Quality of antenatal care and associated factors in a rural county in Kenya: an assessment of service provision and experience dimensions.

BackgroundThis study aimed to assess the quality of antenatal care (ANC) women received in Migori county, Kenya-including both service provision and experience dimensions-and to examine factors associated with each dimension.MethodsWe used survey data collected in 2016 in Migori county from 1031 women aged 15-49 who attended ANC at least once in their most recent pregnancy. ANC quality service provision was measured by nine questions on receipt of recommended ANC services, and experience of care by 18 questions on information, communication, dignity, and facility environment. We summed the responses to the individual items to generate ANC service provision and experience of care scores. We used both linear and logistic regression to examine predictors.ResultsThe average service provision score was 10.9 (SD = 2.4) out of a total of 16. Most women received some recommended services once, but not at the frequency recommended by the Kenyan Ministry of Health. About 90% had their blood pressure measured, and 78% had a urine test, but only 58 and 14% reported blood pressure monitoring and urine test, respectively, at every visit. Only 16% received an ultrasound at any time during ANC. The average experience score is 27.3 (SD = 8.2) out of a total score of 42, with key gaps demonstrated in communication. About half of women were not educated on pregnancy complications. Also, about one-third did not often understand the purposes of tests and medicines received and did not feel able to ask questions to the health care provider. In multivariate analysis, women who were literate, employed, and who received all their ANC in a health center had higher experiences scores than women who were illiterate (coefficient = 1.52, CI:0.26,2.79), unemployed (coefficient = 2.73, CI:1.46,4.00), and received some ANC from a hospital (coefficient = 1.99, CI: 0.84, 3.14) respectively. The wealthiest women had two times higher odds of receiving an ultrasound than the poorest women (OR = 2.00, CI:1.20,3.33).ConclusionQuality of ANC is suboptimal in both service provision and experience domains, with disparities by demographic and socioeconomic factors and facility type. More efforts are needed to improve quality of ANC and to eliminate the disparities

UV Imaging Polarimetry of the Seyfert 2 Galaxy Mrk 3

We present UV imaging polarimetry data of the Seyfert 2 galaxy Mrk 3 taken by the Hubble Space Telescope. The polarized flux is found to be extended to ~1 kpc from the nucleus, and the position angles of polarization are centrosymmetric, confirming that the polarization is caused by scattering. We determine the location of the hidden nucleus as the center of this centrosymmetric pattern. From the polarization images taken in two broad bands, we have obtained the color distribution of the polarized flux. Some regions have blue polarized flux, consistent with optically-thin dust scattering, but some bright knots have a color similar to that of Seyfert 1 nucleus. Also, the recent Chandra X-ray observation suggests that the ratio of scattered UV flux to scattered X-ray flux is rather similar to the intrinsic UV/X-ray ratio in a Seyfert 1 nucleus, if the observed extended X-ray continuum is scattered light. While the scattered X-ray would be essentially from electron scattering, the UV slope and UV/X-ray ratio both being similar to Seyfert 1's would lead to two possibilities as to the nature of the UV scatterers. One is that the UV may also be scattered by electrons, in which case the scattering gas is somehow dust-free. The other is that the UV is scattered by dust grains, but the wavelength-independent UV scattering with low efficiency indicated by the UV slope and UV/X-ray ratio would suggest that the grains reside in UV-opaque clouds, or the dust might be mainly composed of large grains and lacks small-grain population.Comment: 15 pages, 8 figures (plus 2 color versions of grayscale figures), To appear in ApJ; minor corrections for the proofs of the manuscrip

Stable Quantum Resonances in Atom Optics

A theory for stabilization of quantum resonances by a mechanism similar to one leading to classical resonances in nonlinear systems is presented. It explains recent surprising experimental results, obtained for cold Cesium atoms when driven in the presence of gravity, and leads to further predictions. The theory makes use of invariance properties of the system, that are similar to those of solids, allowing for separation into independent kicked rotor problems. The analysis relies on a fictitious classical limit where the small parameter is {\em not} Planck's constant, but rather the detuning from the frequency that is resonant in absence of gravity.Comment: 5 pages, 3 figure

Effect of a Patient-Centered Phone Call by a Clinical Officer at Time of HIV Testing on Linkage to Care in Rural Kenya.

In a randomized controlled trial, we tested whether a structured, patient-centered phone call from a clinical officer after HIV testing improved linkage to/re-engagement in HIV care. Among 130 HIV-positive persons, those randomized to the phone call were significantly more likely to link to care by 7 and 30 days (P = .04)

Observations of the 6 Centimeter Lines of OH in Evolved (OH/IR) Stars

Recent observational and theoretical advances have called into question traditional OH maser pumping models in evolved (OH/IR) stars. The detection of excited-state OH lines would provide additional constraints to discriminate amongst these theoretical models. In this Letter, we report on VLA observations of the 4750 MHz and 4765 MHz lines of OH toward 45 sources, mostly evolved stars. We detect 4765 MHz emission in the star forming regions Mon R2 and LDN 1084, but we do not detect excited-state emission in any evolved stars. The flux density and velocity of the 4765 MHz detection in Mon R2 suggests that a new flaring event has begun.Comment: 4 pages, to appear in ApJ

Hypertension testing and treatment in Uganda and Kenya through the SEARCH study: An implementation fidelity and outcome evaluation.

BackgroundHypertension (HTN) is the single leading risk factor for human mortality worldwide, and more prevalent in sub-Saharan Africa than any other region [1]-although resources for HTN screening, treatment, and control are few. Most regional pilot studies to leverage HIV programs for HTN control have achieved blood pressure control in half of participants or fewer [2,3,4]. But this control gap may be due to inconsistent delivery of services, rather than ineffective underlying interventions.MethodsWe sought to evaluate the consistency of HTN program delivery within the SEARCH study (NCT01864603) among 95,000 adults in 32 rural communities in Uganda and Kenya from 2013-2016. To achieve this objective, we designed and performed a fidelity evaluation of the step-by-step process (cascade) of HTN care within SEARCH, calculating rates of HTN screening, linkage to care, and follow-up care. We evaluated SEARCH's assessment of each participant's HTN status against measured blood pressure and HTN history.FindingsSEARCH completed blood pressure screens on 91% of participants. SEARCH HTN screening was 91% sensitive and over 99% specific for HTN relative to measured blood pressure and patient history. 92% of participants screened HTN+ received clinic appointments, and 42% of persons with HTN linked to subsequent care. At follow-up, 82% of SEARCH clinic participants received blood pressure checks; 75% received medication appropriate for their blood pressure; 66% remained in care; and 46% had normal blood pressure at their most recent visit.ConclusionThe SEARCH study's consistency in delivering screening and treatment services for HTN was generally high, but SEARCH could improve effectiveness in linking patients to care and achieving HTN control. Its model for implementing population-scale HTN testing and care through an existing HIV test-and-treat program-and protocol for evaluating the intervention's stepwise fidelity and care outcomes-may be adapted, strengthened, and scaled up for use across multiple resource-limited settings

A framework for bounding nonlocality of state discrimination

We consider the class of protocols that can be implemented by local quantum operations and classical communication (LOCC) between two parties. In particular, we focus on the task of discriminating a known set of quantum states by LOCC. Building on the work in the paper "Quantum nonlocality without entanglement" [BDF+99], we provide a framework for bounding the amount of nonlocality in a given set of bipartite quantum states in terms of a lower bound on the probability of error in any LOCC discrimination protocol. We apply our framework to an orthonormal product basis known as the domino states and obtain an alternative and simplified proof that quantifies its nonlocality. We generalize this result for similar bases in larger dimensions, as well as the "rotated" domino states, resolving a long-standing open question [BDF+99].Comment: 33 pages, 7 figures, 1 tabl

Enhancing access to the Bibliome: the TREC 2004 Genomics Track

BACKGROUND: The goal of the TREC Genomics Track is to improve information retrieval in the area of genomics by creating test collections that will allow researchers to improve and better understand failures of their systems. The 2004 track included an ad hoc retrieval task, simulating use of a search engine to obtain documents about biomedical topics. This paper describes the Genomics Track of the Text Retrieval Conference (TREC) 2004, a forum for evaluation of IR research systems, where retrieval in the genomics domain has recently begun to be assessed. RESULTS: A total of 27 research groups submitted 47 different runs. The most effective runs, as measured by the primary evaluation measure of mean average precision (MAP), used a combination of domain-specific and general techniques. The best MAP obtained by any run was 0.4075. Techniques that expanded queries with gene name lists as well as words from related articles had the best efficacy. However, many runs performed more poorly than a simple baseline run, indicating that careful selection of system features is essential. CONCLUSION: Various approaches to ad hoc retrieval provide a diversity of efficacy. The TREC Genomics Track and its test collection resources provide tools that allow improvement in information retrieval systems