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ObjectivesWomen may differ by whether they rely on health providers and/or social ties for seeking information and advice about family planning. It is unknown whether these differences matter for contraceptive outcomes. This study assessed the association between women's family planning (FP) network (social and/or provider ties) and contraceptive use.Study designThis cross-sectional, egocentric network study was conducted among reproductive-age women (n = 193) in rural Madagascar. Data included socio-demographics and contraceptive use. Respondents listed who they relied on for contraceptive information, advice or guidance and provided ties' gender, age, relationship, and perceived support of contraceptive use. The primary outcome was current contraceptive use. Predictors included having a FP network (0/1) and FP network composition (no network, social ties only, provider ties only, both provider and social ties), respectively. Analyses were conducted using a generalized linear model specifying a Poisson distribution, with covariate adjustment and cluster robust standard errors.ResultsHaving a network of individuals to turn to for contraceptive information compared to having no FP network was positively associated with contraceptive use (adjusted relative risk [aRR] 4.4, 95% confidence interval [CI] 2.00-9.87). Having a social network, a provider network, or a combination of social and provider network were all positively associated with contraceptive use (aRR 4.30 [CI 1.92-9.66], aRR 4.46 [CI 2.04-9.75], aRR 4.72 [CI 1.93-11.50], respectively), compared to having no FP network.ConclusionsContraceptive use was higher among women who relied on social ties, provider ties or both for contraceptive information and advice, compared to women with no FP network. These findings suggest that FP interventions should use a multicomponent approach taking into account both social and provider networks.ImplicationsIt is unknown whether differences in whether women rely on social ties (friends, partner, family members) vs. providers for contraceptive information and advice affect contraceptive outcomes. Women are just as likely to use contraception whether they rely on social ties, provider ties, or both for contraceptive information and advice.

As demonstrated by the Camp Fire evacuation, communications (city-to-city, city-to-residents) play important roles in coordinating traffic operations and safeguarding region-wide evacuation processes in wildfire events. This collaborative report across multiple domains (fire, communication and traffic), documents a series of simulations and findings of the wildfire evacuation process for resource-strapped towns in Northern California. It consists of: (1) meteorological and vegetation-status dependent fire spread simulation (cellular automata model); (2) agency-level and agency-to-residents communication simulation (system dynamics model); and (3) dynamic traffic assignment (spatial-queue model). Two case studies are conducted: one for the town of Paradise (and the surrounding areas) and another for the community of Bolinas. The data and models are based on site visits and interviews with local agencies and residents. The integrated simulation framework is used to assess the interdependencies among the natural environment, the evacuation traffic and the communication networks from an interdisciplinary point of view, to determine the performance requirements to ensure viable evacuation strategies under urgent, dynamic wildfire conditions. The case study simulations identify both potential traffic and communication bottlenecks. This research supports integrating fire, communication and traffic simulation into evacuation performance assessments.

The rare decay K_{L}→π^{0}νν[over ¯] was studied with the dataset taken at the J-PARC KOTO experiment in 2016, 2017, and 2018. With a single event sensitivity of (7.20±0.05_{stat}±0.66_{syst})×10^{-10}, three candidate events were observed in the signal region. After unveiling them, contaminations from K^{±} and scattered K_{L} decays were studied, and the total number of background events was estimated to be 1.22±0.26. We conclude that the number of observed events is statistically consistent with the background expectation. For this dataset, we set an upper limit of 4.9×10^{-9} on the branching fraction of K_{L}→π^{0}νν[over ¯] at the 90% confidence level.

Study objectivesMany pediatric providers serving adolescents are not trained to offer comprehensive contraceptive services, including intrauterine devices (IUDs) and implants, despite high safety and satisfaction among adolescents. This study assessed an initiative to train providers at school-based health centers (SBHCs) to offer students the full range of contraceptive methods.DesignSurveys were administered at baseline pre-training and at follow-up 3 months post-training. Data were analyzed using generalized estimating equations for clustered data to examine clinical practice changes.SettingEleven contraceptive trainings at SBHCs across the United States from 2016-2019.ParticipantsA total of 260 providers from 158 SBHCs serving 135,800 students.InterventionsOn-site training to strengthen patient-centered counseling and to equip practitioners to integrate IUDs and implants into contraceptive services.Main outcome measuresThe outcomes included counseling experience on IUDs and implants, knowledge of patient eligibility, and clinician method skills.ResultsAt follow-up, providers were significantly more likely to report having enough experience to counsel on IUDs (adjusted odds ratio [aOR], 4.08; 95% confidence interval [CI], 2.62-6.36]) and implants (aOR, 3.06; 95% CI, 2.05-4.57). Provider knowledge about patient eligibility for IUDs, including for adolescents, increased (P

Purpose: This paper argues that large-scale agricultural programmes embedded with the Agricultural Innovations Systems (AIS) thinking helps in facilitating innovations. Design/Methodology/Approach: The study adopted a qualitative approach involving focus group discussions, key informant interviews and secondary document analysis. This approach helped to obtain an in-depth understanding of the processes involved, why and how innovation takes place. Findings: The design and implementation of the MiDA programme had elements of the AIS embedded. This helped to contribute to success in areas that aligned and failures in areas that fell short. Stakeholders encountered implementation challenges that did not ensure reflective learning, conversely, some actors worked independently of others, mimicking linear extension approaches. Practical Implications: The future of extension and research in Ghana should not be prescriptive (top-down) but fully integrate farmers and wider stakeholders in the design and implementation of agricultural investment programmes. This is premised on addressing challenges relating to trust, effective leadership and entrepreneurship. Theoretical Implications: Adds on to the limited use of AIS as a conceptual and operational tool in supporting large-scale agricultural investment in the global south by incorporating AIS thinking in policy formulation and implementation of large-scale programmes. Originality/Value: This article adds to the unbalanced literature in Sub-Saharan Africa on the use of AIS in the design and implementation of large-scale programmes. Additionally, it highlights the use of AIS in extension and research in facilitating innovations.

This paper examines the students' experiences with instructional delivery (ID) of distance and online learning of undergraduate mathematics in two major Nigerian universities. Purposive sampling was used in the study to select mathematics students from University of Lagos Distance Learning Institute (DLI) and the National Open University of Nigeria (NOUN). Data were collected through mixed-methods and a one-sample binomial test was employed to analyse the quantitative data. Furthermore, narrative and content analyses were done to explore how respondents make sense of their experiences of learning mathematics through the distance and online mode. Among others, the results of the study suggest that the abstract nature of mathematics was not appropriately addressed in the course content and that the absence of helpful and visible tutors for the subject complicated the challenge of understanding abstract mathematics even further. Among the many challenges, the abstract nature of mathematics and the absence of qualified tutors points to the need for improvement in the design, development, and provision of mathematics course materials and programmes for distance and online mathematics learning.

Building capacity for contraceptive services in primary care settings, including for intrauterine devices (IUDs) and implants, can help to broaden contraceptive access across the US. Following a randomized trial in family planning clinics, we brought a provider training intervention to other clinical settings including primary care in all regions. This implementation science study evaluates a national scale-up of a contraceptive training intervention to varied practice settings from 2013 to 2019 among 3216 clinic staff serving an estimated 1.6 million annual contraceptive patients. We measured providers' knowledge and clinical practice changes regarding IUDs and implants using survey data. We estimated the overall intervention effect, and its relative effectiveness in primary care settings, with generalized estimating equations for clustered data. Patient-centered counseling improved, along with comfort with method provision and removal. Provider knowledge increased (p

Abstract Cacao pod husk biochar was used as an adsorbent for the adsorption of toxic metals from aqueous phase. Cacao pod husk signifies a readily available source of eco-friendly and low-cost adsorbent in Sub-Saharan Africa that has scarcely been paid attention to. The experiment was conducted in a monosystem to determine how cacao pod husk biochar can efficiently adsorb lead (Pb2+), mercury (Hg2+) and cadmium (Cd2+) from aqueous phase. The experiment was conducted with 100 mL of varied toxic metal concentrations of the aqueous phase with a contact time of 60 min and a constant rotary speed of 14.8 U/min. The removal efficiency of cacao pod husk biochar for Pb2+, Hg2+ and Cd2+ ranged from 99.20 to 99.94%, 99.97 to 99.99%, and 99.85 to 99.99%, respectively. Freundlich adsorption isotherm was favourable for the adsorption of toxic metals onto the cacao pod husk biochar. The toxic metals had a stronger binding affinity to the cacao pod husk biochar. Hence, cacao pod husk was efficient for toxic metals elimination.