Month Of Data Collection Research Articles

An Innovative Approach To Increasing Speech And Language Therapy Intensity For Stroke Patients

Abstract Background Different national guidelines exist for the provision of Speech and Language Therapy (SLT) intensity for stroke patients. The National Institute for Health and Care Excellence (NICE) guidelines on stroke rehabilitation in Adults (2023) advises 3 hours of multidisciplinary therapy a day, five days a week. The National Clinical guideline for Stroke for the UK and Ireland (2023) does not include SLT in this 3-hour provision of motor therapy, but advises 45 minutes of SLT a day, 5 days a week. Poor SLT staffing levels are commonplace, more recently exacerbated by the HSE recruitment embargo, posing significant challenges to rehabilitation provision. Methods A Speech and Language Therapist in a stroke service assessed whether the use of Therapy assistants could add to the delivery of the targeted 45 minutes of SLT. Training was provided in the execution of speech, language and swallow rehabilitation exercises, using patient specific exercise packs. A month of data collection started on 8 patients. Intensity was measured in 3 percentage groups: Results When rehabilitation was provided by SLT alone, 7 patients received insufficient therapy intensity. One patient scored in the moderate group. With the added input of stroke assistants, 4 patients received sufficient therapy time, 3 patients scored in the moderate group and only one patient received insufficient therapy. Conclusion Use of Stroke assistants for the provision of SLT rehabilitation exercises, can be an effective tool in increasing SLT intensity. Training is time intensive, but essential to make assistants knowledgeable and competent in their abilities. All rehabilitation should be under direct supervision of SLT. However, we should not use stroke assistants to mask or minimise the need for adequate SLT resourcing, as specified in international standards.

Alpha radioactivity deep-underground as a probe of axion dark matter

We propose to investigate the time modulation of radioisotope decays deep underground as a method to explore axion dark matter. In this work, we focus on the α-decay of heavy isotopes and develop a theoretical description for the θ-dependence of α-decay half-lives, which enables us to predict the time variation of α-radioactivity in response to an oscillating axion dark matter background. To probe this scenario, we have recently constructed and installed a setup deep underground at the Gran Sasso Laboratory, based on the α-decay of Americium-241. This prototype experiment, named RadioAxion-α, will allow us to explore a broad range of oscillation's periods, from a micro-second up to one year, thus providing competitive limits on the axion decay constant across 13 orders of magnitude in the axion mass, ranging from 10−9 eV to 10−20 eV after one month of data collection, and down to 10−22 eV after three years.

PROTOCOLS FOR COLLECTING CONVERSATIONAL LANGUAGE IN PERSONS WITH DEMENTIA

Abstract We describe first-of-its-kind protocols for collecting spontaneous conversations in persons with dementia living in a community through conversation elicitation tools twice a month over six months. We also describe the preliminary feasibility of the protocol deployment in the first enrolled participants over the first month of data collection. Participants were recruited from the University of Washington ADRC registry. The audio was captured using RODE wireless microphone system. Four conversational elicitation techniques were used: 1) reminiscence using personal photographs; 2) reminiscence using generic historical images; 3) picture description test from neurocognitive batteries; 4) open-ended questions about daily activities. Health measures included Cornell Scale for Depression in Dementia (CSDD), Clinical Dementia Rating (CDR), and Clinical Frailty Scale (CFS). Four male and two female participants (average age 75) were recruited. Average health measures at baseline were CDR = 2, suggesting moderate dementia; CSDD=7, suggesting depressive symptoms, CFS=5, suggesting mild frailty. At baseline, the tasks’ average conversation time in seconds was as follows: daily activities =528; personal reminiscence=443; historical reminiscence =227; picture description =192. The corresponding average times for the subsequent home visits were 917; 518; 474, and 280 at visit 1 and 525; 767; 629, and 311 at visit 2. We established the feasibility of collecting conversational speech in this population. Participants seemed more interested in conversations focused on daily activities and personal pictures than general topics. There was an increase in the duration of conversations over time, which might be related to participants’ greater familiarity with the study protocol and data collectors.

Pengetahuan Gizi dan Riwayat Pola Makan Ibu Hamil Berhubungan dengan Kejadian Stunting pada Balita

Stunting is a global problem including Indonesia and a threat to developing countries related to the impact of malnutrition, malnutrition and infection on children, so this problem is urgent to be addressed. This study aims to analyze the relationship between nutritional knowledge and dietary history of pregnant women with the incidence of Stunting cases. The cross-sectional correlation design study used the purposive sampling method for as many as 53 respondents, based on the guidance of the results of height measurements 6 months earlier in the MCH book and researchers measured height and weight together with nurses/midwives during Posyandu activities in the month of data collection. The research was conducted for 1 month in the working area of the Puskesmas Tanah Tinggi Kota Tangerang. Data were collected using maternal nutrition knowledge questionnaires and dietary history of pregnant women developed by researchers with reliability results of 0.935 and 0.912. The results of the chi-square statistical test, show that low nutritional knowledge in pregnant women can trigger six times the incidence of Stunting with p: 0.002 and poor diet of pregnant women contributes seven times the incidence of Stunting with p: 0.003. Stunting is triggered by low maternal knowledge about nutrition and poor diet during pregnancy. Providing education related to nutrition for pregnant women and diet is better given before pregnancy, especially for adolescent girls or couples before marriage by utilizing adolescent posyandu.

Telemedicine Acceptability Among Patients of Primary Health Care Clinics in the Western Region, Saudi Arabia.

Background Telemedicine has become increasingly important during recent years. Investigating the acceptability of telemedicine among patients is an important first step in adapting and maintaining the use of telemedicine and gaining the advantages of technologies in daily practice. Objective To measure the acceptability of telemedicine among the patients of primary health care centers (PHCC) using the Service User Technology Acceptability Questionnaire (SUTAQ) at King Abdulaziz Medical City (KAMC), Jeddah, Saudi Arabia. Methods This cross-sectional study utilized a validated questionnaire in phone call interviews with patients of PHCC clinics. All patients who had a telemedicine visit at PHCC within the past month of data collection were eligible for inclusion. The SUTAQ tool was used to measure the acceptability of telemedicine technology. Results Out of 365 people selected for participation, 73.9% responded. The study found that the median age was 40 years old with an interquartile range of 30-52. The majority of participants were female (61.1%) and married (86.7%). The median total SUTAQ score was 4.3, out of a maximum score of 6. The medians for SUTAQ subscales were as follows: the perceived benefits score was 5.4, the privacy and discomfort score was 2.1, the health care personnel concerns score was 3, the satisfaction score was 5.7, and the kit as substitution score was 4.3. Patients who had not previously experienced telemedicine visits showed a higher score in "health care personnel concerns" (P-value=0.009), while first-time patients had a higher score in "kit as substitution" (P-value=0.006). Conclusion This study provided positive evidence that telemedicine is an acceptable service among PHCC patients. However, PHCC providers should prioritize patient education and awareness about telemedicine to improve utilization. Addressing privacy, discomfort, and personnel concerns could increase patient satisfaction. Future studies investigating telemedicine utilization can help in understanding its impact on clinical outcome.

Characteristics of the Moveable Middle: Opportunities Among Adults Open to COVID-19 Vaccination

Focusing on subpopulations that express the intention to receive a COVID-19 vaccination but are unvaccinated may improve the yield of COVID-19 vaccination efforts. A nationally representative sample of 789,658 U.S. adults aged ≥18 years participated in the National Immunization Survey Adult COVID Module from May 2021 to April 2022. The survey assessed respondents' COVID-19 vaccination status and intent by demographic characteristics (age, urbanicity, educational attainment, region, insurance, income, and race/ethnicity). This study compared composition and within-group estimates of those who responded that they definitely or probably will get vaccinated or are unsure (moveable middle) from the first and last month of data collection. Because vaccination uptake increased over the study period, the moveable middle declined among persons aged ≥18 years. Adults aged 18-39 years and suburban residents comprised most of the moveable middle in April 2022. Groups with the largest moveable middles in April 2022 included persons with no insurance (10%), those aged 18-29 years (8%), and those with incomes below poverty (8%), followed by non-Hispanic Native Hawaiian or other Pacific Islander (7%), non-Hispanic multiple or other race (6%), non-Hispanic American Indian or Alaska Native persons (6%), non-Hispanic Black or African American persons (6%), those with below high school education (6%), those with high school education (5%), and those aged 30-39 years (5%). A sizable percentage of adults open to receiving COVID-19 vaccination remain in several demographic groups. Emphasizing engagement of persons who are unvaccinated in some racial/ethnic groups, aged 18-39 years, without health insurance, or with lower income may reach more persons open to vaccination.

Locals, tourists, and water recreation issues at Claytor Lake, Virginia

Claytor Lake is a 4,500 acre impoundment of the New River, located in southwestern Virginia and is ideal for pleasure boating, fishing, swimming, and exploration. In fall 2020 a visitor survey was administered to capture boater and adjacent landowner perceptions of the recreation experience, identify safety concerns, and help managers to informed decisions. Almost 200 surveys were collected over a month of data collection. Results indicate that respondents tend to be a dichotomous group of “locals” who live on or within a mile of the lake, and “tourists” who travel greater than 50 miles to visit the lake. Additionally, these two groups access the lake differently through either private docks and launches, or public launch sites and the state park, which further complicates water recreation management action on the lake. Respondents also indicated significantly higher “negative experiences” with PWC and Wake Surf boats. Of these user groups, it appears that more frequent users of the lake were the ones to report more issues with PWC and wake surf boats. Additionally, waterfront owners or those living within one mile of the lake reported the highest levels of concern around wake surf and PWC users. Finally, issues of concern varied across different user groups, and there were issues reported with safety and crowding, which also varied across user groups. These results are valuable highlights of how user type and distance from a site can influence interests, and concerns, and may therefore be an important component for recreation site manager outreach and collaborative planning efforts. Recommendations include outreach, education, and more cross-contextual communication between user groups and adjacent landowners.

Intake of Fruits, Vegetables, and Sugar-Sweetened Beverages among a Sample of Children in Rural Northern Ontario, Canada.

There is evidence to suggest that dietary intake of children differs by rural/urban place of residence: rural children may have a higher intake of foods high in fat and sugar than those living in urban environments. The aim of this study was to examine the intake of fruits and vegetables (FV) and the frequency of sugar-sweetened beverage (SSB) consumption, among a sample of rural children in Northern Ontario, Canada, in two different seasons. Sociodemographic factors and children’s FV and SSB intake were measured using two repeated cross-sectional surveys, and seasonal information was based on the month of data collection. Logistic regressions were used to examine the odds of children eating five or more FVs, and the odds of ‘frequently or always’ consuming SSBs. During the fall, children reported eating five or more FV more often, when compared to winter (53.9% vs. 48.3%). In the fall, 25.8% of children reported ‘frequently or always’ drinking SSB, compared with 16.9% in winter. Indigenous children were less likely to eat five or more FV (OR 0.34 (95% CI 0.12–0.95)) in the fall when compared to non-Indigenous children. Findings indicate that intake of FV among rural students in this region is low, and the frequency of SSB is high, when compared with national recommendations.

Wheelchair User's Barriers in Physical Activity: Rural VS. Urban Area

Individuals with disabilities experience more significant challenges in carrying out physical activity than the general population. Previous studies have identified physical activity and fitness levels without measuring barriers to physical activity. This study examines how wheelchair users assess obstacles to physical activity and looks for the significant factors that hinder the biological activity of wheelchair users in urban and rural areas. The method in this research is a cross-sectional study. An online survey was used to obtain information on physical activity barriers in wheelchair users. A total of 81 respondents consisting of 40 wheelchair users from rural areas and 41 from urban areas, filled out the Barriers Physical Activity Questionnaire Mobility Impairment (BPAQ-MI) with a response rate of 70% during one month of data collection. The analysis data technique is mean, percentage, and an independent sample's T-test to compare physical activity barriers between wheelchair users in urban and rural areas. The chief obstacles to physical activity are friends and family as a support system (p<0.05), lack of public facilities (p<0.05), lack of fitness facilities and infrastructure (p<0,05), staff/program/policy (p<0.05), and community (p<0.05). The conclusion is that wheelchair users in rural areas have more significant barriers to physical activity than those in urban areas. Improving support from family, friends, environment, social policies, and a disability-friendly physical environment can be critical points in increasing the biological activity of wheelchair users in rural areas.

THE EFFECTS OF A TARGETED "EARLY BIRD" INCENTIVE STRATEGY ON RESPONSE RATES, FIELDWORK EFFORT, AND COSTS IN A NATIONAL PANEL STUDY.

Adaptive survey designs are increasingly used by survey practitioners to counteract ongoing declines in household survey response rates and manage rising fieldwork costs. This paper reports findings from an evaluation of an early-bird incentive (EBI) experiment targeting high-effort respondents who participate in the 2019 wave of the US Panel Study of Income Dynamics. We identified a subgroup of high-effort respondents at risk of nonresponse based on their prior wave fieldwork effort and randomized them to a treatment offering an extra time-delimited monetary incentive for completing their interview within the first month of data collection (treatment group; N = 800) or the standard study incentive (control group; N = 400). In recent waves, we have found that the costs of the protracted fieldwork needed to complete interviews with high-effort cases in the form of interviewer contact attempts plus an increased incentive near the close of data collection are extremely high. By incentivizing early participation and reducing the number of interviewer contact attempts and fieldwork days to complete the interview, our goal was to manage both nonresponse and survey costs. We found that the EBI treatment increased response rates and reduced fieldwork effort and costs compared to a control group. We review several key findings and limitations, discuss their implications, and identify the next steps for future research.

Determinants of acute respiratory infection among under-five children in rural Ethiopia

IntroductionIn low- and middle-income nations, acute respiratory infection (ARI) is the primary cause of morbidity and mortality. According to some studies, Ethiopia has a higher prevalence of childhood acute respiratory infection, ranging from 16 to 33.5%. The goal of this study was to determine the risk factors for acute respiratory infection in children under the age of five in rural Ethiopia.MethodsA cross-sectional study involving 7911 children under the age of five from rural Ethiopia was carried out from January 18 to June 27, 2016. A two stage cluster sampling technique was used recruit study subjects and SPSS version 20 was used to extract and analyze data. A binary logistic regression model was used to identify factors associated with a childhood acute respiratory infection. The multivariable logistic regression analysis includes variables with a p-value less than 0.2 during the bivariate logistic regression analysis. Adjusted odds ratios were used as measures of effect with a 95% confidence interval (CI) and variables with a p-value less than 0.05 were considered as significantly associated with an acute respiratory infection.ResultsThe total ARI prevalence rate among 7911 under-five children from rural Ethiopia was 7.8%, according to the findings of the study. The highest prevalence of ARI was found in Oromia (12.8%), followed by Tigray (12.7%), with the lowest frequency found in Benishangul Gumuz (2.4%). A multivariable logistic regression model revealed that child from Poor household (AOR = 2.170, 95% CI: 1.631–2.887), mother’s no education (AOR = 2.050,95% CI: 1.017–4.133), mother’s Primary education (AOR = 2.387, 95% CI:1.176–4.845), child had not received vitamin A (AOR = 1.926, 95% CI:1.578–2.351), child had no diarrhea (AOR = 0.257, 95% CI: 0.210–0.314), mothers not working (AOR = 0.773, 95% CI:0.630–0.948), not stunted (AOR = 0.663, 95% CI: 0.552–0.796), and not improved water source (AOR = 1.715, 95% CI: 1.395–2.109). Similarly, among under-five children, the age of the child, the month of data collection, anemia status, and the province were all substantially linked to ARI.ConclusionsChildhood ARI morbidity is a serious health challenge in rural Ethiopia, according to this study, with demographic, socioeconomic, nutritional, health, and environmental factors all having a role. As a result, regional governments, healthcare staff, and concerned groups should place a priority on reducing ARI, and attempts to solve the issue should take these variables into account.

Public Discussion of Anthrax on Twitter: Using Machine Learning to Identify Relevant Topics and Events.

BackgroundSocial media allows researchers to study opinions and reactions to events in real time. One area needing more study is anthrax-related events. A computational framework that utilizes machine learning techniques was created to collect tweets discussing anthrax, further categorize them as relevant by the month of data collection, and detect discussions on anthrax-related events.ObjectiveThe objective of this study was to detect discussions on anthrax-related events and to determine the relevance of the tweets and topics of discussion over 12 months of data collection.MethodsThis is an infoveillance study, using tweets in English containing the keyword “Anthrax” and “Bacillus anthracis”, collected from September 25, 2017, through August 15, 2018. Machine learning techniques were used to determine what people were tweeting about anthrax. Data over time was plotted to determine whether an event was detected (a 3-fold spike in tweets). A machine learning classifier was created to categorize tweets by relevance to anthrax. Relevant tweets by month were examined using a topic modeling approach to determine the topics of discussion over time and how these events influence that discussion.ResultsOver the 12 months of data collection, a total of 204,008 tweets were collected. Logistic regression analysis revealed the best performance for relevance (precision=0.81; recall=0.81; F1-score=0.80). In total, 26 topics were associated with anthrax-related events, tweets that were highly retweeted, natural outbreaks, and news stories.ConclusionsThis study shows that tweets related to anthrax can be collected and analyzed over time to determine what people are discussing and to detect key anthrax-related events. Future studies are required to focus only on opinion tweets, use the methodology to study other terrorism events, or to monitor for terrorism threats.

Experimental Determination of Carbon Dioxide Flux in Soil and Correlation with Dependent Parameters

Carbon dioxide is one of the greenhouse gases responsible for the effects of climate change. The soil respiration process is an important component of the carbon circuit in nature, through which carbon dioxide returns to the atmosphere. The concentration of CO2 in the atmosphere is directly influenced by any change of carbon flow produced in soil, as the latter is the largest carbon sink in terrestrial ecosystems. The objective of this paper is to present the experimental results obtained using CO2 flow determination with portable GHG analyzer with closed static chamber, and the relation and influence of the main pedoclimatic parameters, namely temperature and humidity. Future research directions will consider the development of a plan to monitor CO2 flow from the soil, for different types of land use, in different climatic conditions. During one month of data collection, has been found that soil CO2 efflux was influenced by soil moisture and soil temperature. Also, the processed data showed how soil respiration rates were dependent on soil moisture.

NO2 Exposure and Lung Function Decline in a Cohort of Adults in Mysore, India

Previous studies suggest a potentially large burden of respiratory disease attributable to ambient air pollution exposure. Increasingly high air pollution levels in low- and middle-income countries (LMICs) may be contributing to worsening respiratory health. In the course of a 5-year longitudinal study, the influence of annual average ambient nitrogen dioxide (NO2) at the home location on lung function decline was investigated in a 485-person cohort of low-income adults in Mysore, Karnataka, India. Health data were gathered in two rounds of qualitative questionnaires (2012-2014 and 2017-2018) using standardized interviews, as well as in-home lung function measurements using field spirometers. We estimated annual average ambient NO2 in 2017 at the home location from spatial interpolation of seasonal air pollution sampling. Linear mixed effects models with a person-specific random effect were used to estimate NO2 versus lung function cross-sectionally at baseline as well as longitudinally over time, with models adjusted for potential confounders including age at baseline, sex, smoking status, and month of data collection to control for potential seasonality. Results indicated cross-sectional associations between NO2 and lung function post-bronchodilation, with a reduction of -28.2 mL (95% CI: -51.2, -5.28) for FEV1 and -34.3 mL (95% CI: -61.2, -7.47) for FVC post-bronchodilation per 10 ppb increase in NO2. We show limited evidence of longitudinal impacts of air pollution on lung function. Future studies would benefit from time-varying air pollution exposure estimates, as well as subsequent rounds of lung function data collection to assess for longer-term trends in lung function decline.

How Seasonal Is the Minimum Dietary Diversity for Children Indicator? An Investigation in Three Countries on Three Continents: Senegal, Nepal and Peru

Abstract Objectives A diverse diet helps to assure adequate micronutrient intakes and normal child growth and development. The revised minimum dietary diversity (MDD) indicator for children 6–23 months (&amp;gt;5 of 8 food groups) is often used to track dietary quality over time, but the influence of seasonality has not been explored. Methods We identified surveys with MDD data across seasons including national continuous Demographic Health Surveys in Senegal (2012–2017, N = 12,183) and Peru (2004–16, N = 36,044) and the PoSHAN substudy seasonal surveys (covering 3 seasons) in Nepal (2013–2016, N = 1364). MDD prevalence and mean food groups were estimated. In Senegal and Peru, data were disaggregated by rainy/dry season and month. Results In Senegal, MDD prevalence was similar in the rainy (10.8%) and dry (9.6%) seasons. In Nepal, MDD prevalence was stable at 35.1–34.9% from the monsoon of 2013 through the end of 2014, and then increased to 41.7–47.7% from the winter 2014 through monsoon seasons of 2015 and 2016. In Peru, the prevalence of MDD ranged from 62% in May to 72% in January, but region-season interactions were apparent, perhaps due to agro-ecological variability. Large variance existed for the MDD indicator for many datasets, with mean scores showing greater stability across seasons. Conclusions There can be periods of seasonal stability as observed in Senegal and the first two years of Nepal data, but also sustained change. Relative national stability can obscure seasonal patterns by, as seen in Peru. Variability by season may influence conclusions about change over time in some contexts if month of data collection is not considered. Funding Sources Bill &amp; Melinda Gates Foundation and Feed the Future Innovation Lab for Nutrition, funded by the United States Agency for International Development under grant ID: AID-OAA-L-1–00006.

Do Sugary Drink Policies Increase Purchases of Non-Calorically Sweetened Beverages? Evidence from Chile

Abstract Objectives Chile's 2016 on food labeling and advertising reduced household (HH) sugary drink purchases by 24%. However, it is unclear if this regulation was also associated with a subsequent increase in non-calorically sweetened (NCS) beverage purchases, nor who is most likely to be a top consumer of NCS beverages. Methods We used longitudinal monthly-level data from Kantar WorldPanel Chile 2015–2017 (HH = 2383) linked to yearly updated nutrition facts panel data to examine changes in NCS beverage purchases from the pre-implementation period (January 2015-June 2016) to the post-implementation period (July 2016-December 2017). Beverages were categorized into 4 mutually exclusive groups: CS: sweetened with caloric sweeteners, NCS: sweetened with non-caloric sweeteners, CS + NCS: sweetened with both sweeteners, and unsweetened. For the pre-implementation period, we used multinomial logistic regression to model HH sociodemographic predictors (head of HH educational level, HH assets, HH composition and region) of being in tertiles of NCS beverages volume purchased. We estimated the changes in beverage volume purchases between pre- and post-implementation using linear regression models adjusted for HH sociodemographic characteristics and month of data collection to account for seasonality. Results HH with higher education (35%) and HH assets (38%) were more likely to be high NCS beverages purchasers, while HH with lower education (37%) and HH assets (42%) were more likely to be low NCS beverages purchasers. After policy implementation, volume of purchases of NCS beverages increased by 6.2 mL/capita/day (95% CI: 4.7, 7.6), while volume of CS, CS + NCS and unsweetened beverages purchases decreased by 24.6 mL (95% CI: −27.5, −21.7), 4.3 mL (95% CI: −6.4, −2.2) and 16.4 mL (95% CI: −20.8, −12.1), respectively. Conclusions In Chile, people of high SES purchase more NCS beverages. After policy implementation, the volume of CS, NCS + CS and unsweetened beverages decreased while the volume of NCS sweetened beverages increased. Funding Sources Bloomberg Philanthropies, International Development Research Centre, and Chilean National Agency of Research and Development. This project was also supported by the Carolina Population Center.

P672 The escalation of therapy or intervention (ETI) calculator for ulcerative colitis: does it have the potential to help outpatient capacity meet demand?

Abstract Background Demand for outpatient clinic appointments for ulcerative colitis (UC) often exceeds capacity, since spaces are frequently assigned to routine follow-up of patients who are well. Demand might better be managed by targeting appointments for patients in need of therapeutic decisions. The TrueColours UC (TCUC) Escalation of Therapy or Intervention (ETI) calculator is a potential enabling tool. Methods TCUC is a web-based programme based on email prompts linked to validated, disease-specific indices. The ETI Calculator was created after logistic regression showed that patient-reported symptoms (Simple Clinical Colitis Activity Index) and quality of life (IBD Control-8) could calculate the probability of therapy escalation or an urgent intervention during an outpatient appointment (OPA, Figure 1). From June 2018 to August 2019, all OPA for 650 patients using TCUC and under standard OPA follow-up were examined. The probability of escalation at each OPA was calculated using the most recent prior SCCAI and IBD-Control scores (within 2 weeks of appointment). Clinic letters were assessed to determine whether treatment escalation or intervention had occurred during the OPA. Results Of 650 patients, 236 had a total of 403 OPAs. 210/403 (52%) of these OPAs resulted in no treatment escalation; 159/403 (40%) had escalation and 34/410 (8%) had de-escalation. An ETI calculator threshold set at 5% estimated probability of treatment escalation would have correctly identified 143/159 (90%) escalation events. 16/159 (10%) escalations were not correctly predicted: 12/16 were escalations of medication (oral 5-aminosalicylic acid, n = 3), azathioprine (2), methotrexate (1), increase infliximab dose (2), adalimumab (3), tofacitinib (1). Other escalations were endoscopy requests (2), dermatology/rheumatology referrals (2). Importantly, 6/16 (38%) had taken steroids within 1 month of data collection. 143/403 (35%) of OPAs could have been deferred using a 5% ETI threshold. In contrast, increasing the ETI threshold to 25% would have allowed 274/403 (68%) OPAs to be deferred but would have resulted in missing an additional 53 escalations. Conclusion A model that predicts the likelihood of treatment escalation or intervention during an OPA, based on real-time data entered by patients, has the potential to improve outpatient clinic resource utilisation. The calculator may not be valid to triage patients recently on steroids.

Exploitation of Pangolins (Pholidota, Mammalia) by Communities Living in and around the Tayna Nature Reserve (RNT) North Kivu, Democratic Republic of Congo (DRC)

Pangolin exploitation has recently increased in diverse forms such as bushmeat consumption; species or parts trade, medical use. This species is protected in Democratic Republic of Congo (DRC) and worldwide, unfortunately it is threatened by numerous human actions. The purpose of this study was to determine the profiles of actors using pangolins, the reasons for pangolin exploitation and its products and their use within the local community in and surrounding the reserve. We carried out surveys in the households of hunters, farmers and people practicing other professions in 12 villages, located within the Tayna Nature Reserve (RNT) and surroundings areas. Two interview techniques were used: the individual interview and the participatory diagnostic technique. During one month of data collection, 175 respondents were interviewed. Respondents had diverse profiles according to sex, age, education level and ethnicity. Men were more represented as actors in pangolin exploitation (71.70%) than women (28.30%); the most represented age interval was 20 - 30 years. The education level is distinct amongst respondents: illiterate (37%), primary school (32.4%) and graduate from university (2.9%). An average number of respondents are motivated to consume pangolin as meat obtained by hunting at 50%. The main reason for its consumption is preference (44%) and habit (33%). The scales are pangolin derivatives most recognized by local people and widely used in the pharmacopoeia. Consequently, pangolin protection needs some rigorous measures to reinforce the current law implementation.

Research note: A prenotice greeting card’s impact on response rates and response time

Maintaining high response rates over time is critical for the integrity of longitudinal studies. A best practice for encouraging survey participation in cross-sectional studies is to send sample members a pre-incentive with the survey invitation. However, in longitudinal studies this may change sample members’ future expectations of incentives. Instead researchers can use a prenotice to remind longitudinal sample members of the study and inform them of the upcoming wave. A unique greeting card format for a prenotice was experimentally tested against a $10 pre-incentive in the longitudinal study Add Health. The prenotice card, which thanked sample members for their ongoing contributions to the study over the last 20-plus years, significantly increased response rates and decreased survey response times over the 12-month course of data collection compared to the control. At the end of data collection, the prenotice card was equally effective as a $10 pre-incentive. However, in the first month of data collection, the combination of the prenotice card and pre-incentive was the most effective approach, suggesting that the best approach may depend on the planned duration of data collection. Additionally, sample members who did not participate in a previous wave had higher response rates this wave with the pre-incentive compared to the control. The findings suggest that long-term longitudinal study participants may evaluate researchers’ gratitude as a type of benefit on par with monetary incentives, offering researchers opportunities to reduce incentive costs, but this may differ based on previous wave participation.

FACTORS ASSOCIATED WITH ADVERSE PREGNANCY OUTCOMES AMONG HOME AND HEALTH FACILITY DELIVERIES IN LAMU COUNTY, KENYA: A COMPARATIVE CROSS SECTIONAL STUDY

Introduction: The burden of adverse perinatal and maternal outcomes is still unacceptably high in low- and middle-income countries. Although much is known on the risk factors, very little is known about specific aspects in Lamu County. This is compounded by the fact that the maternal mortality ratio in Lamu almost doubles the national rate. This study was aimed at providing a framework to assess the probable risk factors for adverse pregnancy outcomes in the County following both hospital and home deliveries. Methodology: Study design: Comparative cross-sectional study. Setting: Lamu County, both home and hospital deliveries. Study population: Female residents of Lamu County interviewed within a month of data collection, having delivered in the year 2017 at gestation age of ≥28 weeks and age ≥14 years. Sample size: Using Fleiss formula for comparative cross-sectional study; the sample size was approximated to be 400 participants after adjusting for attrition. Data collection and management: Data were collected using a questionnaire by trained research assistants, and entered into an Excel spreadsheet. Data analysis: Analysis was done using Statistical Package for Social Sciences (SPSS) version 20. Relevant tests of significance were applied. Results: The most prevalent adverse obstetric outcomes were post-partum hemorrhage (PPH) requiring transfusion of at least 2 units of blood and preterm births. PPH was more common following home delivery. Pre-existing medical conditions, other obstetric emergencies (OR 128.17, CI 14.88 – 110.4, p&lt; 0.001) and long distance were associated with adverse obstetric outcomes. There was no significant difference in the prevalence of adverse outcomes between home and hospital deliveries (OR 0.94, C.I 0.55-1.61, p= 0.812). Conclusion: Multiple factors are associated with adverse obstetric outcomes in Lamu. There is a need to: raise awareness on the need for greater facility-based skilled birth attendance; build capacity of facilities to provide comprehensive emergency obstetric care and to train traditional birth attendants to become ambassadors for early referral.