Missed opportunities for family planning counselling among postpartum women in eleven counties in Kenya

Background: Mothers may access medical facilities for their babies and miss opportunities to access family planning (FP) services. This study was undertaken to describe missed opportunities for FP among women within the extended (0–11months) postpartum period from counties participating in Performance Monitoring and Accountability 2020 (PMA2020) surveys. Design and setting: This study analysed cross-sectional household survey data from 11 counties in Kenya between 2014 and 2018. PMA2020 uses questions extracted from the Demographic and Health survey (DHS) and DHS defnitions were used. Multivariable logistic regression was used for inferential statistics with p-value of \u3c0.05 considered to be signifcant. Participants: Women aged 15-49 years from the households visited. Primary outcome measure: Missed opportunity for family planning/contraceptives (FP/C) counselling. Results: Of the 34,832 women aged 15-49 years interviewed, 10.9% (3803) and 10.8% (3746) were in the period 0–11months and 12–23months postpartum respectively, of whom, 38.8 and 39.6% respectively had their previous pregnancy unintended. Overall, 50.4% of women 0-23months postpartum had missed opportunities for FP/C counselling. Among women who had contact with health care at the facility, 39.2% of women 0-11months and 44.7% of women 12-23months had missed opportunities for FP/C counselling. Less than half of the women 0-11months postpartum (46.5%) and 64.5% of women 12 – 23months postpartum were using highly efcacious methods. About 27 and 18% of the women 0-11months and 12 – 23months postpartum respectively had unmet need for FP/C. Multivariable analysis showed that being low parity and being from the low wealth quintile signifcantly increased the odds of missed opportunities for FP/C counselling among women in the extended postpartum period, p\u3c0.05. Conclusions: A large proportion of women have missed opportunities for FP/C counselling within 2 years postpartum. Programs should address these missed opportunities

Why Don't They Just Give Us Money? Project Cost Estimating and Cost Reporting

Successful projects require an integrated approach to managing cost, schedule, and risk. This is especially true for complex, multi-year projects involving multiple organizations. To explore solutions and leverage valuable lessons learned, NASA's Virtual Project Management Challenge will kick off a three-part series examining some of the challenges faced by project and program managers when it comes to managing these important elements. In this first session of the series, we will look at cost management, with an emphasis on the critical roles of cost estimating and cost reporting. By taking a proactive approach to both of these activities, project managers can better control life cycle costs, maintain stakeholder confidence, and protect other current and future projects in the organization's portfolio. Speakers will be Doug Comstock, Director of NASA's Cost Analysis Division, Kristin Van Wychen, Senior Analyst in the GAO Acquisition and Sourcing Management Team, and Mary Beth Zimmerman, Branch Chief for NASA's Portfolio Analysis Branch, Strategic Investments Division. Moderator Ramien Pierre is from NASA's Academy for Program/Project and Engineering Leadership (APPEL)

The Ursinus Weekly, December 11, 1950

Jeckely calls for resistance to communism • Sheeder talks at Trinity • Juniors choose 1952 Ruby heads • Chaplain to conduct communion • Y group discusses Atlantic Union plan • Red Cross unit plays host to area chapters • Snow Ball opens Fall social season • Students, faculty give blood to Red Cross • Three seniors admitted to dramatic honor frat • Former Ursinus coach dies in auto accident • Over 200 combine to present annual Messiah production • Only memories and souvenirs remain of seniors\u27 colorful formal dance • Warren W. Walters is the official engineer, the man-on-the-spot when trouble arises • French Club holds annual Xmas party • Nachrichten Deutschen Verein • Mack re-elected • Frosberg announces jobs open to grads • Commercialized Christmas forms basis of writer\u27s satire on holiday theme • Storm plays havoc on Ursinus campus • Library has tea • Bears win second 67-38 over Temple Pharmacy • Matmen work out for coming season • Grizzlies whip Crusaders 102-71 as records fall: Bears\u27 fiery attack breaks team mark after absorbing setback by Lycoming • Girls elect Keyser basketball captain • Hooper elected as 1951 hockey captain • Derago leads district scoring; Seibel fourth • Banquet, dance to top pre-holiday festivities • Chess team wins • Thirty couples enjoy reopening of Cafe Pigalle on Saturday • Y conducts Xmas vespers • German Club fetes • Duryea holds tea • Sophs pick committee to decorate at banquet • Lit reading to be held Tuesday • Glessner addresses guildhttps://digitalcommons.ursinus.edu/weekly/1555/thumbnail.jp

What Affects Influenza Vaccination Rates among Older Patients? An Analysis from Inner-city, Suburban, Rural, and Veterans Affairs Practices

BACKGROUND: Despite strong evidence of the effectiveness of influenza vaccination, immunization rates have reached a plateau that is below the 2010 national goals. Our objective was to identify facilitators of, and barriers to, vaccination in diverse groups of older patients. METHODS: A survey was conducted in 2000 by computer-assisted telephone interviewing of patients from inner-city health centers, Veterans Affairs (VA) outpatient clinics, rural practices, and suburban practices. The inclusion criteria were age ≥66 years and an office visit after September 30, 1998. RESULTS: Overall, 1007 (73%) interviews were completed among 1383 patients. Influenza vaccination rates were 91% at VA clinics, 79% at rural practices, 79% at suburban practices, and 67% at inner-city health centers. There was substantial variability in vaccination rates among practices, except at the VA. Nearly all persons who were vaccinated reported that their physicians recommended influenza vaccinations, compared with 63% of unvaccinated patients (P \u3c 0.001). Thirty-eight percent of unvaccinated patients were concerned that they would get influenza from the vaccine, compared with only 6% of vaccinated persons (P \u3c 0.001). Sixty-three percent of those vaccinated, in contrast with 22% of unvaccinated persons, thought that an unvaccinated person would probably contract influenza (P \u3c 0.001). CONCLUSION: Older patients need intentional messages from physicians that recommend vaccination. Furthermore, more patient education is needed to counter myths about adverse reactions

Prospectus, September 24, 1986

https://spark.parkland.edu/prospectus_1986/1022/thumbnail.jp

Calcification-driven CO2emissions exceed blue Carbon sequestration in a carbonate seagrass meadow

Long-term Blue Carbon burial in seagrass meadows is complicated by other carbon and alkalinity exchanges that shape net carbon sequestration. We measured a suite of such processes, including denitrification, sulfur, and inorganic carbon cycling, and assessed their impact on air-water CO2 exchange in a typical seagrass meadow underlain by carbonate sediments. Eddy covariance measurements reveal a consistent source of CO2 to the atmosphere at an average rate of 610 ± 990 μmol m-2 hour-1 during our study and 700 ± 660 μmol m-2 hour-1 (6.1 mol m-2 year-1) over an annual cycle. Net alkalinity consumption by ecosystem calcification explains \u3e95% of the observed CO2 emissions, far exceeding organic carbon burial and anaerobic alkalinity generation. We argue that the net carbon sequestration potential of seagrass meadows may be overestimated if calcification-induced CO2 emissions are not accounted for, especially in regions where calcification rates exceed net primary production and burial

Classification and Regression Tree (CART) analysis to predict influenza in primary care patients

Abstract Background The use of neuraminidase-inhibiting anti-viral medication to treat influenza is relatively infrequent. Rapid, cost-effective methods for diagnosing influenza are needed to enable appropriate prescribing. Multi-viral respiratory panels using reverse transcription polymerase chain reaction (PCR) assays to diagnose influenza are accurate but expensive and more time-consuming than low sensitivity rapid influenza tests. Influenza clinical decision algorithms are both rapid and inexpensive, but most are based on regression analyses that do not account for higher order interactions. This study used classification and regression trees (CART) modeling to estimate probabilities of influenza. Methods Eligible enrollees ≥ 5 years old (n = 4,173) who presented at ambulatory centers for treatment of acute respiratory illness (≤7 days) with cough or fever in 2011–2012, provided nasal and pharyngeal swabs for PCR testing for influenza, information on demographics, symptoms, personal characteristics and self-reported influenza vaccination status. Results Antiviral medication was prescribed for just 15 % of those with PCR-confirmed influenza. An algorithm that included fever, cough, and fatigue had sensitivity of 84 %, specificity of 48 %, positive predictive value (PPV) of 23 % and negative predictive value (NPV) of 94 % for the development sample. Conclusions The CART algorithm has good sensitivity and high NPV, but low PPV for identifying influenza among outpatients ≥5 years. Thus, it is good at identifying a group who do not need testing or antivirals and had fair to good predictive performance for influenza. Further testing of the algorithm in other influenza seasons would help to optimize decisions for lab testing or treatment.http://deepblue.lib.umich.edu/bitstream/2027.42/134640/1/12879_2016_Article_1839.pd

Vaccine effectiveness against COVID-19 among symptomatic persons aged ≥12 years with reported contact with COVID-19 cases, February-September 2021

BACKGROUND: Individuals in contact with persons with COVID-19 are at high risk of developing COVID-19; protection offered by COVID-19 vaccines in the context of known exposure is poorly understood. METHODS: Symptomatic outpatients aged ≥12 years reporting acute onset of COVID-19-like illness and tested for SARS-CoV-2 between February 1 and September 30, 2021 were enrolled. Participants were stratified by self-report of having known contact with a COVID-19 case in the 14 days prior to illness onset. Vaccine effectiveness was evaluated using the test-negative study design and multivariable logistic regression. RESULTS: Among 2229 participants, 283/451 (63%) of those reporting contact and 331/1778 (19%) without known contact tested SARS-CoV-2-positive. Adjusted vaccine effectiveness was 71% (95% confidence interval [CI], 49%-83%) among fully vaccinated participants reporting a known contact versus 80% (95% CI, 72%-86%) among those with no known contact (p-value for interaction = 0.2). CONCLUSIONS: This study contributes to growing evidence of the benefits of vaccinations in preventing COVID-19 and support vaccination recommendations and the importance of efforts to increase vaccination coverage