139 research outputs found
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Identifying Opportunities to Improve the Integration of Sexual and Reproductive Health Services into Primary Care: Qualitative and Quantitative Approaches
No full textObjectives: Unintended pregnancy is endemic in the United States. Primary care physicians (PCPs) are optimally positioned within the health care system to improve the prevention and management of unintended pregnancy by offering comprehensive contraception and abortion care. Factors at the individual, health center, health systems, and policy levels may influence whether PCPs offer these services. Current practice, knowledge, and attitudes about contraception and abortion among PCPs are poorly understood. This investigation fills these gaps using original quantitative and qualitative data.
Methods: This mixed-methods investigation included: 1) a quantitative survey querying a national probability sample of practicing PCPs about contraception, abortion, and other sexual and reproductive health services; 2) a qualitative investigation of determinants of provision of long-acting reversible contraception (LARC) in community health centers (CHCs) through focus group discussions. We applied case weights to survey responses and generated population estimates of current and lifetime abortion provision and current provision of contraceptive methods. Logistic regression modeling identified factors associated with abortion and LARC provision. Qualitative data were coded inductively by multiple investigators using an iterative consensus-based method.
Results: Factors at the health systems and health center levels influence provision of abortion and contraception in primary care. In the survey data, the strongest correlate of having received training in, endorsing training in, or reporting current provision of abortion and all contraceptive methods was residency training in family medicine, as compared to general internal medicine or other residency. PCPs generally support residency training in abortion and contraception. The primary reported barriers to abortion provision were lack of training and resources. Prior training, practice type, and health systems-level factors were associated with provision of abortion and contraception; most physician demographics were not. In the qualitative investigation, insurance issues, device stocking, and scheduling of LARC method placement emerged as primary influences on the pathway to care for women seeking these methods.
Conclusions: PCPs are receptive to contraception and abortion training and service provision. Efforts to support delivery of these services could include enhanced clinical training and interventions at the health center and health systems levels to ensure access to requisite resources.Abortion; contraception; primary care; community health centers; surve
Organic matter as affected by conservation agriculture of cassava and maize cultivation in an acrisol from Southwestern Brazilian Amazon.
No full textIn the Brazilian Southwestern Amazon, food security agriculture predominates in smallholder farms where cassava cultivation is conducted under conventional tillage (CT). We investigated the impact of conservation agriculture on soil C content and organic matter (SOM) composition in an Acrisol (Acre State) cropped with cassava and maize.Editores: Rafael Silvaro; Marie Luise Carolina Bartz
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Young Children’s Meta-Ignorance
No full textMeta-ignorance is an awareness of one’s own knowledge or lack of knowledge. The goal of this dissertation is to examine the development of children’s meta-ignorance between 14 months and 42 months. I examine the hypothesis that children have some awareness of their own epistemic states, notably states of knowledge and ignorance.
In Study 1, eight children’s use of the mental verb know was examined when they were between 18 and 36 months. Children (from the Child Language Data Exchange System) used know to affirm their own knowledge and that of their interlocutor. When they used know in the context of asking a question, they typically asked about their interlocutor’s knowledge states and not their own. Conversely, they often denied their own knowledge but rarely their interlocutor’s. Finally, they rarely referred to a third party’s knowledge.
In Study 2, 64 children’s production of the flip gesture (hold two hands palm up out to the side to communicate “I don’t know”) was examined when they were between 14 and 42 months. The video recordings were from the Language Development Project. Flip gestures were observed at 14 months, which is four months before a minority of children were first observed saying: “I don’t know.” Children often flipped following their interlocutors’ comments and questions, suggesting that children used flips in a dialogic fashion. When children flipped, their interlocutors often interpreted flips as an expression of ignorance and responded accordingly.
Study 3 involved an experiment in which 52 children aged 16 to 37 months were presented with familiar and unfamiliar pictures and asked to label them. For familiar pictures, children mostly produced the correct name. For unfamiliar pictures, children were more likely to display signs of uncertainty, including turning to gaze at an adult, producing a filled pause such as Um, asking for help, and saying I don’t know.
Children’s ability to produce I DON’T KNOW flips, to say I don’t know, and to express uncertainty when asked to name unfamiliar objects indicates that they come to express a simple understanding of knowledge and ignorance in the course of the second and third year.metacognition; meta-ignorance; knowledge; ignorance; early childhood developmen
Combatting Abortion Misinformation and Disinformation in Medical Education
No full textAbstract Introduction: Although abortion has historically been federally legal, functional access to abortion care has been thwarted by inflammatory political discourse. Abortion misinformation and disinformation have been deliberately intertwined into political agendas and ideologies, widening the gap between the lay public’s perception of and patients’ lived experience with abortion care. The politicization of abortion care has adverse effects on its provision and training along lines of inequity and marginalization established by preexisting systems of oppression and structural violence. Critical feminist pedagogy—an examination of class, gender, and sexuality on patriarchal misrepresentations of abortion information—can guide medical students to recognize and combat abortion misinformation and disinformation. Objectives: We apply critical feminist pedagogy to abortion education in medical school curricula to equip students to recognize 1) motives underlying false abortion messaging and 2) mechanisms to produce abortion misinformation and disinformation. We propose interventions that allow medical students to leverage their professional status and privilege in improving the U.S. abortion discourse throughout their careers. Proposed Approaches: We contextualize two classifications of misinformation and disinformation utilized by the anti-abortion movement. We then discuss how educational interventions addressing both of these mechanisms can be adapted through a feminist lens to teach medical students about the complexity of pregnancy decision-making and empower them to debunk false abortion messaging. First, we explore the hijacking of false sensationalized narratives by anti-abortion efforts to frame care-seeking patients as ‘immoral’ and thereby distort our collective knowledge regarding abortion care. We posit that narrative medicine and the complexity of real patient stories can overpower this misleading imagery and allow students to integrate lived realities within their conceptualization of abortion. Second, we examine the co-opting of medical language by the anti-abortion movement to influence abortion policymaking. We propose that curricula allowing medical students to push back against abortion misinformation and disinformation can help them practice debunking false messages while also supporting the public health importance of safe abortion care. Conclusions: Medical students need to recognize and combat the plethora of false abortion messaging in our current post-Roe sociopolitical landscape. Innovations framed within a feminist pedagogy in undergraduate medical education can help trainees understand the importance of reproductive justice, pregnancy decision-making, and abortion care in the context of the patient experience. Over time, these lessons can train future physicians to engage in equitable, accurate conversations about abortion care both inside and outside the exam room
Szczęście społeczeństwa jako cel polityki państwa
No full textAutor analizuje mechanizmy powstawania szczęśliwego
społeczeństwa i podkreśla znaczenie szczęścia społecznego w polityce
państwa.The author analyzes the mechanisms of happy society
and stresses the importance of luck in the policy of state
An extension of dynamic droplet deformation models to secondary atomization
No full textA detailed model for secondary atomization of liquid droplets by aerodynamic forces is presented. As an empirical extension of dynamic droplet deformation models, it accounts for temporal variations of the relative velocity between droplet and gas phase during the deformation and breakup process and describes the characteristic features of different breakup mechanisms (deformation kinetics, aerodynamics and product properties). Computed droplet trajectories and Sauter mean diameters have been compared using the proposed deformation-based model and a model using a breakup criterion based on the local instantaneous Weber number. It is concluded, that a deformation-based criterion should be used for droplets exposed to complex aerodynamic loading and that more experimental research is required to identify the accuracy of the presented detailed breakup product model.Aerodynamics & Wind EnergyAerospace Engineerin
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