Majority Of Days Research Articles

Human-elephant conflict in the African rainforest landscape: crop-raiding situations and damage mitigation strategies in rural Gabon

While the conservation of forest elephants is a global concern, human-elephant conflict (HEC), especially crop-raiding by elephants, is a serious threat to both human livelihoods and conservation efforts. However, only a few studies have explored elephant crop-raiding and related damage mitigation strategies in Central Africa’s forest landscapes, which are characterized by low human and high animal densities and shifting cultivation practices. This study investigates HEC in rural Gabon, where human activities are limited, and local livelihoods are severely threatened by crop-raiding elephants. Through long-term ethnographic research and an in-depth analysis of damage mitigation practices by local people, the study unveils serious crop-raiding by elephants, leading to a significant change in the local lifestyle. Most households spend the majority of days in the field protecting crops, resulting in the village becoming almost empty. In addition to the physical burden of staying in poor living conditions, there is a considerable psychological burden for local people. Establishing effective elephant conservation systems requires understanding each local situation and evaluating the various costs to local people. To sustain livelihoods and address the challenge of HEC, it is crucial for local communities and various stakeholders to act collectively.

A Study on Impact of Earnings Announcements on Share Prices in Indian Stock Market

We made an attempt to examine the stock prices response to quarterly earnings announcements in Indian stock market. To test the market efficiency, the event study methodology is applied and the abnormal returns are measured using the market model method. We have included NSE nifty 500 companies as sample. We observed that the majority of days during the prior to and post-announcement periods, the Abnormal returns are positive and significant. That implies that investors may experience unusual gains as a result of earnings news. So, we came to the conclusion that the Indian stock market is inefficient at the semi-strong level.

Trends in COVID-19 Infections during Four Surges in Bexar County, Texas

Background: Bexar County, Texas has experienced four COVID-19 surges during the pandemic. This study investigates trends in COVID-19 infections over the course of pandemic. The objective is to describe the association of COVID-19 infection cases with changes in testing availability, masking, distancing policies, and occurrence of public holidays during the surges. Methods: Cases occurring since May 26th, 2020, until March 31st, 2022, comprise this analysis. Case data were obtained from the Texas NEDSS database. Aggregate hospitalization data were obtained from STRAC (Southwest Texas Regional Advisory Council) for Bexar County hospitals. Analyses were conducted using R-Studio and Excel. Demographic statistics, percentages, case fatality rates were computed. Results: Average age (34 years), female gender (52%), Hispanic ethnicity (69%), residing in the Southern zip codes of Bexar County, and negative vaccination status were associated with the four COVID-19 surges. During all surges, test positivity, hospitalization and mortality rates all increased. Surges coincided with the major public holidays. Conclusion: These findings highlight the association COVID-19 infections with implementing and loosening restrictive policies, along with sociocultural events and public holidays in Bexar County, Texas. Preventative efforts promoted safer behavior and decreased the COVID-19 infection on majority of days during the pandemic except closer to public holidays when a high infection rate was observed in the form of surges. Public Health Significance: Preventative efforts at the local governmental level along with voluntary compliance with restrictive COVID-19 policies by Bexar County Residents are necessary for decreasing community infection and widespread disease.

Breaking New Ground: Space Agencies and Epidemiologists Partner Up on Particulates

Breaking New Ground: Space Agencies and Epidemiologists Partner Up on Particulates

A smart zero-energy building having bidirectional interaction with electricity/heating networks: An attempt to achieve a higher renewable penetration

The present research introduces an innovative zero-energy building complex equipped with a rule-based control approach for higher integration of renewable resources in the local energy network while bringing down energy costs. The idea centers on establishing several smart controllers to achieve a bidirectional interaction with the heating/electricity network for peak demand shaving and mitigate energy costs. The proposed system comprises Alkaline fuel cells integrated with a hydrogen storage tank driven by either a vanadium chloride cycle or an electrolyzer unit. The system also has an absorption chiller and smart thermal energy storage to supply the heating and cooling demands. TRNSYS-MATLAB developed code is applied to assess the system's indicators from techno-economic standpoints for a residential building complex in the Scandinavian climate. Also, the parametric investigation and time-dependent analysis are carried out to examine the impact of decision parameters and the ambient condition. According to the results, the solar system's physical appearance is very important since it significantly affects performance efficiency and total cost. The results further reveal that picking up the cells' current from 300 A to 500 A improves the performance efficiency by around 12% while lowering the total cost, illustrating the importance of optimization. The results highlight the importance of smart controllers by showing that over 70% of the year's net energy values are positive, indicating that the proposed system may meet demand and sell excess electricity+heating productions to regional networks. The results further demonstrate that since the net energy values are positive for the majority of days in the spring and summer, the system might operate more independently from the local energy networks on warmer days. Eventually, the higher share of solar in summer and wind energy in colder days for hydrogen production shows that the renewable resources combination results in a secure energy supply to obtain the highest independence from the local grid throughout the year.

I WISH I MAY, I WISH I MIGHT FEEL THE AGE I WISH TONIGHT

Abstract Subjective age has traditionally been considered by comparing felt age to chronological age, with those who feel younger reporting more adaptive developmental outcomes. Here we consider a new approach: subjective age discordance, which compares felt ages to the ideal ages of participants. Across eight study days, 116 older and 107 younger adults reported their daily felt and ideal ages. On the majority of days, both older and younger adults idealized ages younger than they felt. The opposite pattern, idealized ages older than felt ages, was rare and primarily seen in younger adults. Days when felt ages were less discordant from ideal ages were characterized by higher levels of positive affect than days with greater subjective age discordance. These findings suggest that positive developmental outcomes can occur not only from feeling younger, but through a greater alignment of ideal and felt ages.

Tiffin habits of school children

Background: The “mid-day meal scheme” is the popular name for the school meal program of India, through which meal is provided to school children studying in the government and government aided schools. In non-government schools, children carry tiffin’s from home. Often, due to lack of time and/or knowledge of the parents and students, the contents of the food are not as per a balanced diet. The objective of the study was to analyse and compare the tiffin habits of primary and senior school children.Methods: This was a clinic-based study. Parents of 300 school going children were asked about tiffin habits of their children in a predesigned questionnaire. Data was analysed and conclusions drawn.Results: Most children carried tiffin to school on the majority of days. There was no statistical difference between primary or older children in their tiffin contents. Very few primary school children had a say in the content of tiffin. The senior students spent money in canteen on more days per week, whereas most primary class students spent only once a week or for treats.Conclusions: It is crucial for schools to establish food committees in school that suggests and monitors tiffin policies and meal plans based on nutrition.

Comparative Analysis of the Drainage Effect Based on Improved Hydraulic Flushing Technology.

The composite structure coal seam composed of coal seams with strong and weak deformation is widely developed in the coalfields in Southwest and North China. The implementation of hydraulic flushing in soft coal stratification can effectively relieve the pressure and increase the permeability of coal seams, so it can improve the effect of underground gas drainage. Taking Xin'an Coal Mine, West Henan province, China, as an example, this paper discussed the influence of hydraulic flushing on the gas drainage effect in soft coal seam by means of field investigation, numerical simulation analysis, similar simulation, and field verification. As the same time, a fluid-solid coupling model of gas drainage based on layered hydraulic flushing technology is established, and the differences and reasons of the gas drainage effect after layered hydraulic flushing in soft and hard composite coal seams are discussed. The results show that (1) the gas concentration change of layered flushing boreholes intermittently rises rapidly, and there is no obvious law, while that of conventional flushing boreholes shows a regular attenuation trend. (2) According to the numerical simulation results, after 30 days of drainage, the effective drainage range of layered hydraulic flushing is 8.33 m3 higher than that of conventional hydraulic flushing. (3) There are not a few points where the single borehole concentration data of each row of layered flushing boreholes are in the high level. Meanwhile, the maximum concentration of all conventional flushing boreholes is less than 40%, except that one borehole can reach 70% at the beginning. (4) All of the average gas drainage concentration of single-row boreholes using layered flushing technology is greater than 20% in the vast majority of days, while that of the conventional flushing boreholes is only higher than 20% in row 5 and has only lasted for 2 days. The difference of the drainage effect is obvious.

928-P: Dysglycemia in Patients without Diabetes after Renal Transplantation

Background: Patients without a prior history of diabetes often experience post-operative hyperglycemia after undergoing renal transplantation. Hyperglycemia in the immediate post-transplant period has been associated with increased risk for infection, graft failure and hospital readmission. Methods: We performed a retrospective review of all adult patients undergoing renal transplantation at a single tertiary referral center from January 1 - December 31, 2019. Results: Of the 292 patients, 191 (65.2%) did not have a history of diabetes. Of these, 83 (43.5%) were female (mean ±SD age 46.3 ±14.7 years) while 1 (56.5%) were male (mean ±SD age 47.9 ±15.5 years) . The percentage of post-operative days (POD) while hospitalized with any hyperglycemia (≥180 mg/dL) was 55.5% (female 51.8%, male 58.3%) with the highest average blood glucose on POD1 among all patients. The mean±SD point of care (POC) glucose on POD0, 1, 2 and 3 was 123.4±31.5, 151.1±28.6, 139.8±29.7, and 117.4±28.9 mg/dL, respectively (n = 181, 145, 141, and 126 for respective days) . As compared with those without hyperglycemia, patients with any detected hyperglycemia up to POD5 had numerically higher percentage of hospital acquired infection (2.1% vs. 1%) , admission to the intensive care unit (7.9% vs. 3.7%) , and 30-day readmission (20.4% vs. 10.5%) . The percentage of post-operative days with POC glucose <70 mg/dl was 7.9% (female 8.4%, male 7.4%) . Conclusions: Patients without a history of diabetes who undergo renal transplantation experience hyperglycemia during the majority of days while hospitalized peri-transplant. Further analysis is needed to determine optimal insulin dosing strategies to improve glycemic control in this population. Disclosure S.A.Seggelke: None. M.Griff: None. R.Hawkins: None. S.Crawley: None. C.C.Low wang: Employee; CPC Clinical Research, Research Support; CellResearch Corporation, Virta Health Corp.

Towards operational impact forecasting of building damage from winter windstorms in Switzerland

AbstractNational meteorological and hydrological services issue warnings for severe weather events, typically based on stakeholder‐agreed fixed thresholds of meteorological parameters such as wind speeds or precipitation amounts. Yet societal decisions on preventive actions depend on the expected impacts of the weather event. In order to better inform such preventive actions, meteorological services are currently working towards including expected impacts into their warnings. We develop an open‐source impact forecasting system for building damage due to winter windstorms in Switzerland. It combines a numerical ensemble weather prediction model with exposure and vulnerability data. This system forecasts expected building damage in Swiss Francs with a 2‐day lead time on a 500‐m grid or aggregated to administrative regions. We compare the forecasted building damage with insurance claims in the canton of Zurich. The uncertainty of the impact forecasts is large. For the majority of days with severe winter windstorm damage, the mean forecasted damage was in the right order of magnitude, with one missed event and one false alarm. For thunderstorms and foehn storms, the rate of missed events and false alarms is much higher, most likely related to the limited meteorological forecast skill. Such impact forecasts can inform decision makers on preventive actions, such as allocating emergency response and other assets. Additionally, impact forecasts could also help communicating the severity of the upcoming event to the general public as well as indirectly help meteorological forecasters with taking warning decisions.

PaLS Study: How Has the COVID-19 Pandemic Influenced Physical Activity and Nutrition? Observations a Year after the Outbreak of the Pandemic

The restrictions implemented to prevent the spread of the SARS-CoV-2 virus have impacted the majority of life domains. To evaluate their potential consequences on physical activity (PA) and dietary habits among Polish undergraduates, a survey consisting of the IPAQ-SF, authors’ questions based on the Polish National Institute of Public Health recommendations, and authors’ questions scaled −5/0/5 on personal opinion was created and administered between 22 February and 3 April 2021. A total of 1323 students met the study conditions (1021 females, 297 males, 5 did not specify gender, mean age: 22 years old (SD = 4), mean BMI = 22.27 kg/m2 (SD = 3.87)). A total of 27.21% of students were in the low, 48.53% in the moderate, and 24.26% in the high PA group. A total of 71.94% estimated that the pandemic had a negative impact on their PA, 8.16% no impact, and 19.9% a positive impact. A total of 35.5% had an insufficient intake of vegetables, 34.3% declared adding salt to meals, and 31.6% ate animal-based products the majority of days in a week or every day. A total of 51.02% assessed the impact of the pandemic on their nutrition as negative, 20.11% did not notice changes, and 28.87% reported a positive impact on their dietary habits. Most of the students saw harmful pandemic effects on their diet and PA compared to the times before restrictions. This can lead to a higher prevalence of non-communicable diseases (NCDs) in the future.

A Climatological Study of National Weather Service Watches, Warnings, and Advisories and Landfalling Atmospheric Rivers in the Western United States 2006–18

AbstractAtmospheric rivers (ARs) are synoptic-scale phenomena associated with long, narrow corridors of enhanced low-level water vapor transport. Landfalling ARs may produce numerous beneficial (e.g., drought amelioration and watershed recharge) and hazardous (e.g., flash flooding and heavy snow) impacts that may require the National Weather Service (NWS) to issue watches, warnings, and advisories (WWAs). Prior research on WWAs and ARs in California found that 50%–70% of days with flood-related and 60%–80% of days with winter weather–related WWAs occurred on days with landfalling ARs in California. The present study further investigates this relationship for landfalling ARs and WWAs during the cool seasons of 2006–18 across the entire western United States and considers additional dimensions of AR intensity and duration. Across the western United States, regional maxima of 70%–90% of days with WWAs issued for any hazard type were associated with landfalling ARs. In the Pacific Northwest and central regions, flood-related and wind-related WWAs were also more frequently associated with more intense and longer-duration ARs. While a large majority of days with WWAs were associated with landfalling ARs, not all landfalling ARs were necessarily associated with WWAs (i.e., not all ARs are hazardous). For example, regional maxima of only 50%–70% of AR days were associated with WWAs issued for any hazard type. However, as landfalling AR intensity and duration increased, the association with a WWA and the “hazard footprint” of WWAs increased quasi-exponentially across the western United States.

Racial/ethnic disparities in the association between fine particles and respiratory hospital admissions in San Diego county, CA

Ambient air pollution exposure is associated with exacerbating respiratory illnesses. Race/ethnicity (R/E) have been shown to influence an individual’s vulnerability to environmental health risks such as fine particles (PM 2.5). This study aims to assess the R/E disparities in vulnerability to air pollution with regards to respiratory hospital admissions in San Diego County, California where most days fall below National Ambient Air Quality Standards (NAAQS) for daily PM 2.5 concentrations. Daily PM 2.5 levels were estimated at the zip code level using a spatial interpolation using inverse-distance weighting from monitor networks. The association between daily PM 2.5 levels and respiratory hospital admissions in San Diego County over a 15-year period from 1999 to 2013 was assessed with a time-series analysis using a multi-level Poisson regression model. Cochran Q tests were used to assess the effect modification of race/ethnicity on this association. Daily fine particle levels varied greatly from 1 μg/m3 to 75.86 μg/m3 (SD = 6.08 μg/m3) with the majority of days falling below 24-hour NAAQS for PM 2.5 of 35 μg/m3. For every 10 μg/m3 increase in PM 2.5 levels, Black and White individuals had higher rates (8.6% and 6.2%, respectively) of hospitalization for respiratory admissions than observed in the county as a whole (4.1%). Increases in PM 2.5 levels drive an overall increase in respiratory hospital admissions with a disparate burden of health effects by R/E group. These findings suggest an opportunity to design interventions that address the unequal burden of air pollution among vulnerable communities in San Diego County that exist even below NAAQS for daily PM 2.5 concentrations.

Intense east coast lows and associated rainfall in eastern Australia

East coast lows (ECLs) are low pressure systems that occur near the east coast of Australia. But not all lows cause the same level of impact, and a small proportion of ECLs are responsible for more than half of all days with widespread rainfall above 50 mm in this region. In this study, we combine analyses of cyclones at both the surface and 500 hPa levels to assess the locations of cyclones responsible for widespread heavy rainfall on the east coast. We found that the majority of days with widespread totals above 100 mm on the east coast occur when a low at 500 hPa over inland southeast Australia coincides with a surface low located more directly over the east coast. Such events occur on about 15 days per year but are responsible for more than 50% of days with widespread heavy rainfall on the eastern seaboard of Australia. We also found that extreme rainfall was most likely when both the surface and upper cyclones were very strong, when measured using the maximum Laplacian of pressure/height. The seasonal frequency of cyclones at the surface and 500 hPa were found to be only weakly correlated with each other and often had opposing relationships (albeit weak in magnitude) with both global climate drivers and indices of local circulation variability. Trends in cyclone frequency were weak over the period 1979–2019, but there was a small decline in the frequency of deep cyclone days, which was statistically significant in some parts of the southeast. Understanding which ECLs are associated with heavy rainfall will help us to better identify how future climate change will influence ECL impacts.

Evaluating the feasibility and effectiveness of self-monitoring of health among Samoan women: a randomized trial

Objective: Self-monitoring technologies that help individuals track their health have proven effective in high-income countries but have not been widely tested or marketed in the Pacific islands. We conducted a pilot randomized controlled trial in Samoa to investigate the feasibility and acceptability of step-counters and digital scales.
 Methods: The trial enrolled 44 Samoan women (31-40 years), without previously diagnosed chronic conditions (hypertension, diabetes, etc.), who reported motivation to become more physically active. After measuring daily step counts for one week in the absence of feedback, participants were randomly assigned to one of three groups for a four-week intervention period: 1) FitBit Zip® step-counter, 2) digital BodyTrace© scale, or 3) both devices. Outcomes of interest were device use, psychosocial indicators of health, daily step counts, and body mass index, measured at baseline and post-intervention.
 Results: Participants who received scales used them a median of 5.5 times during the four-week intervention period. While FitBits were used a majority of days during the baseline period, there was significant decline in use during the intervention. In all groups, Health Locus of Control, Self-Efficacy for Exercise, and Weight Efficacy improved. However, while the Scale Only group reported improved health-related quality of life, the two groups that used FitBits either did not significantly change or significantly decreased in their assessments of this measure. No group demonstrated change in average daily step counts during the intervention; BMI increased among the two groups using the scales.
 Conclusions: Results suggest that self-monitoring technologies are acceptable in Samoa and generally improve psychosocial indicators of health. Further research is necessary to assess their effectiveness as an intervention tool and to determine how best to sustain device use over time. The significant increase in BMI over the relatively short intervention period highlights the importance of developing effective intervention approaches in this setting.

Air pollution and critical air pollutant assessment during and after COVID-19 lockdowns: Evidence from pandemic hotspots in China, the Republic of Korea, Japan, and India

The COVID-19 virus outbreak has been declared a “global pandemic”. Therefore, “lockdown” was issued in affected countries to control the spread of the virus. To assess air pollution during and after lockdowns, this study selected pandemic hotspots in China (Wuhan), Japan (Tokyo), the Republic of Korea (Daegu), and India (Mumbai) and compared the Air Quality Index (AQI) in these areas for the past three years. The results indicated that air pollution levels were positively correlated with a reduction in pollutant levels during and after lockdowns in these cities. In Tokyo, low levels of air pollution, no significant change in the distribution of “good” and “moderate” days was observed during lockdown. In Daegu, mid-level air pollution, the percentage of “unhealthy” days (AQI>100) markedly reduced during lockdown; however, this reverted after lockdown was lifted. In Wuhan and Mumbai, high air pollution levels, the percentage of unhealthy days remarkably decreased during lockdown and continued to reduce after lockdown. It was found that PM2.5 was the critical pollutant for all cities because its sub-AQI was the largest of the six pollutant species for the majority of days. In addition, PM10 dominated the overall AQI for 2.2–9.6% of the period in Wuhan and Mumbai, and its sub-AQI reduced during lockdown. The mean sub-AQI for NO2, SO2, CO, and O3 was within the “good” category for all cities. In conclusion, the lockdown policy reduced air pollution in general and this reduction was more significant for regions with high air pollution levels.

Daily text message assessments of 6-mercaptopurine adherence and its proximal contexts in adolescents and young adults with leukemia: A pilot study.

This pilot study explored the feasibility and acceptability of implementing text-based assessments of oral chemotherapy adherence in adolescents and young adults (AYA) with leukemia. AYA prescribed maintenance 6-mercaptopurine (6MP) received daily text message surveys and utilized an electronic pill bottle for 28days. Text surveys assessed 6MP adherence and contextual associates (eg, mood). Feasibility was defined by recruitment/retention rates, survey completion rates, cost, and technical issues. After the 28-day period, AYA completed an acceptability survey. Secondary analyses compared text survey and electronic pill bottle adherence rates, and explored the daily associations between contextual factors and 6MP nonadherence. Eighteen AYA enrolled (M age=18, range 15-22) and completed study procedures (100% recruitment and retention rates). Adherence survey completion rates were high (M=88.9%), the technology cost was $204.00, and there were few technical issues. AYA reported high satisfaction with the surveys and perceived them as a helpful medication reminder. While not significantly correlated, survey and electronic pill bottle adherence data converged on the majority of days (>90%). Exploratory analyses showed that AYA were more likely to miss a dose of 6MP on weekends (OR=2.33, P=.048) and on days when their adherence motivation (OR=0.28, P=.047) and negative affect (OR=3.92, P=.02) worsened from their own typical functioning. For AYA with leukemia, daily text-based surveys are a feasible and acceptable method for delivering medication adherence assessments, and may operate as a short-term intervention. To develop personalized mobile health interventions, findings also highlighted the need to study time-varying predictors of 6MP nonadherence.

Spatio‐temporal relationships between rainfall and convective clouds during Indian monsoon through a discrete lens

AbstractThe Indian monsoon, a multi‐variable process causing heavy rains during June–September every year, is very heterogeneous in space and time. We study the relationship between rainfall and outgoing longwave radiation (OLR) – a proxy for convective cloud cover – for monsoon between 2004 and 2010. To identify, classify and visualize spatial patterns of rainfall and OLR we use a discrete and spatio‐temporally coherent representation of the data, created using a statistical model based on Markov Random Field. Our approach clusters the days with similar spatial distributions of rainfall and OLR into a small number of spatial patterns. We find that eight daily spatial patterns each in rainfall and OLR, and seven joint patterns of rainfall and OLR, describe over 90% of all days. Through these patterns, we find that OLR generally has a strong negative correlation with precipitation, but with significant spatial variations. In particular, peninsular India (except for the west coast) is under significant convective cloud cover over a majority of days but remains rainless. We also find that much of the monsoon rainfall co‐occurs with low OLR, but some amount of rainfall in Eastern and North‐western India in June occurs on OLR days, presumably from shallow clouds. To study day‐to‐day variations of both quantities, we identify spatial patterns in the temporal gradients computed from the observations. We find that changes in convective cloud activity across India most commonly occur due to the establishment of a north–south OLR gradient which persists for 1–2 days and shifts the convective cloud cover from light to deep or vice versa. Such changes are also accompanied by changes in the spatial distribution of precipitation. The present work thus provides a highly reduced description of the complex spatial patterns and their day‐to‐day variations, and could form a useful tool for future simplified descriptions of this process.

Kinematic and kinetic variability associated with the cable put and seated rotation assessments

ABSTRACT When new protocols are developed, there is a requirement to investigate test–retest reliability of measures for valid use and interpretation of data in research and practice. Therefore, the aim of this investigation was to determine the inter-day reliability of the cable put and seated rotation assessment protocols. On three occasions, nine resistance-trained men performed cable puts and cable rotations at different loads between 6 and 42 kg on a commercially available cable cross over machine. Load stack movement was recorded using a PT5A linear position transducer from which all kinematic and kinetic variables were calculated. Reliability was excellent for peak velocity and displacement based on intraclass correlation coefficient (ICC) and coefficient of variation (CV) across the majority of loads and movements (cable put: ICC = 0.92 to 0.99, CV = 3.1% to 8.6%; cable seated rotation: ICC = 0.76 to 0.99, CV = −1.7% to 16.1%). However, kinetic variables demonstrated inadequate reliability across the majority of days, loads and movements (ICC = 0.70, CV >10%). It was concluded that peak velocity is a reliable kinematic measure to assess muscular capability from cable put and seated rotation protocols; however, kinetic measures are too variable to provide reliable outputs across testing occasions.

Integrating HIV, syphilis, malaria and anaemia point-of-care testing (POCT) for antenatal care at dispensaries in western Kenya: discrete-event simulation modelling of operational impact

BackgroundDespite WHO advocating for an integrated approach to antenatal care (ANC), testing coverage for conditions other than HIV remains low and women are referred to distant laboratories for testing. Using point-of-care tests (POCTs) at peripheral dispensaries could improve access to testing and timely treatment. However, the effect of providing additional services on nurse workload and client wait times are unknown. We use discrete-event simulation (DES) modelling to understand the effect of providing four point-of-care tests for ANC on nurse utilization and wait times for women seeking maternal and child health (MCH) services.MethodsWe collected detailed time-motion data over 20 days from one high volume dispensary in western Kenya during the 8-month implementation period (2014–2015) of the intervention. We constructed a simulation model using empirical arrival distributions, activity durations and client pathways of women seeking MCH services. We removed the intervention from the model to obtain wait times, length-of-stay and nurse utilization rates for the baseline scenario where only HIV testing was offered for ANC. Additionally, we modelled a scenario where nurse consultations were set to have minimum durations for sufficient delivery of all WHO-recommended services.ResultsA total of 183 women visited the dispensary for MCH services and 14 of these women received point-of-care testing (POCT). The mean difference in total waiting time was 2 min (95%CI: < 1–4 min, p = 0.026) for MCH women when integrated POCT was given, and 9 min (95%CI: 4–14 min, p < 0.001) when integrated POCT with adequate ANC consult times was given compared to the baseline scenario. Mean length-of-stay increased by 2 min (95%CI: < 1–4 min, p = 0.015) with integrated POCT and by 16 min (95%CI: 10–21 min, p < 0.001) with integrated POCT and adequate consult times compared to the baseline scenario. The two nurses’ overall daily utilization in the scenario with sufficient minimum consult durations were 72 and 75%.ConclusionThe intervention had a modest overall impact on wait times and length-of-stay for women seeking MCH services while ensuring pregnant women received essential diagnostic testing. Nurse utilization rates fluctuated among days: nurses experienced spikes in workload on some days but were under-utilized on the majority of days. Overall, our model suggests there was sufficient time to deliver all WHO’s required ANC activities and offer integrated testing for ANC first and re-visits with the current number of healthcare staff. Further investigations on improving healthcare worker, availability, performance and quality of care are needed. Delivering four point-of-care tests together for ANC at dispensary level would be a low burden strategy to improve ANC.