Why do women deliver where they had not planned to go? A qualitative study from peri-urban Nairobi Kenya.

BACKGROUND: In urban Kenya, couples face a wide variety of choices for delivery options; however, many women end up delivering in different facilities from those they had intended while pregnant. One potential consequence of this is delivering in facilities that do not meet minimum quality standards and lack the capacity to provide treatment for obstetric and neonatal complications. METHODS: This study investigated why women in peri-urban Nairobi, Kenya deliver in facilities they had not intended to use. We used 60 in-depth audio-recorded interviews in which mothers shared their experiences 2-6 months after delivery. Descriptive statistics were used to summarize socio-demographic characteristics of participants. Qualitative data were analyzed in three steps i) exploration and generation of initial codes; ii) searching for themes by gathering coded data that addressed specific themes; and iii) defining and naming identified themes. Verbatim excerpts from participants were provided to illustrate study findings. The Health Belief Model was used to shed light on individual-level drivers of delivery location choice. RESULTS: Findings show a confluence of factors that predispose mothers to delivering in unintended facilities. At the individual level, precipitate labor, financial limitations, onset of pain, complications, changes in birth plans, undisclosed birth plans, travel during pregnancy, fear of health facility providers, misconception of onset of labor, wrong estimate of delivery date, and onset of labor at night, contributed to delivery at unplanned locations. On the supply side, the sudden referral to other facilities, poor services, wrong projection of delivery date, and long distance to chosen delivery facility, were factors in changes in delivery location. Lack of transport discouraged delivery at a chosen health facility. Social influences included others\u27 perspectives on delivery location and lack of aides/escorts. CONCLUSIONS: Results from this study suggest that manifold factors contribute to the occurrence of women delivering in facilities that they had not intended during pregnancy. Future studies should consider whether these changes in delivery location late in pregnancy contribute to late facility arrival and the use of lower quality facilities. Deliberate counseling during antenatal care regarding birth plans is likely to encourage timely arrival at facilities consistent with women\u27s preferences

Design features and results from fatigue reliability research machines

Design and performance tests for reversed bending with steady torque fatigue test machine using notched steel specimen

Complex Susceptibility of Liquid Water as a Two-Potential System of Reorienting Polar Molecules

The theory elaborated in ref. 1 and 2 is applied to the calculation of the liquid water wide-band (0 < ν/cm^(-1) < 1000) dielectric spectra. These comprise the Debye relaxation region at the centimetre/millimetre wavelengths and the two-humped absorption coefficient frequency dependence in the far infrared (FIR) region. It is supposed that a major part of H2O molecules, called [L]-particles or [L]-molecules, are bonded by relatively strong H-bonds; [L]-molecules perform librations of relatively small amplitude β (β is about 20°). The remaining molecules called R-molecules have more rotational / translational mobility. A new microscopic molecular confined rotator / doble well potential (CR DWP) model of liquid water is developed. The contributions of [L]-and [R]-molecules to the complex permittivity ε are found on the basis of the confined rotator (CR) and the double well potential (DWP) models, with rectangular and cos^2(θ) intermolecular potential profiles, respectively. It is shown that the CR/DWP model gives a good description of the Debye relaxation and a qualitative description of FIR the dielectric spectra of water

Generalized Weyl algebras and diskew polynomial rings

The aim of the paper is to extend the class of generalized Weyl algebras (GWAs) to a larger class of rings (they are also called GWAs) that are determined by two ring endomorphisms rather than one as in the case of ‘old’ GWAs. A new class of rings, the diskew polynomial rings, is introduced that is closely related to GWAs (they are GWAs under a mild condition). Simplicity criteria are given for GWAs and diskew polynomial rings

Variable cavity volume tooling for high-performance resin infusion moulding

This article describes the research carried out by Warwick under the BAE Systems/EPSRC programme ‘Flapless Aerial Vehicles Integrated Interdisciplinary Research – FLAVIIR’. Warwick's aim in FLAVIIR was to develop low-cost innovative tooling technologies to enable the affordable manufacture of complex composite aerospace structures and to help realize the aim of the Grand Challenge of maintenance-free, low-cost unmanned aerial vehicle manufacture. This article focuses on the evaluation of a novel tooling process (variable cavity tooling) to enable the complete infusion of resin throughout non-crimp fabric within a mould cavity under low (0.1 MPa) injection pressure. The contribution of the primary processing parameters to the mechanical properties of a carbon composite component (bulk-head lug section), and the interactions between parameters, was determined. The initial mould gap (di) was identified as having the most significant effect on all measured mechanical properties, but complex interactions between di, n (number of fabric layers), and vc (mould closure rate) were observed. The process capability was low due to the manual processing, but was improved through process optimization, and delivered properties comparable to high-pressure resin transfer moulding

Extended γ‐ray emission in solar flares

During the solar flare events on 11 and 15 June 1991, COMPTEL measured extended emission in the neutron capture line for about 5 hours after the impulsive phase. The time profiles can be described by a double exponential decay with decay constants on the order of 10 min for the fast and 200 min for the slow component. Within the statistical uncertainty both flares show the same long‐term behaviour. The spectrum during the extended phase is significantly harder than during the impulsive phase and pions are not produced in significant numbers before the beginning of the extended emission. Our results with the measurements of others allow us to rule out long‐term trapping of particles in non‐turbulent loops to explain the extended emission of these two flares and our data favour models based on continued acceleration

COMPTEL Observations of the Gamma-Ray Blazar PKS 1622-297

We report results of observations and analyses on the gamma-ray blazar PKS 1622-297, with emphasis on the COMPTEL data (0.75 - 30 MeV) collected between April 1991 and November 1997. PKS 1622-297 was detected as a source of gamma-rays by the EGRET experiment aboard CGRO in 1995 during a gamma-ray outburst at energies above 100 MeV lasting for five weeks. In this time period the blazar was significantly (~ 5.9 sigma) detected by COMPTEL at 10-30 MeV. At lower COMPTEL energies the detection is marginal, resulting in a hard MeV spectrum. The combined COMPTEL/EGRET energy spectrum shows a break at MeV energies. The broad-band spectrum (radio - gamma-rays) shows that the gamma-ray emission dominates the overall power output. On top of the 5-week gamma-ray outburst, EGRET detected a huge flare lasting for > 1 day. Enhanced MeV emission (10 - 30 MeV) is found near the time of this flare, suggesting a possible time delay with respect to the emission above 100 MeV. Outside the 5-week flaring period in 1995, we do not detect MeV emission from PKS 1622-297.Comment: 10 pages including 9 figures, accepted for publication in A&

Prime ideals of the enveloping algebra of the Euclidean algebra and a classification of its simple weight modules

A classification of the simple weight modules is given for the (6-dimensional) Euclidean Lie algebra e(3) = sl2 nV3. As an intermediate step, a classification of all simple modules is given for the centralizer C of the Cartan element H (in the universal enveloping algebra U = U(e(3))). Generators and defining relations for the algebra C are found (there are three quadratic relations and one cubic relation). The algebra C is a Noetherian domain of Gelfand-Kirillov dimension 5. Classifications of prime, primitive, completely prime, and maximal ideals are given for the algebra U

COMPTEL 1.8 MeV all sky survey: The Cygnus region

We present an updated version of COMPTEL’s 1.809 MeV sky survey. Based on eight years of observations we compare results from different imaging techniques using background from adjacent energy bands. We confirm the previously reported characteristics of the galactic 1.809 MeV emission, specifically an extended galactic ridge emission, mainly concentrated towards the inner galaxy, a peculiar emission feature in the Cygnus region, and a low-intensity ridge extending towards Carina and Vela. Because this gamma ray line is due to the decay of radioactive 26Al, predominantly synthesized in massive stars, one anticipates flux enhancements aligned with regions of recent star formation. This is born out by the observations. In particular the Cygnus feature, first presented in 1996 based on three years of COMPTEL data, is confirmed. Based on the stellar population we distinguish three prominent areas in this region, for which we separately derive fluxes, and discuss interpretations