266 research outputs found

    Nonprofit Watchdogs: Do They Serve the Average Donor?

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    Nonprofit watchdog organizations—organizations devoted to rating the accountability and transparency of nonprofits—claim to serve donors who are selecting which nonprofits to support. However, using three waves of the Harris Interactive Donor Pulse, we found that the overwhelming majority of donors (77.6 percent) do not consult these online intermediaries when making donations. Those who do are likely to fall into one of two groups: donors who give large sums of money or donors who are engaged in advocacy. We conclude with conceptual and practical implications

    Early Neoproterozoic limestones from the Gwna Group, Anglesey

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    Limestone megaclasts up to hundreds of metres in size are present within the Gwna Group mélange, North Wales, UK. The mélange has been interpreted as part of a Peri-Gondwanan fore-arc accretionary complex although the age of deposition remains contentious, proposals ranging from Neoproterozoic to Early Ordovician. This paper uses strontium isotope chemostratigraphy to establish the age of the limestone blocks and thus provide a maximum age constraint on mélange formation. Results show that, although the carbonates are locally dolomitized, primary 87Sr/86Sr ratios can be identified and indicate deposition sometime between the late Tonian and earliest Cryogenian. This age is older than that suggested by stromatolites within the limestone and indicates that the limestone did not form as cap carbonate deposits

    Effectiveness of conditional cash transfers (Afya credits incentive) to retain women in the continuum of care during pregnancy, birth and the postnatal period in Kenya: a cluster-randomised trial

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    OBJECTIVES: Given high maternal and child mortality rates, we assessed the impact of conditional cash transfers (CCTs) to retain women in the continuum of care (antenatal care (ANC), delivery at facility, postnatal care (PNC) and child immunisation). DESIGN: We conducted an unblinded 1:1 cluster-randomised controlled trial. SETTING: 48 health facilities in Siaya County, Kenya were randomised. The trial ran from May 2017 to December 2019. PARTICIPANTS: 2922 women were recruited to the control and 2522 to the intervention arm. INTERVENTIONS: An electronic system recorded attendance and triggered payments to the participant's mobile for the intervention arm (US4.5),andphonecreditforthecontrolarm(US4.5), and phone credit for the control arm (US0.5). Eligibility criteria were resident in the catchment area and access to a mobile phone. PRIMARY OUTCOMES: Primary outcomes were any ANC, delivery, any PNC between 4 and 12 months after delivery, childhood immunisation and referral attendance to other facilities for ANC or PNC. Given problems with the electronic system, primary outcomes were obtained from maternal clinic books if participants brought them to data extraction meetings (1257 (50%) of intervention and 1053 (36%) control arm participants). Attendance at referrals to other facilities is not reported because of limited data. RESULTS: We found a significantly higher proportion of appointments attended for ANC (67% vs 60%, adjusted OR (aOR) 1.90; 95% CI 1.36 to 2.66) and child immunisation (88% vs 85%; aOR 1.74; 95% CI 1.10 to 2.77) in intervention than control arm. No intervention effect was seen considering delivery at the facility (90% vs 92%; aOR 0.58; 95% CI 0.25 to 1.33) and any PNC attendance (82% vs 81%; aOR 1.25; 95% CI 0.74 to 2.10) separately. The pooled OR across all attendance types was 1.64 (1.28 to 2.10). CONCLUSIONS: Demand-side financing incentives, such as CCTs, can improve attendance for appointments. However, attention needs to be paid to the technology, the barriers that remain for delivery at facility and PNC visits and encouraging women to attend ANC visits within the recommended WHO timeframe. TRIAL REGISTRATION: NCT03021070

    Cost-effectiveness of conditional cash transfers to retain women in the continuum of care during pregnancy, birth and the postnatal period: protocol for an economic evaluation of the Afya trial in Kenya

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    Introduction A wealth of evidence from a range of country settings indicates that antenatal care, facility delivery and postnatal care can reduce maternal and child mortality and morbidity in high-burden settings. However, the utilisation of these services by pregnant women, particularly in low/middle-income country settings, is well below that recommended by the WHO. The Afya trial aims to assess the impact, cost-effectiveness and scalability of conditional cash transfers to promote increased utilisation of these services in rural Kenya and thus retain women in the continuum of care during pregnancy, birth and the postnatal period. This protocol describes the planned economic evaluation of the Afya trial. Methods and analysis The economic evaluation will be conducted from the provider perspective as a within-trial analysis to evaluate the incremental costs and health outcomes of the cash transfer programme compared with the status quo. Incremental cost-effectiveness ratios will be presented along with a cost-consequence analysis where the incremental costs and all statistically significant outcomes will be listed separately. Sensitivity analyses will be undertaken to explore uncertainty and to ensure that results are robust. A fiscal space assessment will explore the affordability of the intervention. In addition, an analysis of equity impact of the intervention will be conducted. Ethics and dissemination The study has received ethics approval from the Maseno University Ethics Review Committee, REF MSU/DRPI/MUERC/00294/16. The results of the economic evaluation will be disseminated in a peer-reviewed journal and presented at a relevant international conference. Trial registration number NCT0302107

    Pre- and Post-Activity Stretching Practices of Collegiate Soccer Coaches in the United States

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    International Journal of Exercise Science 13(6): 260-272, 2020. Current pre- and post-activity stretching guidelines are designed to optimize performance and reduce injury risk. However, it is unclear whether soccer coaches adhere to these recommendations. The purpose of this study was to determine if collegiate soccer coaches’ perceptions and practices align with current scientific recommendations. A total of 781 questionnaires were electronically distributed to soccer coaches from NCAA Division I and III universities.The questionnaire obtained demographic, professional, and educational information, as well as stretching practices. Statistical analysis consisted of computing frequency counts and means where applicable. Pearson\u27s Chi-square tests were performed to assess the potential differences in stretching perceptions and practices among the cohort of soccer coaches. Results suggest that soccer coaches are choosing some forms of stretching more frequently than other coaches (χ2= 342.7, p\u3c 0.001). Further analysis failed to determine significant associations between stretching type and coaching certification, level, sex, years of experience, and age. Of the 209 respondents, 84.9% believed pre-activity stretching to be of greater than average importance on a seven-point Likert scale. Dynamic stretching (68.7%) or a combination of static and ballistic stretching (18.0%) prior to athletic events was the most typical stretching prescribed. Current post-activity practices demonstrate that most coaches (95.4%) are using some form of a general cool-down following practice or competition. This study is an important assessment of the extent to which collegiate coaches administer appropriate stretching techniques. Most coaches adhere to current recommendations; however, they should continue to evaluate their practices against ongoing research and the practices of their peers

    Summary of the effects of three tillage and three traffic systems on cereal yields over a four-year rotation

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    This paper reports the design and results of a study to consider the effects of deep, shallow and zero tillage with random conventional and low tyre inflation pressures and controlled traffic systems on the yield of winter wheat, winter barley (×2) and spring oats. The results show that crop yields for zero tillage were significantly less (P<0.001) than deep and shallow tillage for all crops with an overall reduction of 1.0 t ha-1 below the mean of the deep and shallow tillage practices. Controlled traffic farming with a 30% trafficked area produced significantly higher yields than random conventional pressure traffic for the winter wheat and spring oats. Controlled traffic farming, with trafficked areas of 30% and 15% showed overall benefits over random conventional inflation pressure traffic of 0.32 t ha-1 (£41 ha-1) and 0.61 t ha-1 (£77 ha-1) respectively, requiring breakeven areas of 312 ha and 168 ha to cover the costs of three vehicle guidance/auto-steering systems

    “Because of mchango, I give my baby gripe water so he sleeps and stops crying”: Exclusive breastfeeding and parents’ concerns about colic-like symptoms in infants under 6 months in Lake Zone, Tanzania

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    Background Effective social and behavior change strategies for exclusive breastfeeding (EBF) rely on understanding how families interpret infant behavior and provide care. Little research thoroughly explores household use of non-prescribed medicine for infants under 6 months in rural Tanzania, which can interrupt EBF and may have other harmful unintended effects. Aim To explore parents’ use of non-prescribed medicine in response to infants’ colic-like symptoms during the EBF period. Methods We conducted thematic analysis of a series of qualitative, semi-structured interviews with 36 mothers and 30 fathers of infants 0-6 months in Lake Zone, Tanzania. Here, we focus on emergent themes related to concerns about colic-like symptoms and global implications for public health practitioners. Results Parents reported concerns about excessive crying and perceived infant abdominal pain, attributed to a potentially serious disease state locally known as mchango. Most parents gave non-prescribed medicines (e.g. gripe water, oral traditional medicine, and/or other commercial medicines) to treat or prevent mchango and associated symptoms, often including infant crying. After receiving supportive counselling on soothing techniques, most were willing to avoid giving non-prescribed medicines. Some reported continued challenges attributed to mchango symptoms, namely inconsolable crying. Conclusion While symptoms of mchango reported in this study overlapped with colic symptoms, literature in Tanzania suggests, in some cases, mchango is perceived to have spiritual origins and potentially be dangerous if left untreated. Empathetic counseling can offer parents knowledge and skills to manage colic-like symptoms without using non-prescribed medicines. Health workers need clear messages and training on risks of non-prescribed medicines and Tanzanian legislation banning its promotion and distribution

    Conditional cash transfers to retain rural Kenyan women in the continuum of care during pregnancy, birth and the postnatal period: protocol for a cluster randomized controlled trial.

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    BACKGROUND: Antenatal care (ANC), facility delivery and postnatal care (PNC) are proven to reduce maternal and child mortality and morbidity in high-burden settings. However, few pregnant rural women use these services sufficiently. This study aims to assess the impact, cost-effectiveness and scalability of conditional cash transfers to promote increased contact between pregnant women or women who have recently given birth and the formal healthcare system in Kenya. METHODS: The intervention tested is a conditional cash transfer to women for ANC health visits, a facility birth and PNC visits until their newborn baby reaches 1 year of age. The study is a cluster randomized controlled trial in Siaya County, Kenya. The trial clusters are 48 randomly selected public primary health facilities, 24 of which are in the intervention arm of the study and 24 in the control arm. The unit of randomization is the health facility. A target sample of 7200 study participants comprises pregnant women identified and recruited at their first ANC visit over a 12-month recruitment period and their subsequent newborns. All pregnant women attending one of the selected trial facilities for their first ANC visit during the recruitment period are eligible for the trial and invited to participate. Enrolled mothers are followed up at all health visits during their pregnancy, at facility delivery and for a number of visits after delivery. They are also contacted at three additional time points after enrolling in the study: 5-10days after enrolment, 6 months after the expected delivery date and 12 27 months after birth. If they have not delivered in a facility, there is an additional follow-up 2 wees after the expected due date. The impact of the conditional cash transfers on maternal healthcare services and utilization will be measured by the trial's primary outcomes: the proportion of all eligible ANC visits made during pregnancy, delivery at a health facility, the proportion of all eligible PNC visits attended, the proportion of referrals attended during the pregnancy and the postnatal period, and the proportion of eligible child immunization appointments attended. Secondary outcomes include; health screening and infection control, live birth, maternal and child survival 48 h after delivery, exclusive breastfeeding, post-partum contraceptive use and maternal and newborn morbidity. Data sources for the measurement of outcomes include routine health records, an electronic card-reader system and telephone surveys and focus group discussions. A full economic evaluation will be conducted to assess the cost of delivery and cost effectiveness of the intervention and the benefit incidence and equity impact of trial activities and outcomes. DISCUSSION: This trial will contribute to evidence on the effectiveness and cost-effectiveness of conditional cash transfers in facilitating health visits and promoting maternal and child health in rural Kenya and in other comparable contexts. TRIAL REGISTRATION: ClinicalTrials.gov, NCT03021070 . Registered on 13 January 2017
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