Decreasing Unintentional Pregnancies for Tennesseans

In 2018, 49% of all pregnancies in the United States were unintended, with women with a lower- income status being five times more likely to experience an unplanned pregnancy. Tennessee has a high rate of unintended pregnancies, particularly among the uninsured, low-income, and rural teen populations; some 22% of these unintended pregnancies end in abortion. Oral or transdermal contraceptives that are affordable and accessible for women of childbearing age can reduce unintentional pregnancies. The addressed gap in clinical practice was that contraceptives are not currently available over the counter in Tennessee pharmacies without a prescription, which necessitates a costly medical visit. The purpose of this study was to document the process of nursing advocacy through a legislative initiative to change health policy to allow for over-the- counter contraception to decrease unintentional pregnancies and abortions in Tennessee. This case study used political process theory to describe the process of assembling a coalition and working with state legislators to implement a change in health policy that affects individuals, populations, and society. The case study findings were designed to inform nurses and other health professionals about advocacy and the health policy process, including the political realities of change in a conservative, antiabortion state

How Beliefs about HIV Status Affect Risky Behaviors: Evidence from Malawi, Second Version

This paper examines whether and to what extent changes in beliefs about own HIV status induce changes in risky sexual behavior using data from married males living in three regions of Malawi. Risky behavior is measured as the propensity to engage in extramarital affairs. The empirical analysis is based on panel surveys for years 2006 and 2008 from the Malawi Diffusion and Ideational Change Project (MDICP), which contain detailed information on beliefs about HIV status and on sexual behaviors. Many individuals change their beliefs over time, because of opportunities to get tested for HIV and informational campaigns. We estimate the effect of belief revisions on the propensity to engage in extra-marital affairs using a panel data estimator developed by Arellano and Carrasco (2003), which accommodates unobserved heterogeneity as well as belief endogeneity arising from the dependence of current beliefs on lagged behaviors. We find that downward revisions in the belief of being HIV positive lead to an increased propensity to engage in extra-marital affairs and upward revisions to a decreased propensity. The estimates are shown to be robust to underreporting of affairs. Using our estimates and a standard epidemeological model of disease transmission, we find that increasing the responsiveness of beliefs to test results would reduce the HIV transmission rate as infected individuals reduce sexual behavior and decrease the likelihood that uninfected persons have contact with an HIV-positive person.AIDS, Malawi, Beliefs

How Beliefs about HIV Status Affect Risky Behaviors: Evidence from Malawi, Fifth Version

This paper examines how beliefs about own HIV status affect decisions to engage in risky sexual behavior using data on married males living in Malawi. Risky behavior is measured as the propensity to engage in extramarital affairs. The empirical analysis is based on panel surveys for years 2006 and 2008 from the Malawi Diffusion and Ideational Change Project (MDICP). Beliefs vary significantly over time in the data, in part because of HIV testing and informational campaigns. We estimate the effect of beliefs about own HIV status on risky behavior using a panel data estimator developed by Arellano and Carrasco (2003), which accommodates unobserved heterogeneity as well as belief endogeneity arising from the dependence of current beliefs on lagged behaviors. We find that beliefs are an important determinant of risky behavior, with downward revisions in the belief of being HIV positive increasing risky behavior and upward revisions decreasing it. We modify Arellano and Carrasco’s (2003) estimator to allow for underreporting of affairs and find the estimates to be relatively robust to underreporting. Using our estimates and a prototypical epidemiological model of disease transmission, we show that making individuals better informed about their HIV status, either by increasing the credibility of test results and/or increasing access to testing, would on net reduce the HIV transmission rate.Beliefs, Malawi, HIV

How Beliefs About HIV Status affect Risky Behaviors: Evidence From Malawi, Second Version

This paper examines how beliefs about own HIV status affect sexual behavior. Risky behavior is measured as the propensity to engage in extramarital affairs or not use condoms. The empirical analysis is based on 2004 and 2006 data from the Malawi Diffusion and Ideational Change Project. Controlling for endogeneity between beliefs and risk-taking, we find that downward revisions in the belief of being HIV positive lead to a lower propensity to engage in extramarital affairs but have no effect on condom use. We show that the estimates provide a lower bound when there is measurement error in reported extra-marital affairs.Beliefs,AIDS,Malawi

How Beliefs about HIV Status Affect Risky Behaviors: Evidence from Malawi, Sixth Version

This paper examines how beliefs about own HIV status affect decisions to engage in risky sexual behavior (as measured by extramarital affairs) and analyzes the potential for interventions that influence beliefs, such as HIV testing and informational campaigns, to reduce transmission rates. The empirical analysis is based on a panel survey of married males for years 2006 and 2008 from the Malawi Diffusion and Ideational Change Project (MDICP). In the data, beliefs about HIV status vary significantly geographically and over time, in part because of newly available testing opportunities and because of cultural differences. We estimate the effect of beliefs on risky behavior using Arellano and Carrasco’s (2003) semiparametric panel data estimator, which accommodates unobserved heterogeneity and belief endogeneity. Results show that changes in the belief of being HIV positive induce changes in risky behavior. Downward revisions in beliefs increase risky behavior and upward revisions decrease it. We modify Arellano and Carrasco’s (2003) estimator to allow for underreporting of extramarital affairs and find the estimates to be robust. Using the estimates and a prototypical epidemiological model of disease transmission, we show that better informing people about their HIV status on net reduces the population HIV transmission rate.Malawi,HIV,beliefs

HOW BELIEFS ABOUT HIV STATUS AFFECT RISKY BEHAVIORS: EVIDENCE FROM MALAWI

This paper examines how beliefs about own HIV status affect decisions to engage in risky sexual behavior, as measured by having extramarital sex and/or multiple sex partners. The empirical analysis is based on a panel survey of males from the 2006 and 2008 rounds of the Malawi Diffusion and Ideational Change Project (MDICP). The paper develops a behavioral model of the belief-risky behavior relationship and estimates the causal effect of beliefs on risky behavior using the Arellano and Carrasco (2003) semiparametric panel data estimator, which accommodates both unobserved heterogeneity and belief endogeneity arising from a possible dependence of current beliefs on past risky behavior. Results show that downward revisions in the belief assigned to being HIV positive increase risky behavior and upward revisions decrease it. For example, based on a linear specification, a decrease in the perceived probability of being HIV positive from 10 to 0 percentage points increases the probability of engaging in risky behavior (extramarital affairs) from 8.3 to 14.1 percentage points. We also develop and implement a modified version of the Arellano and Carrasco (2003) estimator to allow for misreporting of risky behavior and find estimates to be robust to a range of plausible misreporting levels. © 2013 The Authors. Journal of Applied Econometrics published by John Wiley & Sons, Ltd

How Beliefs about HIV Status Affect Risky Behaviors: Evidence from Malawi

Many HIV testing programs in Africa and elsewhere aim to reduce risk-taking behaviors by providing individuals with information about their own HIV status. This paper examines how beliefs about own HIV status affect risky sexual behavior using data from married couples living in three regions of Malawi. Risky behavior is measured as the propensity to engage in extramarital affairs or to not use condoms. The empirical analysis is based on two panel surveys for years 2004 and 2006 from the Malawi Diffusion and Ideational Change Project (MDICP) and from an experimental HIV testing intervention carried out in 2004 that provided randomized incentives for picking up test results. Most individuals participating in the MDICP testing learned that they were HIV negative and a small fraction that they were positive. Controlling for potential endogeneity between beliefs and risk-taking, we find that downward revisions in the subjective belief of being HIV positive lead to decreases in the propensity to engage in extra-marital affairs but have no effect on condom use. These results are generally supported by survey questions that directly elicited from respondents how participating in testing altered their behavior. We show that the estimates provide a lower bound in the presence of measurement error in extra-marital affairs

Fabrication of Robust, Flat, Thinned, UV-Imaging CCDs

An improved process that includes a high-temperature bonding subprocess has been developed to enable the fabrication of robust, flat, silicon-based charge-coupled devices (CCDs) for imaging in ultraviolet (UV) light and/or for detecting low-energy charged particles. The CCDs in question are devices on which CCD circuitry has already been formed and have been thinned for backsurface illumination. These CCDs may be delta doped, and aspects of this type of CCD have been described in several prior articles in NASA Tech Briefs. Unlike prior low-temperature bonding subprocesses based on the use of epoxies or waxes, the high-temperature bonding subprocess is compatible with the deltadoping process as well as with other CCD-fabrication processes. The present improved process and its bonding, thinning, and delta-doping subprocesses, are characterized as postfabrication processes because they are undertaken after the fabrication of CCD circuitry on the front side of a full-thickness silicon substrate. In a typical case, it is necessary to reduce the thickness of the CCD to between 10 and 20 m in order to take advantage of back-side illumination and in order to perform delta doping and/or other back-side treatment to enhance the quantum efficiency. In the prior approach to the fabrication of back-side-illuminated CCDs, the thinning subprocess turned each CCD into a free-standing membrane that was fragile and tended to become wrinkled. In the present improved process, prior to thinning and delta doping, a CCD is bonded on its front side to a silicon substrate that has been prefabricated to include cutouts to accommodate subsequent electrical connections to bonding pads on the CCD circuitry. The substrate provides structural support to increase ruggedness and maintain flatness. At the beginning of this process, the back side of a CCD as fabricated on a full-thickness substrate is polished. Silicon nitride is deposited on the back side, opposite the bonding pads on the front side, in order to define a relatively thick frame. The portion of the CCD not covered by the frame is the portion to be thinned by etching

Chemical Thinning Process for Fabricating UV-Imaging CCDs

The thinning stage of the postfabrication process reported in the immediately preceding article is notable in its own right. Although the thinning process was described in the preceding article as part of an overall process of fabrication of a supported charge-coupled device (CCD), it is more generally applicable to both free-standing and supported devices that have been fabricated in die and wafer formats. Like the thermocompression bonding process described in the preceding article, the thinning process is compatible with CCD-fabrication processes, as well as postfabrication processes that enhance the response of CCDs to ultraviolet (UV) light, including the delta-doping process. CCDs that are thinned by this process and then delta-doped exhibit high quantum efficiencies that are stable with time and with exposure to the environment

Phenex: Ontological Annotation of Phenotypic Diversity

Phenex is a platform-independent desktop application designed to facilitate efficient and consistent annotation of phenotypic variation using Entity-Quality syntax, drawing on terms from community ontologies for anatomical entities, phenotypic qualities, and taxonomic names. Despite the centrality of the phenotype to so much of biology, traditions for communicating information about phenotypes are idiosyncratic to different disciplines. Phenotypes seem to elude standardized descriptions due to the variety of traits that compose them and the difficulty of capturing the complex forms and subtle differences among organisms that we can readily observe. Consequently, phenotypes are refractory to attempts at data integration that would allow computational analyses across studies and study systems. Phenex addresses this problem by allowing scientists to employ standard ontologies and syntax to link computable phenotype annotations to evolutionary character matrices, as well as to link taxa and specimens to ontological identifiers. Ontologies have become a foundational technology for establishing shared semantics, and, more generally, for capturing and computing with biological knowledge