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Wollum A, Bornstein M, Mopiwa G, Norris A, Gipson JD. Assessing the relationship between reproductive autonomy and contraceptive use in rural Malawi. Reprod Health 2023; 20:142. [PMID: 37736687 PMCID: PMC10515069 DOI: 10.1186/s12978-023-01688-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 09/12/2023] [Indexed: 09/23/2023] Open
Abstract
Reproductive autonomy, or the extent to which people control matters related to their own sexual and reproductive decisions, may help explain why some people who do not intend to become pregnant nevertheless do not use contraception. Using cross-sectional survey data from 695 women aged 16 to 47 enrolled in the Umoyo Wa Thanzi (UTHA) study in Malawi in 2019, we conducted confirmatory factor analysis, descriptive analyses, and multivariable logistic regression to assess the freedom from coercion and communication subscales of the Reproductive Autonomy Scale and to examine relationships between these components of reproductive autonomy and current contraceptive use. The freedom from coercion and communication subscales were valid within this population of partnered women; results from a correlated two-factor confirmatory factor analysis model resulted in good model fit. Women with higher scores on the freedom from coercion subscale had greater odds of current contraceptive use (aOR 1.13, 95% CI: 1.03-1.23) after adjustment for pregnancy intentions, relationship type, parity, education, employment for wages, and household wealth. Scores on the communication subscale were predictive of contraceptive use in some, but not all, models. These findings demonstrate the utility of the Reproductive Autonomy Scale in more holistically understanding contractive use and non-use in a lower-income setting, yet also highlight the need to further explore the multidimensionality of women's reproductive autonomy and its effects on achieving desired fertility.
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Affiliation(s)
- Alexandra Wollum
- Department of Community Health Sciences, Fielding School of Public Health, University of California Los Angeles (UCLA), UCLA Bixby Center on Population and Reproductive Health, Los Angeles, USA.
| | - Marta Bornstein
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH, USA
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, USA
| | - Gladson Mopiwa
- Adolescent Girls and Young Women Program-The Global Fund Grant ActionAid Malawi, Lilongwe City, Malawi
| | - Alison Norris
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Jessica D Gipson
- Department of Community Health Sciences, Fielding School of Public Health, University of California Los Angeles (UCLA), UCLA Bixby Center on Population and Reproductive Health, Los Angeles, USA
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2
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Merling MR, Williams A, Mahfooz NS, Ruane-Foster M, Smith J, Jahnes J, Ayers LW, Bazan JA, Norris A, Norris Turner A, Oglesbee M, Faith SA, Quam MB, Robinson RT. The emergence of SARS-CoV-2 lineages and associated saliva antibody responses among asymptomatic individuals in a large university community. PLoS Pathog 2023; 19:e1011596. [PMID: 37603565 PMCID: PMC10470930 DOI: 10.1371/journal.ppat.1011596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 08/31/2023] [Accepted: 08/02/2023] [Indexed: 08/23/2023] Open
Abstract
SARS-CoV-2 (CoV2) infected, asymptomatic individuals are an important contributor to COVID transmission. CoV2-specific immunoglobulin (Ig)-as generated by the immune system following infection or vaccination-has helped limit CoV2 transmission from asymptomatic individuals to susceptible populations (e.g. elderly). Here, we describe the relationships between COVID incidence and CoV2 lineage, viral load, saliva Ig levels (CoV2-specific IgM, IgA and IgG), and ACE2 binding inhibition capacity in asymptomatic individuals between January 2021 and May 2022. These data were generated as part of a large university COVID monitoring program in Ohio, United States of America, and demonstrate that COVID incidence among asymptomatic individuals occurred in waves which mirrored those in surrounding regions, with saliva CoV2 viral loads becoming progressively higher in our community until vaccine mandates were established. Among the unvaccinated, infection with each CoV2 lineage (pre-Omicron) resulted in saliva Spike-specific IgM, IgA, and IgG responses, the latter increasing significantly post-infection and being more pronounced than N-specific IgG responses. Vaccination resulted in significantly higher Spike-specific IgG levels compared to unvaccinated infected individuals, and uninfected vaccinees' saliva was more capable of inhibiting Spike function. Vaccinees with breakthrough Delta infections had Spike-specific IgG levels comparable to those of uninfected vaccinees; however, their ability to inhibit Spike binding was diminished. These data are consistent with COVID vaccines having achieved hoped-for effects in our community, including the generation of mucosal antibodies that inhibit Spike and lower community viral loads, and suggest breakthrough Delta infections were not due to an absence of vaccine-elicited Ig, but instead limited Spike binding activity in the face of high community viral loads.
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Affiliation(s)
- Marlena R. Merling
- Department of Microbial Infection & Immunity, The Ohio State University, Columbus, Ohio, United States of America
| | - Amanda Williams
- Department of Microbial Infection & Immunity, The Ohio State University, Columbus, Ohio, United States of America
- Infectious Disease Institute, The Ohio State University, Columbus, Ohio, United States of America
| | - Najmus S. Mahfooz
- Department of Microbial Infection & Immunity, The Ohio State University, Columbus, Ohio, United States of America
| | - Marisa Ruane-Foster
- Department of Microbial Infection & Immunity, The Ohio State University, Columbus, Ohio, United States of America
| | - Jacob Smith
- Infectious Disease Institute, The Ohio State University, Columbus, Ohio, United States of America
| | - Jeff Jahnes
- Infectious Disease Institute, The Ohio State University, Columbus, Ohio, United States of America
| | - Leona W. Ayers
- Department of Pathology, The Ohio State University, Columbus, Ohio, United States of America
| | - Jose A. Bazan
- Division of Infectious Disease, Department of Internal Medicine, The Ohio State University, Columbus, Ohio, United States of America
| | - Alison Norris
- Division of Infectious Disease, Department of Internal Medicine, The Ohio State University, Columbus, Ohio, United States of America
- Department of Epidemiology, The Ohio State University, Columbus, Ohio, United States of America
| | - Abigail Norris Turner
- Division of Infectious Disease, Department of Internal Medicine, The Ohio State University, Columbus, Ohio, United States of America
| | - Michael Oglesbee
- Infectious Disease Institute, The Ohio State University, Columbus, Ohio, United States of America
| | - Seth A. Faith
- Infectious Disease Institute, The Ohio State University, Columbus, Ohio, United States of America
| | - Mikkel B. Quam
- Department of Epidemiology, The Ohio State University, Columbus, Ohio, United States of America
| | - Richard T. Robinson
- Department of Microbial Infection & Immunity, The Ohio State University, Columbus, Ohio, United States of America
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3
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Angelopoulos V, Zhang XJ, Artemyev AV, Mourenas D, Tsai E, Wilkins C, Runov A, Liu J, Turner DL, Li W, Khurana K, Wirz RE, Sergeev VA, Meng X, Wu J, Hartinger MD, Raita T, Shen Y, An X, Shi X, Bashir MF, Shen X, Gan L, Qin M, Capannolo L, Ma Q, Russell CL, Masongsong EV, Caron R, He I, Iglesias L, Jha S, King J, Kumar S, Le K, Mao J, McDermott A, Nguyen K, Norris A, Palla A, Roosnovo A, Tam J, Xie E, Yap RC, Ye S, Young C, Adair LA, Shaffer C, Chung M, Cruce P, Lawson M, Leneman D, Allen M, Anderson M, Arreola-Zamora M, Artinger J, Asher J, Branchevsky D, Cliffe M, Colton K, Costello C, Depe D, Domae BW, Eldin S, Fitzgibbon L, Flemming A, Frederick DM, Gilbert A, Hesford B, Krieger R, Lian K, McKinney E, Miller JP, Pedersen C, Qu Z, Rozario R, Rubly M, Seaton R, Subramanian A, Sundin SR, Tan A, Thomlinson D, Turner W, Wing G, Wong C, Zarifian A. Energetic Electron Precipitation Driven by Electromagnetic Ion Cyclotron Waves from ELFIN's Low Altitude Perspective. Space Sci Rev 2023; 219:37. [PMID: 37448777 PMCID: PMC10335998 DOI: 10.1007/s11214-023-00984-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 06/28/2023] [Indexed: 07/15/2023]
Abstract
We review comprehensive observations of electromagnetic ion cyclotron (EMIC) wave-driven energetic electron precipitation using data collected by the energetic electron detector on the Electron Losses and Fields InvestigatioN (ELFIN) mission, two polar-orbiting low-altitude spinning CubeSats, measuring 50-5000 keV electrons with good pitch-angle and energy resolution. EMIC wave-driven precipitation exhibits a distinct signature in energy-spectrograms of the precipitating-to-trapped flux ratio: peaks at >0.5 MeV which are abrupt (bursty) (lasting ∼17 s, or Δ L ∼ 0.56 ) with significant substructure (occasionally down to sub-second timescale). We attribute the bursty nature of the precipitation to the spatial extent and structuredness of the wave field at the equator. Multiple ELFIN passes over the same MLT sector allow us to study the spatial and temporal evolution of the EMIC wave - electron interaction region. Case studies employing conjugate ground-based or equatorial observations of the EMIC waves reveal that the energy of moderate and strong precipitation at ELFIN approximately agrees with theoretical expectations for cyclotron resonant interactions in a cold plasma. Using multiple years of ELFIN data uniformly distributed in local time, we assemble a statistical database of ∼50 events of strong EMIC wave-driven precipitation. Most reside at L ∼ 5 - 7 at dusk, while a smaller subset exists at L ∼ 8 - 12 at post-midnight. The energies of the peak-precipitation ratio and of the half-peak precipitation ratio (our proxy for the minimum resonance energy) exhibit an L -shell dependence in good agreement with theoretical estimates based on prior statistical observations of EMIC wave power spectra. The precipitation ratio's spectral shape for the most intense events has an exponential falloff away from the peak (i.e., on either side of ∼ 1.45 MeV). It too agrees well with quasi-linear diffusion theory based on prior statistics of wave spectra. It should be noted though that this diffusive treatment likely includes effects from nonlinear resonant interactions (especially at high energies) and nonresonant effects from sharp wave packet edges (at low energies). Sub-MeV electron precipitation observed concurrently with strong EMIC wave-driven >1 MeV precipitation has a spectral shape that is consistent with efficient pitch-angle scattering down to ∼ 200-300 keV by much less intense higher frequency EMIC waves at dusk (where such waves are most frequent). At ∼100 keV, whistler-mode chorus may be implicated in concurrent precipitation. These results confirm the critical role of EMIC waves in driving relativistic electron losses. Nonlinear effects may abound and require further investigation.
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Affiliation(s)
- V. Angelopoulos
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
| | - X.-J. Zhang
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Present Address: University of Texas at Dallas, Richardson, TX 75080 USA
| | - A. V. Artemyev
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
| | | | - E. Tsai
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
| | - C. Wilkins
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
| | - A. Runov
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
| | - J. Liu
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Atmospheric and Oceanic Sciences Departments, University of California, Los Angeles, CA USA
| | - D. L. Turner
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Present Address: Johns Hopkins University Applied Physics Laboratory, Laurel, Maryland USA
| | - W. Li
- Atmospheric and Oceanic Sciences Departments, University of California, Los Angeles, CA USA
| | - K. Khurana
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
| | - R. E. Wirz
- Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Present Address: School of Mechanical, Industrial, and Manufacturing Engineering, Oregon State University, Corvallis, OR 97331 USA
| | - V. A. Sergeev
- University of St. Petersburg, St. Petersburg, Russia
| | - X. Meng
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109 USA
| | - J. Wu
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
| | - M. D. Hartinger
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Space Science Institute, Boulder, CO 80301 USA
| | - T. Raita
- Sodankylä Geophysical Observatory, University of Oulu, Sodankylä, Finland
| | - Y. Shen
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
| | - X. An
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
| | - X. Shi
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
| | - M. F. Bashir
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
| | - X. Shen
- Department of Astronomy and Center for Space Physics, Boston University, Boston, MA USA
| | - L. Gan
- Department of Astronomy and Center for Space Physics, Boston University, Boston, MA USA
| | - M. Qin
- Department of Astronomy and Center for Space Physics, Boston University, Boston, MA USA
| | - L. Capannolo
- Department of Astronomy and Center for Space Physics, Boston University, Boston, MA USA
| | - Q. Ma
- Department of Astronomy and Center for Space Physics, Boston University, Boston, MA USA
| | - C. L. Russell
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
| | - E. V. Masongsong
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
| | - R. Caron
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
| | - I. He
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Materials Science and Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
| | - L. Iglesias
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Present Address: Deloitte Consulting, New York, NY 10112 USA
| | - S. Jha
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Computer Science Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Present Address: Microsoft, Redmond, WA 98052 USA
| | - J. King
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Computer Science Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
| | - S. Kumar
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Physics and Astronomy Department, University of California, Los Angeles, CA 90095 USA
- Present Address: Department of Astronomy and Astrophysics, The University of Chicago, Chicago, IL 60637 USA
| | - K. Le
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Materials Science and Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
| | - J. Mao
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Computer Science Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Present Address: Raybeam, Inc., Mountain View, CA 94041 USA
| | - A. McDermott
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
| | - K. Nguyen
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Present Address: SpaceX, Hawthorne, CA 90250 USA
| | - A. Norris
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
| | - A. Palla
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Computer Science Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Present Address: Reliable Robotics Corporation, Mountain View, CA 94043 USA
| | - A. Roosnovo
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Physics and Astronomy Department, University of California, Los Angeles, CA 90095 USA
- Present Address: Los Alamos National Laboratory, Los Alamos, NM 87545 USA
| | - J. Tam
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
| | - E. Xie
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Present Address: Deloitte Consulting, New York, NY 10112 USA
- Computer Science Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
| | - R. C. Yap
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Mathematics Department, University of California, Los Angeles, CA 90095 USA
- Present Address: Planet Labs, PBC, San Francisco, CA 94107 USA
| | - S. Ye
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
| | - C. Young
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Computer Science Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Present Address: Microsoft, Redmond, WA 98052 USA
| | - L. A. Adair
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Physics and Astronomy Department, University of California, Los Angeles, CA 90095 USA
- Present Address: KSAT, Inc., Denver, CO 80231 USA
| | - C. Shaffer
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Present Address: Tyvak Nano-Satellite Systems, Inc., Irvine, CA 92618 USA
| | - M. Chung
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Present Address: Northrop Grumman Aerospace Systems, Redondo Beach, CA 90278 USA
| | - P. Cruce
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Present Address: Apple, Cupertino, CA 95014 USA
| | - M. Lawson
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
| | - D. Leneman
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
| | - M. Allen
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Present Address: Zipline International, South San Francisco, CA 94080 USA
| | - M. Anderson
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Mathematics Department, University of California, Los Angeles, CA 90095 USA
- Present Address: Lucid Motors, Newark, CA 94560 USA
| | - M. Arreola-Zamora
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Present Address: Northrop Grumman Aerospace Systems, Redondo Beach, CA 90278 USA
| | - J. Artinger
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Physics and Astronomy Department, University of California, Los Angeles, CA 90095 USA
- Present Address: College of Engineering and Computer Science, California State University, Fullerton, Fullerton, CA 92831 USA
| | - J. Asher
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Present Address: The Aerospace Corporation, El Segundo, CA 90245 USA
| | - D. Branchevsky
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Present Address: The Aerospace Corporation, El Segundo, CA 90245 USA
- Electrical and Computer Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
| | - M. Cliffe
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Present Address: SpaceX, Hawthorne, CA 90250 USA
- Electrical and Computer Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
| | - K. Colton
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Mathematics Department, University of California, Los Angeles, CA 90095 USA
- Present Address: Planet Labs, PBC, San Francisco, CA 94107 USA
| | - C. Costello
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Computer Science Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Present Address: Heliogen, Pasadena, CA 91103 USA
| | - D. Depe
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Electrical and Computer Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Present Address: Argo AI, LLC, Pittsburgh, PA 15222 USA
| | - B. W. Domae
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Electrical and Computer Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
| | - S. Eldin
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Present Address: Microsoft, Redmond, WA 98052 USA
- Electrical and Computer Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
| | - L. Fitzgibbon
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Physics and Astronomy Department, University of California, Los Angeles, CA 90095 USA
- Present Address: Terran Orbital, Irvine, CA 92618 USA
| | - A. Flemming
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Present Address: Northrop Grumman Aerospace Systems, Redondo Beach, CA 90278 USA
| | - D. M. Frederick
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Present Address: Millenium Space Systems, El Segundo, CA 90245 USA
| | - A. Gilbert
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Electrical and Computer Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Present Address: Department of Electrical Engineering, Stanford University, Stanford, CA 94305 USA
| | - B. Hesford
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109 USA
- Electrical and Computer Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
| | - R. Krieger
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Materials Science and Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Present Address: Mercedes-Benz Research and Development North America, Long Beach, CA 90810 USA
| | - K. Lian
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Present Address: The Aerospace Corporation, El Segundo, CA 90245 USA
| | - E. McKinney
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Present Address: Geosyntec Consultants, Inc., Costa Mesa, CA 92626 USA
| | - J. P. Miller
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Computer Science Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Present Address: Juniper Networks Sunnyvale, California, 94089 USA
| | - C. Pedersen
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
| | - Z. Qu
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Present Address: Niantic Inc., San Francisco, CA 94111 USA
| | - R. Rozario
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Present Address: SpaceX, Hawthorne, CA 90250 USA
| | - M. Rubly
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Present Address: Teledyne Scientific and Imaging, Thousand Oaks, CA 91360 USA
| | - R. Seaton
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
| | - A. Subramanian
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Present Address: Northrop Grumman Aerospace Systems, Redondo Beach, CA 90278 USA
- Electrical and Computer Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
| | - S. R. Sundin
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Present Address: Naval Surface Warfare Center Corona Division, Norco, CA 92860 USA
| | - A. Tan
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Electrical and Computer Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Present Address: Epirus Inc., Torrance, CA 90501 USA
| | - D. Thomlinson
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Present Address: The Aerospace Corporation, El Segundo, CA 90245 USA
| | - W. Turner
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Physics and Astronomy Department, University of California, Los Angeles, CA 90095 USA
- Present Address: Department of Astronomy, Ohio State University, Columbus, OH 43210 USA
| | - G. Wing
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Computer Science Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Present Address: Amazon, Seattle, WA 98109 USA
| | - C. Wong
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Physics and Astronomy Department, University of California, Los Angeles, CA 90095 USA
- Present Address: Department of Radiology, University of California, San Francisco, San Francisco, CA 94143 USA
| | - A. Zarifian
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109 USA
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Rivlin K, Brenner-Levoy J, Odum T, Muzyczka Z, Norris A, Norris Turner A, Bessett D. Provider Mistrust and Telemedicine Abortion Care Preferences Among Patients in Ohio, West Virginia, and Kentucky. Telemed J E Health 2023; 29:414-424. [PMID: 35856859 PMCID: PMC10081726 DOI: 10.1089/tmj.2022.0101] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 04/29/2022] [Accepted: 05/07/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives: The convenience and privacy provided by telemedicine medication abortion may make this service preferable to patients who mistrust their abortion provider. We assessed associations between mistrust in the abortion provider and preferences for telemedicine abortion. Study Design: From April 2020 to April 2021, we surveyed patients seeking abortion in Ohio, West Virginia, and Kentucky. Using unconditional logistic regression models, we examined unadjusted and adjusted associations between mistrust in the abortion provider and preferences for telemedicine abortion among all participants, and among only participants undergoing medication abortion. Results: Of 1,218 patients who met inclusion criteria, 546 used medication abortion services. Just more than half (56%) of all participants and many (64%) of medication abortion participants preferred telemedicine services. Only 6% of medication abortion participants received telemedicine medication dispensing services. Only 1.4% of all participants and 1% of medication abortion participants mistrusted the abortion provider. Participants who mistrusted the abortion provider were somewhat more likely to prefer telemedicine abortion (unadjusted odds ratio [OR]: 2.5, 95% CI: 0.8-7.9; adjusted OR: 2.9, 95% CI: 0.9-9), and medication abortion participants who mistrusted the abortion provider were also somewhat more likely to prefer telemedicine abortion (unadjusted OR: 3.5, 95% CI: 0.4-28.9; adjusted OR: 5.0, 95% CI: 0.6-43), although these associations were not statistically significant. Conclusions: In three abortion-restrictive states, most patients expressed preferences for telemedicine abortion, but few accessed them. Provider mistrust was rare, but those experiencing mistrust trended toward preferring telemedicine services. Telemedicine may improve access to abortion services for patients experiencing medical mistrust.
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Affiliation(s)
- Katherine Rivlin
- Department of Obstetrics and Gynecology, The College of Medicine, The Ohio State University, Columbus, Ohio, USA
| | | | - Tamika Odum
- Behavioral Science Department, Blue Ash College, University of Cincinnati, Cincinnati, Ohio, USA
| | - Zoe Muzyczka
- Department of Sociology, University of Cincinnati, Cincinnati, Ohio, USA
| | - Alison Norris
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, Ohio, USA
| | - Abigail Norris Turner
- Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Danielle Bessett
- Department of Sociology, University of Cincinnati, Cincinnati, Ohio, USA
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Heymann O, Bessett D, Norris A, Hill J, Czarnecki D, Gyuras HJ, Pensak M, McGowan ML. Unlimited Discretion: How Unchecked Bureaucratic Discretion Can Threaten Abortion Availability. J Health Polit Policy Law 2023:10449914. [PMID: 36693185 DOI: 10.1215/03616878-10449914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Previous research assessed the impact of state regulations on clinics and patients, but how bureaucrats implement them is less understood and increasingly important as states arbitrate abortion regulation. We conducted a case study of how bureaucrats use discretion to implement state regulations on abortion, focusing on two abortion facilities in Southwest Ohio from 2010-2022. Ohio abortion facilities are required to obtain a written transfer agreement, despite it offering no demonstrable health or safety benefits. We find that state requirements for obtaining variances, a process that allows abortion facilities to operate without a written transfer agreement, have become exceedingly difficult to comply with. We show how state statutes and administrative law enabled bureaucrats to wield unlimited discretion and enforce arbitrary requirements. This unlimited bureaucratic discretion and accompanying administrative burden exacerbated clinic instability and threatened abortion availability in Southwest Ohio for almost a decade. As implementation and interpretation of abortion policy is increasingly left to state bureaucrats and civil servants following the Supreme Court's Dobbs decision, how bureaucrats use discretion will influence clinic stability and abortion availability. We posit that unlimited bureaucratic discretion may exert greater influence on abortion availability across the nation as states scramble to clarify and implement policies post-Dobbs.
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Bornstein M, Norris A, Shaba G, Huber-Krum S, Gipson JD. "I know my body and I just can't get pregnant that easily" - Women's use and non-use of the injection to manage fertility. SSM Qual Res Health 2022; 2:100071. [PMID: 37021076 PMCID: PMC10069985 DOI: 10.1016/j.ssmqr.2022.100071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Approximately one-third of contraceptive users in Malawi use the Depo-Provera injection, a method that must be re-injected every three-months to prevent pregnancy and may reduce fecundity for a time after discontinuation. Little is known about how women use the injection to achieve their desired family size. In 2018, we conducted 20 in-depth interviews with women who were part of a cohort study in rural Malawi. Interviews focused on contraceptive decision-making. Data were indexed (summarized) and coded using narrative, process, and thematic codes. Women described the importance of knowing about their "natural" fertility by having children prior to ever using contraception because women considered contraception to have a potential negative effect on fertility. Women then applied what they learned about their fertility (i.e., how easy/difficult it was to become pregnant) to manage their fertility over their reproductive life-course. As part of fertility management, women frequently described using the injection less frequently than clinically recommended, using signs from their body (e.g., menstruation) to determine when to reinject. Managing fertility through subclinical injection use was viewed as a way to optimize women's' chances of preventing unintended pregnancy while maintaining their ability to become pregnant when they wanted to. Women wanted to play an active role in managing their fertility and were not passive consumers of contraception. It is therefore critical that family planning programs provide contraceptive counseling to women that engages their desire to manage their fertility, acknowledges their concerns about fertility, and helps them choose a method that best fits their needs.
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Affiliation(s)
- Marta Bornstein
- The Ohio State University College of Public Health, Division of Epidemiology, 250 Cunz Hall, 1841 Neil Ave, Columbus, OH, 43201, USA
- University of California Los Angeles Fielding School of Public Health, Department of Community Health Sciences, 650 Charles E. Young Drive S, Los Angeles, CA, 90015, USA
| | - Alison Norris
- The Ohio State University College of Public Health, Division of Epidemiology, 250 Cunz Hall, 1841 Neil Ave, Columbus, OH, 43201, USA
| | | | - Sarah Huber-Krum
- Harvard T.H. Chan School of Public Health, Cambridge, MA, 02115, USA
| | - Jessica D. Gipson
- University of California Los Angeles Fielding School of Public Health, Department of Community Health Sciences, 650 Charles E. Young Drive S, Los Angeles, CA, 90015, USA
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Turner AN, Kline D, Norris A, Phillips WG, Root E, Wakefield J, Li ZR, Lemeshow S, Spahnie M, Luff A, Chu Y, Francis MK, Gallo M, Chakraborty P, Lindstrom M, Lozanski G, Miller W, Clark S. Prevalence of current and past COVID-19 in Ohio adults. Ann Epidemiol 2021; 67:50-60. [PMID: 34921991 DOI: 10.1016/j.annepidem.2021.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 11/22/2021] [Accepted: 11/27/2021] [Indexed: 11/01/2022]
Abstract
PURPOSE To estimate the prevalence of current and past COVID-19 in Ohio adults. METHODS We used stratified, probability-proportionate-to-size cluster sampling. During July 2020, we enrolled 727 randomly-sampled adult English- and Spanish-speaking participants through a household survey. Participants provided nasopharyngeal swabs and blood samples to detect current and past COVID-19. We used Bayesian latent class models with multilevel regression and poststratification to calculate the adjusted prevalence of current and past COVID-19. We accounted for the potential effects of non-ignorable non-response bias. RESULTS The estimated statewide prevalence of current COVID-19 was 0.9% (95% credible interval: 0.1-2.0%), corresponding to ∼85,000 prevalent infections (95% credible interval: 6,300-177,000) in Ohio adults during the study period. The estimated statewide prevalence of past COVID-19 was 1.3% (95% credible interval: 0.2-2.7%), corresponding to ∼118,000 Ohio adults (95% credible interval: 22,000-240,000). Estimates did not change meaningfully due to non-response bias. CONCLUSIONS Total COVID-19 cases in Ohio in July 2020 were approximately 3.5 times as high as diagnosed cases. The lack of broad COVID-19 screening in the United States early in the pandemic resulted in a paucity of population-representative prevalence data, limiting the ability to measure the effects of statewide control efforts.
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Affiliation(s)
| | - David Kline
- Department of Biostatistics and Data Science, Division of Public Health Sciences, School of Medicine, Wake Forest University
| | - Alison Norris
- Division of Infectious Diseases, College of Medicine, Ohio State University; Division of Epidemiology, College of Medicine, Ohio State University
| | | | - Elisabeth Root
- Division of Epidemiology, College of Medicine, Ohio State University; Institute for Disease Modeling, The Bill and Melinda Gates Foundation
| | | | | | - Stanley Lemeshow
- Division of Biostatistics, College of Public Health, Ohio State University
| | - Morgan Spahnie
- Division of Epidemiology, College of Medicine, Ohio State University
| | - Amanda Luff
- Division of Epidemiology, College of Medicine, Ohio State University
| | - Yue Chu
- Department of Sociology, College of Arts and Sciences, Ohio State University
| | | | - Maria Gallo
- Division of Epidemiology, College of Medicine, Ohio State University
| | - Payal Chakraborty
- Division of Epidemiology, College of Medicine, Ohio State University
| | - Megan Lindstrom
- Institute for Disease Modeling, The Bill and Melinda Gates Foundation
| | - Gerard Lozanski
- Department of Pathology, College of Medicine, Ohio State University
| | - William Miller
- Division of Epidemiology, College of Medicine, Ohio State University
| | - Samuel Clark
- Department of Sociology, College of Arts and Sciences, Ohio State University; MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Yi Y, Sun X, Liang B, Wu P, Wang H, Norris A, Engelhardt J. 628: Abnormalities in glucose metabolism differ between early and late onset of CF pancreatitis in CFTR-G551D-KI ferrets. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)02051-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Muzyczka Z, Brenner-Levoy J, Turner AN, Norris A, Bessett D. POSTER ABSTRACTS. Contraception 2021. [DOI: 10.1016/j.contraception.2021.07.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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10
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Beckmeyer A, Brenner-Levoy J, Hill J, Turner AN, Norris A, Bessett D, Rivlin K. POSTER ABSTRACTS. Contraception 2021. [DOI: 10.1016/j.contraception.2021.07.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Bornstein M, Huber-Krum S, Kaloga M, Norris A. Messages around contraceptive use and implications in rural Malawi. Cult Health Sex 2021; 23:1126-1141. [PMID: 32619393 DOI: 10.1080/13691058.2020.1764625] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Accepted: 04/30/2020] [Indexed: 06/11/2023]
Abstract
The unmet need for contraception in Malawi remains high, despite progress increasing knowledge and access over the past two decades. Understanding the reasons for this unmet need is critical to programme planning and service delivery. In this study, we conducted 30 in-depth interviews and 13 focus group discussions with women and men in rural Malawi to understand social, cultural and relational barriers and facilitators to contraceptive use. We found that contraceptive decisions were influenced by complex, often conflicting messages with varying implications based on individual and contextual factors. Common factors that influence contraceptive use, such as spousal support, side effects and social norms that dictated acceptable users of contraception could act as both barriers and facilitators to use depending on context. While strides have been made in increasing access to contraception, findings indicate a need for public health programmes to take a nuanced approach to increasing contraceptive use that does not presume particular factors will be a barrier or facilitator across groups. Instead, programmes should seek to understand how social, cultural and relational factors influencing contraceptive use differ across groups.
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Affiliation(s)
- Marta Bornstein
- Department of Community Health Sciences, Fielding School of Public Health and the California Center for Population Research, University of California, Los Angeles, USA
| | - Sarah Huber-Krum
- College of Social Work, The Ohio State University, Columbus, OH, USA
| | - Marissa Kaloga
- Department of Social and Community Work, School of Social Sciences, University of Otago, Dunedin, New Zealand
| | - Alison Norris
- College of Public Health, The Ohio State University, Columbus, OH, USA
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Gallo MF, Casterline JB, Chakraborty P, Norris A, Bessett D, Turner AN. Passage of abortion ban and women's accurate understanding of abortion legality. Am J Obstet Gynecol 2021; 225:63.e1-63.e8. [PMID: 33577763 DOI: 10.1016/j.ajog.2021.02.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 02/02/2021] [Accepted: 02/07/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Legislative and judicial procedures related to banning abortion after 6 weeks of gestation in Ohio occurred from November 2018 to July 2019. These activities could have increased the belief that abortion has become illegal even though the 6-week abortion ban has never been in effect to date. OBJECTIVE We sought to determine the prevalence and correlates of holding the belief that abortion is illegal in Ohio and to evaluate whether this belief increased over the time in which the 6-week abortion ban was introduced, passed twice, and then blocked in Ohio. STUDY DESIGN We analyzed data from the first wave of the Ohio Survey of Women, a population-based survey of adult, reproductive-aged Ohioan women conducted from October 2018 to June 2019. During each of the 8 survey months, a median of 240 women (range, 70-761) completed the survey, including the survey question "Based on what you know or have heard, is it legal to get an abortion in your state?" We used multivariable logistic regression to assess the prevalence and correlates of believing that abortion is illegal in the state of Ohio. In addition, we used multinomial logistic regression to evaluate whether this belief increased over the interval during which women completed the survey, which roughly corresponded to the interval marked by legislative and judicial activities surrounding the 6-week abortion ban. RESULTS Most of the 2359 participants understood that abortion is legal in the state of Ohio (64.0%) with the remainder believing it to be illegal (9.8%) or being unsure (26.2%). Correlates of believing abortion to be illegal included younger age, lower socioeconomic status, never married or married status, and Black, non-Hispanic race and ethnicity. Being unsure about legality did not change over time; however, the proportion of women who believed that abortion is illegal increased from the first month (4.5%) to the last month (15.9%) of the study period. Each additional study month was associated with a 17% increase in the odds of believing abortion to be illegal, in both unadjusted and adjusted models (odds ratio, 1.17; 95% confidence interval, 1.08-1.27). CONCLUSION Attempts to restrict abortion access could contribute to women mistakenly believing that abortion is illegal despite it being unsuccessful.
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Affiliation(s)
- Maria F Gallo
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH.
| | - John B Casterline
- Department of Sociology, College of Arts and Sciences, The Ohio State University, Columbus, OH
| | - Payal Chakraborty
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH
| | - Alison Norris
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH
| | - Danielle Bessett
- Department of Sociology, College of Arts and Sciences, University of Cincinnati, Cincinnati, OH
| | - Abigail Norris Turner
- Division of Infectious Diseases, College of Medicine, The Ohio State University, Columbus, OH
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13
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Moseson H, Jayaweera R, Huber-Krum S, Garver S, Norris A, Gerdts C. Reducing underreporting of abortion in surveys: Results from two test applications of the list experiment method in Malawi and Senegal. PLoS One 2021; 16:e0247201. [PMID: 33657126 PMCID: PMC7928519 DOI: 10.1371/journal.pone.0247201] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 02/02/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Accurately measuring abortion incidence poses many challenges. The list experiment is a method designed to increase the reporting of sensitive or stigmatized behaviors in surveys, but has only recently been applied to the measurement of abortion. To further test the utility of the list experiment for measuring abortion incidence, we conducted list experiments in two countries, over two time periods. MATERIALS AND METHODS The list experiment is an indirect method of measuring sensitive experiences that protects respondent confidentiality by hiding individual responses to a binary sensitive item (i.e., abortion) by combining this response with answers to other non-sensitive binary control items. Respondents report the number of list items that apply to them, not which ones. We conducted a list experiment to measure cumulative lifetime incidence of abortion in Malawi, and separately to measure cumulative five-year incidence of abortion in Senegal, among cisgender women of reproductive age. RESULTS Among 810 eligible respondents in Malawi, list experiment results estimated a cumulative lifetime incidence of abortion of 0.9% (95%CI: 0.0, 7.6). Among 1016 eligible respondents in Senegal, list experiment estimates indicated a cumulative five-year incidence of abortion of 2.8% (95%CI: 0.0, 10.4) which, while lower than anticipated, is seven times the proportion estimated from a direct question on abortion (0.4%). CONCLUSIONS Two test applications of the list experiment to measure abortion experiences in Malawi and Senegal likely underestimated abortion incidence. Future efforts should include context-specific formative qualitative research for the development and selection of list items, enumerator training, and method delivery to assess if and how these changes can improve method performance.
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Affiliation(s)
- Heidi Moseson
- Ibis Reproductive Health, Oakland, CA, United States of America
| | | | - Sarah Huber-Krum
- Harvard T. H. Chan School of Public Health, Cambridge, MA, United States of America
| | - Sarah Garver
- University of Chicago, Chicago, IL, United States of America
| | - Alison Norris
- The Ohio State University, Columbus, OH, United States of America
| | - Caitlin Gerdts
- Ibis Reproductive Health, Oakland, CA, United States of America
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Chakraborty P, Gallo M, Smith M, Hood R, Nawaz S, Chettri S, Norris A, Casterline J, Turner A. P67 Non-use of preferred contraceptive method among contracepting women in Ohio. Contraception 2020. [DOI: 10.1016/j.contraception.2020.07.086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Angelopoulos V, Tsai E, Bingley L, Shaffer C, Turner DL, Runov A, Li W, Liu J, Artemyev AV, Zhang XJ, Strangeway RJ, Wirz RE, Shprits YY, Sergeev VA, Caron RP, Chung M, Cruce P, Greer W, Grimes E, Hector K, Lawson MJ, Leneman D, Masongsong EV, Russell CL, Wilkins C, Hinkley D, Blake JB, Adair N, Allen M, Anderson M, Arreola-Zamora M, Artinger J, Asher J, Branchevsky D, Capitelli MR, Castro R, Chao G, Chung N, Cliffe M, Colton K, Costello C, Depe D, Domae BW, Eldin S, Fitzgibbon L, Flemming A, Fox I, Frederick DM, Gilbert A, Gildemeister A, Gonzalez A, Hesford B, Jha S, Kang N, King J, Krieger R, Lian K, Mao J, McKinney E, Miller JP, Norris A, Nuesca M, Palla A, Park ESY, Pedersen CE, Qu Z, Rozario R, Rye E, Seaton R, Subramanian A, Sundin SR, Tan A, Turner W, Villegas AJ, Wasden M, Wing G, Wong C, Xie E, Yamamoto S, Yap R, Zarifian A, Zhang GY. The ELFIN Mission. Space Sci Rev 2020; 216:103. [PMID: 32831412 PMCID: PMC7413588 DOI: 10.1007/s11214-020-00721-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 07/09/2020] [Indexed: 06/11/2023]
Abstract
The Electron Loss and Fields Investigation with a Spatio-Temporal Ambiguity-Resolving option (ELFIN-STAR, or heretoforth simply: ELFIN) mission comprises two identical 3-Unit (3U) CubeSats on a polar (∼93∘ inclination), nearly circular, low-Earth (∼450 km altitude) orbit. Launched on September 15, 2018, ELFIN is expected to have a >2.5 year lifetime. Its primary science objective is to resolve the mechanism of storm-time relativistic electron precipitation, for which electromagnetic ion cyclotron (EMIC) waves are a prime candidate. From its ionospheric vantage point, ELFIN uses its unique pitch-angle-resolving capability to determine whether measured relativistic electron pitch-angle and energy spectra within the loss cone bear the characteristic signatures of scattering by EMIC waves or whether such scattering may be due to other processes. Pairing identical ELFIN satellites with slowly-variable along-track separation allows disambiguation of spatial and temporal evolution of the precipitation over minutes-to-tens-of-minutes timescales, faster than the orbit period of a single low-altitude satellite (Torbit ∼ 90 min). Each satellite carries an energetic particle detector for electrons (EPDE) that measures 50 keV to 5 MeV electrons with Δ E/E < 40% and a fluxgate magnetometer (FGM) on a ∼72 cm boom that measures magnetic field waves (e.g., EMIC waves) in the range from DC to 5 Hz Nyquist (nominally) with <0.3 nT/sqrt(Hz) noise at 1 Hz. The spinning satellites (Tspin ∼ 3 s) are equipped with magnetorquers (air coils) that permit spin-up or -down and reorientation maneuvers. Using those, the spin axis is placed normal to the orbit plane (nominally), allowing full pitch-angle resolution twice per spin. An energetic particle detector for ions (EPDI) measures 250 keV - 5 MeV ions, addressing secondary science. Funded initially by CalSpace and the University Nanosat Program, ELFIN was selected for flight with joint support from NSF and NASA between 2014 and 2018 and launched by the ELaNa XVIII program on a Delta II rocket (with IceSatII as the primary). Mission operations are currently funded by NASA. Working under experienced UCLA mentors, with advice from The Aerospace Corporation and NASA personnel, more than 250 undergraduates have matured the ELFIN implementation strategy; developed the instruments, satellite, and ground systems and operate the two satellites. ELFIN's already high potential for cutting-edge science return is compounded by concurrent equatorial Heliophysics missions (THEMIS, Arase, Van Allen Probes, MMS) and ground stations. ELFIN's integrated data analysis approach, rapid dissemination strategies via the SPace Environment Data Analysis System (SPEDAS), and data coordination with the Heliophysics/Geospace System Observatory (H/GSO) optimize science yield, enabling the widest community benefits. Several storm-time events have already been captured and are presented herein to demonstrate ELFIN's data analysis methods and potential. These form the basis of on-going studies to resolve the primary mission science objective. Broad energy precipitation events, precipitation bands, and microbursts, clearly seen both at dawn and dusk, extend from tens of keV to >1 MeV. This broad energy range of precipitation indicates that multiple waves are providing scattering concurrently. Many observed events show significant backscattered fluxes, which in the past were hard to resolve by equatorial spacecraft or non-pitch-angle-resolving ionospheric missions. These observations suggest that the ionosphere plays a significant role in modifying magnetospheric electron fluxes and wave-particle interactions. Routine data captures starting in February 2020 and lasting for at least another year, approximately the remainder of the mission lifetime, are expected to provide a very rich dataset to address questions even beyond the primary mission science objective.
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Affiliation(s)
- V Angelopoulos
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - E Tsai
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - L Bingley
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - C Shaffer
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Present Address: Tyvak Nano-Satellite Systems, Inc., Irvine, CA 92618 USA
| | - D L Turner
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Present Address: Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723 USA
| | - A Runov
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - W Li
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Present Address: Department of Astronomy and Center for Space Physics, Boston University, Boston, MA 02215 USA
| | - J Liu
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - A V Artemyev
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - X-J Zhang
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - R J Strangeway
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - R E Wirz
- Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
| | - Y Y Shprits
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- GFZ German Research Centre for Geosciences, Potsdam, 14473 Germany
| | - V A Sergeev
- Saint Petersburg State University, St. Petersburg, 199034 Russia
| | - R P Caron
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - M Chung
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Present Address: Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723 USA
| | - P Cruce
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Present Address: Northrop Grumman Aerospace Systems, Redondo Beach, CA 90278 USA
| | - W Greer
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - E Grimes
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - K Hector
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Present Address: Raytheon Space and Airborne Systems, El Segundo, CA 90245 USA
| | - M J Lawson
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - D Leneman
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - E V Masongsong
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - C L Russell
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - C Wilkins
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - D Hinkley
- The Aerospace Corporation, El Segundo, CA 90245 USA
| | - J B Blake
- The Aerospace Corporation, El Segundo, CA 90245 USA
| | - N Adair
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Present Address: Millenium Space Systems, El Segundo, CA 90245 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - M Allen
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Present Address: Northrop Grumman Aerospace Systems, Redondo Beach, CA 90278 USA
| | - M Anderson
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Present Address: Aptiv, Agoura Hills, CA 91301 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - M Arreola-Zamora
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - J Artinger
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Physics and Astronomy Department, University of California, Los Angeles, CA 90095 USA
| | - J Asher
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Present Address: Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723 USA
| | - D Branchevsky
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- The Aerospace Corporation, El Segundo, CA 90245 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - M R Capitelli
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Present Address: Millenium Space Systems, El Segundo, CA 90245 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - R Castro
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Present Address: Raytheon Space and Airborne Systems, El Segundo, CA 90245 USA
| | - G Chao
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Present Address: The Boeing Company, Long Beach, CA 90808 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - N Chung
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Present Address: SF Motors, Santa Clara, CA 95054 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - M Cliffe
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Present Address: SpaceX, Hawthorne, CA 90250 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - K Colton
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Present Address: Planet Labs, Inc., San Francisco, CA 94107 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - C Costello
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Computer Science Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - D Depe
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Electrical and Computer Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - B W Domae
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Electrical and Computer Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - S Eldin
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Electrical and Computer Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - L Fitzgibbon
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Present Address: Tyvak Nano-Satellite Systems, Inc., Irvine, CA 92618 USA
| | - A Flemming
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Present Address: Northrop Grumman Aerospace Systems, Redondo Beach, CA 90278 USA
| | - I Fox
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
| | - D M Frederick
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Present Address: Millenium Space Systems, El Segundo, CA 90245 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - A Gilbert
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Electrical and Computer Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - A Gildemeister
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Present Address: Northrop Grumman Aerospace Systems, Redondo Beach, CA 90278 USA
| | - A Gonzalez
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Present Address: SpaceX, Hawthorne, CA 90250 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - B Hesford
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Present Address: Jet Propulsion Laboratory, Pasadena, CA 91109 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - S Jha
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Computer Science Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - N Kang
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Present Address: Millenium Space Systems, El Segundo, CA 90245 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - J King
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Computer Science Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - R Krieger
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Present Address: Mercedes-Benz Research and Development North America, Long Beach, CA 90810 USA
| | - K Lian
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Present Address: Northrop Grumman Aerospace Systems, Redondo Beach, CA 90278 USA
| | - J Mao
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Present Address: Verona, WI 53593 USA
| | - E McKinney
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Present Address: California State Polytechnic University, Pomona, CA 91768 USA
| | - J P Miller
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Computer Science Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - A Norris
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
| | - M Nuesca
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Computer Science Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - A Palla
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Computer Science Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - E S Y Park
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Present Address: Economics Department, University of California, Los Angeles, CA 90095 USA
| | - C E Pedersen
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
| | - Z Qu
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
| | - R Rozario
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Present Address: SpaceX, Hawthorne, CA 90250 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - E Rye
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Electrical and Computer Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - R Seaton
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
| | - A Subramanian
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Present Address: Northrop Grumman Aerospace Systems, Redondo Beach, CA 90278 USA
| | - S R Sundin
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Present Address: Tyvak Nano-Satellite Systems, Inc., Irvine, CA 92618 USA
| | - A Tan
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Present Address: Experior Laboratories, Oxnard, CA 93033 USA
| | - W Turner
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Physics and Astronomy Department, University of California, Los Angeles, CA 90095 USA
| | - A J Villegas
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Physics and Astronomy Department, University of California, Los Angeles, CA 90095 USA
| | - M Wasden
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
| | - G Wing
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Computer Science Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - C Wong
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Physics and Astronomy Department, University of California, Los Angeles, CA 90095 USA
| | - E Xie
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Electrical and Computer Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - S Yamamoto
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
| | - R Yap
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Mathematics Department, University of California, Los Angeles, CA 90095 USA
| | - A Zarifian
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Present Address: Jet Propulsion Laboratory, Pasadena, CA 91109 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - G Y Zhang
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Present Address: Qualcomm, San Diego, CA 92121 USA
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Aggarwal S, Norris A. Professional attitudes to a ‘smart’ tracheal tube: report of a survey of Difficult Airway Society delegates in 2018. Br J Anaesth 2020. [DOI: 10.1016/j.bja.2020.04.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Bornstein M, Gipson JD, Failing G, Banda V, Norris A. Individual and community-level impact of infertility-related stigma in Malawi. Soc Sci Med 2020; 251:112910. [PMID: 32182444 DOI: 10.1016/j.socscimed.2020.112910] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 03/03/2020] [Accepted: 03/04/2020] [Indexed: 11/16/2022]
Abstract
Infertility, a common experience among women and men worldwide, remains on the margins of public health and medicine in low-resource settings. Previous studies identified associations between individual experiences of infertility and negative outcomes, particularly in contexts where childbearing is imperative, but few have examined broader implications of infertility and infertility-related stigma on communities. To understand the production and impact of infertility-related stigma, this study analyzes 12 focus group discussions (FGDs) conducted with 104 women and men in rural Malawi. FGDs, conducted July-September 2018, were used to elicit the range of community norms around family formation, pregnancy, fertility, and infertility. Data were analyzed through memo-ing during and after data collection and collaborative, thematic coding. We found that stigma manifested within existing systems of gender and power. Aligning with Link and Phelan's stigma framework (2001) there were three primary mechanisms by which infertility-related stigma was produced and reinforced: labeling of a person perceived to be infertile (i.e., establishing 'other'), perpetuating negative stereotypes associated with suspected causes of infertility (e.g., abortion, multiple sexual partners, weak sperm), and consequences of infertility that reinforced stigma (e.g., social ridicule and distancing, divorce). Labels, presumed causes, and consequences of infertility were entrenched within gender and sexuality norms. Women perceived as infertile were unable to follow a normative path to achieving adult status, presumed to be sexually transgressive, and considered "useless." Men's masculinity was questioned. Both women's and men's identities, as well as social positions within relationships and communities, were threatened by perceptions of infertility. Ultimately, the manifestation of infertility-related stigma contributed to an environment wherein the risk of being perceived as infertile was highly consequential and unrelenting. Pervasive stigma, at the community-level, impacts decisions around contraceptive use and timing of childbearing, as women and men not only wanted to avoid infertility, but also the appearance of infertility.
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Affiliation(s)
- Marta Bornstein
- Department of Community Health Sciences, Jonathan and Karin Fielding School of Public Health, University of California - Los Angeles, Los Angeles, CA, USA; California Center for Population Research, University of California - Los Angeles, Los Angeles, CA, USA.
| | - Jessica D Gipson
- Department of Community Health Sciences, Jonathan and Karin Fielding School of Public Health, University of California - Los Angeles, Los Angeles, CA, USA; California Center for Population Research, University of California - Los Angeles, Los Angeles, CA, USA
| | - Gates Failing
- College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Venson Banda
- Child Legacy Hospital, Umoyo Wa Thanzi Research Program, Lilongwe, Malawi
| | - Alison Norris
- College of Public Health and College of Medicine, The Ohio State University, Columbus, OH, USA
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18
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Morgan SP, Canfarotta F, Piletska EV, Grillo F, Korposh S, Liu L, Hernandez FU, Correia R, Norris A, Sinha R, Hayes-Gill BR, Piletsky SA. Optical fiber sensors for monitoring in critical care. Annu Int Conf IEEE Eng Med Biol Soc 2020; 2019:1139-1143. [PMID: 31946095 DOI: 10.1109/embc.2019.8856893] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Monitoring of key physiological and pharmacological parameters is an important part of a closed loop control system in critical care. Optical fiber sensors provide a versatile platform technology that can be easily incorporated into existing in-dwelling catheters or face masks. With appropriate functional coatings they can be used to monitor a range of relevant parameters and two different examples are presented: (i) respiration monitoring; (ii) drug level monitoring. Respiration monitoring involves monitoring of temperature and humidity in inhaled and exhaled breath. The optical fiber sensor consists of a fiber Bragg grating to measure temperature and a tip coating whose refractive index changes with humidity. The sensor is demonstrated to be able to track breath to breath changes when incorporated into a mask. Drug level monitoring is demonstrated in vitro using a long period grating coated with molecularly imprinted polymer nanoparticles that are sensitive to fentanyl. The sensor has a limit of detection of 50ng/ml.
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Abstract
Background Schistosoma haematobium infection has been documented as an uncommon cause of vesicovaginal fistula (VVF) and can result in impaired wound healing of urogenital tissues. For these reasons, it could potentially be linked to an increased rate of obstetric fistula among women who experience obstructed labor and/or in a higher failure rate of fistula repair. Therefore, the primary objective of our study was to determine the prevalence of S. haematobium infection among women undergoing obstetric VVF repair in Lilongwe, Malawi. Our secondary objectives were to assess if S. haematobium infection could be a risk factor for obstetric fistula development or unsuccessful VVF repair in our patient population. Methods From July to October 2013, we conducted S. haematobium testing via urine microscopy on 96 patients undergoing obstetric VVF repair surgery at the Fistula Care Centre in Lilongwe, Malawi. Results The prevalence of S. haematobium infection among women undergoing obstetric VVF repair was 2% (n=2). Both women with S. haematobium had successful VVF repairs. Conclusions Although S. haematobium has the potential to be a risk factor for obstetric VVF formation or unsuccessful VVF repair, it was uncommon among the women in our clinic with obstetric VVF.
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Affiliation(s)
| | - Jennifer H Tang
- UNC Project-Malawi.,UNC Department of Obstetrics and Gynaecology
| | | | | | | | - Ronald Mataya
- Loma Linda University School of Public Health.,Malawi College of Medicine, Department of Obstetrics and Gynaecology
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20
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Norris A, Crossland W, Tedeschi L, Foster J, Muir J, Pinchak W. 419 Effect of Differing Rates of Quebracho (Schinopsis balansae) Extract provided in a Limit-Fed High Roughage Total Mixed Ration Upon Digestibility and Nitrogen Balance. J Anim Sci 2018. [DOI: 10.1093/jas/sky404.448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- A Norris
- Texas A&M University, College Station,College Station, TX, United States
| | - W Crossland
- Texas Tech University,Lubbock, TX, United States
| | - L Tedeschi
- Department of Animal Science, Texas A&M University-College Station,College Station, TX, United States
| | - J Foster
- Texas A&M AgriLife Research,Beeville, College station, TX, United States
| | - J Muir
- Texas A&M AgriLife Research,Stephenville, TX, United States
| | - W Pinchak
- Texas A&M AgriLife Research,Beeville, College station, TX, United States
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21
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Rao N, Esber A, Turner A, Mopiwa G, Banda J, Norris A. Infertility and self-rated health among Malawian women. Women Health 2018; 58:1081-1093. [PMID: 29240537 DOI: 10.1080/03630242.2017.1414098] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Revised: 10/29/2017] [Accepted: 10/31/2017] [Indexed: 10/18/2022]
Abstract
Infertility is prevalent and stigmatized in sub-Saharan Africa. Self-rated health, a subjective indicator that has been consistently related to objectively measured health, may be useful in evaluating the relationship between women's infertility and health. Data were from surveys conducted from July 2014 to January 2015 with women aged 15-39 years (n = 915) as part of the initial assessment in a cohort study in Lilongwe district, Malawi. We first assessed correlates of self-reported infertility among women in rural Malawi. We then used multiple logistic regression to examine associations between infertility and self-rated health. Of women surveyed, 20 percent had a history of infertility. Compared to women who had not experienced infertility, women with a history of infertility were older (p = 0.05), less educated (p = 0.01), and more likely to report depressive symptoms (p = 0.02) and forced first intercourse (p = 0.02) and to have been previously diagnosed with a sexually transmitted infection (p = 0.05). However, women with a history of infertility were not significantly more likely to report poor self-rated health (adjusted odds ratio: 1.69; 95 percent confidence interval: 0.70-4.07). Infertility was prevalent in our sample of Malawian women but was not significantly related to self-rated health, an instrument widely used in public-health research.
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Affiliation(s)
- Nisha Rao
- a The Ohio State University College of Medicine , Columbus , Ohio , USA
- b Department of Medicine , Columbia University Medical Center , New York , New York , USA
| | - Allahna Esber
- c The Ohio State University College of Public Health , Columbus , Ohio, USA
| | - Abigail Turner
- a The Ohio State University College of Medicine , Columbus , Ohio , USA
- c The Ohio State University College of Public Health , Columbus , Ohio, USA
| | | | - Joana Banda
- d Child Legacy International , Lilongwe , Malawi
| | - Alison Norris
- a The Ohio State University College of Medicine , Columbus , Ohio , USA
- c The Ohio State University College of Public Health , Columbus , Ohio, USA
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Zhang A, Jumbe E, Krysiak R, Sidiki S, Kelley HV, Chemey EK, Kamba C, Mwapasa V, García JI, Norris A, Pan XJ, Evans C, Wang SH, Kwiek JJ, Torrelles JB. Low-cost diagnostic test for susceptible and drug-resistant tuberculosis in rural Malawi. Afr J Lab Med 2018; 7:690. [PMID: 29977794 PMCID: PMC6018377 DOI: 10.4102/ajlm.v7i1.690] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2017] [Accepted: 01/29/2018] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Rural settings where molecular tuberculosis diagnostics are not currently available need easy-to-use tests that do not require additional processing or equipment. While acid-fast bacilli (AFB) smear is the most common and often only tuberculosis diagnosis test performed in rural settings, it is labour intensive, has less-than-ideal sensitivity, and cannot assess tuberculosis drug susceptibility patterns. OBJECTIVE The objective of this study was to determine the feasibility of a multidrug-resistant (MDR) or extensively drug-resistant (XDR)-tuberculosis coloured agar-based culture test (tuberculosis CX-test), which can detect Mycobacterium tuberculosis growth and evaluate for drug susceptibility to isoniazid, rifampicin and a fluoroquinolone (i.e. ciprofloxacin) in approximately 14 days. METHOD In this study, 101 participants were enrolled who presented to a rural health clinic in central Malawi. They were suspected of having active pulmonary tuberculosis. Participants provided demographic and clinical data and submitted sputum samples for tuberculosis testing using the AFB smear and tuberculosis CX-test. RESULTS The results showed a high level of concordance between the AFB smear (12 positive) and tuberculosis CX-test (13 positive); only one sample presented discordant results, with the molecular GeneXpert MTB/RIF® test confirming the tuberculosis CX-test results. The average time to a positive tuberculosis CX-test was 10 days. Of the positive samples, the tuberculosis CX-test detected no cases of drug resistance, which was later confirmed by the GeneXpert MTB/RIF®. CONCLUSION These findings demonstrate that the tuberculosis CX-test could be a reliable low-cost diagnostic method for active pulmonary tuberculosis in high tuberculosis burden rural areas.
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Affiliation(s)
- Annie Zhang
- Department of Microbiology, College of Arts and Sciences, The Ohio State University, Columbus, Ohio, United States
| | - Enoch Jumbe
- Child Legacy International, Msundwe, Lilongwe, Malawi
| | - Robert Krysiak
- Department of Infectious Diseases, School of Medicine, University of North Carolina Project, Tidziwe Centre, Lilongwe, Malawi
| | - Sabeen Sidiki
- Department of Microbial Infection and Immunity, College of Medicine, The Ohio State University, Columbus, Ohio, United States
| | - Holden V. Kelley
- Department of Microbial Infection and Immunity, College of Medicine, The Ohio State University, Columbus, Ohio, United States
| | | | - Chancy Kamba
- District Tuberculosis Control Office, Ministry of Health, Lilongwe, Malawi
| | - Victor Mwapasa
- Department of Community Health, College of Medicine, Blantyre, Malawi
| | - Juan I. García
- Department of Pediatrics, Obstetrics, Gynecology and Preventive Medicine, Autonomous University of Barcelona, Barcelona, Spain
| | - Alison Norris
- College of Public Health, The Ohio State University, Columbus, Ohio, United States
| | - Xueliang J. Pan
- Center for Biostatistics, College of Medicine, The Ohio State University, Columbus, Ohio, United States
| | - Carlton Evans
- The Wellcome Centre for Clinical Tropical Medicine, Imperial College of London, London, United Kingdom,Department of Microbiology, Cayetano Heredia University, Lima, Peru
| | - Shu-Hua Wang
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, Ohio, United States
| | - Jesse J. Kwiek
- Department of Microbiology, College of Arts and Sciences, The Ohio State University, Columbus, Ohio, United States
| | - Jordi B. Torrelles
- Department of Microbial Infection and Immunity, College of Medicine, The Ohio State University, Columbus, Ohio, United States
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Esber A, Norris A, Jumbe E, Kandodo J, Nampandeni P, Reese PC, Turner AN. Feasibility, validity and acceptability of self-collected samples for human papillomavirus (HPV) testing in rural Malawi. Malawi Med J 2018; 30:61-66. [PMID: 30627330 PMCID: PMC6307066 DOI: 10.4314/mmj.v30i2.2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 12/19/2017] [Accepted: 01/30/2018] [Indexed: 12/20/2022] Open
Abstract
Aim The World Health Organization (WHO) recently endorsed human papillomavirus (HPV) testing as a cervical cancer screening method in countries without established programs. Self-collection for HPV testing may be an effective way to expand screening. Our objective was to assess the feasibility, validity, and acceptability of self-collection for HPV testing in a population of care-seeking, unscreened women in rural Malawi. Methods We enrolled women reporting to a rural Malawian clinic from January to August 2015. Participants were offered the option to self-collect a vaginal sample and the study clinician collected a cervical sample for HPV testing. Using the clinician-collected sample as the reference standard, we calculated a kappa statistic, sensitivity, and specificity by hr-HPV type. Participants also received a brief survey assessing acceptability of the procedure. Results Among the 199 enrolled women, 22% had any high risk-HPV. Comparing self- and clinician-collected samples for HPV testing, we found generally high agreement (ϰ = 0.66-0.90) and high specificity (98%-100%), but varied sensitivity (50%-91%) for different types of hr-HPV. We also found that self-collection was acceptable, with 98% of women reporting it was easy to do and 99% reporting willingness to do so again. Conclusions WHO guidelines recommend that treatment is available immediately after a positive screening test for clinic-based cervical cancer screening programs. Our findings demonstrate that self-collection of samples for HPV testing is a feasible and acceptable method of cervical cancer screening in this rural Malawian population. High agreement between the self- and clinician-collected samples and high levels of acceptability among women in the study suggest that self-collection of vaginal samples for HPV testing may be effectively incorporated into screening programs among rural, largely unscreened populations.
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Affiliation(s)
- Allahna Esber
- Division of Epidemiology, The Ohio State University, Columbus, USA
| | - Alison Norris
- Division of Epidemiology, The Ohio State University, Columbus, USA
| | - Enock Jumbe
- Child Legacy International, Umoyo wa Thanzi Research, Lilongwe Malawi
| | - Jonathan Kandodo
- Child Legacy International, Umoyo wa Thanzi Research, Lilongwe Malawi
| | | | | | - Abigail Norris Turner
- Division of Infectious Diseases, Department of Internal Medicine, The Ohio State University, Columbus, USA
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Wilmot E, Yotebieng M, Norris A, Ngabo F. Missed Opportunities in Neonatal Deaths in Rwanda: Applying the Three Delays Model in a Cross-Sectional Analysis of Neonatal Death. Matern Child Health J 2017; 21:1121-1129. [PMID: 28214925 DOI: 10.1007/s10995-016-2210-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Objective Administered in a timely manner, current evidence-based interventions could reduce neonatal deaths from infections, intrapartum injuries and complications due to prematurity. The three delays model (delay in seeking care, in arriving at a health facility, and in receiving adequate care), which has been applied to understanding maternal deaths, may be useful for understanding neonatal deaths. We assess the main causes of neonatal deaths in Rwanda and their associated delays. Methods Using a cross-sectional study design, we evaluated data from 2012 from 40 facilities in which babies were delivered. Audit committees in each facility reviewed each neonatal death in the facility and reported finding to the Ministry of Health using structured questionnaires. Information from questionnaires were centralized in an electronic database. At the end of 2012, records from 40 health facilities across Rwanda's five provinces (mainly district hospitals) were available in the database and were used for this analysis. Results Of the 1324 neonates, the major causes of death were: asphyxia and its complications (36.7%), lower respiratory tract infections (LRTI) (22.5%), and prematurity (22.4%). At least one delay was experienced by nearly three-quarters of neonates: Maternal Delay in Seeking Care 22.1%, Maternal Delay in Arrival to Care 11.2%, Maternal Delay in Adequate Care 14.2%, Neonatal Delay in Seeking Care 8.1%, Neonatal Delay in Arrival to Care 9.3%, and Neonatal Delay in Adequate Care 29.1%. Neonates with each of the main causes of death had statistically significantly increased odds of experiencing Maternal Delay in Seeking Care. Asphyxia deaths had increased odds of experiencing all three Maternal Delays. LRTI deaths had increased odds of all three Neonatal Delays. Conclusion Delays for women in seeking obstetrical care is a critical factor associated with the main causes of neonatal death in Rwanda. Improving obstetrical care quality could reduce neonatal deaths due to asphyxia. Likewise, reducing all three delays could reduce neonatal deaths due to LRTI.
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Affiliation(s)
- Efua Wilmot
- College of Public Health, The Ohio State University, Columbus, OH, USA. .,Edward Via College of Osteopathic Medicine, Spartanburg, SC, USA.
| | - Marcel Yotebieng
- College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Alison Norris
- College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Fidele Ngabo
- Ministry of Health (Maternal and Child Health), Kigali, Rwanda
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Huber S, Esber A, Garver S, Banda V, Norris A. The Relationship Between Ambivalent and Indifferent Pregnancy Desires and Contraceptive Use Among Malawian Women. Int Perspect Sex Reprod Health 2017; 43:13-19. [PMID: 28930624 DOI: 10.1363/43e3417] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
CONTEXT Pregnancy ambivalence and pregnancy indifference are thought to be associated with nonuse of contraceptives, but their conceptualization and measurement vary, and their relationship to contraceptive use in developing countries is poorly understood. METHODS Data from the Umoyo wa Thanzi research program in rural Lilongwe, Malawi, were used to classify the pregnancy desires of 592 women aged 15-39 as antinatal, pronatal, ambivalent or indifferent, according to both the women's desire to conceive and their desire to avoid pregnancy. Logistic regression was used to assess the relationship between each of the four pregnancy desire categories and use of modern contraceptives. RESULTS Overall, 12% of women were classified as ambivalent, 32% as indifferent, 44% as antinatal and 12% as pronatal. In the logistic regression analysis, the odds of contraceptive use among women with indifferent pregnancy desires (having both a desire not to avoid pregnancy and a desire not to conceive) were twice those of women with pronatal desires (odds ratio, 2.2) and were similar to those among women with antinatal desires (2.7). In contrast, the odds of contraceptive use among women with ambivalent pregnancy desires (having both a desire to avoid pregnancy and a desire to conceive) did not differ from those of women who had pronatal desires. CONCLUSIONS Ambivalent and indifferent pregnancy desires are common in Malawi and are associated with modern contraceptive use in different ways. Understanding the complex nature of pregnancy desires may be valuable in improving family planning programs.
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Affiliation(s)
| | - Allahna Esber
- Henry M. Jackson Foundation for the Advancement of Military Medicine
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Kaplan JA, Kandodo J, Sclafani J, Raine S, Blumenthal-Barby J, Norris A, Norris-Turner A, Chemey E, Beckham JM, Khan Z, Chunda R. An investigation of the relationship between autonomy, childbirth practices, and obstetric fistula among women in rural Lilongwe District, Malawi. BMC Int Health Hum Rights 2017. [PMID: 28629455 PMCID: PMC5477240 DOI: 10.1186/s12914-017-0125-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background Obstetric fistula is a childbirth injury caused by prolonged obstructed labor that results in destruction of the tissue wall between the vagina and bladder. Although obstetric fistula is directly caused by prolonged obstructed labor, many other factors indirectly increase fistula risk. Some research suggests that many women in rural Malawi have limited autonomy and decision-making power in their households. We hypothesize that women’s limited autonomy may play a role in reinforcing childbirth practices that increase the risk of obstetric fistula in this setting by hindering access to emergency care and further prolonging obstructed labor. Methods A medical student at Baylor College of Medicine partnered with a Malawian research assistant in July 2015 to conduct in-depth qualitative interviews in Chichewa with 25 women living within the McGuire Wellness Centre’s catchment area (rural Central Lilongwe District) who had received obstetric fistula repair surgery. Results This study assessed whether women’s limited autonomy in rural Malawi reinforces childbearing practices that increase risk of obstetric fistula. We considered four dimensions of autonomy: sexual and reproductive decision-making, decision-making related to healthcare utilization, freedom of movement, and discretion over earned income. We found that participants had limited autonomy in these domains. For example, many women felt pressured by their husbands, families, and communities to become pregnant within three months of marriage; women often needed to seek permission from their husbands before leaving their homes to visit the clinic; and women were frequently prevented from delivering at the hospital by older women in the community. Conclusions Many of the obstetric fistula patients in our sample had limited autonomy in several or all of the aforementioned domains, and their limited autonomy often led both directly and indirectly to an increased risk of prolonged labor and fistula. Reducing the prevalence of fistula in Malawi requires a broad understanding of the causes of fistula, so we recommend that the relationship between women’s autonomy and fistula risk undergo further investigation. Electronic supplementary material The online version of this article (doi:10.1186/s12914-017-0125-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Zara Khan
- , 6100 Main Street, Houston, TX, 77005, USA
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Rao N, Norris Turner A, Harrington B, Nampandeni P, Banda V, Norris A. Correlations between intimate partner violence and spontaneous abortion, stillbirth, and neonatal death in rural Malawi. Int J Gynaecol Obstet 2017; 138:74-78. [PMID: 28387948 DOI: 10.1002/ijgo.12173] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Revised: 02/05/2017] [Accepted: 04/05/2017] [Indexed: 11/10/2022]
Abstract
OBJECTIVE To characterize associations between intimate partner violence (IPV) and adverse delivery outcomes among married Malawian women. METHODS In the present secondary analysis of an ongoing project investigating sexual and reproductive health decision making in rural, Lilongwe District, Malawi, married women who had experienced at least one pregnancy were interviewed between July 15, 2014, and February 25, 2015. Associations between physical IPV experienced with participants' current partners and history of adverse delivery outcomes (spontaneous abortions, stillbirths, and neonatal deaths) were examined using log-binomial regression. RESULTS The analyses included 792 women. The 166 (21.0%) participants who reported having experienced physical IPV with their current partner were significantly more likely to have a history of adverse delivery outcomes in the unadjusted (prevalence ratio 1.23; 95% confidence interval 1.08-1.41) and adjusted (adjusted prevalence ration 1.19; 95% CI 1.01-1.40) analyses. CONCLUSION Physical IPV was reported by a large proportion of participants in the present study and was significantly associated with adverse delivery outcomes. Public health interventions providing physical IPV screening and referral to support services could help improve maternal and child health in Malawi.
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Affiliation(s)
- Nisha Rao
- The Ohio State University College of Medicine, Columbus, OH, USA
| | - Abigail Norris Turner
- The Ohio State University College of Medicine, Columbus, OH, USA.,The Ohio State University College of Public Health, Columbus, OH, USA
| | - Bryna Harrington
- Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | | | | | - Alison Norris
- The Ohio State University College of Medicine, Columbus, OH, USA.,The Ohio State University College of Public Health, Columbus, OH, USA
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Affiliation(s)
| | - A. Norris
- Nottingham University Hospital NHS Trust; Nottingham UK
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Houghton F, Norris A. Credibility, integrity, transparency & courage: The Haitian Cholera outbreak and the United Nations (UN). J Infect Public Health 2017; 11:140-141. [PMID: 28209469 PMCID: PMC7128315 DOI: 10.1016/j.jiph.2016.11.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Accepted: 11/25/2016] [Indexed: 11/24/2022] Open
Affiliation(s)
- F Houghton
- Department of Public Health & Health Promotion, Eastern Washington University, United States.
| | - A Norris
- Department of Public Health & Health Promotion, Eastern Washington University, United States
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Aaron GJ, Strutt N, Boateng NA, Guevarra E, Siling K, Norris A, Ghosh S, Nyamikeh M, Attiogbe A, Burns R, Foriwa E, Toride Y, Kitamura S, Tano-Debrah K, Sarpong D, Myatt M. Assessing Program Coverage of Two Approaches to Distributing a Complementary Feeding Supplement to Infants and Young Children in Ghana. PLoS One 2016; 11:e0162462. [PMID: 27755554 PMCID: PMC5068796 DOI: 10.1371/journal.pone.0162462] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Accepted: 08/23/2016] [Indexed: 12/02/2022] Open
Abstract
The work reported here assesses the coverage achieved by two sales-based approaches to distributing a complementary food supplement (KOKO Plus™) to infants and young children in Ghana. Delivery Model 1 was conducted in the Northern Region of Ghana and used a mixture of health extension workers (delivering behavior change communications and demand creation activities at primary healthcare centers and in the community) and petty traders recruited from among beneficiaries of a local microfinance initiative (responsible for the sale of the complementary food supplement at market stalls and house to house). Delivery Model 2 was conducted in the Eastern Region of Ghana and used a market-based approach, with the product being sold through micro-retail routes (i.e., small shops and roadside stalls) in three districts supported by behavior change communications and demand creation activities led by a local social marketing company. Both delivery models were implemented sub-nationally as 1-year pilot programs, with the aim of informing the design of a scaled-up program. A series of cross-sectional coverage surveys was implemented in each program area. Results from these surveys show that Delivery Model 1 was successful in achieving and sustaining high (i.e., 86%) effective coverage (i.e., the child had been given the product at least once in the previous 7 days) during implementation. Effective coverage fell to 62% within 3 months of the behavior change communications and demand creation activities stopping. Delivery Model 2 was successful in raising awareness of the product (i.e., 90% message coverage), but effective coverage was low (i.e., 9.4%). Future programming efforts should use the health extension / microfinance / petty trader approach in rural settings and consider adapting this approach for use in urban and peri-urban settings. Ongoing behavior change communications and demand creation activities is likely to be essential to the continued success of such programming.
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Affiliation(s)
- Grant J. Aaron
- Global Alliance for Improved Nutrition (GAIN), Geneva, Switzerland
- * E-mail:
| | - Nicholas Strutt
- International Nutrition Foundation (INF), Boston, Massachusetts, United States of America
| | | | | | - Katja Siling
- Valid International, Oxford, England, United Kingdom
| | - Alison Norris
- Valid International, Oxford, England, United Kingdom
| | - Shibani Ghosh
- International Nutrition Foundation (INF), Boston, Massachusetts, United States of America
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, United States of America
| | | | | | | | | | | | | | | | | | - Mark Myatt
- Brixton Health, Llawryglyn, Wales, United Kingdom
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Rao N, Esber A, Turner A, Chilewani J, Banda V, Norris A. The impact of joint partner decision making on obstetric choices and outcomes among Malawian women. Int J Gynaecol Obstet 2016; 135:61-4. [PMID: 27357611 DOI: 10.1016/j.ijgo.2016.03.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Revised: 03/16/2016] [Accepted: 05/23/2016] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To determine the effects of joint partner decision making on obstetric choices and outcomes in Malawi. METHODS Between July 15, 2014 and February 25, 2015, interviews were performed with women who reported at least one lifetime pregnancy in Lilongwe District, Malawi as part of a cross-sectional study of reproductive decision making. Logistic regression models were applied to examine associations of joint decision making with delivery location and obstetric complications. RESULTS The study population included 860 women. Women who engaged in joint decision making with partners (adjusted odds ratio [aOR] 4.9; 95% confidence interval [CI] 3.3-7.2) and women whose partners made obstetric-care decisions alone (aOR 3.2; 95% CI 2.4-4.4) were more likely to undergo delivery at a healthcare facility compared with women who made obstetric-care decisions individually. In comparison with women who made obstetric decisions individually, no difference in the likelihood of experiencing obstetric complications was observed for women who engaged in joint decision making (aOR 1.1; 95% CI 0.7-1.7) or for women whose partners made decisions individually (aOR 0.8; 95% CI 0.5-1.3). CONCLUSION In rural Malawi, partner involvement in obstetric decision making was associated with improved obstetric choices.
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Affiliation(s)
- Nisha Rao
- The Ohio State University College of Medicine, Columbus, Ohio, USA.
| | - Allahna Esber
- The Ohio State University College of Public Health, Columbus, Ohio, USA
| | - Abigail Turner
- The Ohio State University College of Medicine, Columbus, Ohio, USA; The Ohio State University College of Public Health, Columbus, Ohio, USA
| | | | | | - Alison Norris
- The Ohio State University College of Medicine, Columbus, Ohio, USA; The Ohio State University College of Public Health, Columbus, Ohio, USA
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Dieckmann NF, Peters E, Leon J, Benavides M, Baker DP, Norris A. The Role of Objective Numeracy and Fluid Intelligence in Sex-Related Protective Behaviors. Curr HIV Res 2016; 13:337-46. [PMID: 26149157 DOI: 10.2174/1570162x13666150511123841] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Revised: 01/16/2014] [Accepted: 01/26/2014] [Indexed: 11/22/2022]
Abstract
A wealth of studies has indicated that greater cognitive ability is related to healthier behaviors and outcomes throughout the lifespan. In the present paper, we focus on objective numeracy (ability with numbers) and present findings from a study conducted in the Peruvian Highlands that examines the relations among formal education, numeracy, other more general cognitive skills, and a sex-related protective behavior (condom use). Our results show a potential unique protective effect of numeracy on this healthprotective behavior even after accounting for measures of fluid intelligence and potential confounding factors. These results add to a growing literature highlighting the robust protective effect on health behaviors of greater cognitive skills that are enhanced through schooling. Challenges for future research will be identifying the causal mechanisms that underlie these effects and translating this knowledge into effective interventions for improving health.
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Affiliation(s)
- Nathan F Dieckmann
- Oregon Health & Science University, 3375 SW Terwilliger Boulevard, Portland, Oregon, OR 97239, USA.
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Norris A, Harrington BJ, Grossman D, Hemed M, Hindin MJ. Abortion experiences among Zanzibari women: a chain-referral sampling study. Reprod Health 2016; 13:23. [PMID: 26969305 PMCID: PMC4788822 DOI: 10.1186/s12978-016-0129-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Accepted: 02/11/2016] [Indexed: 11/17/2022] Open
Abstract
Background In Zanzibar, a semi-autonomous region of Tanzania, induced abortion is illegal but common, and fewer than 12 % of married reproductive-aged women use modern contraception. As part of a multi-method study about contraception and consequences of unwanted pregnancies, the objective of this study was to understand the experiences of Zanzibari women who terminated pregnancies. Methods The cross-sectional study was set in Zanzibar, Tanzania. Participants were a community-based sample of women who had terminated pregnancies. We carried out semi-structured interviews with 45 women recruited via chain-referral sampling. We report the characteristics of women who have had abortions, the reasons they had abortions, and the methods used to terminate their pregnancies. Results Women in Zanzibar terminate pregnancies that are unwanted for a range of reasons, at various points in their reproductive lives, and using multiple methods. While clinical methods were most effective, nearly half of our participants successfully terminated a pregnancy using non-clinical methods and very few had complications requiring post abortion care (PAC). Conclusions Even in settings where abortion is illegal, some women experience illegal abortions without adverse health consequences, what we might call ‘safer’ unsafe abortions; these kinds of abortion experiences can be missed in studies about abortion conducted among women seeking PAC in hospitals.
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Affiliation(s)
- Alison Norris
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD, 21205, USA. .,Present address: College of Public Health, The Ohio State University, 326 Cunz Hall, 1841 Neil Ave, Columbus, OH, 43210-1351, USA.
| | - Bryna J Harrington
- Yale College Charles P. Howland Fellow, 74 High Street, New Haven, CT, 06511, USA.,Present address: Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 2101 McGavran-Greenberg Hall CB#7435, Chapel Hill, NC, 27599, USA
| | - Daniel Grossman
- Ibis Reproductive Health, 1330 Broadway, Suite 1100, Oakland, CA, 94612, USA.,Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, CA, USA
| | - Maryam Hemed
- African Union Commission, Department of Medical Services, Addis Ababa, Ethiopia
| | - Michelle J Hindin
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD, 21205, USA
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Abstract
BACKGROUND Designing effective public health campaigns in areas of armed conflict requires a nuanced understanding of how violence impacts the epidemiology of the disease in question. METHODS We examine the geographical relationship between violence (represented by the location of detonated Improvised Explosive Devices) and polio incidence by generating maps of IEDs and polio incidence during 2010, and by comparing the mean number of IED detonations in polio high-risk districts with non polio high-risk districts during 2004-2009. RESULTS We demonstrate a geographic relationship between IED violence and incident polio. Districts that have high-risk for polio have highly statistically significantly greater mean numbers of IEDs than non polio high-risk districts (p-values 0.0010-0.0404). CONCLUSIONS The geographic relationship between armed conflict and polio incidence provides valuable insights as to how to plan a vaccination campaign in violent contexts, and allows us to anticipate incident polio in the regions of armed conflict. Such information permits vaccination planners to engage interested armed combatants to co-develop strategies to mitigate the effects of violence on polio.
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Affiliation(s)
- Alison Norris
- Division of Epidemiology, College of Public Health, Ohio State University, Columbus, Ohio, United States of America
| | - Kevin Hachey
- College of Medicine, Ohio State University, Columbus, Ohio, United States of America
| | - Andrew Curtis
- GIS, Health & Hazards Lab, Department of Geography, Kent State University, Kent, Ohio, United States of America
| | - Margaret Bourdeaux
- Brigham and Women’s Hospital, Division of Global Health, Boston, Massachusetts, United States of America
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Esber A, McRee AL, Norris Turner A, Phuka J, Norris A. Factors influencing Malawian women's willingness to self-collect samples for human papillomavirus testing. ACTA ACUST UNITED AC 2016; 43:135-141. [PMID: 26944955 DOI: 10.1136/jfprhc-2015-101305] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Revised: 10/29/2015] [Accepted: 01/31/2016] [Indexed: 02/01/2023]
Abstract
BACKGROUND Malawi has the highest incidence of cervical cancer in the world. Only 3% of Malawian women have ever been screened for cervical cancer. Self-collection of samples for human papillomavirus (HPV) testing could increase screening among under-screened and hard-to-reach populations. However, little is known about the acceptability of self-collection in rural African settings. AIM We aimed to characterise Malawian women's willingness to self-collect vaginal samples for HPV testing and to identify potential barriers. DESIGN We used data from the baseline wave of a community-based cohort study, collected from July 2014 to February 2015. SETTING Participants were enrolled from the catchment area of a clinic in rural Lilongwe District, Malawi. METHODS We enrolled women aged 15-39 years (n=824). Participants answered questions assessing willingness to self-collect a sample for HPV testing, concerns about testing and other hypothesised correlates of willingness to self-collect. RESULTS Two-thirds (67%) of the women reported willingness to self-collect a vaginal sample in their homes. Awareness of cervical cancer, supportive subjective norms, perceived behavioural control, and clinician recommendations were all positively associated with increased willingness to self-collect samples for HPV testing. Identified barriers to self-testing endorsed by women included: concerns that the test might hurt (22%), that they might not do the test correctly (21%), and that the test might not be accurate (17%). CONCLUSIONS This study suggests that self-collection for HPV testing could be an acceptable cervical cancer screening method in this rural population. Findings identify modifiable beliefs and barriers that can inform the development of effective screening programmes.
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Affiliation(s)
- Allahna Esber
- Doctoral Candidate, Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Annie-Laurie McRee
- Assistant Professor, Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - Abigail Norris Turner
- Associate Professor, Division of Infectious Diseases, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - John Phuka
- Assistant Professor, School of Public Health and Family Medicine, College of Medicine, University of Malawi, Lilongwe, Malawi
| | - Alison Norris
- Assistant Professor, Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH, USA
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Yáñez JM, Naswa S, López ME, Bassini L, Correa K, Gilbey J, Bernatchez L, Norris A, Neira R, Lhorente JP, Schnable PS, Newman S, Mileham A, Deeb N, Di Genova A, Maass A. Genomewide single nucleotide polymorphism discovery in Atlantic salmon (Salmo salar): validation in wild and farmed American and European populations. Mol Ecol Resour 2016; 16:1002-11. [PMID: 26849107 DOI: 10.1111/1755-0998.12503] [Citation(s) in RCA: 92] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Revised: 01/11/2016] [Accepted: 01/16/2016] [Indexed: 11/29/2022]
Abstract
A considerable number of single nucleotide polymorphisms (SNPs) are required to elucidate genotype-phenotype associations and determine the molecular basis of important traits. In this work, we carried out de novo SNP discovery accounting for both genome duplication and genetic variation from American and European salmon populations. A total of 9 736 473 nonredundant SNPs were identified across a set of 20 fish by whole-genome sequencing. After applying six bioinformatic filtering steps, 200 K SNPs were selected to develop an Affymetrix Axiom(®) myDesign Custom Array. This array was used to genotype 480 fish representing wild and farmed salmon from Europe, North America and Chile. A total of 159 099 (79.6%) SNPs were validated as high quality based on clustering properties. A total of 151 509 validated SNPs showed a unique position in the genome. When comparing these SNPs against 238 572 markers currently available in two other Atlantic salmon arrays, only 4.6% of the SNP overlapped with the panel developed in this study. This novel high-density SNP panel will be very useful for the dissection of economically and ecologically relevant traits, enhancing breeding programmes through genomic selection as well as supporting genetic studies in both wild and farmed populations of Atlantic salmon using high-resolution genomewide information.
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Affiliation(s)
- J M Yáñez
- Faculty of Veterinary and Animal Sciences, University of Chile, Av. Santa Rosa 11735, Santiago, Chile.,Aquainnovo, Talca 60, Puerto Montt, Chile
| | - S Naswa
- Genus plc, 100 Bluegrass Commons Blvd. Suite 2200, Hendersonville, TN 37075, USA
| | - M E López
- Aquainnovo, Talca 60, Puerto Montt, Chile.,Faculty of Agricultural Sciences, University of Chile, Av. Santa Rosa 11315, Santiago, Chile
| | - L Bassini
- Aquainnovo, Talca 60, Puerto Montt, Chile.,Faculty of Agricultural Sciences, University of Chile, Av. Santa Rosa 11315, Santiago, Chile
| | - K Correa
- Faculty of Veterinary and Animal Sciences, University of Chile, Av. Santa Rosa 11735, Santiago, Chile.,Aquainnovo, Talca 60, Puerto Montt, Chile
| | - J Gilbey
- Marine Scotland Science, Freshwater Fisheries Laboratory, Faskally, Pitlochry, PH16 5LB, Scotland, UK
| | - L Bernatchez
- Institut de Biologie Intégrative et des Systèmes (IBIS), Université Laval, Québec, QC G1V 0A6, Canada
| | - A Norris
- Marine Harvest, Kindrum, Fanad, C. Donegal, Ireland
| | - R Neira
- Aquainnovo, Talca 60, Puerto Montt, Chile.,Faculty of Agricultural Sciences, University of Chile, Av. Santa Rosa 11315, Santiago, Chile
| | | | - P S Schnable
- Data2Bio LLC, Ames, IA 50011, USA.,Department of Agronomy, Iowa State University, Ames, IA 50011, USA
| | - S Newman
- Genus plc, 100 Bluegrass Commons Blvd. Suite 2200, Hendersonville, TN 37075, USA
| | - A Mileham
- Genus plc, 1525 River Road, DeForest, WI 53532, USA
| | - N Deeb
- Genus plc, 100 Bluegrass Commons Blvd. Suite 2200, Hendersonville, TN 37075, USA
| | - A Di Genova
- Fondap Center for Genome Regulation, Av. Blanco Encalada 2085, 3rd floor, Santiago, Chile.,Mathomics Bioinformatics Laboratory, Center for Mathematical Modeling and Center for Genome Regulation, University of Chile, Av. Blanco Encalada 2120, 7th floor, Santiago, Chile
| | - A Maass
- Fondap Center for Genome Regulation, Av. Blanco Encalada 2085, 3rd floor, Santiago, Chile.,Mathomics Bioinformatics Laboratory, Center for Mathematical Modeling and Center for Genome Regulation, University of Chile, Av. Blanco Encalada 2120, 7th floor, Santiago, Chile.,Department of Mathematical Engineering, University of Chile, Av. Blanco Encalada 2120, 5th floor, Santiago, Chile
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Haydocy KE, Yotebieng M, Norris A. Restavèk children in context: Wellbeing compared to other Haitian children. Child Abuse Negl 2015; 50:42-48. [PMID: 25891309 DOI: 10.1016/j.chiabu.2015.03.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Revised: 03/19/2015] [Accepted: 03/26/2015] [Indexed: 06/04/2023]
Abstract
In Haiti, large numbers of vulnerable children and the country's particular historical context has led to a unique phenomenon known as the "restavèk" system. An estimated 300,000 Haitian children are restavèks, living as unpaid domestic servants. Child-welfare advocates describe the restavèk system as modern slavery, but researchers and advocates lack information about restavèk children's circumstances, particularly vis-à-vis other children in Haiti. In a cross-sectional analysis of a nationally representative sample, we evaluated differences in well-being (school attendance, work responsibilities, physical abuse, and hunger) between restavèk children and: (a) all non-restavèk children; and (b) the poorest quintile of non-restavèk children. As compared to all Haitian children and the poorest Haitian children, restavèk children have statistically significantly lower school attendance rates and more labor responsibilities. However, restavèk children experience statistically significantly less physical abuse and less hunger than non-restavèk Haitian children. The restavèk system remains active in Haiti because poor families lack basic resources to support their children, and restavèk children are at risk for mistreatment due to their vulnerable social status. The surprising finding that restavèk children are better off in some respects than their non-restavèk peers highlights the desperate poverty in Haiti and suggests that structural changes for poverty reduction will be required before the restavèk system will end.
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Affiliation(s)
- Kelci E Haydocy
- Division of Epidemiology, College of Public Health, The Ohio State University, 250 Cunz Hall, Columbus, OH 43210, USA
| | - Marcel Yotebieng
- Division of Epidemiology, College of Public Health, The Ohio State University, 250 Cunz Hall, Columbus, OH 43210, USA
| | - Alison Norris
- Division of Epidemiology, College of Public Health, The Ohio State University, 250 Cunz Hall, Columbus, OH 43210, USA
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Curtis A, Ye X, Hachey K, Bourdeaux M, Norris A. A space-time analysis of the WikiLeaks Afghan War Diary: a resource for analyzing the conflict-health nexus. Int J Health Geogr 2015; 14:29. [PMID: 26475472 PMCID: PMC4609116 DOI: 10.1186/s12942-015-0022-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Accepted: 10/05/2015] [Indexed: 11/10/2022] Open
Abstract
Background Although it is widely acknowledged that areas of conflict are associated with a high health burden, from a geospatial perspective it is difficult to establish these patterns at fine scales because of a lack of data. The release of the “WikiLeaks” Afghan War Diary (AWD) provides an interesting opportunity to advance analysis and theory into this interrelationship. Methods This paper will apply two different space time analyses to identify patterns of improvised explosive devices (IED) detonations for the period of 2004 to 2009 in Afghanistan. Results There is considerable spatial and temporal heterogeneity in IED explosions, with concentrations often following transportation links. The results are framed in terms of a resource for subsequent analyses to other existing health research in Afghanistan. To facilitate this, in our discussion we present a Google Earth file of overlapping rates that can be distributed to any researcher interested in combining his/her fine scale health data with a similarly granular layer of violence. Conclusion The release of the AWD presents a previously unavailable opportunity to consider how spatially detailed data about violence can be incorporated into understanding, and predicting, health related spillover effects. The AWD can enrich previous research conducted on Afghanistan, and provide a justification for future “official” data sharing at appropriately fine scales.
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Affiliation(s)
- Andrew Curtis
- GIS, Health and Hazards Lab, Department of Geography, Kent State University, Kent, OH, 44242, USA.
| | - Xinyue Ye
- GIS, Health and Hazards Lab, Department of Geography, Kent State University, Kent, OH, 44242, USA.
| | - Kevin Hachey
- College of Medicine, Ohio State University, Meiling Hall, 370 W 9th Ave, Columbus, OH, 43210, USA.
| | - Margaret Bourdeaux
- Division of Global Health Equity, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, USA.
| | - Alison Norris
- Epidemiology and Medicine, College of Public Health, Ohio State University, 326 Cunz Hall, 1841 Neil Ave, Columbus, OH, 43210-1351, USA.
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Norris A, Bessett D, Esber A, Littman L, Serpico J, Kavanaugh M. Do the know-it-alls actually know? Comparing perceived and assessed knowledge of sexual and reproductive health among US adults. Contraception 2015. [DOI: 10.1016/j.contraception.2015.06.094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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41
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Norris A, Pritt N, Berlan E. Pediatrician attitudes and beliefs about long-acting reversible contraceptive methods may influence counseling. Contraception 2015. [DOI: 10.1016/j.contraception.2015.06.092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Esber A, Turner AN, Norris A. P04.17 Intravaginal practices among rural malawian women. Br J Vener Dis 2015. [DOI: 10.1136/sextrans-2015-052270.271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Esber A, Norris A, Turner AN. P04.18 Are intravaginal practices associated with precancerous lesions and hpv infection? Br J Vener Dis 2015. [DOI: 10.1136/sextrans-2015-052270.272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Norris A, Esber A, Chemey E, Phuka J, Kwiek JJ, Turner AN. O18.4 Sex differences in hiv knowledge, testing behaviours, and decision making influences in rural malawi. Br J Vener Dis 2015. [DOI: 10.1136/sextrans-2015-052270.179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Gonen S, Baranski M, Thorland I, Norris A, Grove H, Arnesen P, Bakke H, Lien S, Bishop SC, Houston RD. Mapping and validation of a major QTL affecting resistance to pancreas disease (salmonid alphavirus) in Atlantic salmon (Salmo salar). Heredity (Edinb) 2015; 115:405-14. [PMID: 25990876 PMCID: PMC4611234 DOI: 10.1038/hdy.2015.37] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Revised: 02/22/2015] [Accepted: 03/23/2015] [Indexed: 01/01/2023] Open
Abstract
Pancreas disease (PD), caused by a salmonid alphavirus (SAV), has a large negative economic and animal welfare impact on Atlantic salmon aquaculture. Evidence for genetic variation in host resistance to this disease has been reported, suggesting that selective breeding may potentially form an important component of disease control. The aim of this study was to explore the genetic architecture of resistance to PD, using survival data collected from two unrelated populations of Atlantic salmon; one challenged with SAV as fry in freshwater (POP 1) and one challenged with SAV as post-smolts in sea water (POP 2). Analyses of the binary survival data revealed a moderate-to-high heritability for host resistance to PD in both populations (fry POP 1 h2~0.5; post-smolt POP 2 h2~0.4). Subsets of both populations were genotyped for single nucleotide polymorphism markers, and six putative resistance quantitative trait loci (QTL) were identified. One of these QTL was mapped to the same location on chromosome 3 in both populations, reaching chromosome-wide significance in both the sire- and dam-based analyses in POP 1, and genome-wide significance in a combined analysis in POP 2. This independently verified QTL explains a significant proportion of host genetic variation in resistance to PD in both populations, suggesting a common underlying mechanism for genetic resistance across lifecycle stages. Markers associated with this QTL are being incorporated into selective breeding programs to improve PD resistance.
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Affiliation(s)
- S Gonen
- The Roslin Institute and Royal (Dick) School of Veterinary Studies, University of Edinburgh, Midlothian, UK
| | | | - I Thorland
- Akvaforsk Genetics Center AS, Sunndalsøra, Norway
| | | | - H Grove
- Department of Animal and Aquacultural Sciences and Centre for Integrative Genetics, Norwegian University of Life Sciences, Ås, Norway
| | | | - H Bakke
- SalmoBreed AS, Bergen, Norway
| | - S Lien
- Department of Animal and Aquacultural Sciences and Centre for Integrative Genetics, Norwegian University of Life Sciences, Ås, Norway
| | - S C Bishop
- The Roslin Institute and Royal (Dick) School of Veterinary Studies, University of Edinburgh, Midlothian, UK
| | - R D Houston
- The Roslin Institute and Royal (Dick) School of Veterinary Studies, University of Edinburgh, Midlothian, UK
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Yotebieng M, Norris A, Chalachala JL, Matumona Y, Ramadhani HO, Behets F. Fertility desires, unmet need for family planning, and unwanted pregnancies among HIV-infected women in care in Kinshasa, DR Congo. Pan Afr Med J 2015; 20:235. [PMID: 27386031 PMCID: PMC4919670 DOI: 10.11604/pamj.2015.20.235.5859] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Accepted: 01/28/2015] [Indexed: 11/24/2022] Open
Abstract
Introduction We assessed the fertility desires, utilization of family planning (FP) methods, and incidence of pregnancies among HIV-infected women receiving care in an HIV clinic with an onsite FP services in Kinshasa, Democratic Republic of Congo. Methods Between November 2011 and May 2012, all HIV-infected women who attended a routine visit at the clinic were interviewed about their fertility desires and utilization of contraceptive methods using a structured questionnaire. Routine follow-up visit data were used to identify pregnancies recorded between the interview and June 2013. Results Overall, of the 699 HIV-infected women interviewed. 249 (35.7%) reported not wanting another child. Of the 499 (72.2%) participants who were sexually active at the time of interview, 177 (35.5%) were using an effective contraceptive method, including 70 (14.0%) women who reported using condoms consistently and 104 (20.8%) who were using injectable contraception. Overall, 88 (17.6%) sexually active participants who did not want another child were not using an effective FP method, and thus are considered to have had unmet need. During the median follow-up time of 22.2 (IQR: 20.2, 23.6) months, among all women interviewed, 96 (14.1%) became newly pregnant [pregnancy rate 9.3 (95%CI: 7.6, 11.4) per 100 women-years] including 21 (8.7%) among women who initially reported not wanting another child [unwanted pregnancy rate 5.8 (95%CI: 3.6, 9.3) per 100 women-years]. Conclusion The persistence of relatively high unmet need among women receiving HIV care in a clinic with onsite FP services suggests the existence of barriers that must be identified and addressed.
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Affiliation(s)
- Marcel Yotebieng
- Ohio State University, College of Public Health, Division of Epidemiology, Columbus, OH; University of North Carolina at Chapel Hill, Department of Epidemiology, Chapel Hill, NC
| | - Alison Norris
- Ohio State University, College of Public Health, Division of Epidemiology, Columbus, OH
| | | | - Yori Matumona
- University of Kinshasa, School of Public Health, Kinshasa, DR Congo
| | - Habib Omari Ramadhani
- University of North Carolina at Chapel Hill, Department of Epidemiology, Chapel Hill, NC
| | - Frieda Behets
- University of North Carolina at Chapel Hill, School of Medicine, Chapel Hill, NC
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Evans D, McCahon R, Barley M, Norris A, Khajuria A, Moppett I. Cognitive Aids in Medicine Assessment Tool (CMAT): preliminary validation of a novel tool for the assessment of emergency cognitive aids. Anaesthesia 2015; 70:922-32. [PMID: 25758401 DOI: 10.1111/anae.13015] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/27/2014] [Indexed: 01/29/2023]
Abstract
Applying human factors principles to the design of clinical emergency guidelines is important. The UK Civil Aviation Authority uses a Checklist Assessment Tool for evaluating the content and usability of emergency drills before introduction into service on aircraft. We hypothesised that this model could be used to develop a generic medical tool. A three-stage modified Delphi process was used to adapt the above tool for use in designing medical emergency guidelines. The resulting Cognitive aids in Medicine Assessment Tool was then used to score and rank seven published difficult airway guidelines; the scores were used to assess its validity and reliability. Pearson's rank coefficient between these scores and scores from independent assessors was 0.89 (p = 0.007). Internal consistency, as assessed by Cronbach's alpha, was 0.74, 0.96 and 0.72 for the tool's three constituent domains of physical characteristics, content and layout/format, respectively. Inter-rater reliability, as assessed by Cohen's kappa, ranged from 0.33 to 0.72. The adoption of our tool has the potential to improve the usability of medical emergency guidelines.
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Affiliation(s)
- D Evans
- Anaesthesia and Critical Care Research Group, University of Nottingham, Nottingham, UK
| | - R McCahon
- Anaesthesia and Critical Care Research Group, University of Nottingham, Nottingham, UK.,Department of Anaesthesia, Queen's Medical Centre, Nottingham, UK
| | - M Barley
- Department of Anaesthesia, Queen's Medical Centre, Nottingham, UK
| | - A Norris
- Anaesthesia and Critical Care Research Group, University of Nottingham, Nottingham, UK.,Department of Anaesthesia, Queen's Medical Centre, Nottingham, UK
| | - A Khajuria
- Anaesthesia and Critical Care Research Group, University of Nottingham, Nottingham, UK
| | - I Moppett
- Anaesthesia and Critical Care Research Group, University of Nottingham, Nottingham, UK
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Bessett D, Gerdts C, Littman LL, Kavanaugh ML, Norris A. Does state-level context matter for individuals' knowledge about abortion, legality and health? Challenging the 'red states v. blue states' hypothesis. Cult Health Sex 2015; 17:733-746. [PMID: 25622191 DOI: 10.1080/13691058.2014.994230] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Recently, the hypothesis that state-level political context influences individuals' cultural values--the 'red states v. blue states' hypothesis--has been invoked to explain the hyper-polarisation of politics in the USA. To test this hypothesis, we examined individuals' knowledge about abortion in relation to the political context of their current state of residence. Drawing from an internet-survey of 586 reproductive-age individuals in the USA, we assessed two types of abortion knowledge: health-related and legality. We found that state-level conservatism does not modify the existing relationships between individual predictors and each of the two types of abortion knowledge. Hence, our findings do not support the 'red states' versus 'blue states' hypothesis. Additionally, we find that knowledge about abortion's health effects in the USA is low: 7% of our sample thought abortion before 12 weeks gestation was illegal.
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Affiliation(s)
- Danielle Bessett
- a Department of Sociology , University of Cincinnati , Cincinnati , USA
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Littman L, Esber A, Kavanaugh M, Bessett D, Norris A. does the source matter? The association between individuals’ trusted information source and reproductive health knowledge. Contraception 2014. [DOI: 10.1016/j.contraception.2014.05.189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Esber A, Foraker RE, Hemed M, Norris A. Partner approval and intention to use contraception among Zanzibari women presenting for post-abortion care. Contraception 2014; 90:23-8. [PMID: 24809805 DOI: 10.1016/j.contraception.2014.03.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2013] [Revised: 03/03/2014] [Accepted: 03/05/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVE We examined the effect of partner approval of contraception on intention to use contraception among women obtaining post-abortion care in Zanzibar. STUDY DESIGN Our data source was a 2010 survey of 193 women obtaining post-abortion care at a large public hospital in Zanzibar. We used multivariable logistic regression analysis to assess associations between partner approval and intention to use contraception. RESULTS Overall, 23% of participants had used a contraceptive method in the past, and 66% reported intending to use contraception in the future. We found that partner approval of contraception and ever having used contraception in the past were each associated with intending to use contraception in the future. In the multivariable model, adjusting for past contraception use, partner approval of contraception was associated with 20 times the odds of intending to use contraception (odds ratio, 20.25; 95% confidence interval, 8.45-48.56). CONCLUSIONS We found a strong association between partner approval and intention to use contraception. Efforts to support contraceptive use must include both male and female partners. IMPLICATIONS Public health and educational efforts to increase contraceptive use must include men and be targeted to both male and female partners. Given that male partners are often not present when women obtain health care, creative efforts will be required to meet men in community settings.
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Affiliation(s)
- Allahna Esber
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH 43210, USA.
| | - Randi E Foraker
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH 43210, USA
| | - Maryam Hemed
- Medical Services Directorate, African Union Commission, Addis Ababa, Ethiopia
| | - Alison Norris
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH 43210, USA
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