Trends in emergency contraception awareness among women and girls in 28 sub-Saharan countries

Background Studies have shown that emergency contraception (EC) remains underutilised in preventing unintended pregnancy in sub-Saharan Africa (SSA). Small-scale surveys have attributed EC underutilisation to gaps in EC awareness among SSA women and girls. However, limited studies have explored trends in EC awareness in SSA. We address this gap by examining trends in EC awareness using data from 28 SSA countries. Our analysis was disaggregated by age distribution, place of residence, level of education, and wealth to show differences in EC awareness trend. Methods We analysed the Demographic and Health Surveys (DHS) data of 1,030,029 women aged 15 to 49 on emergency contraception awareness. EC awareness was defined as having ever heard of special pills to prevent pregnancy within 3 days after unprotected sexual intercourse. Frequencies and percentages were used to summarise trends in EC awareness between years 2000 and 2019. Results Overall, there was an upward shift in the level of EC awareness in all countries, except in Burkina Faso, Niger, Chad, and Ethiopia. While some countries recorded a significant upward trend in EC awareness, others recorded just a slight increase. Women in Kenya, Ghana, Gabon, and Cameroon had the highest upward shift in EC awareness. For example, only 28% of women were aware of EC in Ghana in 2003, but in 2014, 64% of women knew about EC, an increase of over 36 percentage points. Increase in EC awareness was starker among women aged 20–24 years, those who resided in urban areas, had higher education, and belong to the highest wealth quintile, than those aged 15–19, in rural areas, with no formal education and belonging to the lowest wealth quintile. Conclusion Our analysis shows that the level of EC awareness has increased substantially in most SSA countries. However, EC awareness still differs widely within and between SSA countries. Intervention to improve EC awareness should focus on women aged 15 to 19, those with no formal education, residing in rural areas, and within the lowest quintile, especially, in countries such as Chad, Niger, Burkina Faso, and Ethiopia where level of EC is low with lagging progress.

Trends in Emergency Contraception Awareness Among Women and Girls in 28 Sub-Saharan Countries

BackgroundStudies have shown that emergency contraception (EC) remains underutilised in preventing unintended pregnancy in sub-Saharan Africa (SSA). Small-scale surveys have attributed EC underutilisation to gaps in EC awareness among SSA women and girls. However, limited studies have explored trends in EC awareness in SSA. We address this gap by examining trends in EC awareness using data from 28 SSA countries. Our analysis was disaggregated by age distribution, place of residence, level of education, and wealth to show differences in EC awareness trend. Methods We analysed the Demographic and Health Surveys (DHS) data of 1,030,029 women aged 15 to 49 on emergency contraception awareness. EC awareness was defined as having ever heard of special pills to prevent pregnancy within three days after unprotected sexual intercourse. Frequencies and percentages were used to summarise trends in EC awareness between years 2000 and 2019. Results Overall, there was an upward shift in the level of EC awareness in all countries, except in Burkina Faso, Niger, Chad, and Ethiopia. While some countries recorded a significant upward trend in EC awareness, others recorded just a slight increase. Women in Kenya, Ghana, Gabon, and Cameroon had the highest upward shift in EC awareness. For example, only 28 percent of women were aware of EC in Ghana in 2003, but in 2014, 64 percent of women knew EC, an increase of over 36 percentage points. Increase in EC awareness was starker among women aged 20-24 years, who resided in urban areas, had higher education, and belong to the highest wealth quintile, than those aged 15-19, in rural areas, with no formal education and belonging to the lowest wealth quintile. ConclusionOur analysis shows that the level of EC awareness has increased substantially in most SSA countries. However, EC awareness still differs widely within and between SSA countries. Intervention to improve EC awareness should focus on women aged 15 to 19, with no formal education, residing in rural areas, and those within the lowest quintile, especially, in countries such as Chad, Niger, Burkina Faso, and Ethiopia were level of EC is low with lagging progress.

Vos and tú in the linguistic landscape

Although vos is common in speech in Medellín, it is considered non-prestigious for writing (Agudelo Montoya et al. 2016). Nonetheless, vos is an important marker of local identity (Jang 2013) that increasingly appears in writing (Weyers 2016a). Its presence suggests a potential upward shift in its prestige. For that to happen, favorable attitudes toward its use in writing are called for. Here we examine the linguistic attitudes of 222 medellinenses toward vos, tú, and their corresponding verb forms in advertising. We find that (1) all speakers prefer vos; (2) they favor the pronoun vos over its corresponding verb forms; (3) younger speakers prefer vos over their older counterparts; and (4) men prefer voseo verb forms while women prefer tuteo forms. Given the overall positive attitudes toward vos, it is possible that its prestige will increase.

Effect of the single mutation N9Y on the catalytical properties of xylanase Xyn11A from Cellulomonas uda: a biochemical and molecular dynamic simulation analysis

Cellulomonas uda produces Xyn11A, moderately thermostable xylanase, with optimal activity at 50 °C and pH 6.5. An improvement in the biochemical properties of Xyn11A was achieved by site-directed mutagenesis approach. Wild-type xylanase, Xyn11A-WT, and its mutant Xyn11A-N9Y were expressed in Escherichia coli, and then both enzymes were purified and characterized. Xyn11A-N9Y displayed optimal activity at 60 °C and pH 7.5, an upward shift of 10 ºC in the optimum temperature, and an upward shift of one unit in optimum pH; also, it manifested an 11-fold increase in thermal stability at 60 ºC, compared to that displayed by Xyn11A-WT. Molecular dynamics (MD) simulations of Xyn11A-WT and Xyn11A-N9Y suggest the substitution N9Y leads to an array of secondary structure changes at the N-terminal end and an increase in the number of hydrogen bonds in Xyn11A-N9Y. Based on the significant improvements, Xyn11A-N9Y may be considered as a candidate for several biotechnological applications.

Flexible Average Inflation Targeting and Inflation Expectations: A Look at the Reaction by Professional Forecasters

This Commentary examines the response of longer-run inflation expectations to the FOMC’s August 2020 announced switch to a flexible average inflation-targeting (FAIT) regime. The data indicate an upward shift in the lower end (below 2 percent) of the distribution of inflation expectations and a stronger anchoring of expectations around the 2 percent inflation objective following the announcement, evidence that is consistent with intended effects of the change in the monetary policy framework. To provide context, we also include a retrospective assessment of the response of inflation expectations to the FOMC’s January 2012 announcement of an inflation objective. Lessons from the 2012 announcement suggest that conclusions about the adoption of the FAIT regime should be viewed as tentative. Consequently, we also describe indicators and features of the data to monitor developments going forward.

A biological indicator for measuring and communicating local sea level rise captured in historic photographs.

This paper explores a novel approach to collecting and communicating local site-specific data on recent sea level rise (SLR) using black zone biotic levels left on historic coastal stone structures by a stable community of cyanobacteria (blue-green algae) at the Royal Naval Dockyard in Bermuda. Photographs taken at the Dockyard in 1870, 2007 and 2017 show an upward shift in this living cyanobacterial community. A spatio-temporal digital twin computed from historic and contemporary photo assets was created to test the viability of these black zone lines as a proxy for sea level rise (SLR) measurements in Bermuda. Shifts in these black zone lines when analyzed through the digital twin demonstrate an average upward shift of 2.2 mm per year between 1870 and 2007 and 2.7 mm per year between 1870 and 2017, somewhat lower than the Global estimates from the Intergovernmental Panel on Climate Change Assessment Report predictions. However, the digital twin showed a dramatic upward shift of 8.8 cm between 2007 and 2017, or 8.8 mm per year, which coincided with Bermuda's highest recorded tidal extent since 1932. Black zone cyanobacteria are highly SLR sensitive and over long time scales comparative imagery of black zones could present a proper indicator of average sea level rise. At timescales less than 10 years the black zone may be best indicative of episodic tidal extent. As SLR will continue to shift supralittoral cyanobacteria upwards in Bermuda and in warm rocky intertidal zones worldwide, tidal monitoring and black zone assessments may prove to be a useful combination in documenting and communicating the reality, extent and possible acceleration of local SLR.

Administrative Federalism

The German federal architecture is shaped by a peculiar mix of strong decentralisation and high autonomy at lower levels of government coupled with an administrative culture of uniformity, solidarity and coordination. This system has been described as ‘administrative federalism’ to emphasise the prominent role of executives and administrations in policymaking and policy implementation. The federal level relies on the Länder for executing its tasks; in turn, the Länder executives possess rights of co-decision in federal legislation via the Bundesrat. While formal jurisdictions are strongly decentralised, a dense web of interlocking powers and processes, as well as institutions of coordination, creates incentives for territorial governments to closely cooperate with each other. The German-style administrative federalism has been successful, but is requiring adaptation and developments caused by trends like the upward shift of tasks from the Länder to the federal level and increasing party-system fragmentation.

Regional pattern of annual snow cover duration in the Greater Alpine Region (2000 – 2018)

<p>This study analyses regional differences in annual snow cover duration as quantified by the annual number of days with snow cover (D<sub>sc</sub>) and investigates differences in sensitivity of D<sub>sc</sub> to climatic variability across the Greater Alpine Region over the 2000-2018 period. MODIS snow cover data were used to estimate D<sub>sc</sub> based on the Regional Snowline Elevation (RSLE) method, a spatial filter technique for large-scale cloud cover reduction.</p><p>D<sub>sc</sub> over the study period closely follows the relief, with a mean D<sub>sc</sub> of ~10–60 days at elevations of 500 m that increase to about 100–150 days at 1500m. South of the main alpine ridge, D<sub>sc</sub> is, at the same elevation, consistently lower than north of it with differences of ΔD<sub>sc</sub>  ~25–50 days. Similarly, the eastern part of the study region experiences longer snow cover duration than the western part. This difference is particularly pronounced at elevations below 1500m where ΔD<sub>sc</sub> ~25 days. Throughout the study period, a general upward shift of the RSLE was observed for most parts of the Greater Alpine Region. This upward shift, characterized by later onset of snow accumulation (∆D<sub>start</sub> ~14–30 d) and earlier melt-out at the end of the snow season (∆D<sub>end</sub> ~10–20 d), translates into reductions of the annual number of snow-covered days by up to ΔD<sub>sc</sub> = -46 days over the study period. The data suggest that, in particular, low-elevation  (< 600m.a.s.l.) regions in the north-eastern part of the Greater Alpine Region, as well as elevations between 1400 and 2000 m in the north-western part of the study region experienced the most pronounced reductions of D<sub>sc</sub>., whereas ΔD<sub>sc</sub> remained very limited south of the main Alpine ridge. The spatially integrated MODIS-derived estimates of D<sub>sc</sub> correspond well with D<sub>sc</sub> estimates derived from longer-term point-scale observations at >500 ground station observations across the region. In the majority of regions, the temporal evolution of D<sub>sc</sub> over the 2000-2018 study period also reflects the longer-term D<sub>sc</sub> trends as estimated from these point-scale observations (1970-2014). This provides supporting evidence that the widespread decline of D<sub>sc</sub> across the Greater Alpine Region as estimated based on MODIS data is largely not caused by isolated short-term climatic variability but coincides with multi-decadal fluctuations. A comparison of the sensitivities of D<sub>sc</sub> to climatic variability indicates that neither mean winter temperatures T<sub>w</sub> nor annual solid precipitation totals P<sub>s</sub>, are consistent first order controls on D<sub>sc</sub> across  elevations and regions. Rather, the data highlight the importance of the interaction between the two variables: depending on the respective sensitivities of D<sub>sc</sub> to changes in either variable, T<sub>w</sub> or P<sub>s</sub>, respectively, the interplay between them can reinforce or largely off-set potential effects on D<sub>sc</sub> in different regions in the Greater Alpine Region. The regional differences in ΔD<sub>sc</sub> with a less pronounced decline south of the main Alpine ridge are largely a consequence of this interplay: while T<sub>w</sub> evolved similarly North and South of the Alpine ridge, many southern regions, unlike the northern regions, experienced an increase in P<sub>s</sub> that offsets the effects of positive temperature trends.</p>

Quantification of gas exchange-related upward motion of the liver during prolonged breathholding—potential reduction of motion artifacts in abdominal MRI

Objective: To test the hypothesis that there is a measureable upward motion of the diaphragm during prolonged breath-holds that could have a detrimental effect on image quality in liver MRI and to identify factor that potentially influence the magnitude of this motion. Methods: 15 healthy volunteers underwent MRI examination using prolonged breath-holds in the maximum inspiratory position and a moderate inspiratory position. Coronal T1 weighted three-dimensional gradient echo sequences of the entire thorax were acquired every 6 s during breath-holding allowing the calculation of total lung volume and the measurement of the absolute position of the dome of the liver. The potential impact of subject’s gender, body mass index, and total lung capacity on the change in lung volume/diaphragmatic motion was assessed using random coefficient regression. Results: All volunteers demonstrated a slow reduction of the total lung volume during prolonged breath-holding up to 123 ml. There was a measurable associated upward shift of the diaphragm, measuring up to 5.6 mm after 24 s. There was a positive correlation with female gender (p = 0.037) and total lung volume (p = 0.005) and a negative association with BMI (p = 0.012) for the maximum inspiratory position only. Conclusion: There is a measureable reduction of lung volumes with consecutive upward shift of the diaphragm during prolonged breath-holding which likely contributes to motion artifacts in liver MRI. Advances in knowledge: There is a measureable gas exchange-related reduction of lung volumes with consecutive upward shift of the diaphragm during prolonged breath-holding which likely contributes to motion artifacts in liver MRI. Correcting for this predictable upward shift has potential to improve image quality. The magnitude of this effect does not seem to be related to gender, BMI or total lung capacity if a moderate inspiratory position is used.