Planning Program Research Articles

PERFORMANCE MEASURES OF RURAL DEVELOPMENT STRATEGIES IN IFELODUN LOCAL GOVERNMENT AREA OF KWARA STATE

The study assessed the performance measures of rural development strategies in Ifelodun LGA of Kwara State. The instruments used in this study are questionnaires, key informant interviews, and observation. The adopted sample size for the study is 384 persons. Simple random sampling was used to distribute questionnaires proportionally to the nine districts according to population size. Data analysis for this research was descriptive and inferential. Multiple regression analysis was used to measure the performance of development strategies in the study area. The result from the socio-economic characteristics of respondents revealed that 66% of the respondents were male, while 34% were female. Most (51.3%) of the respondents are within the age bracket of 31-45 years. It was also observed that over 90% of the respondents have attained one level of formal education or the other and apart from 17.13% and 28.73% that engage in civil service and business enterprises other than farming, 44.20% of the respondents are solely farmers and 94.5% earn above ₦20,000 monthly. Furthermore, the State Government was the major contributor to health, transport, agriculture, and education with a percentage contribution of 28.2%, 30.4%, 29.6%, and 44.8% respectively. The regression analysis result revealed that 82% of the impact of development strategies implemented in the study area could be explained by the transport, health, and agricultural sectors. Therefore, the study recommends that the federal government be more involved in the development of the study area and rural dwellers should be involved in the initiation, planning, and execution of development programs.

HIV seropositive disclosure and associated factors among adult HIV positive clients in public health facilities in East Wollega Zone, Oromia Regional State, Western Ethiopia.

Disclosure of HIV-seropositive is important for HIV prevention and maintenance of health for people living with HIV and the community at large. Although HIV seropositive disclosure is mandatory for access to care and treatment, there is a paucity of data in the study setting. This study aimed to assess the magnitude of HIV Sero Positive Disclosure and associated factors among adult HIV positive clients in public health facilities in the east wollega zone, Oromia Regional State, Western Ethiopia, in 2023. A facility-based cross-sectional study design was conducted among 250 adult HIV-positive clients in public health facilities in East Wollega Zone. Systematic sampling was used to select the study participants. Data were collected from February 1 to April 15, 2023, using a structured, pretested, interviewer-administered questionnaire and reviewing patient cards using a checklist. Data were entered into Epi Data version 3.1 and exported to SPSS version 25 for analysis. Bivariable and multivariable logistic regression analyses were done. In bivariable analyses, variables with a P-value <0.25 were candidates for the multivariable model; in the multivariable model, significant associations were declared at a P-value < 0.05 and reported by an adjusted odds ratio along with a 95% confidence interval. The magnitude of HIV seropositive disclosure to at least one person was found to be 68.2% (95%CI = 62.5%, 73.9%). HIV seropositive disclosure was significantly associated with being married ((AOR = 5.47, 95%CI: 2.87-10.43), low knowledge level (AOR = 0.095, 95% CI = 0.017-0.54), and perceived community discrimination (AOR = 0.192, 95% CI = 0.050, 0.74). This study reveals that HIV seropositive disclosure was low among the adult population living in the study area as compared to the other study findings. Disclosure of seropositives was significantly associated with marital status, knowledge level about the importance of disclosure, and perceived discrimination in societies. Healthcare providers and HIV prevention programme planners should provide health education about the importance of HIV disclosure and the stigma against HIV-positive patients by increasing society's awareness through appropriate channels.

Reasons for contraceptive discontinuation among women of reproductive age in Kano, Nigeria: A qualitative study

Women’s attempts to achieve their desired levels of fertility are hindered when they stop using contraceptives, which could lead to unwanted pregnancies. This study aimed to assess reasons for contraceptive discontinuation among women of reproductive age in urban and rural areas of Kano State, Nigeria. Qualitative data were collected in urban and rural communities of Kano State in February to May, 2022 from women of reproductive age group, their male partners, family planning service providers, and community and religious leaders. Focus group discussions (FGD), and key informant interviews (KII), using multi-stage sampling methods explored previous experience with contraceptive use, fertility consequences and reasons for contraceptive discontinuation. Following data collection, digitally recorded data were transcribed verbatim, translated, and coded using thematic analysis through an inductive approach. Study reported the high discontinuation rates and identified side effects as the primary reason for discontinuation, with injectable contraceptives being the most commonly discontinued method. Other reported reasons for contraceptive discontinuation by respondents in both urban and rural groups were: method failure, intention to get pregnant, health concerns, husband disapproval, methods not available, inconvenience to use and interference with body structure or functions. The high contraceptive discontinuation poses significant risks of unintended pregnancies and unsafe abortions, thereby increasing maternal morbidity and mortality rates in Kano State. These consequences emphasize the need for family planning interventions that incorporate quality of care in service provision to address contraceptive discontinuation. Engaging men and other social influencers in family planning programs and services will help gather support for contraception, rather than focusing exclusively on women.

Manajemen Blended Learning Pasca Pandemi Covid-19: Studi Kasus Sekolah di Indonesia

This study aims to find out the main factors that contribute to blended learning management in Indonesia. The research is focused on identifying the management process which includes, planning, organizing, implementing, and evaluating the blended learning management program at SMAN 2 Jember, SMKN 1 Wanayasa Banjarnegara and SMP 1 Prambanan Yogyakarta. This research is qualitative descriptive research with a naturalistic approach. The results show that the four functions of the management process have a very large influence on the results of the blended learning management program. First, the planning of the blended learning program involves all school stakeholders, as well as through the creation of a regular schedule. Second, in terms of organizing blended learning programs, the school goes through the curriculum work process so that teachers fill out a daily journal, to monitor activities. Third, the implementation of the blended learning program based on the learning process in the classroom by providing materials and explanations, as well as information transformation through room meeting to do practice questions at home. Fourth, learning evaluation is carried out through google classroom for attitude knowledge, and practicum for skill aspects, as well as private universities and UAS. Blended learning management policies involving all school stakeholders, filling out daily journals, learning in the classroom and delivering material through room meetings can optimize the learning process in the post-covid-19 pandemic period.

Breaking Down the Barriers: Rethinking Government's Role in Indonesian Tourism Destination Development

Stakeholder involvement is essential to destination development. They may serve as catalysts or impediments to the growth of tourist sites. This study explores the barriers to tourism destination development associated with the role of local tourism authorities. A qualitative approach, employing semi-structured interviews, was utilized to examine the root causes of these challenges. Sixteen stakeholders, including ten government officials responsible for regional tourism development and six community leaders, were selected as informants in this study. Thematic analysis was used to analyze the interview data. The investigation revealed four main barriers to destination development from government agencies. There are bureaucratic hurdles, contrived program activities, overlapping roles of local governments, and the community’s misconceptions about the government’s role in destination development. These factors collectively hinder the successful implementation of government-led tourism programs. The study suggests that understanding and addressing these barriers are vital to fostering a progressive, sustainable, competitive tourist destination. On a practical level, the findings can help policymakers redesign their strategies to create more community-centric programs, clearly define roles, and manage community expectations. Conceptually, this study expands the existing literature on the role of government and bureaucracy in developing tourist destinations. The study highlights the importance of a participatory approach that engages all stakeholders in the planning and implementation tourism policies and programs.

Principal Supervision in Improving the Quality of Learning Administration Services at the State Islamic Elementary School

This study focuses on the role of managerial supervision in enhancing learning administration services at MIN 03 Kepahiang. It adopts a descriptive research method with a qualitative approach. The research participants included the school principal, the curriculum deputy principal, and the administration head. Data were collected through observation, interviews, and documentation and were analyzed through data reduction (summarizing), data presentation (organizing information), and concluding (formulating a comprehensive description). The findings reveal that the principal and head of administration at MIN 03 Kepahiang have successfully implemented managerial supervision to improve learning administration services, which covers program planning, organizing, implementation, and evaluation. The supervision by the school principal has been carried out effectively, resulting in enhanced administrative services and overall education quality. Through structured supervision programs, supervisors have assessed, monitored, and developed the performance of learning administration services at MIN 03 Kepahiang.

A hybrid transformer and attention based recurrent neural network for robust and interpretable sentiment analysis of tweets

Sentiment analysis is a pivotal tool in understanding public opinion, consumer behavior, and social trends, underpinning applications ranging from market research to political analysis. However, existing sentiment analysis models frequently encounter challenges related to linguistic diversity, model generalizability, explainability, and limited availability of labeled datasets. To address these shortcomings, we propose the Transformer and Attention-based Bidirectional LSTM for Sentiment Analysis (TRABSA) model, a novel hybrid sentiment analysis framework that integrates transformer-based architecture, attention mechanism, and recurrent neural networks like BiLSTM. The TRABSA model leverages the powerful RoBERTa-based transformer model for initial feature extraction, capturing complex linguistic nuances from a vast corpus of tweets. This is followed by an attention mechanism that highlights the most informative parts of the text, enhancing the model’s focus on critical sentiment-bearing elements. Finally, the BiLSTM networks process these refined features, capturing temporal dependencies and improving the overall sentiment classification into positive, neutral, and negative classes. Leveraging the latest RoBERTa-based transformer model trained on a vast corpus of 124M tweets, our research bridges existing gaps in sentiment analysis benchmarks, ensuring state-of-the-art accuracy and relevance. Furthermore, we contribute to data diversity by augmenting existing datasets with 411,885 tweets from 32 English-speaking countries and 7,500 tweets from various US states. This study also compares six word-embedding techniques, identifying the most robust preprocessing and embedding methodologies crucial for accurate sentiment analysis and model performance. We meticulously label tweets into positive, neutral, and negative classes using three distinct lexicon-based approaches and select the best one, ensuring optimal sentiment analysis outcomes and model efficacy. Here, we demonstrate that the TRABSA model outperforms the current seven traditional machine learning models, four stacking models, and four hybrid deep learning models, yielding notable gain in accuracy (94%) and effectiveness with a macro average precision of 94%, recall of 93%, and F1-score of 94%. Our further evaluation involves two extended and four external datasets, demonstrating the model’s consistent superiority, robustness, and generalizability across diverse contexts and datasets. Finally, by conducting a thorough study with SHAP and LIME explainable visualization approaches, we offer insights into the interpretability of the TRABSA model, improving comprehension and confidence in the model’s predictions. Our study results make it easier to analyze how citizens respond to resources and events during pandemics since they are integrated into a decision-support system. Applications of this system provide essential assistance for efficient pandemic management, such as resource planning, crowd control, policy formation, vaccination tactics, and quick reaction programs.

Program Evaluation of Pancasila Student Profile Strengthening Project Using the CSE-UCLA Model

The research aims to evaluate the program of the Pancasila student profile strengthening project in elementary schools in Semarang Regency, Indonesia. This research method used the CSE-UCLA evaluation model with a qualitative approach that included the aspects of program assessment, program planning, program implementation, program improvement, and program certification. The data sources came from the school principal/curriculum teachers, classroom teachers, students, and the parents of students at Pangudi Luhur Ambarawa Elementary School and Tlompakan 1 Tuntang Elementary School in Semarang Regency. Data collection was through interviews, document studies, and observations. The data analysis technique used qualitative descriptive methods. The research results showed that in the Assessment program, P5 was implemented in accordance with the vision, mission, and objectives. The theme and project options were chosen based on environmental issues and the needs of the students, and the project was also supported by the parents; Program planning, both schools had goals to be achieved in P5 so that the project ran with a clear direction and purpose; Program implementation, teachers have good strategies in carrying out P5 but improvements were needed in the socialization of the P5 program; Program improvement, there needs to be enhancements in the documentation of monitoring and supervision results; Certification program, the goals of the P5 program were achieved and all parties were satisfied with the existence of the P5 program, which had a positive impact on the students. The P5 program was running well, and all stakeholders were satisfied. However, there was a need for improvement in documentation and communication with students' parents. In addition, it is necessary to broaden project options, support teachers, and encourage them to prioritize character development over tangible results.

An observational analysis of the impact of deltamethrin + piperonyl butoxide insecticide-treated nets on malaria case incidence and entomological indicators in Ebonyi State, Nigeria, 2017–2021

BackgroundIntense pyrethroid resistance threatens the effectiveness of the primary vector control intervention, insecticide-treated nets (ITNs), in Nigeria, the country with the largest malaria burden globally. In this study, the epidemiological and entomological impact of a new type of ITN (piperonyl-butoxide [PBO] ITNs) distributed in Ebonyi State were evaluated. The epidemiological impact was also compared to the impact of standard pyrethroid-only ITNs in Cross River State.MethodsA controlled interrupted time series analysis was conducted on monthly malaria incidence data collected at the health facility level, using a multilevel mixed-effects negative binomial model. Data were analysed two years before and after the PBO ITN campaign in Ebonyi State (December 2017 to November 2021). A pre-post analysis, with no comparison group, was used to assess the impact of PBO ITNs on human biting rates and indoor resting density in Ebonyi during the high transmission season immediately before and after the PBO ITN campaign.ResultsIn Ebonyi, PBO ITNs were associated with a 46.7% decrease (95%CI: -51.5, -40.8%; p < 0.001) in malaria case incidence in the 2 years after the PBO ITN distribution compared to a modelled scenario of no ITNs distributed, with a significant decrease from 269.6 predicted cases per 1000 population to 143.6. In Cross River, there was a significant 28.6% increase (95%CI: -10.4, 49.1%; p < 0.001) in malaria case incidence following the standard ITN distribution, with an increase from 71.2 predicted cases per 1000 population to 91.6. In Ebonyi, the human biting rate was 72% lower (IRR: 0.28; 95%CI 0.21, 0.39; p < 0.001) and indoor resting density was 73% lower (IRR: 0.27; 95%CI 0.21, 0.35; p < 0.001) after the PBO ITNs were distributed.ConclusionsThe epidemiological and entomological impact of the PBO ITNs underscore the impact of these ITNs in areas with confirmed pyrethroid resistance. These findings contribute to ongoing research on the impact of new types of ITNs in Nigeria, providing critical evidence for the Nigeria National Malaria Elimination Programme and other countries for future ITN procurement decisions as part of mass ITN campaign planning and malaria programming.

The Mediating Effect of Organizational Productivity on The Relationship between Competencies, Engagement, And Commitment with Talent Management &amp; Succession Planning Programs in Saudi Arabia

The purpose of the current study is to investigate the relationship between Competencies, Engagement, and Commitment with the Talent Management and Succession Planning Programs in the Saudi Electricity Company. In addition, the mediating role of the Organizational Productivity on the relationship between the variables. This study was conducted following the quantitative research methods through the distribution of 408 questionnaires to the employees of the Saudi Electricity Company. The results revealed that significant relationship between Competencies, Engagement, and Organizational Productivity with the success of the Talent Management &amp; Succession Planning programs, which support what was found in the majority of the previous published literature. But unlike most of the published literature, Commitment was found to be insignificant to the success of the Talent Management &amp; Succession Planning programs. In addition, this study showed that Organizational Productivity played a significant mediating effect on the relationship between Engagement and Commitment with Talent Management &amp; Succession Planning programs. However, Organizational Productivity has shown an insignificant mediating effect on the relationship between Competencies and Talent Management &amp; Succession Planning programs.

Pelatihan Pembuatan Pakan Ternak Fermentasi Berbahan Baku Sumberdaya Lokal Di Kelompok Tani Ternak (KTT) Berlian Desa Sukadana

The purpose of this activity is training in special production technology for fermented feed using local resources such as straw and others. The implementation of preparation for community service activities includes: initial observation/survey activities, identification of potential and problems, preparing an action program plan, determining activities, coordinating and taking care of permits for all parties related to the service activities. The results obtained were that most group members did not utilize local raw materials for animal feed and they did not provide fermented animal feed for their livestock. Providing an understanding of the importance of the concept of increasing livestock production in the form of information transfer, knowledge about the concept of fermented animal feed related to its benefits and functions for increasing production carried out through FGD and lecture methods. During the discussion session, input and feedback were obtained from participants that could be useful for the implementation of the service process. The next session was a demonstration or practice of making fermented animal feed using local resources. In the follow-up stage, assistance was provided in providing fermented animal feed to each farmer's livestock, with the hope that the livestock would accept and eat the results of the fermented feed so that it could increase production and increase the income of livestock farmers. The implementation of community service activities went according to plan and could be realized according to expectations. In order to optimize and massively implement the activity of making fermented animal feed among livestock farmers, especially in the surrounding areas, the next community service activities were carried out in various community groups that could be directly affected by handling vulnerable animal feed.

Daily exercises uptake and associated factors among Social Security and National Insurance Trust pensioners in the Greater Accra Region of Ghana

BackgroundWith a growing body of evidence highlighting the positive impact of regular physical activity or exercise on achieving healthy aging, it is important to gain insight into the factors influencing daily exercises uptake. However, to the best of our knowledge, no study has been focused on factors predicting daily exercises uptake among pensioners, who form a substantial portion of Ghana’s aging population. The goal of this preliminary study was to estimate the factors associated with daily exercises uptake among Social Security and National Insurance Trust (SSNIT) pensioners in Ghana.MethodsData for this study came from a cross-sectional study on survival strategies and quality of life among SSNIT pensioners in the Greater Accra Region of Ghana. Cluster and stratified sampling techniques were used to recruit the study participants. The analytic sample was 410 participants. Multivariable binary logistic regressions were used to estimate factors associated with daily exercises uptake among the participants. The significance of the test was pegged at a p-value of 0.05 or less.ResultsThe results showed that 62% of the participants self-identified as male, 47.6% were aged between 60 and 64 years, 52.7% were employed in the public sector and 44.4% performed daily exercises. The results showed that those who were aged 60–64 years (AOR: 1.197, 95% CI: 1.019–1.405), aged 65–69 years (AOR:1.254, 95% CI: 1.071–1.468), who do not incur expenditure on their household in a month (AOR: 1.519, 95% CI: 1.127–2.046), earned less than GH¢260 (AOR: 1.221, 95% CI: 1.018–1.465), accessed/utilized herbalist medical services (AOR: 1.252, 95% CI: 1.129–1.388), very dissatisfied (AOR: 1.637, 95% CI: 1.242–2.157) and dissatisfied (AOR: 1.516, 95% CI: 1.212–1.896) with their sex life were more likely to undertake daily exercises and this was statistically significant. The results again demonstrated that participants who joined fitness club (AOR: 0.685, 95% CI: 0.614-0.764) and those who were very dissatisfied with their health services access/use (AOR: 0.598, 95% CI: 0.363-0.984) were less likely to undertake daily exercises and this was statistically significant.ConclusionFindings of this study have provided important insights for policy makers and thus constitute a useful framework to help plan and shape future policies and programs on daily exercises uptake among pensioners in Ghana and other geographical contexts with similar cultural, demographic, and socio-economic characteristics.

Feasibility of an environmental scan-based approach to collecting information about factors impacting cancer genetics services in Latin American countries.

Clinical cancer genetics services are expanding globally, but national policy and health care systems influence availability and implementation. Understanding the environmental factors within a country is required to appropriately implement, adapt, and evaluate cancer genetics service delivery models. An environmental scan (ES) is an approach used in business, public health, health care and other sectors to collect information about an environment or system for strategic decision making and program planning. An ES has been previously used to assess cancer genetics clinic-level factors to inform quality improvement efforts in the United States. We assessed the feasibility of using an ES to collect information about factors that may influence cancer genetics service delivery in the outer-most socio-ecological model environmental levels (policy, national agencies, healthcare systems, cultural considerations) in three Latin American countries. Oncology and Genetics care team members at three participating sites used publicly available sources and personal experiences to complete a data collection form (DCF) that included questions about subtopics: laws and policies, relevant agencies and regulations, health care systems and insurance, and cultural considerations. Time to complete the DCF and DCF completeness were used to measure ES feasibility. Participating sites completed the DCF in 3 months, and most questions (average, 87.0%) were answered. Questions in the cultural considerations subtopic had the fewest answers (average, 77.8%). Overall, the ES was feasible and identified a lack of published literature related to cultural considerations impacting health care and genetics services uptake in Latin America. Environmental factors impact cancer genetics services, and identification of these factors will facilitate future collaborative research and genetics service delivery dissemination efforts.

Exploring attachment and couple relationships in endometriosis: A pilot study

Introduction: Endometriosis is the therapeutic and clinical complexity extends beyond its effects on the body’s organic system, with psychological and social impacts. However, studies analyzing the quality of attachment and couple adjustment, beyond the effects on sexuality and fertility, are currently lacking. Methods: The main objective of this study was to investigate the quality of past attachment by means of the Parental Bonding Instrument, current attachment through the Relationship Questionnaire, and the perception of couple quality and satisfaction by means of the Dyadic Adjustment Scale, in a sample of 68 women aged between 23 and 54 years. Results: The analysis revealed that women with endometriosis reported experiencing greater paternal and maternal control, and less paternal care compared to those in the control group. Moreover, women in the endometriosis group exhibited a higher degree of insecure attachment in adult intimate relationships when compared to the predominantly secure control group. Regarding the DAS, women with endometriosis reported lower scores than the control group. Conclusion: Despite the limitations of a pilot study, it provides a foundational basis for future research aiming to explore endometriosis within the context of women’s relationships. It also contributes to the planning of prevention and support programs for significant figures in women’s lives.

Differences in Exposures to Adverse Childhood Experiences by Primary Source of Health Care, Behavioral Risk Factor Surveillance System 2019-2020.

To estimate the prevalence of adverse childhood experiences (ACEs) among a population-based sample of adults in the United States by their primary source of health care. Debate continues around the effectiveness and implementation of health care-based screening of ACEs. However, it is unclear how the burden of ACEs would be distributed across different sources of health care (ie, what a health system might expect should it implement ACEs screening). Data are from 8 U.S. states that include optional modules for ACEs and health care utilization in their 2019 or 2020 Behavioral Risk Factor Surveillance System survey. The analytic sample includes respondents with completed interviews (n = 45,820). ACEs were categorized into ordinal categories of 0, 1, 2, 3, or ≥4, and the prevalence of ACEs was summarized across 5 sources of health care: (1) employer-based or purchased plan, (2) Medicare, Medicaid, or other state programs, (3) TRICARE, Veterans Affairs, or military (ie, military-related health care), (4) Indian Health Service, or (5) some other source. All estimates were weighted to account for the complex sampling design. Across all health insurance types, at least 60% of individuals reported at least one ACE. The greatest prevalence of patients reporting ≥4 ACEs occurred for military-related health care (21.6%, 95% CI = 18.2-25.5) and Indian Health Service (45.4%, 95% CI = 22.6-70.3). ACEs are extremely common across sources of health care, but some health systems have greater proportions of patients with high ACE exposures. The unique strengths and challenges of specific health care systems need to be integrated into the debate about clinical ACEs screening.

ФОРМУВАННЯ ПОРТФЕЛЮ ІНСТРУМЕНТІВ ЦИФРОВОГО МАРКЕТИНГУ ПІДПРИЄМСТВА В УМОВАХ ВІДНОВЛЕННЯ ЕКОНОМІКИ УКРАЇНИ

The article examines the peculiarities of the period of post-war recovery of the Ukrainian economy and their influence on the composition of the portfolio of digital marketing tools of enterprises. The purpose of the article is to develop an algorithm for forming a portfolio of digital marketing tools for an enterprise in the period of post-war recovery, to clarify the concept of a "portfolio of digital marketing tools of an enterprise." It is substantiated that in the post-war period, the provisions of the concept of anti-crisis marketing will be relevant for planning the marketing activities of enterprises. The most common digital marketing tools are identified. The definition of the term "portfolio of digital marketing tools of the enterprise" is proposed. An algorithm for forming a portfolio of enterprise digital marketing tools has been developed. It was determined that the audit of the enterprise's marketing activity is the foundation for the formation of the enterprise's portfolio of digital marketing tools. It was determined that conducting marketing research will contribute to increasing the accuracy of the planning of the enterprise's anti-crisis marketing program. It is proposed to apply decision-making criteria in conditions of uncertainty and risk when choosing optimal alternatives for achieving the company's marketing goals in the post-war period. It was determined that monitoring the level of rationality of the company's portfolio of digital marketing tools is a necessary condition for controlling the company's marketing activities. The expediency of focusing on a proactive strategy in the implementation of marketing activities has been investigated. It has been studied that in recent years the tools of digital marketing have been constantly improved and this allows it to be considered as an opportunity to spend the marketing budget of enterprises more rationally. The portfolio of digital marketing tools can include content marketing, SEO, contextual and targeted advertising, advertising in social networks, e-mail marketing, influencer marketing, lead generation, complex analytics, viral marketing.

A Case Study Analysis of Library Services for Adults Experiencing Chronic Homelessness in Harrison County, Mississippi

ABSTRACT The author partnered with the Harrison County Library System (HCLS) to create a multilevel program plan for expanding library services to the growing number of homeless people who seek refuge in the library’s facilities. The research for this program plan involved evaluating existing library resources such as collections, programming, and available staff resources; identifying the best practices for providing services to people experiencing homelessness; identifying staff perceptions of working with the homeless; and identifying potential partners for expanded service offerings. The author used document analysis to research data on the library system (IMLS 2021 and reviewed library policy to identify barriers to providing service for the homeless. The author applied qualitative and humanistic research methods involving personal narratives (scenarios) provided through two separate one-on-one interviews with the library director to discuss the library system in general, and one one-on-one interview with six library staff working in the three libraries with the highest use by people experiencing homelessness. This paper discusses the findings from this mixed methods research project and their application to expanding services for chronically homeless patrons who use the HCLS.

Factors affecting mammogram breast cancer surveillance effectiveness in the ipsilateral and contralateral breast

AimMammography is the mainstay of imaging surveillance after breast cancer (BC) treatment, but false negatives can occur. The objective of the study was to determine the factors that can predict poorer second breast cancer (SBC) mammogram detection of the ipsilateral and contralateral breast separately. MethodsA multicentre retrospective review was performed on female patients with a previous history of treated BC who developed a second breast cancer (SBC) in the ipsilateral (ISBC) or contralateral breast (CSBC) within 10 years from the first BC. SBC cases that occurred between January 2006 and October 2017 were included from the institutional database. The ISBC and CSBC mammogram-occult (MO) rates were correlated with mammographic breast density as well as various clinical, radiological and histological characteristics of the first BC. Results274 cases of SBC were evaluated. 39.4 % (108/274) of cases were ISBC and 60.6 % (166/274) were CSBC. 35 (32.4 %) of the ISBCs and 42 (25.3 %) of the CSBCs were MO (p = 0.218). On multivariate analysis, symptomatic first BC (p = 0.041), prevailing dense breast tissue at the time of SBC diagnosis (p = 0.003) and trabecular thickening on surveillance mammograms (p = 0.017) were associated with MO ISBC. MO first BC (p < 0.001) was the only factor found to correlate with MO CSBC. ConclusionThe study found various clinical, radiological and pathological factors associated with mammogram surveillance failure for the ipsilateral and contralateral breast. This information can provide additional guidance in the planning of a personalised surveillance program using adjunct imaging screening.

Validity and Reliability of the Turkish Version of the Reproductive Autonomy Scale

Objective: This study aimed to determine the reliability and validity of the Reproductive Autonomy Scale (RES), which is a measurement tool that will determine the views of women in Turkey regarding reproductive autonomy by adapting it to the Turkish language and culture. Material and Methods: This was a cross-sectional, methodological research study. A purposive sampling technique was employed to recruit 237 women who applied to the gynecology polyclinic between February 2019 and August 2019. Results: The consistency of the scale, which was translated into Turkish and then back to English, was determined with expert opinion (Kendall W =0.101; p&gt;0.05). The Cronbach's alpha coefficient was 0.72 for the total scale and 0.70 to 0.85 for the subscales. Factor analysis revealed three subscales that explained 58.4% of the total variance. Based on the confirmatory factor analysis, the goodness of fit index was 0.92, the comparative fit index was 0.95, and the non-normed fit index was 0.94. Conclusion: The RAS is valid and reliable for the determination of reproductive autonomy among Turkish women. These results suggested that RAS could be used in family planning programs to identify coercion or barriers against contraception, understand the limitations of reproductive autonomy, and improve women's health.

Societal Upheaval and the Contraceptive Transition

AbstractHuman development and family planning programs since the 1970s have led to a fast‐rising prevalence of modern contraceptive means at the global level. However, countries with rising but still low levels of contraceptive use experienced an increasing number of societal upheavals, including armed conflicts, sudden and high‐intensity natural disasters, as well as dramatic effects of health epidemics. This may challenge the continued diffusion of modern means of birth regulation as well as their adherent use. To better understand the role of societal upheavals in the contraceptive transition, we provide a narrative literature review of their multidimensional pathways of influence in the contraceptive decision‐making process. The review suggests four main findings. First, well‐known contemporary barriers to contraceptive use become more salient during societal upheavals. Second, historical barriers reemerge predominantly. Third, societal upheavals exert specific effects on the contraceptive transition, such as through birth replacement, the repopulation of communities, and the sexual vulnerability of girls and young women. Fourth, there are more pathways leading to a reduced (rather than a heightened) contraceptive prevalence. The conclusion discusses the implications of those insights for the contraceptive transition, provides a critical perspective of the literature, and draws avenues for future research.