The Prevalence and Knowledge of Emergency Contraceptive Pills (ECP’s) among women in Kibera, Nairobi

Background: Emergency contraception (EC) refers to the use of certain contraceptive methods by women and girls to prevent pregnancy after unprotected sexual intercourse. Many women who have a need for emergency contraception do not use it. Usually, women simply do not know that it exists or, if they know, they do not know where to get it or how or when to use it.Young and unmarried women constitute a high risk group for unsafe abortions. It has been estimated that widespread use of emergency contraception may significantly reduce the number of abortion-related morbidity and mortality. The Consortium for Emergency has set a goal of making emergency contraceptive pills a standard part of reproductive health care worldwide. Objectives: The main objective of this study was to evaluate the prevalence, knowledge, attitudes and practises towards the uptake of emergency contraceptive pills by women in Kibera slum,Nairobi, Kenya Design: A Cross-sectional survey was conducted in Kibera, Nairobi Method: Multi stage sampling was used to determine the study population and 384 women were interviewed using a structured questionnaire. SPSS version 16 and STATA version 11 were used for statistical analyses. Results: The results were that the mean age of the women was 26 years with a standard deviation of 7.4. Majority of the women were married (52%). More than half (58%) reported to use a method of contraception. The prevalence of emergency contraceptive pill was found to be (23%).The findings of this study show that knowledge of emergency contraceptive pills was high (74%) meaning many women have heard about it. The main source of information of Emergency Contraceptive Pills (ECPs) was from friends and family (34%). However when it came to its usage, (37%) of the women thought that it would cause health problems if they used it, while (25%) were not familiar with the emergency contraceptive pill itself, hence were afraid of using it. The main reason for the women not using emergency contraceptives was because of misinformation (62%) followed by a lack of awareness (38%). Conclusion: This study found the prevalence of ECP to be 23% and that knowledge on ECP was adequate with more than half the women reporting to have heard of ECP. However awareness does not lead to use of ECP’s and the method is underused. The major constraint to ECP use was misinformation, with many women fearing that ECP might cause health problems or interfere with their fertility. Religion was also a constraint to ECP with only Protestants reporting its use.&nbsp

LeMMINGs. VI. Connecting nuclear activity to bulge properties of active and inactive galaxies: radio scaling relations and galaxy environment

Multiwavelength studies indicate that nuclear activity and bulge properties are closely related, but the details remain unclear. To study this further, we combine $Hubble~Space~Telescope$ bulge structural and photometric properties with 1.5 GHz, $e$-MERLIN nuclear radio continuum data from the LeMMINGs survey for a large sample of 173 `active' galaxies (LINERs and Seyferts) and `inactive' galaxies (H IIs and absorption line galaxies, ALGs). Dividing our sample into active and inactive, they define distinct (radio core luminosity)$-$(bulge mass), L_R,core-M_*,bulge, relations, with a mass turnover at M_*, bulge ~ 10^(9.8 +- 0.3) M_sun (supermassive black hole mass M_BH ~ 10^(6.8 +- 0.3) M_sun), which marks the transition from AGN-dominated nuclear radio emission in more massive bulges to that mainly driven by stellar processes in low-mass bulges. None of our 10/173 bulgeless galaxies host an AGN. The AGN fraction increases with increasing M_*, bulge such that f_optical_AGN $\propto$ M_*,bulge^(0.24 +- 0.06) and f_radio_AGN $\propto$ M_*,bulge^(0.24 +- 0.05). Between M_*,bulge ~ 10^8.5 and 10^11.3 M_sun, f_optical_AGN steadily rises from 15 +- 4 to 80 +- 5 per cent. We find that at fixed bulge mass, the radio loudness, nuclear radio activity and the (optical and radio) AGN fraction exhibit no dependence on environment. Radio-loud hosts preferentially possess an early-type morphology than radio-quiet hosts, the two types are however indistinguishable in terms of bulge S\'ersic index and ellipticity, while results on the bulge inner logarithmic profile slope are inconclusive. We finally discuss the importance of bulge mass in determining the AGN triggering processes, including potential implications for the nuclear radio emission in nearby galaxies.Comment: 27 pages, 15 figures, 4 tables, accepted for publication in MNRA

LeMMINGs III. The e-MERLIN legacy survey of the Palomar sample: exploring the origin of nuclear radio emission in active and inactive galaxies through the [O iii] – radio connection

What determines the nuclear radio emission in local galaxies? To address this question, we combine optical [O III] line emission, robust black hole (BH) mass estimates, and high-resolution e-MERLIN 1.5-GHz data, from the LeMMINGs survey, of a statistically complete sample of 280 nearby optically active (LINER and Seyfert) and inactive [H II and absorption line galaxies (ALGs)] galaxies. Using [O III] luminosity (⁠L[OIII]⁠) as a proxy for the accretion power, local galaxies follow distinct sequences in the optical–radio planes of BH activity, which suggest different origins of the nuclear radio emission for the optical classes. The 1.5-GHz radio luminosity of their parsec-scale cores (Lcore) is found to scale with BH mass (MBH) and [O III] luminosity. Below MBH ∼ 106.5 M⊙, stellar processes from non-jetted H II galaxies dominate with Lcore∝M0.61±0.33BH and Lcore∝L0.79±0.30[OIII]⁠. Above MBH ∼ 106.5 M⊙, accretion-driven processes dominate with Lcore∝M1.5−1.65BH and Lcore∝L0.99−1.31[OIII] for active galaxies: radio-quiet/loud LINERs, Seyferts, and jetted H II galaxies always display (although low) signatures of radio-emitting BH activity, with L1.5GHz≳1019.8 W Hz−1 and MBH ≳ 107 M⊙, on a broad range of Eddington-scaled accretion rates (⁠m˙⁠). Radio-quiet and radio-loud LINERs are powered by low-m˙ discs launching sub-relativistic and relativistic jets, respectively. Low-power slow jets and disc/corona winds from moderately high to high-m˙ discs account for the compact and edge-brightened jets of Seyferts, respectively. Jetted H II galaxies may host weakly active BHs. Fuel-starved BHs and recurrent activity account for ALG properties. In conclusion, specific accretion–ejection states of active BHs determine the radio production and the optical classification of local active galaxies

Predicting and elucidating the etiology of fatty liver disease : A machine learning modeling and validation study in the IMI DIRECT cohorts

Background Non-alcoholic fatty liver disease (NAFLD) is highly prevalent and causes serious health complications in individuals with and without type 2 diabetes (T2D). Early diagnosis of NAFLD is important, as this can help prevent irreversible damage to the liver and, ultimately, hepatocellular carcinomas. We sought to expand etiological understanding and develop a diagnostic tool for NAFLD using machine learning. Methods and findings We utilized the baseline data from IMI DIRECT, a multicenter prospective cohort study of 3,029 European-ancestry adults recently diagnosed with T2D (n= 795) or at high risk of developing the disease (n= 2,234). Multi-omics (genetic, transcriptomic, proteomic, and metabolomic) and clinical (liver enzymes and other serological biomarkers, anthropometry, measures of beta-cell function, insulin sensitivity, and lifestyle) data comprised the key input variables. The models were trained on MRI-image-derived liver fat content (= 5%) available for 1,514 participants. We applied LASSO (least absolute shrinkage and selection operator) to select features from the different layers of omics data and random forest analysis to develop the models. The prediction models included clinical and omics variables separately or in combination. A model including all omics and clinical variables yielded a cross-validated receiver operating characteristic area under the curve (ROCAUC) of 0.84 (95% CI 0.82, 0.86;p = 5%) rather than a continuous one. Conclusions In this study, we developed several models with different combinations of clinical and omics data and identified biological features that appear to be associated with liver fat accumulation. In general, the clinical variables showed better prediction ability than the complex omics variables. However, the combination of omics and clinical variables yielded the highest accuracy. We have incorporated the developed clinical models into a web interface (see:) and made it available to the community.Peer reviewe

LeMMINGs III. The e-MERLIN legacy survey of the Palomar sample: exploring the origin of nuclear radio emission in active and inactive galaxies through the [O III] - radio connection

What determines the nuclear radio emission in local galaxies? To address this question, we combine optical [O III] line emission, robust black hole (BH) mass estimates, and high-resolution e-MERLIN 1.5-GHz data, from the LeMMINGs survey, of a statistically complete sample of 280 nearby optically active (LINER and Seyfert) and inactive [H II and absorption line galaxies (ALGs)] galaxies. Using [O III] luminosity (⁠L[OIII]⁠) as a proxy for the accretion power, local galaxies follow distinct sequences in the optical–radio planes of BH activity, which suggest different origins of the nuclear radio emission for the optical classes. The 1.5-GHz radio luminosity of their parsec-scale cores (Lcore) is found to scale with BH mass (MBH) and [O III] luminosity. Below MBH ∼ 106.5 M⊙, stellar processes from non-jetted H II galaxies dominate with Lcore∝M0.61±0.33BH and Lcore∝L0.79±0.30[OIII]⁠. Above MBH ∼ 106.5 M⊙, accretion-driven processes dominate with Lcore∝M1.5−1.65BH and Lcore∝L0.99−1.31[OIII] for active galaxies: radio-quiet/loud LINERs, Seyferts, and jetted H II galaxies always display (although low) signatures of radio-emitting BH activity, with L1.5GHz≳1019.8 W Hz−1 and MBH ≳ 107 M⊙, on a broad range of Eddington-scaled accretion rates (⁠m˙⁠). Radio-quiet and radio-loud LINERs are powered by low-m˙ discs launching sub-relativistic and relativistic jets, respectively. Low-power slow jets and disc/corona winds from moderately high to high-m˙ discs account for the compact and edge-brightened jets of Seyferts, respectively. Jetted H II galaxies may host weakly active BHs. Fuel-starved BHs and recurrent activity account for ALG properties. In conclusion, specific accretion–ejection states of active BHs determine the radio production and the optical classification of local active galaxies

Grand Challenges in global eye health: a global prioritisation process using Delphi method

Background We undertook a Grand Challenges in Global Eye Health prioritisation exercise to identify the key issues that must be addressed to improve eye health in the context of an ageing population, to eliminate persistent inequities in health-care access, and to mitigate widespread resource limitations. Methods Drawing on methods used in previous Grand Challenges studies, we used a multi-step recruitment strategy to assemble a diverse panel of individuals from a range of disciplines relevant to global eye health from all regions globally to participate in a three-round, online, Delphi-like, prioritisation process to nominate and rank challenges in global eye health. Through this process, we developed both global and regional priority lists. Findings Between Sept 1 and Dec 12, 2019, 470 individuals complete round 1 of the process, of whom 336 completed all three rounds (round 2 between Feb 26 and March 18, 2020, and round 3 between April 2 and April 25, 2020) 156 (46%) of 336 were women, 180 (54%) were men. The proportion of participants who worked in each region ranged from 104 (31%) in sub-Saharan Africa to 21 (6%) in central Europe, eastern Europe, and in central Asia. Of 85 unique challenges identified after round 1, 16 challenges were prioritised at the global level; six focused on detection and treatment of conditions (cataract, refractive error, glaucoma, diabetic retinopathy, services for children and screening for early detection), two focused on addressing shortages in human resource capacity, five on other health service and policy factors (including strengthening policies, integration, health information systems, and budget allocation), and three on improving access to care and promoting equity. Interpretation This list of Grand Challenges serves as a starting point for immediate action by funders to guide investment in research and innovation in eye health. It challenges researchers, clinicians, and policy makers to build collaborations to address specific challenge

Connecting women, connecting men: How communities and organizations interact to strengthen adaptive capacity and food security in the face of climate change

Given the different roles that women and men play in households and communities, strategies to improve food security and build adaptive capacity need to take gender differences into account. In many developing countries, local organizations have a role to play in it. However, the degree to which there is an overlap among the priorities of men, women, and organizations (including non-governmental bodies, local government offices, and other agencies working in the community) is not generally known, nor do we know whether organizations are strengthening the adaptive capacity of both men and women effectively and equally. Using gender-disaggregated data arising from community-level participatory research and organizational-level interviews from 15 sites across West Africa, East Africa, and South Asia, we conduct a cross-regional analysis of local organizational landscapes as they relate to livelihoods and food security. We find that in all regions, women tend to value local organizations more highly and thus appear to be less connected to external organizations than men. Additionally, women’s perception of food security is broader than men’s, going beyond a production focus. Most of the local organizations with food security as a stated objective focus on production, which can marginalize/alienate women. Given the effects that climate change is predicted to have on food security, development organizations should consider the differing priorities of men and women, and use a gendered perspective when building adaptive capacity to respond to climate change, and to maintain/improve food security. Such work can, perhaps, most effectively be implemented through existing community groups

Transitions in agro-pastoralist systems of East Africa:Impacts on food security and poverty

Climate-induced livelihood transitions in the agricultural systems of Africa are increasingly likely. There is limited evidence on what such transitions might look like. We carried out fieldwork in 12 sites in Kenya, Tanzania and Uganda to understand changes in farming systems in the recent past, and to test the hypothesis that sedentary farmers in zones that may become warmer and drier in the future may be forced to increase their reliance on livestock vis-à-vis cropping in the future. We estimated the contribution of crop and livestock activities to incomes, food security and poverty. Householders were asked how to adapt farming in the future. We found no direct evidence for the hypothesised extensification of production across study sites. Human diets have changed considerably in the last 40 years, as cropping has been taken up by increasing numbers of pastoral households, even in marginal places. Maize and legumes predominate, but some householders are increasing their crop and diet diversity, particularly in locations with annual rainfall higher than 800. mm. At all sites people want more livestock. Food insecurity is common at all sites with an annual rainfall of 800. mm or less, and critical levels are seen at sites wit

LeMMINGs. VI. Connecting nuclear activity to bulge properties of active and inactive galaxies: radio scaling relations and galaxy environment

Multiwavelength studies indicate that nuclear activity and bulge properties are closely related, but the details remain unclear. To study this further, we combine Hubble Space Telescope bulge structural and photometric properties with 1.5 GHz, e-MERLIN nuclear radio continuum data from the LeMMINGs survey for a large sample of 173 `active' galaxies (LINERs and Seyferts) and `inactive' galaxies (H IIs and absorption line galaxies, ALGs). Dividing our sample into active and inactive, they define distinct (radio core luminosity)−(bulge mass), L_R,core-M_*,bulge, relations, with a mass turnover at M_*, bulge ~ 10^(9.8 +- 0.3) M_sun (supermassive black hole mass M_BH ~ 10^(6.8 +- 0.3) M_sun), which marks the transition from AGN-dominated nuclear radio emission in more massive bulges to that mainly driven by stellar processes in low-mass bulges. None of our 10/173 bulgeless galaxies host an AGN. The AGN fraction increases with increasing M_*, bulge such that f_optical_AGN ∝ M_*,bulge^(0.24 +- 0.06) and f_radio_AGN ∝ M_*,bulge^(0.24 +- 0.05). Between M_*,bulge ~ 10^8.5 and 10^11.3 M_sun, f_optical_AGN steadily rises from 15 +- 4 to 80 +- 5 per cent. We find that at fixed bulge mass, the radio loudness, nuclear radio activity and the (optical and radio) AGN fraction exhibit no dependence on environment. Radio-loud hosts preferentially possess an early-type morphology than radio-quiet hosts, the two types are however indistinguishable in terms of bulge Sérsic index and ellipticity, while results on the bulge inner logarithmic profile slope are inconclusive. We finally discuss the importance of bulge mass in determining the AGN triggering processes, including potential implications for the nuclear radio emission in nearby galaxies