Predictors Of Prenatal Care Satisfaction Among Pregnant Women In American Samoa

Objectives: Women of reproductive age in American Samoa have a high-risk for pregnancy complications, due to their high levels of overweight and obesity. Prenatal care can mitigate this risk; however, many women do not seek care. The low rate of prenatal care utilization may stem from a low-level of prenatal care satisfaction. By understanding the predictors of prenatal care satisfaction in America Samoa, targets for improvement may be identified, with the ultimate goal of increasing prenatal care utilization. Methods: A cross-sectional survey was distributed to women (n=174) in the waiting areas of the clinic at the Lyndon B Johnson Tropical Medical Center, Pago Pago. Women were asked about their demographic background, pregnancy traits, and their satisfaction with prenatal care. Complete satisfaction data was obtained for 165 participants. Different components of satisfaction were extracted using principal components analysis. Linear regression was used to examine associations between maternal characteristics and satisfaction score within these individual components and overall. Results: The satisfaction questionnaire yielded three components: satisfaction with Clinic Services, Accessibility, and Physician Interactions. Waiting two hours or more to see the doctor was a significant predictor of less satisfaction with Clinic Services, Accessibility, and Overall satisfaction compared to waiting less than 30 minutes. Living more than 20 minutes away from the clinic was associated with less satisfaction with Accessibility, Physician Interactions, and Overall, whereas non-residence was associated with greater satisfaction with Accessibility. Women who were employed or on maternity leave were less satisfied with Physician Interactions than women who were unemployed or students. Of women who had previously been pregnant, a previous pregnancy loss was associated with less satisfaction with Physician Interactions compared to women who had not experienced a pregnancy loss. Women who did not attend all of their appointments were less satisfied with their care overall compared to women who did. Conclusions for Practice: Prenatal care satisfaction is an important determinant of prenatal care utilization. By identifying specific characteristics that predicted lower satisfaction, we are able to guide providers and health services towards improved prenatal care delivery. Prenatal care clinics should focus on making it easier for women to get to the clinics, decreasing waiting times, and increasing quality face time with providers

Performance Improvement of Wireless Network Based on Effective Data Transmission

A major requirement of any computer network is scalability. This can be as a result of increase in the number of users, upgrading due to technological advancement, additional services, or the need for performance improvement. This will inevitably require changing infrastructure, deploying new applications, and dealing with security which definitely touches both hardware and software, in the sense that, the complexities of the hardware, software and firmware increase with the attendant growth of the network and maintainability. However, for the network to remain reliable and efficient, it is necessary that, implementation and administration of it requires a means of monitoring both the model of the network structures and processes occurring in them. The efficiency and throughput of the network depend on improving the effectiveness of data transmission carried out by the network protocols. This paper discusses the use of a protocol to meet the technological challenge towards improving the performance and throughput of a wireless network based on effective data transmission

Social determinants and child survival in Nigeria in the era of Sustainable Development Goals: Progress, challenges, and opportunities

Introduction: Like in many low- and middle-income settings, childhood mortality remains a big challenge in Nigeria—being the second largest contributor to under-five mortality globally, after India. Currently, there is little local evidence to guide policymakers in Nigeria to tailor appropriate social interventions to make the Sustainable Development Goal (SDG) targets of child survival (SDG-3), gender equality (SDG-5), and social inclusiveness (SDG-10) achievable by 2030. In addition, lack of methodological rigor and theoretical foundations of child survival research in Nigeria limit their use for proper planning of child health services. Aims: The basis of this thesis is to understand the complex issues relating to child survival and recommend new approaches to guide policymakers on interventions that will improve child survival in Nigeria. The overarching goal of this thesis is to address the methodological and theoretical shortcomings identified in the previous studies conducted in Nigeria. Using robust interdisciplinary analytic techniques, this thesis assessed the following specific objectives. Objective 1: (a) Compare predictive abilities of the most used conventional statistical time-series methods—ARIMA and Holt-Winters exponential smoothing models, with artificial intelligence technique such as group method of data handling (GMDH)-type artificial neural network (ANN), and (b) estimate the age- and sex-specific mortality trends in child-related SDG indicators (i.e., neonatal and under-five mortality rates) over the 1960s-2017 period, and estimate the expected annual reduction rates needed to achieve the SDG-3 targets by projecting rates from 2018 to 2030. Objective 2: (a) Identify the social determinants of age-specific childhood (0-59 months) mortalities, which are disaggregated into neonatal mortality (0-27 days), post-neonatal mortality (1-11 months) and child mortality (12-59 months), and (b) estimate the within- and between-community variations of mortality among under-five children in Nigeria. Objective 3: Identify the critical pathways through which social factors (at maternal, household, community levels) determine neonatal, infant, and under-five mortalities in Nigeria. Objective 4: (a) Determine patterns and determinants of geographical clustering of neonatal mortality at the state and regional levels in Nigeria, (b) assess gender inequity for neonatal mortality between urban and rural communities across the regions in Nigeria, and (c) measure gaps in SDG-3 target for neonatal mortality at the state and regional levels in Nigeria. Methods: This thesis is a quantitative study which used two secondary datasets—aggregated historical childhood mortality data from 1960s to 2017 (objective 1), and the latest (2016/2017) Nigeria Multiple Indicator Cluster Survey (MICS) for 36 states and Federal Capital Territory (FCT) in Nigeria (objectives 2-4). To minimize recall bias, analysis was limited to a weighted nationally representative sample of 30,960 live births delivered within five years before the survey. The selection of relevant social determinants of child survival was primarily informed by Mosley-Chen framework. The candidate variables were layered across child, maternal, household, and community-levels. The analytic approaches include artificial intelligence technique (i.e., group method of data handling (GMDH)-type artificial neural network, and multilayer perceptron (MLP) neural network), autoregressive integrated moving average (ARIMA), Holt-Winters exponential smoothing models, spatial cluster analysis, hierarchical path analysis with time-to-event outcome, and multilevel multinomial regression. Results: Progress towards achieving SDG targets – Nigeria is not likely to achieve SDG targets for child survival and, within, gender equity by 2030 at the current annual reduction rates (ARR) under-five mortality rate (U5MR): 1.2%, and neonatal mortality rate (NMR): 2.0%. If the current trend continues, U5MR will begin to increase by 2028. Also, at the end of SDG-era, female deaths will be higher than male deaths (80.9 vs. 62.6 deaths per 1000 live births). To make child-related SDG targets achievable by 2030, Nigeria needs to reduce annual U5MR by 9 times and annual NMR by 4 times the current rate of decrease. Social determinants of childhood mortality – At each stage of early childhood development, there are different factors relating to survival outcomes. Surprisingly, attendance of skilled health providers during delivery was associated with an increased neonatal mortality risk, although its effect disappeared during post-neonatal and toddler/pre-school stages. The observed association requires cautious interpretation because of unavailability of variables on quality of care in MICS dataset to assess how skilled birth delivery impacts child survival in Nigeria. However, there is a possibility of under-reporting under-five mortalities at the community level. Also, it could indicate a functioning referral system that sends the high-risk deliveries to health facilities to a greater extent. There is a large variation (39%) of under-five mortalities across the Nigerian communities, which is accounted for by maternal-level factors (i.e., maternal education, contraceptive use, maternal wealth, parity, death of previous children and quality of perinatal care). Pathways to childhood mortality – Region and area of residence (urban/rural), infrastructural development, maternal education, contraceptive use, marital status, and maternal age at birth were found to operate indirectly on neonatal, infant and under-five survival. Female children, singleton, children whose mothers delivered at least two years apart and aged 20-34 years survived much longer. Specifically, women from Northern areas of Nigeria were less likely to reside in urban cities and towns than those in the Southern areas. This, in turn, limited their access to social infrastructure and acted as a barrier to maternal education. Without adequate education, women were less likely to use contraceptive methods. Women with no history of contraceptive use were more likely to have childbirths closer together (less than two-year gap), which in turn, negatively impacted child survival. Regional inequities in childhood mortality – There was significant state-level clustering of NMR in Nigeria. The states with higher neonatal mortality rates were majorly clustered in the North-West and North-Central regions, and states with lower neonatal mortality rates were clustered in the South-South and South-East regions. Gender inequity was worse in the rural areas of Northern Nigeria, while it was worse in the urban areas of Southern Nigeria. NMR was disproportionately higher among females in urban areas (except North-West and South-West regions). Conversely, male neonates had higher mortality risks in the rural areas for all the regions. Conclusions: This thesis provides more refined age- and sex-specific mortality estimates for Nigeria. At the current rates, Nigeria will not meet SDG targets for child survival. In addition, this thesis identifies the critical intervention pathways to child survival in Nigeria during the SDG-era. The new estimates may be used to improve the design and accelerate the implementation of child health programmes to attain the SDG targets. Also, it is important for stakeholders to implement more impactful policies that promote maternal education and improve living conditions of women (especially in the rural areas). To address gender inequities, gender-sensitive policies, and community mobilization against gender-based discrimination towards girl-child should be implemented. Further research is required to assess the quality of skilled birth attendants in Nigeria

INFLUENCE OF INFORMATION TECHNOLOGY SKILLS ON LIBRARY PATRONAGE BY UNDERGRADUATE STUDENTS IN SOUTH-WEST, NIGERIA

This study investigated the influence of information technology skills on library patronage by undergraduate students in South-west Nigerian universities. A descriptive research design of the ex-post facto was adopted using a sample size of 1527 selected out of the total population of 239,048 undergraduate students in the universities. Questionnaire was used to collect data. The results of the study revealed that the majority of undergraduate students patronised the library between two to three times a day. The finding of the study also revealed that information technology skills had influence on library patronage by undergraduate students in the universities (r = 0.59, N = 1333, p \u3c 0.05). The study concluded that information technology skills influenced library patronage of undergraduate students in the universities. The study, therefore, recommended that students should enhance their information technology skills to enhance their library patronag

Occupation, Culture and Religion as Mediating Effect of Borrowers` Poverty Alleviation Loan Repayment

It is widely believed that religion and culture offer distinctiveness to credit loan for poverty alleviation programmes, and loan repayment. The major religions of the world urge members to assist the poor, devoting time, material and spiritual resources to this cause. It is widely believed that religion and culture offer distinctiveness to credit loan for poverty alleviation programmes, and loan repayment, but this has not sufficiently proved true. The purpose of the study is to resolve the problem of the small entrepreneurs in accessing loans for poverty alleviation through further investigating the moderating effect or otherwise of culture, religion and occupation on poverty alleviation loan repayment. The exploratory cross sectional research design was adopted. The population is the entire microfinance banks in Ogun State, Nigeria which are 53 (CBN, 2012), including micro-loan beneficiaries. The value of loan granted to the beneficiaries of selected microfinance banks is N185,115,000 while the total numbers of beneficiaries is 4,016 between the year 2008 and 2012. Logistic regressions model was adopted to ascertain if borrower’s culture, religion and occupation have mediating effect on Loan Repayment-Poverty Alleviation relationship. The simultaneous effect of the three predictor variable (borrower’s culture, religion and occupation) was analyzed using logistic regression model and the results were presented. The analysis was performed with a total of 1745 cases. The full model significantly predicted the poverty alleviation and loan repayments among beneficiaries (omnibus chi square = 16.997, df = 3, p < 0.05). i.e., there is statistically, simultaneous effect of borrower’s culture, religion and occupation on loan repayment and poverty alleviation. The full model accounted for between 1 and 2.5% of the variance in poverty alleviation and loan repayments. However, the logistic regression model for each predictor variables revealed that only borrower’s culture is significant. The model predicts a negative effect of borrower’s culture on loan repayment-poverty alleviation relationship. The negative value indicates that the probability of alleviating poverty and loan repayments among beneficiaries declined with increase in borrower’s culture by a factor of 0.442 and 0.170. The magnitude of the decrease for poverty alleviation is in the range of 23.3 to 83.9% and 9.2 and 31.6% for loan repayment Keywords: Borrowers’ poverty alleviation, Occupation, culture, Religion, mediating effect

HCME: An Environment-Friendly I.C. Engine Fuel

The study revealed that Hura crepitans oil is a good candidate for Hura crepitans methyl ester (HCME) production. Two steps (esterification and transesterification) production stages influenced the high yield of HCME. Three possible experimental runs were performed in each step, the best of the three conditions were 1.45 (% v/v) for H2SO4 conc., 5:1 for methanol/oil molar ratio, 40 min for reaction time which gave 1.06 % for FFA in the first step, in the second step, 92.70 %(w/w) of HCME was obtained at 0.55% KOH, 5:1 methanol/oil molar ratio, 60 oC temperature and 30 min reaction time. The produced HCME had fuel properties which satisfied both ASTME D6751 and EN 1424 standards. The fatty acid profile of the HCME revealed the dominant fatty acids were linoleic (64.50%), oleic (17.54%) and palmitic (12.70%). Exhaust emissions from an internal combustion (I.C.) engine revealed that there is 60% decreased in CO, 58% decreased in NOx, 60% decreased in HC, 39% decrease in smoke opacity and 42% decreased in BSFC at B20, respectively. Flue gas temperature increased by 12% at B20, 45% increased in BTE at B50 when compared to pure diesel (AGO). Hence, it can be concluded that B20 (20% HCME + 80% AGO) will provides the best emission reduction at the lowest cost

‘Hanging by Invitation: Capital Punishment, The Carceral Archipelago and Escalating Homicide Rates in the Caribbean and Africa’

The escalating rate of violent crime in the Caribbean has prompted calls for the resumption of capital punishment as an appropriate response. This paper reviews the philosophical debates and statistical evidence of the effects of previous executions on the rates of homicide and concludes that the role of the Privy Council in permitting capital punishment in the Caribbean allows us to critically reflect on the theory of industrialization by invitation that was attributed to Sir Arthur Lewis. A comparative analysis of evidence from other parts of the world would be used to present a case for the abolition of capital punishment in the Caribbean and Africa

Development Of An SMS Based Alert Systemusing Object Oriented Design Concept

An automated lecture alert management system has been developed using java programming concept knownfor its portability. This backend system was interfaced with the GSM network through USB port of a PC and GSM modem. The desktop SMS application was developed using C# programming language. It generates updates and reminder from a time schedule stored in a database thereby making the system a time triggered application

Fan Speed Control of Processor Based On Environmental Temperature

Temperature is a physical property that is an essential part of life and Maintaining control of it is of paramount importance to man. Temperature is measured with various types of measuring instruments. But beyond the need to measure temperature, it must also be controlled and monitored. In an industrial setting with heavy equipment that need a round the clock cooling system so as to perform optimally without breakdown, it is important to have a mechanism that monitors the temperature situation, one that can detect the slightest threat to the condition of the systems as regards temperature change. Also temperature control can be used in personal computers to prevent overheating of the processor. This work involves sensing the temperature level of an environment and if a temperature out of range is detected, the fan speed increases to maximum. W hen the temperature drops below a threshold again, the fans are turned back off. The circuit is designed using a temperature sensor that is a thermistor. The temperature transducer is used to sense the temperature of the environment at that point in time and an indication shown on an LED

Development of Web-based Interactive Map Using Object-Oriented Programming Concept

The program incorporates an interactive map which responds to origin and destination selection, by analyzing the relative positions of both locations and creating real-time routes on the road network to display to the user the required path from the origin to the destination and the approximate distance/time required. System design is based on the Model- View-Controller (MVC) design pattern, and the application has been developed using Adobe Flash CS3 (with ActionScrip