Improving Breastfeeding Supports in Primary Care Settings

Background: Although 84% of Vermont mothers initiate breastfeeding, only 26% exclusively breastfeed at 6 months of age. Surveyed physicians agree with the benefits of breastfeeding but claim insufficient knowledge and lack confidence in evaluating and managing breastfeeding, despite the availability of evidence-based strategies that address these concerns. Objectives: To increase the percentage of infants receiving a documented breastfeeding assessment at each well-child visit in the first 6 months. To increase documentation of follow up plan in well-child exams in which a breastfeeding problem is identified. To increase duration and exclusivity of breastfeeding and increase confidence of providers in performing a clinical breastfeeding assessment

Clustered lot quality assurance sampling: a tool to monitor immunization coverage rapidly during a national yellow fever and polio vaccination campaign in Cameroon, May 2009

We used the clustered lot quality assurance sampling (clustered-LQAS) technique to identify districts with low immunization coverage and guide mop-up actions during the last 4 days of a combined oral polio vaccine (OPV) and yellow fever (YF) vaccination campaign conducted in Cameroon in May 2009. We monitored 17 pre-selected districts at risk for low coverage. We designed LQAS plans to reject districts with YF vaccination coverage <90% and with OPV coverage <95%. In each lot the sample size was 50 (five clusters of 10) with decision values of 3 for assessing OPV and 7 for YF coverage. We ‘rejected' 10 districts for low YF coverage and 14 for low OPV coverage. Hence we recommended a 2-day extension of the campaign. Clustered-LQAS proved to be useful in guiding the campaign vaccination strategy before the completion of the operation

Ultrasonic Wave Propagation Assessment of Native Cartilage Explants and Hydrogel Scaffolds for Tissue Engineering

Non-destructive techniques characterising the mechanical properties of cells, tissues, and biomaterials provide baseline metrics for tissue engineering design. Ultrasonic wave propagation and attenuation has previously demonstrated the dynamics of extracellular matrix synthesis in chondrocyte-seeded hydrogel constructs. In this paper, we describe an ultrasonic method to analyse two of the construct elements used to engineer articular cartilage in real-time, native cartilage explants and an agarose biomaterial. Results indicated a similarity in wave propagation velocity ranges for both longitudinal (1500-1745 m/s) and transverse (350-950 m/s) waveforms. Future work will apply an acoustoelastic analysis to distinguish between the fluid and solid properties including the cell and matrix biokinetics as a validation of previous mathematical models

The relative importance of phytoplankton aggregates and zooplankton fecal pellets to carbon export: insights from free-drifting sediment trap deployments in naturally iron-fertilised waters near the Kerguelen Plateau

The first KErguelen Ocean and Plateau compared Study (KEOPS1), conducted in the naturally iron-fertilised Kerguelen bloom, demonstrated that fecal material was the main pathway for exporting carbon to the deep ocean during summer (January–February 2005), suggesting a limited role of direct export via phytodetrital aggregates. The KEOPS2 project reinvestigated this issue during the spring bloom initiation (October–November 2011), when zooplankton communities may exert limited grazing pressure, and further explored the link between carbon flux, export efficiency and dominant sinking particles depending upon surface plankton community structure. Sinking particles were collected in polyacrylamide gel-filled and standard free-drifting sediment traps (PPS3/3), deployed at six stations between 100 and 400 m, to examine flux composition, particle origin and their size distributions. Results revealed an important contribution of phytodetrital aggregates (49+/-10 and 45+/-22% of the total number and volume of particles respectively, all stations and depths averaged). This high contribution dropped when converted to carbon content (30+/-16% of total carbon, all stations and depths averaged), with cylindrical fecal pellets then representing the dominant fraction (56+/-19 %). At 100 and 200m depth, iron- and biomass-enriched sites exhibited the highest carbon fluxes (maxima of 180 and 84+/- 27 mgCm-2 d-1, based on gel and PPS3/3 trap collection respectively), especially where large fecal pellets dominated over phytodetrital aggregates. Below these depths, carbon fluxes decreased (48+/-21%decrease on average between 200 and 400 m), and mixed aggregates composed of phytodetritus and fecal matter dominated, suggesting an important role played by physical aggregation in deep carbon export. Export efficiencies determined from gels, PPS3/3 traps and 234Th disequilibria (200m carbon flux/net primary productivity) were negatively correlated to net primary productivity with observed decreases from ~0.2 at low-iron sites to ~0.02 at high-iron sites. Varying phytoplankton communities and grazing pressure appear to explain this negative relationship. Our work emphasises the need to consider detailed plankton communities to accurately identify the controls on carbon export efficiency, which appear to include small spatio-temporal variations in ecosystem structure

Examining Ray Bradbury’s Dystopian Vision: A Philosophical Analysis of His Literary Works and Their Nuanced Impact on Contemporary Realities

This paper examines the philosophical implications of Ray Bradbury’s literary contributions and their impact on modern society. Through the analysis of two opposing articles that reference selective works, it explores Bradbury’s impact on ongoing philosophical discussions, specifically centering on themes such as censorship, conformity, and the preservation of individual identity and freedom. The contrasting viewpoints presented contribute to a compelling analysis of Bradbury’s ideas and their relevance in the context of today’s world

Foundation-funded journalism, Philanthrocapitalism and Tainted donors

Not-for-profit news organisations are increasingly funded by private foundations, supported by wealthy entrepreneurs. This raises a range of ethical dilemmas for journalists, which are particularly serious when their donors are alleged to have been involved in unethical or illegal activities. Although this is a relatively common occurrence in the non-profit sector, so far there has been no critical discussion of these issues in relation to foundation-funded journalism. In this article, we interrogate a rich and detailed case study of the relations between a nonprofit news organisation and a donor accused of being involved in a massive, international fraud scandal. We document how the news outlet justified their acceptance of this donor’s money; the defensive strategies they used to protect their reputation, organisational values and editorial freedom; and the conditions that ultimately led to journalists parting ways with the foundation. In so doing, we draw on ideas about philanthrocapitalism, stakeholders and resource dependence in order to develop Dunn’s (2010) model of how nonprofits respond to “tainted” donors

Quality Of Antenatal Care In Rural Southern Tanzania: A Reality Check.

Counselling on the danger signs of unpredictable obstetric complications and the appropriate management of such complications are crucial in reducing maternal mortality. The objectives of this study were to identify gaps in the provision of ANC services and knowledge of danger signs as well as the quality of care women receive in case of complications. The study took place in the Rufiji District of Tanzania in 2008 and was conducted in seven health facilities. The study used (1) observations from 63 antenatal care (ANC) sessions evaluated with an ANC checklist, (2) self-assessments of 11 Health workers, (3) interviews with 28 pregnant women and (4) follow-up of 12 women hospitalized for pregnancy-related conditions.Blood pressure measurements and abdominal examinations were common during ANC visits while urine testing for albumin or sugar or haemoglobin levels was rare which was often explained as due to a lack of supplies. The reasons for measuring blood pressure or abdominal examinations were usually not explained to the women. Only 15/28 (54%) women were able to mention at least one obstetric danger sign requiring medical attention. The outcomes of ten complicated cases were five stillbirths and three maternal complications. There was a considerable delay in first contact with a health professional or the start of timely interventions including checking vital signs, using a partograph, and detailed record keeping. Linking danger signs to clinical and laboratory examination results during ANC with the appropriate follow up and avoiding delays in emergency obstetric care are crucial to the delivery of coordinated, effective care interventions

Polly’s story : using structural narrative analysis to understand a trans migration journey

There is scant theoretical and empirical research on experiences of trans and its significance for social work practice. In this paper we premise that research on trans identity and practice needs to be located in particular temporal, cultural, spatial/geographical contexts and argue that a structural narrative analytical approach centring on plot, offers the opportunity to unravel the ‘how’ and ‘why’ stories are told. We posit that attending to narrative structure facilitates a deeper understanding of trans people’s situated, lived experiences than thematic narrative analysis alone, since people organise their narratives according to a culturally available repertoire including plots. The paper focuses on the life and narrative of Polly, a male-to-female trans woman, and her gender migration journey using the plot typology ‘the Quest’. We are cognisant of the limitations to structural narrative analysis and Western conventions of storytelling, and acknowledge that our approach is subjective; however, we argue that knowledge itself is contextual and perspective ridden, shaped by researchers and participants. Our position holds that narratives are not – and cannot – be separated from the context in which they are told, and importantly the resources used to tell them, and that analysing narrative structure can contextualise individual unique biographies and give voice to less heard communities

Statistical Estimates of the Binary Properties of Rotational Variables

We present a model to estimate the average primary masses, companion mass ranges, the inclination limit for recognizing a rotational variable, and the primary mass spreads for populations of binary stars. The model fits a population's binary mass function distribution and allows for a probability that some mass functions are incorrectly estimated. Using tests with synthetic data, we assess the model's sensitivity to each parameter, finding that we are most sensitive to the average primary mass and the minimum companion mass, with less sensitivity to the inclination limit and little to no sensitivity to the primary mass spread. We apply the model to five populations of binary spotted rotational variables identified in ASAS-SN, computing their binary mass functions using RV data from APOGEE. Their average primary mass estimates are consistent with our expectations based on their CMD locations ($\sim0.75 M_{\odot}$ for lower main sequence primaries and $\sim 0.9$--$1.2 M_{\odot}$ for RS CVn and sub-subgiants). Their companion mass range estimates allow companion masses down to $M_2/M_1\simeq0.1$, although the main sequence population may have a higher minimum mass fraction ($\sim0.4$). We see weak evidence of an inclination limit $\gtrsim50^{\circ}$ for the main sequence and sub-subgiant groups and no evidence of an inclination limit in the other groups. No groups show strong evidence for a preferred primary mass spread. We conclude by demonstrating that the approach will provide significantly better estimates of the primary mass and the minimum mass ratio and reasonable sensitivity to the inclination limit with 10 times as many systems.Comment: 10 pages, 7 figures, 4 tables, submitted to MNRA