"You Know You Are Sick, Why Do You Carry A Pregnancy Again?" Applying the Socio-Ecological Model to Understand Barriers to PMTCT Service Utilization in Western Kenya.

ObjectiveThroughout most of sub-Saharan Africa (SSA), prevention of mother-to-child transmission (PMTCT) services are readily available. However, PMTCT programs in SSA have had suboptimal performance compared to other regions of the world. The main objective of this study is to explore the socio-ecological and individual factors influencing the utilization of PMTCT services among HIV-positive pregnant women in western Kenya using a social ecological model as our analytical lens.MethodsData were collected using in-depth interviews with 33 HIV-infected women attending government health facilities in rural western Kenya. Women with HIV-infected infants aged between 6 weeks to 6 months with a definitive diagnosis of HIV in the infant, as well as those with an HIV-negative test result in the infant were interviewed between November 2012 and June 2013. Coding and analysis of the transcripts followed grounded theory tenets. Coding reports were discussed in a series of meetings held among the authors. We then employed constant comparative analysis to discover dominant individual, family, society and structural determinants of PMTCT use.ResultsBarriers to women's utilization of PMTCT services fell within the broad constructs of the socio-ecological model of individual, family, society and structural determinants. Several themes cut across the different steps of PMTCT cascade and relate to different constructs of the socio-ecological model. These themes include: self-motivation, confidence and resilience, family support, absence or reduced stigma, right provider attitude and quality of health services provided. We also found out that these factors ensured enhanced maternal health and HIV negative children.ConclusionThe findings of this study suggest that a woman's social environment is an important determinant of MTCT. PMTCT Interventions must comprehensively address multiple factors across the different ecological levels. More research is however required for the development of multi-component interventions that combine strategies at different ecological levels

ELIGMOS: time domain simulation of the maneuvering of ships in deep and shallow waters

Calm water manoeuvring simulations are commonly used at the initial design stage as they provide useful an practical insight concerning ship's manoeuvrability and compliance with the relevant IMO criteria. In this paper the authors present ELIGMOS; a time-domain numerical code utilizing a 3-DOF manoeuvring model based on the MMG method. For the validation of the code's predictions, a comparison with the experimental results on the turning ability of S-175 has been conducted. The paper presents also the investigation performed regarding the accuracy of certain empirical formulas for the derivation of the manoeuvring derivatives is also investigated, especially for the case of shallow water where experimental data and results remain scarce. The code is written in C++ programming language, adopting a modular approach for the calculation of external forces and moment (i.e. hydrodynamic hull, rudder and propeller) which allows future enhancements with the introduction of additional terms

A numerical trim methodology study for the Kriso container ship with bulbous bow form variation

The application of Computational Fluid Dynamics (CFD) is the fastest developing area in marine fluid dynamics as an alternative to Experimental Fluid Dynamics (EFD). While EFD employs well-established methods for predicting a ship's performance, CFD is still challenged to reach a reliable level of accuracy in a reasonable amount of time. In the present study, this issue is addressed in the context of trim optimization by exploring the combination of time-inexpensive potential flow simulations with high-fidelity Unsteady Reynolds-averaged Navier-Stokes (URANS) simulations. This approach allowed covering a broad fore body design space by running a large number of potential flow simulations while at the same time important flow effects due to viscous forces were included by running URANS simulations over the full speed range for a small set of simulations. The KCS baseline design results were validated against an experimental towing tank dataset ensuring a valid CFD setup and thus demonstrating its competitiveness to EFD

Sensitivity analysis of the tool for assessing safe manoeuvrability of ships in adverse sea conditions

In 2013, International Maritime Organization (IMO) introduced the Interim Guidelines for determining the minimum propulsion power to maintain the manoeuvrability of ships in adverse conditions. Considering the sufficiency of propulsion system in adverse sea conditions, the European project SHOPERA has developed alternative processes and tools for assessing safe manoeuvrability of ships. The main objective of these procedures is to identify the critical conditions where the vessel maintains its course keeping and manoeuvring ability at the vessel available propulsion power by using basic ship design values as input into the simplified methods proposed. Outcomes of this project were submitted and discussed in the 70th session of IMO’s Marine Environmental Protection Committee. In this paper, a brief description of these new assessment procedures is presented and a sensitivity analysis is conducted. The analysis is performed for a range of different open water propeller and hull resistance characteristics, hull – propeller interaction factors and engine power limit values, investigating the influence of these various performance parameters on the performance of the vessel

The Casimir Force in Randall Sundrum Models

We discuss and compare the effects of one extra dimension in the Randall Sundrum models on the evaluation of the Casimir force between two parallel plates. We impose the condition that the result reproduce the experimental measurements within the known uncertainties in the force and the plate separation, and get an upper bound kR < 20 if the curvature parameter k of AdS_5 is equal to the Planck scale. Although the upper bound decreases as k decreases, kR ~ 12, which is the required value for solving the hierarchy problem, is consistent with the Casimir force measurements. For the case where the 5th dimension is infinite, the correction to the Casimir force is very small and negligible.Comment: 16 pages, 2 figures, references added, text improved, accepted for publication in PR

Numerical Investigation of Shallow Depth Sloshing Absorbers for Structural Control

A liquid sloshing absorber consists of a container, partially filled with liquid. The absorber is attached to the structure to be controlled, and relies on the structure’s motion to excite the liquid. Consequently, a sloshing wave is produced at the liquid free surface within the absorber, possessing energy dissipative qualities. The behaviour of liquid sloshing absorbers has been well documented, although their use in structural control applications has attracted considerably less attention. Generally it is accepted that sloshing absorbers with lower liquid levels are more effective energy dissipaters than those with higher levels, although there has not yet been a study to reveal an ‘optimum’ design mechanism. The main limitation of numerically modelling such circumstances is the inherent complexity in the free surface behaviour, predictions of which are limited when using grid-based modelling techniques. Considering such limitations, Smoothed Particle Hydrodynamics (SPH) is used in this study to model a 2-dimensional rectangular liquid sloshing absorber. SPH is a Lagrangian method of solving the equations of fluid flow that is suitable to model liquid sloshing due its grid-free nature, and inherent ability to model complex free surface behaviour. The primary objective of this paper is to numerically demonstrate the effect of tuning a container's width, to complement previous work [6] on the effect of liquid depth. This study is in an attempt to reveal geometry that enables both effective energy transfer to sloshing liquid and to dissipate this energy quickly

Constraining Non-minimal Dark Sector Scenarios with the COHERENT Neutrino Scattering Data

Abelian dark sector scenarios embedded into the two-Higgs doublet model are scrutinized within the Coherent Elastic Neutrino-Nucleus Scattering (CE$\nu$NS) experiment, which was first measured by the COHERENT Collaboration in 2017 with an ongoing effort to improve it since then and recently released data for the CsI target in 2022. In the theoretical framework, it is assumed that there is a $U(1)$ gauge group in the dark sector with a non-zero kinetic mixing with the hypercharge field. The COHERENT data for the targets CsI and liquid argon (LAr) are treated in both single and multi bin bases to constrain the multi dimensional parameter space, spanned by the dark gauge coupling, kinetic mixing parameter and the dark photon mass, of totally seven different representative scenarios which are also compared and contrasted among each other to find out about the most sensitive one to the data. The effect of refined quenching factor is also addressed.Comment: 27 pages, 3 tables, 6 figures, references organized and new ones adde

The Casimir Force in a Lorentz Violating Theory

We study the effects of the minimal extension of the standard model including Lorentz violation on the Casimir force between two parallel conducting plates in vacuum. We provide explicit solutions for the electromagnetic field using scalar field analogy, for both the cases in which the Lorentz violating terms come from the CPT-even or CPT-odd terms. We also calculate the effects of the Lorentz violating terms for a fermion field between two parallel conducting plates and analyze the modifications of the Casimir force due to the modifications of the Dirac equation. In all cases under consideration, the standard formulas for the Casimir force are modified by either multiplicative or additive correction factors, the latter case exhibiting different dependence on the distance between the plates.Comment: 20 pages, no figures, references added, accepted for publication in Phys. Rev.

Perspective of turkish medicine students on cancer, cancer treatments, palliative care, and oncologists (ares study): A study of the palliative care working committee of the turkish oncology group (TOG)

Cancer is one of the most common causes of death all over the World (Rahib et al. in Cancer Res 74(11):2913–2921, 2014; Silbermann et al. in Ann Oncol 23(Suppl 3):iii15–iii28, 2012). It is crucial to diagnose this disease early by effective screening methods and also it is very important to acknowledge the community on various aspects of this disease such as the treatment methods and palliative care. Not only the oncologists but every medical doctor should be educated well in dealing with cancer patients. Previous studies suggested various opinions on the level of oncology education in medical schools (Pavlidis et al. in Ann Oncol 16(5):840–841, 2005). In this study, the perspectives of medical students on cancer, its treatment, palliative care, and the oncologists were analyzed in relation to their educational status. A multicenter survey analysis was performed on a total of 4224 medical school students that accepted to enter this study in Turkey. After the questions about the demographical characteristics of the students, their perspectives on the definition, diagnosis, screening, and treatment methods of cancer and their way of understanding metastatic disease as well as palliative care were analyzed. The questionnaire includes questions with answers and a scoring system of Likert type 5 (absolutely disagree = 1, completely agree = 5). In the last part of the questionnaire, there were some words to detect what the words “cancer” and “oncologist” meant for the students. The participant students were analyzed in two study groups; “group 1” (n = 1.255) were phases I and II students that had never attended an oncology lesson, and “group 2” (n = 2.969) were phases III to VI students that had attended oncology lessons in the medical school. SPSS v17 was used for the database and statistical analyses. A value of p < 0.05 was noted as statistically significant. Group 1 defined cancer as a contagious disease (p = 0.00025), they believed that early diagnosis was never possible (p = 0.042), all people with a diagnosis of cancer would certainly die (p = 0.044), and chemotherapy was not successful in a metastatic disease (p = 0.003) as compared to group 2. The rate of the students that believed gastric cancer screening was a part of the national screening policy was significantly more in group 1 than in group 2 (p = 0.00014). Group 2 had a higher anxiety level for themselves or their family members to become a cancer patient. Most of the students in both groups defined medical oncologists as warriors (57% in group 1 and 40% in group 2; p = 0.097), and cancer was reminding them of “death” (54% in group 1 and 48% in group 2; p = 0.102). This study suggested that oncology education was useful for the students’ understanding of cancer and related issues; however, the level of oncology education should be improved in medical schools in Turkey. This would be helpful for medical doctors to cope with many aspects of cancer as a major health care problem in this country. © 2018, American Association for Cancer Education