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

Numerical and experimental investigation of dry particle coating

Dry particle coating is an emerging field in the industries that deal with particulate products and powder processing. Compared to the widely reported experimental studies of the dry particle coating, the theoretical modeling of such processes is found to be less comprehensive. The work presented in this thesis is an attempt to fill this gap. The first part of the dissertation aims at the numerical investigation of the hybridization system (Nara Machinery, Tokyo, Japan). The flow behavior of different materials processed in this device is analyzed using three-dimensional Discrete Element Method (DEM) as well as the computational fluid dynamics (CFD) models. The particulate motion is directly simulated using the D EM c ode, which incorporates the effect of the fluid drag force, computed through the CFD models. The diagnostic investigation includes various aspects pertinent to the effectiveness of the hybridizer system in the coating process. Inter-particle collisions and particle-wall collisions as well as the normal and tangential forces between the particles are estimated which play an important role in the surface modification process of a powder. Experimentally measured velocities in the mixing chamber are in good agreement with the computed velocities. CFD results show that the flow field is not significantly affected as the volume fraction of particles is varied from 3 to 10 percent. Overall, it is found that the combined DEM-CFD model appears to be an adequate approximation of the behavior of the fluid-particle system in the hybridizer. The experimental part of this dissertation presents an investigation of different powder processing devices such as the Hybridizer, Mechanofusion and Magnetically Assisted Impaction Coating (MAIC) devices for a specific application of improving the humidity resistance of the ground magnesium powder through the dry particle coating technique. It is shown that coating by wax (1 percent by weight) is sufficient to increase the humidity resistance of ground magnesium to a level almost as good as the atomized magnesium powder. The last part of the dissertation deals with a related, yet different type of numerical study, carried out using the DEM approach, of the granular flows and mixing behavior in the oscillating sectorial containers. Mixing patterns are observed for a wide range of frequencies of oscillation as well as different operating conditions such as the powder loading, the coefficient of friction, and the coefficient of restitution. It is observed that the flow patterns follow a particular trend and there exists a critical frequency at which the mixing rate is very small

Cross Entropy-based Analysis of Spacecraft Control Systems

Space missions increasingly require sophisticated guidance, navigation and control algorithms, the development of which is reliant on verification and validation (V&V) techniques to ensure mission safety and success. A crucial element of V&V is the assessment of control system robust performance in the presence of uncertainty. In addition to estimating average performance under uncertainty, it is critical to determine the worst case performance. Industrial V&V approaches typically employ mu-analysis in the early control design stages, and Monte Carlo simulations on high-fidelity full engineering simulators at advanced stages of the design cycle. While highly capable, such techniques present a critical gap between pessimistic worst case estimates found using analytical methods, and the optimistic outlook often presented by Monte Carlo runs. Conservative worst case estimates are problematic because they can demand a controller redesign procedure, which is not justified if the poor performance is unlikely to occur. Gaining insight into the probability associated with the worst case performance is valuable in bridging this gap. It should be noted that due to the complexity of industrial-scale systems, V&V techniques are required to be capable of efficiently analysing non-linear models in the presence of significant uncertainty. As well, they must be computationally tractable. It is desirable that such techniques demand little engineering effort before each analysis, to be applied widely in industrial systems. Motivated by these factors, this thesis proposes and develops an efficient algorithm, based on the cross entropy simulation method. The proposed algorithm efficiently estimates the probabilities associated with various performance levels, from nominal performance up to degraded performance values, resulting in a curve of probabilities associated with various performance values. Such a curve is termed the probability profile of performance (PPoP), and is introduced as a tool that offers insight into a control system's performance, principally the probability associated with the worst case performance. The cross entropy-based robust performance analysis is implemented here on various industrial systems in European Space Agency-funded research projects. The implementation on autonomous rendezvous and docking models for the Mars Sample Return mission constitutes the core of the thesis. The proposed technique is implemented on high-fidelity models of the Vega launcher, as well as on a generic long coasting launcher upper stage. In summary, this thesis (a) develops an algorithm based on the cross entropy simulation method to estimate the probability associated with the worst case, (b) proposes the cross entropy-based PPoP tool to gain insight into system performance, (c) presents results of the robust performance analysis of three space industry systems using the proposed technique in conjunction with existing methods, and (d) proposes an integrated template for conducting robust performance analysis of linearised aerospace systems

Influence of Gender and Aerobic Training Background on Exercise-Induced Increase in Adiponectin

Adipose tissue secretes the adipokine, adiponectin (ADPN), which is insulinsensitizing, anti-inflammatory, and anti-atherogenic. Exercise training improves insulin sensitivity and lowers the risk of cardiovascular complications. As some of the metabolic effects of exercise training and ADPN overlap, exercise training has been proposed to increase ADPN. However, most single bout exercise, or short-term (ï‚£3 months) and constant-effort (fixed session duration, fixed number of sessions/week, and fixed intensity) exercise protocols do not produce increases in ADPN in untrained and trained cohorts. Furthermore, most exercise studies were conducted on male-female mixed gender cohorts or male/female single gender cohorts. As a result, no direct comparison of male and female subjects pertaining to the effect of exercise on ADPN levels has been reported. Our governing hypothesis is that long-term aerobic exercise increases ADPN, and the increase in ADPN is influenced by gender and exercise training background. We tested two specific hypotheses using different cohorts of human volunteers. Hypothesis 1 states that ADPN levels will increase significantly in previously untrained, middle-aged males and females in response to a long-term, progressive aerobic training protocol. Hypothesis 2 states that ADPN levels in multi-year trained female marathoners will increase significantly in response to a long-term, progressive aerobic training, but not in comparably trained males. We compared ADPN levels in trained marathoner males (n=10) and females (n=8) subjects and untrained males (n=9) and females (n=11) subjects in a 6-mo aerobic training intervention study. Fasting plasma samples were collected at the beginning and end of the 6-mo training period and analyzed. ADPN levels increased significantly in both trained and untrained females and untrained males, but non-significantly in trained males. Ours is the first study to compare changes in ADPN in mean age and BMI-matched male and female groups with two non-overlapping exercise training backgrounds in response to the same long-term, progressive aerobic training. The insight provided by the results of the two studies will help in understanding gender differences in ADPN

Religious Philosophy of Guru Nanak: Literary Speculation

India has been a land of diverse culture and traditions. When we say culture it includes many things like language, social customs, food habits, religion and so on. Of this religion seems to be the most influential factor in the life of an individual. It is something which lends meaning and purpose to our life. It is that which binds human beings to the Divine. And this bond can be established through the practise of Bhakti. The concept of Bhakti is an old one. It emphasises devotion to the personal God. Bhakti movement is an important development in the cultural history of India which originated in the south. The saints of Bhakti movement preached personal devotion to God as a means of attaining Salvation. They made use of local language to spread the ideology of Bhakti. Guru Nanak is one of the most influential saints of the Bhakti movement. In his teaching he incorporated ideas both from Hinduism as well as Islam. He revealed the truth of monotheism, importance of the recitation of God’s name with utmost devotion, need of a Guru for salvation. He tried to bridge the gap between the two communities of Islam and Hinduism and eradicate social problems by focusing on the truth of monotheism and the concept of equality

ACUTE AND SUB ACUTE SAFETY STUDIES OF HERBMED PLUS-A HERBAL FORMULATION IN LABORATORY ANIMALS

Objective: To study Acute, sub-acute oral toxicity profile of Herbmed plus (HP) - A herbal formulation.Methods: HP was derived from Crataeva nurvala Buch - Ham (Varun) bark, Musa paradisiaca Linn (Kadali/Banana) stem and roots, Achyranthes aspera Linn (Aghada) whole plant and Hordeum vulgare Linn (Yav) seeds. Above materials were converted into Varun bhavit kadali bhavit, kshars of Kadali, Aghada and Yav respectively and were mixed in certain proportions in GMP certified manufacturing facility to formulate HP capsules form remove soft gelatin. Acute and sub-acute safety profiles of HP was studied by OECD guidelines Number 423 and FDA guidelines in Swiss albino mice and Wistar rats respectively. For the acute study, HP was administered orally in a single dose of 2000mg/kg and for sub-acute study HP was administered orally using 90,180 and 450 mg/kg doses for 90 days. Results: In an acute study there were no behavioral changes and mortality at 2000 mg/kg by the oral route in mice up to 14 days. In sub-acute study after administration of various doses of HP for 90 days to various groups; there was no significant difference in body weight, food consumption, hematology / enzyme profiles, relative organ weights and histological observations of vital organs in comparison to control animals.Conclusion: The acute LD50 cut off for HP was found to be > 2000mg/kg in mice and No Observed Adverse Effect Level (NOAEL) for HP was found to be > 450 mg/kg by oral route for 90 days in Wistar rats. Â

Near-field imaging and frequency tuning of a high-Q photonic crystal membrane microcavity

We discuss experimental studies of the interaction between a nanoscopic object and a photonic crystal membrane resonator of quality factor Q=55000. By controlled actuation of a glass fiber tip in the near-field of a photonic crystal, we constructed a complete spatio-spectral map of the resonator mode and its coupling with the fiber-tip. On the one hand, our findings demonstrate that scanning probes can profoundly influence the optical characteristics and the near-field images of photonic devices. On the other hand, we show that the introduction of a nanoscopic object provides a low-loss method for on-command tuning of a photonic crystal resonator frequency. Our results are in a very good agreement with the predictions of a combined numerical/analytical theory.Comment: 9 pages, 4 figure