-associated toxicity has not been well investigated yet. This study aimed to investigate the inhibitory effects of FP extract and its major constituents against human UDP-glucuronosyltransferase 1A1 (UGT1A1), the key enzyme responsible for metabolic elimination of bilirubin. To this end, N-(3-carboxy propyl)-4-hydroxy-1,8-naphthalimide (NCHN), a newly developed specific fluorescent probe formore » UGT1A1, was used to evaluate the inhibitory effects of FP extract or its fractions in human liver microsomes (HLM), while LC-UV fingerprint and UGT1A1 inhibition profile were combined to identity and characterize the naturally occurring inhibitors of UGT1A1 in FP. Our results demonstrated that both the extract of FP and five major components of FP displayed evident inhibitory effects on UGT1A1 in HLM. Among these five identified naturally occurring inhibitors, bavachin and corylifol A were found to be strong inhibitors of UGT1A1 with the inhibition kinetic parameters (K{sub i}) values lower than 1 μM, while neobavaisoflavone, isobavachalcone, and bavachinin displayed moderate inhibitory effects against UGT1A1 in HLM, with the K{sub i} values ranging from 1.61 to 9.86 μM. These findings suggested that FP contains natural compounds with potent inhibitory effects against human UGT1A1, which may be one of the important reasons for triggering FP-associated toxicity, including elevated bilirubin levels and liver injury. - Graphical abstract: LC-UV fingerprint and UGT1A1 inhibition profiles were combined to identity and characterize the natural inhibitors of UGT1A1 in F. psoraleae for the first time. Five major components in F. psoraleae were identified as strong inhibitors against UGT1A1 in human liver microsomes, with the K{sub i} values ranging from 1.18–9.86 μM. - Highlights: • A method for rapid identification of UGT1A1 inhibitors from herbals was developed. • Fructus psoraleae (FP) extract displayed strong inhibitory effects on UGT1A1. • Five UGT1A1 inhibitory constituents in FP were identified for the first time. • The inhibition mechanism and the inhibition constant were well-characterized.« less

Influence of ferrule preparation with or without glass fiber post on fracture resistance of endodontically treated teeth

PubMed Central

de LIMA, Alexandra Furtado; SPAZZIN, Aloísio Oro; GALAFASSI, Daniel; CORRER-SOBRINHO, Lourenço; CARLINI-JÚNIOR, Bruno

2010-01-01

Objective This study evaluated the effect of ferrule preparation (Fp) on the fracture resistance of endodontically treated teeth, restored with composite resin cores with or without glass fiber posts. Material and Methods Forty-four bovine teeth were sectioned 19 or 17 mm (2 mm ferrule) from the apex, endodontically treated and assigned to four groups (n = 11): Group 1: Fp and post; Group 2: Fp and without post; Group 3: without Fp and with post; Group 4: without Fp and without post. All specimens were restored with composite resin core and metal crown. Specimens were subjected to fracture resistance testing in a universal testing machine at a crosshead speed of 0.5 mm/min. The data were analyzed by two-way ANOVA and Tukey’s tests (α=0.05). Results The mean fracture resistance values were as follows: Group 1: 573.3 N; Group 2: 552.5 N; Group 3: 275.3 N; Group 4: 258.6 N. Significantly higher fracture resistance was found for the groups with Fp (p<0.001). Conclusion There was no statistically significant interaction between the "Fp" and "post" factors (p = 0.954). The ferrule preparation increased the fracture resistance of endodontically treated teeth. However, the use of glass fiber post showed no significant influence on the fracture resistance. PMID:20835570

Adolescents and Young Adults With Cancer: Oncology Nurses Report Attitudes and Barriers to Discussing Fertility Preservation.

PubMed

Nobel Murray, Alexandra; Chrisler, Joan C; Robbins, Mark L

2016-08-01

Fertility issues have been found to be an important topic for adolescents and young adults (AYAs) with cancer. Medical technology has made fertility preservation (FP) increasingly effective for postpubertal patients whose treatment course may inhibit their future ability to achieve biologic parenthood. Oncology providers' recommendations have been shown to vary, potentially affecting patients' decision-making processes regarding FP. This study was designed to assess oncology nurses' recommendations for patients to consider FP options and to explore what patient-related factors may influence discussion of FP with AYAs with cancer. 116 oncology nurses participated in this study and were randomized to read one of four vignettes about a patient whose proposed treatment course could affect his or her fertility. Participants' recommendations to partake in FP were analyzed to test for differences by patient age and gender. Open-ended responses to questions about their experiences as oncology nurses were analyzed descriptively. Nurses strongly recommended that all patients explore FP options before the start of treatment. Oncology nurses endorsed stronger opinions that young adult female patients should be given independent decision-making power to delay treatment for FP, compared to male and female adolescent patients and young adult male patients. Participants mentioned barriers to discussions that included concerns about exacerbating negative emotions and the decision-making capacity of young patients.

The potential use of novel chitosan-coated deformable liposomes in an ocular drug delivery system.

PubMed

Chen, Hongdan; Pan, Hao; Li, Panpan; Wang, Hui; Wang, Xin; Pan, Weisan; Yuan, Yue

2016-07-01

In this study, novel chitosan-coated deformable liposomes (DL-CS) were proposed as an ocular drug delivery system to prolong pre-corneal retention, and improve transcorneal penetration and absorption. Flurbiprofen-loaded deformable liposomes (FP-DL) were prepared by a modified ethanol injection method and then coated with chitosan. Both DL and DL-CS exhibited a homogeneous particle size distribution, high encapsulation efficiency and good stability. After coating with 0.1% CS, the zeta potential was shifted from negative to positive. The apparent permeability coefficient of FP-DL-0.1% CS evaluated using isolated rabbit corneas was 1.29-, 1.95- and 4.59- fold greater than that of uncoated FP-DL, conventional liposomes and FP solution (P<0.01), respectively. The in vivo pre-corneal retention time and elimination dynamics were assessed using gamma scintigraphy technology. The area under the remaining activity-time of FP-DL-0.1% CS was prolonged 2.84- and 1.53-fold compared with that of the FP solution and FP-DL groups, respectively. Moreover, the ocular irritation test in vivo revealed that DL-0.1% CS produced no ocular damage or abnormal clinical signs. These results indicate that DL-CS appears to be a novel ophthalmic drug delivery strategy with the potential to overcome the limitations of conventional eye drops. Copyright © 2016 Elsevier B.V. All rights reserved.

Managing the Increasing Water Footprint of Hydraulic Fracturing in the Bakken Play, United States.

PubMed

Scanlon, Bridget R; Reedy, Robert C; Male, Frank; Hove, Michael

2016-09-20

The water footprint of oil production, including water used for hydraulic fracturing (HF) and flowback-produced (FP) water, is increasingly important in terms of HF water sourcing and FP water management. Here, we evaluate trends in HF water use relative to supplies and FP water relative to disposal using well by well analysis in the Bakken Play. HF water use per well increased by ∼6 times from 2005-2014, totaling 24.5 × 10(9) gal (93 × 10(9) L) for ∼10 140 wells. Water supplies expanded to meet increased demand, including access of up to ∼33 × 10(9) gal/year (125 × 10(9) L/year) from Lake Sakakawea, expanding pipeline infrastructure by hundreds of miles and allowing water transfers from irrigation. The projected inventory of ∼60 000 future wells should require an additional ∼11 times more HF water. Cumulative FP water has been managed by disposal into an increasing number (277 to 479) of salt water disposal wells. FP water is projected to increase by ∼10 times during the play lifetime (∼40 years). Disposal of FP water into deeper geologic units should be considered because of reported overpressuring of parts of the Dakota Group. The long time series shows how policies have increased water supplies for HF and highlights potential issues related to FP water management.

Prospective study of depression and anxiety in female fertility preservation and infertility patients.

PubMed

Lawson, Angela K; Klock, Susan C; Pavone, Mary Ellen; Hirshfeld-Cytron, Jennifer; Smith, Kristin N; Kazer, Ralph R

2014-11-01

To prospectively assess anxiety, depression, coping, and appraisal in female fertility preservation (FP) patients compared with infertile patients. Prospective pre- and post-treatment survey. Academic medical center. Forty-seven women with cancer (FP patients) and 91 age-matched infertile patients. None. Depression, anxiety, coping, infertility-related stress, appraisal of treatment, and medical outcomes. FP patients reported more symptoms of anxiety and depression than infertile patients, but infertile patients' symptoms worsened over time; 44% of FP and 14% of infertile patients' scores exceeded the clinical cutoff for depression before treatment. The interval between surveys and medical treatment data did not predict changes in mood symptoms. Coping strategies and infertility-related stress did not differ between groups, and avoidant coping predicted higher depression and anxiety scores. FP patients reported more anxiety and depression than infertile patients at enrollment in treatment, with more than one-third of FP patients reporting clinically significant depressive symptoms. However, infertile patients' anxiety and depressive symptoms increased across treatment. This increase was not related to time between registration for IVF and oocyte retrieval or the medical aspects of treatment. FP and infertile patients should be provided psychologic consultation before treatment to identify mood and anxiety symptoms and to refer patients for counseling as needed to prevent worsening of symptoms. Copyright © 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.