Family planning counselling and use among clients seeking abortion services in private health facilities in Kenya

This paper examines family planning service provision and use among clients seeking abortion services in private health facilities in Kenya. Data are from observations of client-provider interactions and exit interviews conducted in May-June 2013 with 125 clients from 30 private clinics in Kisumu, Nairobi, and Mombasa counties. Analysis entails simple frequencies, cross-tabulations with Chi-square tests, and estimation of multivariate logistic regression models. The results show that: (1) although 78% of the clients had used family planning before, it was mostly short-acting methods such as condoms (44%), injectables (35%), oral (40%) and emergency (26%) pills; (2) providers did not counsel clients on family planning in 20% of the consultations while clients were offered a method in 47% of the consultations; and (3) among clients who had ever used family planning and accepted a method during the visit, 60% chose a different method with the shift being from short-acting to long-term methods

Investigating the relationship between impulsivity and executive function in Parkinson’s disease, and healthy older and younger participants: A quantitative database and real-world study.

Executive function (EF) in this study will be explored in older healthy controls and Parkinson’s Disease patients, with regards to working memory (WM) in younger healthy controls. Past literature suggests a lack of understanding between EF, WM and impulsivity despite vast research that shows the relationship between these concepts are related to a multitude of negative behaviours such as substance abuse (Moeller et al., 2004), addiction (Zhou et al., 2014; 2016), and the development of impulsive-compulsive disorders (ICDs) in neurodegenerative diseases such as Parkinson’s (Foster et al., 2013).The present study intends to build on previous literature by investigating the relationship between the two variables in 102 younger healthy controls, 196 older healthy controls, and 498 PD patients. Correlation analyses supported literature that suggests impulsivity is higher in younger participants and that the relationship between impulsivity and EF is different across age groups; however, previous assumptions that PD patients who have not yet begun medication will be less impulsive than age-matched controls and therefore exhibit an altered relationship between their EF scores were not met. Future research should expand on data using unmedicated PD patients to better understand the relationship between impulsivity and EF, and the development of ICDs

A model for predicting dissolved organic carbon distribution in a reservoir water using fluorescence spectroscopy

A number of water treatment works (WTW) in the north of England (UK) have experienced problems in reducing the dissolved organic carbon (DOC) present in the water to a sufficiently low level. The problems are experienced in autumn/ winter when the colour increases and the coagulant dose at the WTW needs to be increased in order to achieve sufficient colour removal. However, the DOC content of the water varies little throughout the year. To investigate this further, the water was fractionated using resin adsorption techniques into its hydrophobic (fulvic and humic acid fractions) and hydrophilic (acid and non-acid fractions) components. The fractionation process yields useful information on the changing concentration of each fraction but is time consuming and labour intensive. Here, a method of rapidly determining fraction concentration was developed using fluorescence spectroscopy. The model created used synchronous spectra of fractionated material compared against bulk water spectra and predicted the fraction concentrations to within 10% for a specific water. The model was unable to predict fraction concentrations for waters from a different watershed

Cemetery Inscriptions - Village Cemetery and Elm Grove Cemetery, Thomaston, Maine

Compiled by Edith H. Wilson, Maria O. Hawley, and Harriet R. Williams of the General Knox Chapter of the Maine Society of the Daughters of the American Revolution during the Summer and Fall of 1956.https://digitalmaine.com/books/1036/thumbnail.jp

Lolita's Time Leaks and Transatlantic Decadence

In this paper I investigate the matrix of transatlantic literary exchange in Vladimir Nabokov’s Lolita (1955) in order to suggest how the novel’s rehabilitation of an international decadent aesthetics constitutes a radical challenge to the American literary establishment in the postwar. I begin by identifying the figures of Edgar Allen Poe, Charles Baudelaire and Algernon Swinburne as the key constellation for Nabokov in his plotting of Lolita’s ambivalent engagement with the ethics of temporality and artistic autonomy. I then go on to situate Lolita’s composition within debates current in the American academy from the late 1930s to the early 1950s over the value of decadent aesthetics within the modernist project and anxieties over Poe’s place within American national literary culture. Read alongside the critical writings of T.S. Eliot, Allen Tate, and the New Criticism, Lolita emerges as the risky reinstatement of a transatlantic decadent tradition, in which the failure of temporal and ethical containment disrupts a dominant narrative of modernism’s history in American letters

Country mapping: Kenya

The Population Council embarked on a three-year project to explore the acceptability of the progesterone vaginal ring (PVR) among women in sub-Saharan Africa and to develop a strategic plan for its introduction. This technical report presents the findings of the assessments in Kenya with specific focus on: (1) the country’s demographic profile; (2) the health systems, health policy, and family planning program context; and (3) stakeholder perspectives regarding the PVR. The findings suggest that the introduction of the PVR would fill a gap in the family planning needs of breastfeeding women in Kenya, and there is strong support from stakeholders for its future introduction. Given the health system challenges (staffing and infrastructure), there is a need for contraceptives that require little training on the part of the provider, do not require a sophisticated health infrastructure, are long-acting and thus do not require monthly visits to a health center, are user-friendly and woman-controlled, and are safe. The PVR addresses all of these concerns and, based on the information documented thus far, is likely to be a welcome addition to the existing contraceptive method mix in the country

Risk indicators to identify intimate partner violence in the emergency department

Background: Intimate partner violence against women is prevalent and is associated with poor health outcomes. Understanding indicators of exposure to intimate partner violence can assist health care professionals to identify and respond to abused women. This study was undertaken to determine the strength of association between selected evidence-based risk indicators and exposure to intimate partner violence. Methods: In this cross-sectional study of 768 English-speaking women aged 18–64 years who presented to 2 emergency departments in Ontario, Canada, participants answered questions about risk indicators and completed the Composite Abuse Scale to determine their exposure to intimate partner violence in the past year. Results: Intimate partner violence was significantly associated with being separated, in a common-law relationship or single (odds ratio [OR]

Hydroclimate variability was the main control on fire activity in northern Africa over the last 50,000 years

North Africa features some of the most frequently burnt biomes on Earth, including the semi-arid grasslands of the Sahel and wetter savannas immediately to the south. Natural fires are fuelled by rapid biomass production during the wet season, its desiccation during the dry season and ignition by frequent dry lightning strikes. Today, fire activity decreases markedly both to the north of the Sahel, where rainfall is extremely low, almost eliminating biomass over the Sahara, and to the south where forest biomes are too wet to burn. Over the last glacial cycle, rainfall and vegetation cover over northern Africa varied dramatically in response to gradual astronomically-forced insolation change, changes in atmospheric carbon dioxide levels, and abrupt cooling events over the North Atlantic Ocean associated with the reorganisation of Meridional Overturning Circulation (MOC). Here we report the results of a study into the impact of these climate changes on fire activity in northern African over the last 50,000 years (50 kyr). Our reconstructions come from marine sediments with strong age control that provide an uninterrupted record of charcoal particles exported from the African continent. We studied three sites on a latitudinal transect along the northwest African margin between 21 and 9°N. Our sites exhibit a distinct latitudinal relationship between past changes in rainfall and fire activity. At the southernmost site (GeoB9528-3, 9°N), fire activity decreased during intervals of increasing humidity, while our northernmost site (ODP Site 658, 21°N) clearly demonstrates the opposite relationship. The site in the middle of our transect, offshore of the present day southern Sahel today (GeoB9508-5, 15°N), exhibits a “Goldilocks” relationship between fire activity and hydroclimate, wherein charcoal fluxes peak under intermediate rainfall climate conditions and are supressed by transition to more arid or more humid conditions. Our results are remarkably consistent with the predictions of the intermediate fire-productivity hypothesis developed in conceptual macroecological models and supported by empirical evidence of modern day fire activity. Feedback processes operating between fire, climate and vegetation are undoubtedly complex but temperature is suggested to be the main driver of temporal change in fire activity globally, with the precipitation-evaporation balance perhaps a secondary influence in the Holocene tropics. However, there is only sparse coverage of Africa in the composite records upon which those interpretations are based. We conclude that hydroclimate (not temperature) exerted the dominant control on burning in the tropics of northern Africa well before the Holocene (from at least 50 ka).publishedVersio

Availability, use and quality of care for medical abortion services in private facilities in Kenya

The overall goal of this study was to generate evidence on the availability, use, and quality of care for medical abortion services in private facilities (pharmacies and clinics) in Kenya. With the passing of a new constitution in 2010, there was renewed interest in the right to health and the need to reduce the high levels of maternal morbidity and mortality arising from unsafe abortion in the country. In spite of recent developments, there is limited understanding of the extent to which the changes have influenced the provision of medical abortion information and services in the country, the acceptability of the practice among providers and clients, and the content of care offered. Implications of the findings indicate a need for: widespread dissemination of the existing policies and guidelines regarding abortion among private providers to ensure that they offer services within existing regulations; improvement of the supply chain for medical abortion drugs in private clinics; and strategies to improve the capacity of private providers to offer appropriate family planning services to clients seeking abortion, especially long-term methods given the high rate of repeat abortions