Analysis of Intrauterine Device Implementation and Review of Prevention Strategies to Reduce Adolescent Pregnancy in Nicaragua

Adolescent pregnancy is one of the main healthcare issues facing Nicaragua. Prevention strategies are needed to avoid the maternal and fetal outcomes associated with young pregnancies. Extensive literature analysis and face-to-face discussions in Nicaragua were conducted to determine the current incidence of adolescent pregnancy and contraception use, barriers to reproductive health for adolescents, maternal outcomes of adolescent pregnancy, and if intrauterine devices have the potential to be a culturally effective method of contraception. Specific barriers to reproductive health for adolescents were identified to be machismo, societal criticism, lack of reproductive education, fear of infection from IUDs, and underutilization of healthcare facilities. Intrauterine devices are more effective and have a lower discontinuation rate compared to other contraceptives. Intrauterine devices also provide an option for a less extensive treatment regimen following implantation compared to daily or monthly dosing with other contraceptives. However, current attitudes regarding IUDs for contraception remain skeptical, which explains why they are the least favored contraceptive method in Nicaragua. Solely educating clinicians and patients about the effectiveness of IUDs does not increase their use nor change patient and provider attitudes. Instead, a multifactorial approach to IUD implementation has shown increased uptake of IUDs as contraception and has given hope for adolescent pregnancy prevention

A Case Study Comparing the Life Skills Development and Knowledge in Youth Participants of Horseless and Traditional Horse Programs in Utah

Traditional horse 4-H programs develop life skills and knowledge in youth. Horseless horse programs lack evaluation for the same benefits. This study evaluated and compared four horseless and seven traditional horse participants from Washington County 4-H in Utah for gains in horse knowledge and development of 10 life skills that are commonly found in 4-H curriculum today: leadership, teamwork, self-responsibility, personal safety, problem solving, decision making, critical thinking, goal setting, communication, and concern for others. The researcher conducted interviews to learn about life skill experiences of the horse program participants and discover what barriers prevented horseless youth from participating in traditional 4-H horse clubs. Participants also took a short knowledge quiz and a demographic survey. Money was identified as the most common reason horseless participants don’t have access to a horse and cannot participate in the traditional 4-H horse program. When compared, traditional horse youth showed greater life skill development and knowledge gain than horseless participants. Recommendations for future research into horseless programming included using other forms of research to evaluate the program further and identifying life skills for a statewide horseless curriculum

Evaluating the Use of Monetary Incentive in Text-Delivered Sexually Transmitted Infection Education

Background: The Centers for Disease Control and Prevention (CDC) reported increases in chlamydia, gonorrhea, and syphilis from 2016 to 2017 despite numerous testing and education programs. In addition, young adults are at an increased risk of STIs.Aim: To describe the effectiveness of monetary incentives provided to college females for engaging with automated mobile messaging delivered education over the course of six weeks concerning sexually transmitted infections (STIs).Methods: A longitudinal cohort study was conducted at a large Southeastern, public university in the United States. One hundred and fifty-six female college students (18-24 years in age) participated in a mobile messaging and marketing automation platform delivered once a week for six weeks. Engagement with weekly education was measured by clicks on educational content.Results: Out of the six messages, χ2 analysis revealed that paid participants were more likely to engage with the STI education in weeks two, four, five, and six. In this study, simple linear regression ANOVA confirmed that compensation was the main extrinsic motivator for engagement rather than other factors, such as the delivery method.Conclusions: Monetary incentive can increase engagement with STI education in college females while mobile messaging also has the potential

Changes in Midwestern Fly Ash II. Air Classification, Magnetic Separation and the Pozzolanic Characteristics of the Ash

Changes in Midwestern Fly Ash II. Air Classification, Magnetic Separation and the Pozzolanic Characteristics of the Ash Authors Ms. Anne Oberlink - United States - University of Kentucky Center for Applied Energy Research Ms. Sydney Dendekker - United States - University of Kentucky Center for Applied Energy Research Ms. Haley Johnson - United States - University of Kentucky Center for Applied Energy Research Dr. Thomas Robl - United States - University of Kentucky Center for Applied Energy Research Dr. Bob Jewell - United States - University of Kentucky Center for Applied Energy Research Abstract Six current production fly ashes from Kentucky power plants were processed into coarse and fine-size fractions with an air classifier. This process separates material by size and density. The strong contrast with the silicate fraction of the fly ash in density to that of the magnetite (~5.2 to ~2.4 g/cm3) makes this separation less challenging than that of carbon. The classification of these fly ashes resulted in finer-sized ash yields ranging from +90% to ~50%. As expected, the coarse ash had high concentrations of magnetite (up to ~55% by weight). The fine fraction had increased SiO2 and Al2O3 content and reduced Fe2O3. This is reflective of greater fused glass content. The fine fraction was also substantially improved in fineness as defined by retention on a 325-mesh screen. It did have an increased LOI over the parent material. However, with one exception, this increase was within the requirement of ASTM C-618 of 5%. Preliminary results found that the fine fraction of the fly ash had improved the pozzolanic activity, as measured by the EN-196 strength index test and resistivity measurements over the parent ash. The coarse fraction of the ash did not pass the strength index test and showed little improvement in resistivity. The beneficiation potential for these fly ashes and new uses for coarse and fine materials will be discussed

The Effect Of Diversity Mandates: The Case Of Mississippi Institutions Of Higher Learning

After more than 40 years since the University of Mississippi integrated its student body and the passage of civil rights and affirmative action legislation throughout the United States, universities are confronting the issue of developing not only a diverse student body, but also a diverse faculty, staff, and administration.  In the intervening years, much research has been conducted in the area of diversity within universities.  Past research focused on the attitudes towards diversity, necessity and benefits of diversity, and student initiatives to address these issues.  However, the vast majority of diversity research centers on human resources issues.  In 2006, Commissioner Tom Meredith of the Mississippi Institutions of Higher Learning (IHL) charged the Mississippi higher education institutions with increasing the diversity of faculty, staff, and students.  The purpose of this study is to investigate the diversity among these institutions and to determine the effect of the mandate by the IHL on the diversity of employees and students at these universities.  Data analysis includes a report of the current diversity status and analysis of change based on the mandate.  This study concludes with a discussion of the results, implications of these results, and directions for future research

Preparing for a Changing Climate: The State of Adaptation Planning in Maine’s Coastal Communities

Climate change is having a range of impacts on Maine’s coastal communities, impacts that will be further exacerbated by increased coastal flooding, storm events, and a warming Gulf of Maine. To better understand the status of adaptation planning by Maine coastal communities, we conducted a survey and in-depth interviews with decision makers from coastal communities. We found that communities are addressing the effects of climate change and have moved towards specific implementation strategies. Adaptation planning to date includes incorporation of climate change impacts in comprehensive planning and addressing impacts on roads, culverts, and waterfront infrastructure. Respondents indicated the need for more specific data on the direct impacts of climate change in their communities over the next two years. They identified a preference for spatial data and interactive websites, followed by support from technical experts. Although the majority of respondents had an understanding of the physical vulnerabilities their communities face, they identified a need for increased resources to assess social vulnerability impacts. Additionally, communities face challenges in identifying appropriate funding sources that match identified needs. Adaptation planning processes are often stymied by the lack of dedicated funding that enables coastal communities to be proactive in addressing the physical and social impacts of climate change

Publication trends among emergency medicine residents, fellows, and graduates and its relationship to future academic achievement

Purpose: Scholastic activity through research involvement is a fundamental aspect of a physician's training, and may have a significant influence on residency and fellowship match success. Despite this fact, little is known regarding the pursuit of academia and/or fellowships in emergency medicine graduates. In this review, we will (1) describe factors involved in academic research including peer-reviewed publications among emergency medicine residency graduates and (2) determine if a relationship exists between publication rates before, during, and after emergency medicine residency.Methods: Using a cross-sectional study design, we analyzed the research output of emergency medicine graduates and its relationship to future academic involvement from a random sample of 50 emergency medicine programs' graduates. Data were extracted for each graduate and analyzed using STATA 15.1 and Microsoft Excel. A public protocol is available here: https://osf.io/pwa6d/.Results: Using Doximity, we identified 238 emergency medicine residency programs of which we sampled 50. Of the 50 included programs, 6 programs were included, amounting in 154 graduates available for analysis. Of the 154 analyzed graduates, 97 (63.0%) were male, 91 (59.1%) were osteopathic graduates, and 91 (59.1%) had zero publications. Additionally, we found that 26/154 (16.9%) pursued academia and 16/164 (10.4%) pursued a fellowship, with 4/16 (25%) in medical toxicology and 4/16 (25%) in emergency medical services. The mean number of publications for each graduate was 0.87. Of the graduates with research, more research was published on average after graduation from residency (0.42) compared to before residency (0.17) and during residency (0.34).Conclusion: While a majority of psychiatry graduate's publications were post-residency, many publications occurred during residency, with the lowest number of publications occurring pre-residency

Condom Versus Indwelling Urinary Catheters: A Randomized Trial

To compare condom and indwelling urinary catheters in terms of infection risk and patient satisfaction. DESIGN : A prospective, randomized, unblinded, controlled trial. SETTING : An academically affiliated Veterans Affairs Medical Center. PARTICIPANTS : Hospitalized men aged 40 and older who required a urinary collection device. MEASUREMENTS : The incidence of adverse outcomes (bacteriuria, symptomatic urinary tract infection (UTI), or death) and patient device-related satisfaction as determined according to a questionnaire. Dementia status was recorded to assess effect modification by the presence of dementia. RESULTS : Seventy-five subjects were randomized: 41 receiving an indwelling catheter and 34 a condom catheter. The incidence of an adverse outcome was 131/1,000 patient-days with an indwelling catheter and 70/1,000 patient-days with a condom catheter ( P =.07). The median time to an adverse event was 7 days in the indwelling group and 11 days in the condom group. After adjusting for other risk factors, it was found that condom catheter use reduced adverse outcomes ( P =.04). Patients without dementia who had an indwelling catheter were approximately five times as likely to develop bacteriuria or symptomatic UTI or to die (hazard ratio=4.84, 95% confidence interval=1.46–16.02) as those with a condom catheter ( P =.01). Patients reported that condom catheters were more comfortable ( P =.02) and less painful ( P =.02) than indwelling catheters. CONCLUSION : The use of condom catheters is less likely to lead to bacteriuria, symptomatic UTI, or death than the use of indwelling catheters. This protection is especially apparent in men without dementia.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/66301/1/j.1532-5415.2006.00785.x.pd

Project ACCCES: A Collaboration to develop Capacity for Community-Engaged research in Springfield

Background: Residents of Springfield, Massachusetts experience disproportionately poorer health compared to the rest of the state. Springfield\u27s community of color population (39.5% Hispanic/Latino; 21.6% Black; 2% Asian) experiences high rates of poverty, unemployment, and low educational attainment leading to large health disparities. Objective: The overall objective of the PCORI-funded Project ACCCES is to develop capacity to conduct community engaged research (CEnR) in Springfield that is based on patient and community needs, can be more easily translated, and improves community health. This engagement framework will be applied to development of patient-centered comparative effectiveness research proposals. Methods: In the project\u27s first phase, we conducted focus groups with patients, community organization leaders, and physicians to better understand the most pressing health needs of the community, past research experiences, and important considerations for building community-academic partnerships. We then convened a multi-stakeholder Advisory Board to inform all Project ACCCES activities. In the second phase, we developed and implemented two half-day workshops to give participants the knowledge and tools to conduct CEnR and to begin to build community-academic partnerships in the areas of perinatal/maternal-child health, mental health/substance use, chronic disease/nutrition, and respiratory health. The third phase is currently underway and is focused on convening research partnership action groups that will seek to address Springfield residents\u27 health needs through culturally appropriate interventions. The final phases will entail dissemination of both the process used to develop new collaborations to conduct CEnR in an underserved community and the workshop template, and development of structures to foster sustainability of partnerships