Close female friendships and knowledge of recommended abortion methods in Nigeria and the Democratic Republic of the Congo among a representative sample of reproductive-aged women

IntroductionThere is a high incidence of unsafe abortion among women in Nigeria and the DRC. Low knowledge of recommended abortion methods [i.e., surgical and medication abortion (MA) pills] is a barrier for women accessing safe abortions. Women often rely on friends for information about abortion methods. Understanding characteristics of women with knowledge of recommended abortion methods, and MA specifically, and how it is influenced by close female friendships may help identify women most at risk of relying on unsafe abortion.MethodsWe used survey data from Performance Monitoring for Action from 11,106 women of reproductive age in Nigeria (April–May 2018) and 3,697 women in Kinshasa and Kongo Central, DRC, (December 2021–April 2022) to produce representative estimates of knowledge of abortion methods at the national and province levels, respectively. We performed bivariate and multivariate logistic regression to determine which characteristics were independently associated with knowing a recommended abortion method, with knowing of MA pills specifically, and to assess our hypothesis that having at least one female confidante would increase one's odds of knowing about these methods.ResultsA minority (26.9%) of women in Nigeria and the majority in Kinshasa (76.7%) and Kongo Central (58.1%) reported having knowledge of at least one recommended abortion method, while knowledge of MA pills was low in all sites. Having at least one close female confidante was associated with increased odds of knowing a recommend abortion method in Nigeria (aOR = 1.50, 95% CI 1.25–1.79) and in Kongo Central (aOR = 2.66, 95% CI 1.40–5.40), and with increased odds of knowing about MA specifically in Kinshasa (aOR = 1.44, 95% CI 1.08–1.93) and Kongo Central (aOR = 3.61, 95% CI 1.28–10.22), but not Nigeria.DiscussionIn legally restrictive contexts where knowledge of recommended abortion methods (particularly medication abortion) is low, having close female friends is related to increased knowledge of recommended abortion methods

Understanding Galaxy Formation via Near-Infrared Surveys in the 2020s

A discussion of science cases in extragalactic astrophysics and galaxy formation that wide-area space-based infrared surveys will address in the 2020s. <p/

Combinations of Plant Water-Stress and Neonicotinoids Can Lead to Secondary Outbreaks of Banks Grass Mite (Oligonychus Pratensis Banks)

Spider mites, a cosmopolitan pest of agricultural and landscape plants, thrive under hot and dry conditions, which could become more frequent and extreme due to climate change. Recent work has shown that neonicotinoids, a widely used class of systemic insecticides that have come under scrutiny for non-target effects, can elevate spider mite populations. Both water-stress and neonicotinoids independently alter plant resistance against herbivores. Yet, the interaction between these two factors on spider mites is unclear, particularly for Banks grass mite (Oligonychus pratensis; BGM). We conducted a field study to examine the effects of water-stress (optimal irrigation = 100% estimated evapotranspiration (ET) replacement, water stress = 25% of the water provided to optimally irrigated plants) and neonicotinoid seed treatments (control, clothianidin, thiamethoxam) on resident mite populations in corn (Zea mays, hybrid KSC7112). Our field study was followed by a manipulative field cage study and a parallel greenhouse study, where we tested the effects of water-stress and neonicotinoids on BGM and plant responses. We found that water-stress and clothianidin consistently increased BGM densities, while thiamethoxam-treated plants only had this effect when plants were mature. Water-stress and BGM herbivory had a greater effect on plant defenses than neonicotinoids alone, and the combination of BGM herbivory with the two abiotic factors increased the concentration of total soluble proteins. These results suggest that spider mite outbreaks by combinations of changes in plant defenses and protein concentration are triggered by water-stress and neonicotinoids, but the severity of the infestations varies depending on the insecticide active ingredient

Health System, Community-Based, or Usual Dementia Care for Persons With Dementia and Caregivers

ImportanceThe effectiveness of different approaches to dementia care is unknown.ObjectiveTo determine the effectiveness of health system-based, community-based dementia care, and usual care for persons with dementia and for caregiver outcomes.Design, setting, and participantsRandomized clinical trial of community-dwelling persons living with dementia and their caregivers conducted at 4 sites in the US (enrollment June 2019-January 2023; final follow-up, August 2023).InterventionsParticipants were randomized 7:7:1 to health system-based care provided by an advanced practice dementia care specialist (n = 1016); community-based care provided by a social worker, nurse, or licensed therapist care consultant (n = 1016); or usual care (n = 144).Main outcomes and measuresPrimary outcomes were caregiver-reported Neuropsychiatric Inventory Questionnaire (NPI-Q) severity score for persons living with dementia (range, 0-36; higher scores, greater behavioral symptoms severity; minimal clinically important difference [MCID], 2.8-3.2) and Modified Caregiver Strain Index for caregivers (range, 0-26; higher scores, greater strain; MCID, 1.5-2.3). Three secondary outcomes included caregiver self-efficacy (range, 4-20; higher scores, more self-efficacy).ResultsAmong 2176 dyads (individuals with dementia, mean age, 80.6 years; 58.4%, female; and 20.6%, Black or Hispanic; caregivers, mean age, 65.2 years; 75.8%, female; and 20.8% Black or Hispanic), primary outcomes were assessed for more than 99% of participants, and 1343 participants (62% of those enrolled and 91% still alive and had not withdrawn) completed the study through 18 months. No significant differences existed between the 2 treatments or between treatments vs usual care for the primary outcomes. Overall, the least squares means (LSMs) for NPI-Q scores were 9.8 for health system, 9.5 for community-based, and 10.1 for usual care. The difference between health system vs community-based care was 0.30 (97.5% CI, -0.18 to 0.78); health system vs usual care, -0.33 (97.5% CI, -1.32 to 0.67); and community-based vs usual care, -0.62 (97.5% CI, -1.61 to 0.37). The LSMs for the Modified Caregiver Strain Index were 10.7 for health system, 10.5 for community-based, and 10.6 for usual care. The difference between health system vs community-based care was 0.25 (97.5% CI, -0.16 to 0.66); health system vs usual care, 0.14 (97.5% CI, -0.70 to 0.99); and community-based vs usual care, -0.10 (97.5% CI, -0.94 to 0.74). Only the secondary outcome of caregiver self-efficacy was significantly higher for both treatments vs usual care but not between treatments: LSMs were 15.1 for health system, 15.2 for community-based, and 14.4 for usual care. The difference between health system vs community-based care was -0.16 (95% CI, -0.37 to 0.06); health system vs usual care, 0.70 (95% CI, 0.26-1.14); and community-based vs usual care, 0.85 (95% CI, 0.42 to 1.29).Conclusions and relevanceIn this randomized trial of dementia care programs, no significant differences existed between health system-based and community-based care interventions nor between either active intervention or usual care regarding patient behavioral symptoms and caregiver strain.Trial registrationClinicalTrials.gov Identifier: NCT03786471

Understanding the Audience for a Digital Capacity-Building Platform for Micro-Retailers in Nairobi, Kenya: A Latent Class Segmentation Analysis

Background: Digital programs need to understand the characteristics of their audiences to develop services that meet the needs of different user groups.Focus of the Article: This manuscript is related to research and evaluation, and to four social marketing benchmarks: Consumer Research, Segmentation and Targeting, Consumer Orientation, and Exchange.Research Question: What are the behavioral characteristics and user profiles among duka owners who are using a digital business capacity-building platform in Nairobi, Kenya.Design/Approach: Survey assessment of use of a mobile-friendly online platform for promoting business growth among underserved micro-retail shop (duka) owners in Nairobi, Kenya. The UJoin platform offers duka owners access to business and financial courses, online mentoring, networking opportunities, and access to product information.Importance to the Field: The research will provide critical insights into program and audience needs for use of digital platforms, including promoting, scaling, and strengthening digital services.Methods: 805 shop owners in Nairobi, Kenya participated in a survey about perceptions and use of the internet. Latent class analysis identified homogeneous “classes” within the sample, and behavioral profiles and predictors of platform use.Results: Analysis yielded a 3-class model. Class 1 Endorsers endorsed community norms, social support, learning, networking, and perceived business benefits from websites. Class 2 Skeptics did not support collaboration and learning. Class 3 Unengaged lacked support to use online platforms. Predictors of frequent use of digital platforms were self-efficacy (OR: 5.95, p &lt; .001), Endorser (OR: 3.13, p &lt; .001) and Unengaged (OR: 2.42, p &lt; .055) class, and agreeing that connections to duka owners is important (OR: 3.02, p &lt; .003).Conclusion: Diversified strategies to promote use of online platforms may meet different needs of sub-groups among user groups.Recommendations for Research and Practice: Multiple strategies are needed to address different needs of sub-groups within a larger audience. Programs may benefit from investments to characterize the audience during recruitment to better understand attitudes towards, and efficacy to use, the internet, level of motivation, technology and support needs, and attitudes towards learning and networking.Limitations: The survey sample was a non-random selection of duka owners and relied on self-reported data which may be subject to social-desirability bias and recall. Some of the survey questions about perceptions were derived from single-item variables rather than an index or scale. The cross-sectional design of the survey precludes causal inferences. </jats:p