Integration of Family Planning Services within Post Abortion Care at Health Facilities in Dessie –North East Ethiopia

The aim of this study is to investigate the integration of family planning services within post abortion care that plays a vital role in reducing maternal morbidity and mortality resulting from abortion and its  complications. Facility based cross - sectional study design was used including both quantitative and qualitative data collection method. The sample size was 291. The number of study units to be sampled from each facility was determined using proportional allocation to size and systematic random sampling was employed to select and approach each study  subjects. A validated semi structured questionnaire was used to collect thedata. Bi-variate analysis and multivariate logistic regression analysis was carried out to identify the most important predictors of integrating family planning services within post abortion care. A total of 282 post abortion women were included in the exit interview. Among these 158 (56.0%) reported that they have got family planning (FP) counselling and 134 (47.5%) left the health facility with modern contraceptive method. Lack of trained provider, being over loaded by other routine activities, absence of separate post abortion room, lack of commodities and supplies were major identified barriers of integrating family planning services within post  abortion care. Family planning services were partially integrated within post abortion care. Attention should be given in service providers training,  availing post abortion family planning supplies and equipments in the post abortion recovery room

Changes in hospitals' credentialing requirements for board certification from 2005 to 2010

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/98213/1/jhm2033.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/98213/2/jhm23033-sup-0001-suppinfo.pd

Microscopically-based energy density functionals for nuclei using the density matrix expansion: Implementation and pre-optimization

In a recent series of papers, Gebremariam, Bogner, and Duguet derived a microscopically based nuclear energy density functional by applying the Density Matrix Expansion (DME) to the Hartree-Fock energy obtained from chiral effective field theory (EFT) two- and three-nucleon interactions. Due to the structure of the chiral interactions, each coupling in the DME functional is given as the sum of a coupling constant arising from zero-range contact interactions and a coupling function of the density arising from the finite-range pion exchanges. Since the contact contributions have essentially the same structure as those entering empirical Skyrme functionals, a microscopically guided Skyrme phenomenology has been suggested in which the contact terms in the DME functional are released for optimization to finite-density observables to capture short-range correlation energy contributions from beyond Hartree-Fock. The present paper is the first attempt to assess the ability of the newly suggested DME functional, which has a much richer set of density dependencies than traditional Skyrme functionals, to generate sensible and stable results for nuclear applications. The results of the first proof-of-principle calculations are given, and numerous practical issues related to the implementation of the new functional in existing Skyrme codes are discussed. Using a restricted singular value decomposition (SVD) optimization procedure, it is found that the new DME functional gives numerically stable results and exhibits a small but systematic reduction of our test $\chi^2$ function compared to standard Skyrme functionals, thus justifying its suitability for future global optimizations and large-scale calculations.Comment: 17 pages, 6 figure

Public Interest in Medical Research Participation: Does It Matter if Patients or Community Members Have Helped Design the Study?

PurposeWe determined national levels of public participation in medical research study design. We compared public interest in medical research participation (MRP) in studies overall, versus studies explicitly designed with public involvement.MethodCross‐sectional household survey of US population in June 2013. Descriptive statistics estimated participation in medical research study design. Chi‐square test compared levels of interest in MRP if respondent knew patients or community members helped design the study.ResultsOf 2,048 respondents (participation rate 60%), 5% knew someone who had helped design a medical research study. There was no association between having known someone or personal participation in study design and willingness to engage in MRP. Although the overall proportion of respondents who would consider MRP initially (51%) was similar to the proportion who would consider MRP with community member involvement in study design (49%), the changes in respondents' views across the different scenarios were significantly greater than what would have been expected by chance.ConclusionsWe found similar levels of interest in MRP whether or not the public is involved in medical research study design. This finding may indicate that public involvement in study design, like community‐based participatory research, may not affect overall rates of MRP.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/115983/1/cts12278.pd

Effect of Soil and Water Conservation on Rehabilitation of Degraded Lands and Crop Productivity in Maego Watershed, North Ethiopia

Many soil and water conservation (SWC) measures were undertaken to decrease land degradation in Ethiopia. However, evaluation of their performance is essential to understand their success or failure and readjusting accordingly in the future planning. Therefore, the objective of this study was to evaluate effectiveness of SWC measures in rehabilitation of degraded watershed and increase crop productivity in Maego watershed, Ethiopia. Seventy six sample plots were randomly taken from treated and untreated sub-watersheds for woody species and soil sampling. Crops yield was measured on top side, middle zone and below side of SWC structures. There were significantly higher woody species density and diversity, total nitrogen (TN), soil organic matter (SOM) and soil moisture in the treated uncultivated land than the untreated one. The highest tree and sapling species density and diversity, TN and SOM were recorded on the exclosure part of the treated sub-watershed. Landscape position affected soil fertility, but has no effect on woody species density and diversity. The highest barley and wheat yield was measured on top side of SWC structures. Therefore, physical SWC structures should be integrated with exclosure to enhance rehabilitation of degraded watersheds/landscapes. Integration of biological SWC measures that improve soil fertility are essential on the cultivated land of the watershed. Most of the existing SWC structures, especially the old ones are filled with accumulated sediment, so maintenance is needed

Isovector part of nuclear energy density functional from chiral two- and three-nucleon forces

A recent calculation of the nuclear energy density functional from chiral two- and three-nucleon forces is extended to the isovector terms pertaining to different proton and neutron densities. An improved density-matrix expansion is adapted to the situation of small isospin-asymmetries and used to calculate in the Hartree-Fock approximation the density-dependent strength functions associated with the isovector terms. The two-body interaction comprises of long-range multi-pion exchange contributions and a set of contact terms contributing up to fourth power in momenta. In addition, the leading order chiral three-nucleon interaction is employed with its parameters fixed in computations of nuclear few-body systems. With this input one finds for the asymmetry energy of nuclear matter the value $A(\rho_0) \simeq 26.5\,$MeV, compatible with existing semi-empirical determinations. The strength functions of the isovector surface and spin-orbit coupling terms come out much smaller than those of the analogous isoscalar coupling terms and in the relevant density range one finds agreement with phenomenological Skyrme forces. The specific isospin- and density-dependences arising from the chiral two- and three-nucleon interactions can be explored and tested in neutron-rich systems.Comment: 14 pages, 7 figures, to be published in European Physical Journal

Knowledge of hepatitis C screening and management by internal medicine residents: trends over 2 years

Over 2 million people in the United States are infected with hepatitis C, and there has been an explosion in knowledge regarding this disease in the last decade. Internal medicine residents must be able to identify patients at risk for hepatitis C and institute appropriate diagnostic testing and referral of these patients. Methods : A survey regarding hepatitis C risk factors and the management of hepatitis C patients was administered on three occasions over 15 months (time 0, 1 month, and 15 months) to members of a large university-based internal medicine residency. Results : During the study period 59 residents completed all three surveys. Less than half of the residents (39%) ask patients about hepatitis C risk factors. Only 58% reported that they would refer a hepatitis C antibody positive patient with elevated liver enzymes to a subspecialist on the initial survey. The residents who did not refer patients cited low response rates, high side-effect profiles, and the high cost of therapy as reasons for not referring the patient. There was significant improvement (58% vs 78%, p < 0.01 ) in the rate of patient referral during the 15-month study period but no substantial improvement in the other knowledge deficits. Conclusions : The knowledge base of the internal medicine residents about hepatitis C screening and management is suboptimal. New, more effective hepatitis C education programs for internal medicine residents should be initiated.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/75407/1/j.1572-0241.2002.05708.x.pd

Low-Temperature Orientation Dependence of Step Stiffness on {111} Surfaces

For hexagonal nets, descriptive of {111} fcc surfaces, we derive from combinatoric arguments a simple, low-temperature formula for the orientation dependence of the surface step line tension and stiffness, as well as the leading correction, based on the Ising model with nearest-neighbor (NN) interactions. Our formula agrees well with experimental data for both Ag and Cu{111} surfaces, indicating that NN-interactions alone can account for the data in these cases (in contrast to results for Cu{001}). Experimentally significant corollaries of the low-temperature derivation show that the step line tension cannot be extracted from the stiffness and that with plausible assumptions the low-temperature stiffness should have 6-fold symmetry, in contrast to the 3-fold symmetry of the crystal shape. We examine Zia's exact implicit solution in detail, using numerical methods for general orientations and deriving many analytic results including explicit solutions in the two high-symmetry directions. From these exact results we rederive our simple result and explore subtle behavior near close-packed directions. To account for the 3-fold symmetry in a lattice gas model, we invoke a novel orientation-dependent trio interaction and examine its consequences.Comment: 11 pages, 8 figure

Incremental Hospital Charges Associated With Obesity as a Secondary Diagnosis in Children

Objective: The objective was to evaluate the association of obesity as a comorbidity with hospital charges, by comparing charges for pediatric hospitalizations with vs. without obesity as a secondary diagnosis. Methods: Using the 2000 Healthcare Cost and Utilization Project (HCUP) Kids’ Inpatient Database (KID), a nationally representative sample of pediatric hospital discharges, we identified the most common non‐pregnancy‐related principal diagnoses for children 2 to 18 years of age: asthma, pneumonia, affective disorders, and appendicitis. For each we compared mean charges and mean length of stay for hospitalizations with vs. without obesity as a secondary diagnosis, adjusting for relevant socio‐demographics and hospital type. Results: Among children's discharges in 2000, 1.1% listed obesity as a secondary diagnosis. These had a disproportionate likelihood of being older, black, Medicaid beneficiaries, and hospitalized at a general hospital. Adjusted mean hospital charges were significantly higher for discharges with obesity as a secondary diagnosis vs. those without: appendicitis ($14,134 vs.$11,049; p < 0.01), asthma ($7766 vs.$6043; p < 0.05), pneumonia ($12,228 vs.$9688; p < 0.05), and affective disorders ($8292 vs.$7769; p < 0.01). Whereas obesity as a secondary diagnosis was associated with a pattern of increased adjusted mean length of stay, only asthma and affective disorders had statistically significant differences (0.6 days) ( p < 0.01). Conclusion: This national analysis suggests obesity as a secondary diagnosis is associated with significantly higher charges for the most common reasons for pediatric hospitalizations. This presents a financial imperative for further research to evaluate factors that contribute to higher inpatient charges related to obesity as a comorbidity and underscores the need for obesity prevention initiatives.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/93704/1/oby.2007.224.pd