Fertility intentions and use of contraception among monogamous couples in northern Malawi in the context of HIV testing: a cross-sectional analysis.

CONTEXT: Knowledge of HIV status may influence fertility desires of married men and women. There is little knowledge about the importance of this influence among monogamously married couples and how knowledge of HIV status influences use of contraception among these couples. METHODOLOGY: We carried out a cross-sectional analysis of interview data collected between October 2008 and September 2009 on men aged 15-59 years and women aged 15-49 years who formed 1766 monogamously married couples within the Karonga Prevention Study demographic surveillance study in northern Malawi. RESULTS: 5% of men and 4% of women knew that they were HIV positive at the time of interview and 81% of men and 89% of women knew that they were HIV negative. 73% of men and 83% of women who knew that they were HIV positive stated that they did not want more children, compared to 35% of men and 38% of women who knew they were HIV negative. Concordant HIV positive couples were more likely than concordant negative couples to desire to stop child bearing (odds ratio 11.5, 95%CI 4.3-30.7, after adjusting for other factors) but only slightly more likely to use contraceptives (adjusted odds ratio 1.5 (95%CI 0.8-3.3). CONCLUSION: Knowledge of HIV positive status is associated with an increase in the reported desire to cease childbearing but there was limited evidence that this desire led to higher use of contraception. More efforts directed towards assisting HIV positive couples to access and use reproductive health services and limit HIV transmission among couples are recommended

The Second Conference on Lunar Bases and Space Activities of the 21st Century, volume 1

These papers comprise a peer-review selection of presentations by authors from NASA, LPI industry, and academia at the Second Conference (April 1988) on Lunar Bases and Space Activities of the 21st Century, sponsored by the NASA Office of Exploration and the Lunar Planetary Institute. These papers go into more technical depth than did those published from the first NASA-sponsored symposium on the topic, held in 1984. Session topics covered by this volume include (1) design and operation of transportation systems to, in orbit around, and on the Moon, (2) lunar base site selection, (3) design, architecture, construction, and operation of lunar bases and human habitats, and (4) lunar-based scientific research and experimentation in astronomy, exobiology, and lunar geology

The Second Conference on Lunar Bases and Space Activities of the 21st Century, volume 2

These 92 papers comprise a peer-reviewed selection of presentations by authors from NASA, the Lunar and Planetary Institute (LPI), industry, and academia at the Second Conference on Lunar Bases and Space Activities of the 21st Century. These papers go into more technical depth than did those published from the first NASA-sponsored symposium on the topic, held in 1984. Session topics included the following: (1) design and operation of transportation systems to, in orbit around, and on the Moon; (2) lunar base site selection; (3) design, architecture, construction, and operation of lunar bases and human habitats; (4) lunar-based scientific research and experimentation in astronomy, exobiology, and lunar geology; (5) recovery and use of lunar resources; (6) environmental and human factors of and life support technology for human presence on the Moon; and (7) program management of human exploration of the Moon and space

Voting at Home Is Associated with Lower Cortisol than Voting at the Polls

Previous research finds that voting is a socially stressful activity associated with increases in cortisol levels. Here we extend this research by investigating whether different voting modalities have differential effects on the stress response to voting. Results from a field experiment conducted during the 2012 presidential elections strongly suggest that traditional “at the polls” voting is more stressful, as measured by increases in cortisol levels, than voting at home by mail-in ballot or engaging in comparable non-political social activities. These findings imply that increased low-stress voting options such as mail-in ballots may increase political participation among individuals who are sensitive to social stressors

An Assessment of Childbearing Preferences in Northern Malawi.

Fertility preferences are an essential component of family planning program evaluation; however, doubts about their validity in sub-Saharan Africa exist and little methodological assessment has been carried out. This study investigates prospective fertility intentions in terms of their temporal stability, intensity, degree of spousal agreement, and association with future childbearing in northern Malawi. A total of 5,222 married women participated in the three-round study. The odds of having a child or becoming pregnant within 36 months were 4.2 times higher when both wife and husband wanted a child within three years and 2 times higher when both wanted to wait at least three years, compared with the odds when both wanted to cease childbearing. The influence of husbands' and wives' preferences on subsequent fertility was equal. Compared with the intention to stop, the intention to postpone childbearing was less stable, recorded less spousal agreement, and was much less strongly predictive of fertility

Molecule Microscopy

Contains research objectives and reports on four research projects.National Institutes of Health (Grant AM-25535)Whitaker FoundationFrancis L. Friedman Chai

Analysis of 24 years of mesopause region OH rotational temperature observations at Davis, Antarctica – Part 2: Evidence of a quasi-quadrennial oscillation (QQO) in the polar mesosphere

Observational evidence of a quasi-quadrennial oscillation (QQO) in the polar mesosphere is presented based on the analysis of 24 years of hydroxyl (OH) nightglow rotational temperatures derived from scanning spectrometer observations above Davis research station, Antarctica (68◦ S, 78◦ E). After removal of the long-term trend and solar cycle response, the residual winter mean temperature variability contains an oscillation over an approximately 3.5–4.5-year cycle with a peak-to-peak amplitude of 3–4 K. Here we investigate this QQO feature in the context of the global temperature, pressure, wind, and surface fields using satellite, meteorological reanalysis, sea surface temperature, and sea ice concentration data sets in order to understand possible drivers of the signal. Specifically, correlation and composite analyses are made with data sets from the Microwave Limb Sounder on the Aura satellite (Aura/MLS v4.2) and the Sounding of the Atmosphere using Broadband Emission Radiometry instrument on the Thermosphere Ionosphere Mesosphere Energetics Dynamics satellite (TIMED/SABER v2.0), ERA5 reanalysis, the Extended Reconstructed Sea Surface Temperature (ERSST v5), and Optimum-Interpolation (OI v2) sea ice concentration. We find a significant anti-correlation between the QQO temperature and the meridional wind at 86 km altitude measured by a medium-frequency spaced antenna radar at Davis (R 2 ∼ 0.516; poleward flow associated with warmer temperatures at ∼ 0.83±0.21 K (ms−1)−1). The QQO signal is also marginally correlated with vertical transport as determined from an evaluation of carbon monoxide (CO) concentrations in the mesosphere (sensitivity 0.73 ± 0.45 K ppmv−1 CO,R 2 ∼ 0.18). Together this relationship suggests that the QQO is plausibly linked to adiabatic heating and cooling driven by the meridional flow. The presence of quasi-stationary or persistent patterns in the ERA5 data geopotential anomaly and the meridional wind anomaly data during warm and cold phases of the QQO is consistent with tidal or planetary waves influencing its formation, which may act on the filtering of gravity waves to drive an adiabatic response in the mesosphere. The QQO signal plausibly arises from an ocean–atmosphere response, and appears to have a signature in Antarctic sea ice extent

Utilization of care among drug resistant epilepsy patients with symptoms of anxiety and depression

AbstractPurposeEpilepsy patients have a significantly higher rate of anxiety and depression than the general population, and psychiatric disease is particularly prevalent among drug resistant epilepsy patients. Symptoms of anxiety and depression might serve as a barrier to appropriate epilepsy care.The aim of this study was to determine if drug resistant epilepsy patients with symptoms of anxiety and/or depression receive different epilepsy management than controls.MethodWe identified 83 patients with drug resistant focal epilepsy seen at the Penn Epilepsy Center. Upon enrollment, all patients completed 3 self-report scales and a neuropsychiatric inventory and were grouped into those with symptoms of anxiety and/or depression and controls. Each patient's medical records were retrospectively reviewed for 1–2 years, and objective measures of outpatient and inpatient epilepsy management were assessed.ResultsAt baseline, 53% (n=43) of patients screened positive for symptoms of anxiety and/or depression. The remaining 47% (n=38) served as controls. Patients with anxiety and/or depression symptoms had more missed outpatient visits per year compared to controls (median 0.84 vs. 0.48, p=0.02). Patients with symptoms of both anxiety and depression were more likely to undergo an inpatient admission or procedure (56% vs. 24%, p=0.02).ConclusionFor most measures of epilepsy management, symptoms of anxiety and/or depression do not alter epilepsy care; however, drug resistant epilepsy patients with anxiety and/or depression symptoms may be more likely to miss outpatient appointments, and those with the highest burden of psychiatric symptoms may be admitted more frequently for inpatient services compared to controls