The role and attributes of social networks in the provision of support to women after stillbirth: experiences from Uganda

Introduction Communities exert stigma on mothers after stillbirth despite their potential to offer social support to the grieving family. Maternal healthcare-seeking behaviors are socially reinforced rendering a social network approach vital in understanding support dynamics which when utilized can improve community response to mothers experiencing stillbirth. However, the form and direction of social support for women when in need is not clear. The study explored the role and attributes of women’s social networks in the provision of support to mothers who have experienced a stillbirth in Uganda. Methods An exploratory cross-sectional study design adopting a social network approach was conducted. Data collection following established procedures was conducted on a convenient sample of 17 mothers who had experienced a stillbirth six months before the study. Frequencies and bivariate analysis were conducted to determine the factors influencing the provision of social support from 293 network members elicited during the alter generation. We then performed a Poisson regression on each of the social support forms and the explanatory variables. Network structure variables were calculated using UCINET version 6 while Netdraw facilitated the visualization of networks. Results Overall, social support was available from all network relations mentioned by the respondents. No major variations were observed between the two time periods during pregnancy and following a stillbirth. The most common support received was in form of intangible support such as emotional and information support, mainly from females who were married and from the naturally occurring networks such as family and friends. We also observed that social support followed patterns of network relational characteristics including trust, frequency of contact and alters counted on for support more likely to provide the same. Conclusions A great potential for social support exists within women’s social networks to help address stillbirth risk factors during pregnancy and cope after experiencing the same. Alter characteristics like being female, married, and from naturally occurring networks together with relational characteristics such as trust, frequency of contact, and count on alter for support were predictors of eventual social support. Interventions aiming at addressing stillbirth risks at the community level ought to harness these network characteristics for benefits to the mothers.

Building a Common Support Framework in Differing Realities—Conditions for Renewable Energy Communities in Germany and Bulgaria

The revised EU Renewable Energy Directive first introduced renewable energy communities into the EU policy framework and requires Member States to implement a support framework for them. Given the broad scientific evidence showing the benefits of community energy for a just energy transition, a successful implementation across all Member States is essential. However, the preconditions for developing support frameworks differ largely between EU nations, as some countries have long-term experiences with supporting renewable energy communities (i.e., Germany and Denmark), while in other Member States, renewable energy communities are notably non-existent (i.e., Eastern European nations). With the purpose of providing scientific evidence to support the development of a policy framework for renewable energy communities in Eastern European Member States, this article compares key factors for the development of such communities in Bulgaria and Germany, combining a literature review with expert interviews to collect primary information on Bulgaria. A country analysis puts these factors into the contexts of both countries, while a cross-country comparison demonstrates that there are significant gaps in the support framework of Bulgaria, although these gaps are, to a lesser extent, also present in Germany. We discuss these shortcomings, derive policy recommendations and identify further research needs.

Computational Study of Reinforcement Mechanisms of Cuttlefish Bone Inspired Structure for 3D Printing

Cuttlebone, the internal shell structure of a cuttlefish, presents a unique labyrinthian wall-septa design that promotes high energy absorption, porosity, and damage tolerance. This structure offers us an inspiration for the design of lightweight and strong structures for potential applications in mechanical, aerospace and biomedical engineering. However, the complexity of the cuttlebones structural design makes its fabrication by traditional manufacturing techniques not feasible. The advances in additive manufacturing (3D printing) make highly complex structures like cuttlebone possible to manufacture. In this work, the authors sought to establish comparative data between cuttlebone structures and some common support structures used in additive manufacturing. The structures compared to cuttlebone in this work include the cubic, honeycomb and triangular support structures. This was accomplished by using CAD modeling and simulation software. This study found that the cuttlefish structures had higher average stress values than the others but similar average strain values. This leads to a higher modulus of elasticity for the cuttlebone structures. The data suggests that further research into cuttlebone structures could produce future designs that improve upon the current well-established additive manufacturing support structures. Further study will be performed for the 3D printing of cuttlebone inspired structures by using various types of materials, such as soft and rigid polymers, functional ceramics, composites, and metals.

POS0501 SUSTAINED 2-YEAR REMISSION OF THE DISEASE IN A CLINIC OF EXCELLENCE IN RHEUMATOID ARTHRITIS. EXPERIENCE OF THE CLINICAL REGISTRY IN COLOMBIA

Background:Rheumatoid arthritis (RA) is a chronic autoimmune disease with no cure, characterized by episodes of exacerbation and remission, which requires permanent use of medications. Clinics of excellence are multidisciplinary and centralized programs that improve adherence to treatments. Information on the benefits of these models of care has been published but is not definitive. In Colombia, the clinical registry of patients with RA is kept in the Cuenta de Alto Costo (CAC).Objectives:To demonstrate the difference in the percentages of sustained remission at 2 years, between an institution with non-centralized management or standard of care (Hospital Militar Central-HMC) compared to another institution with centralized management or clinic of excellence (BIOMAB-IPS) and determine if the results are determined by any of the intervention variables or by the program.Methods:The 2-year clinical records for the CAC were compared between an institution with non-centralized management (HMC) in comparison with another institution with centralized management (BIOMAB-IPS), performing a sociodemographic description, measuring control of the disease DAS28 clinimetry, Fisher’s test non-parametric bivariate analysis, multiple regression model, and population matching with Propensity score Matching (PSM).Results:Complete information was obtained from 2 years of follow-up, in centralized management 3457 patients and for the non-centralized unit 114 patients. Most of them corresponded to 2962 women (82%), with time of illness of 9.5 years and 10.2 years, respectively, without statistically significant differences. A difference was observed in the 2 programs to maintain remission at 2 years, in favor of the centralized program 54.7% vs 28.6.2% (p <0.00). With the binomial generalized linear regression model, it was confirmed that this difference was not explained by variables such as the use of biological therapy (RR = 0.77; 95% CI 0.69-0.86), use of DMARDs (RR = 0.71; 95% CI 0.62-0.82) and number of rheumatology consultations (RR = 0.97; 95% CI 0.92-1.02) in comparison with the centralized care model (RR = 2.32; 95% CI 1.58-3.35). Due to the biases between the groups due to the non-probability sampling, a PSM was performed, with a 1: 1 match, caliper of 0.065, obtaining a pseudo population with well-balanced covariates (see table 1). In the common support area, statistically significant differences were documented in sustained remission over 2 years, in favor of the centralized care group 45 vs 17.9% (p = 0.001).Conclusion:With the information from the clinical records, statistical strategies can be used to evaluate important differences in centralized care programs, observing favorable results of these types of care that are not related to isolated elements of the program, but to the overall effect of the program.References:[1]Austin PC. Double propensity-score adjustment: A solution to design bias or bias due to incomplete matching. Stat Methods Med Res. 2017;26(1):201–22.33333Disclosure of Interests:Juan Manuel Bello-Gualtero: None declared, Esperanza Peña: None declared, Pedro Iván Santos Moreno: None declared, Jasmin Vesga Gualdrón Employee of: Baxter, Ginna Saavedra: None declared, Clara Perez: None declared

Outliers in Semi-Parametric Estimation of Treatment Effects

Outliers can be particularly hard to detect, creating bias and inconsistency in the semi-parametric estimates. In this paper, we use Monte Carlo simulations to demonstrate that semi-parametric methods, such as matching, are biased in the presence of outliers. Bad and good leverage point outliers are considered. Bias arises in the case of bad leverage points because they completely change the distribution of the metrics used to define counterfactuals; good leverage points, on the other hand, increase the chance of breaking the common support condition and distort the balance of the covariates, which may push practitioners to misspecify the propensity score or the distance measures. We provide some clues to identify and correct for the effects of outliers following a reweighting strategy in the spirit of the Stahel-Donoho (SD) multivariate estimator of scale and location, and the S-estimator of multivariate location (Smultiv). An application of this strategy to experimental data is also implemented.

Attitudes about Paid Parental Leave In the U.S.

Paid parental leave offerings in the U.S. are relatively rare and unequal. Yet, little is known about public opinions about paid leave and the factors that distinguish adults’ attitudes about them. With the use of data from the General Social Survey, we investigated attitudes about paid parental leave availability, preferred lengths of paid leave offerings, and government funding of leave in the U.S. We found overwhelming support for paid parental leave availability, an average preference for four months of paid leave offerings, and common support for at least some government funding for leaves. Older and more politically conservative individuals were consistently less supportive of paid parental leave availability, longer lengths of leave, and government funding of leave. Women, supporters of dual-earner expectations, black individuals, and those who were not working in paid labor were typically more supportive of generous paid parental leave offerings. These findings suggest that there have been longstanding desires for more widespread and generous paid parental leave offerings in the U.S. but that this has not yet been sufficient to prompt widely applicable policy changes across the nation.

Fast-Tracking an FLNG Relocation in Malaysia

This article, written by JPT Technology Editor Judy Feder, contains highlights of paper OTC 30440, “Floating LNG 1 Relocation: Another World’s First,” by Muhammad Fakhruddin Jais, Wan Mahsuri Wan Hashim, and Ariff Azhari Ayadali, Petronas, et al., prepared for the 2020 Offshore Technology Conference Asia, originally scheduled to be held in Kuala Lumpur, Malaysia, 17–19 August. The paper has not been peer reviewed. Copyright 2020 Offshore Technology Conference. Reproduced by permission. Floating liquefied natural gas (FLNG) allows LNG to be processed hundreds of kilometers away from land to unlock gas reserves in remote and stranded fields previously uneconomical to monetize. The complete paper describes the operator’s fast-tracking of a 450-km FLNG unit relocation from Sarawak to Sabah offshore Malaysia. The time from selecting the new field to unloading LNG at the new location was 13 months. The complete paper discusses pre-execution and engineering studies, relocation preparation and execution, and challenges encountered, including timeline, cost minimization, and manning. Introduction Since 2016, Petronas has operated its first floating LNG production, storage, and offloading facility offshore Sarawak. During the tenure of operation, cargo was delivered successfully to customers worldwide. An opportunity to help a different gas supplier monetize another stranded field offshore Sabah, approximately 450 km away from the unit’s original location, presented itself. The new opportunity was deemed feasible for several reasons. - The identified location is still within Malaysian waters and thus is subject to similar authority and regulations. - Operation within the same country ensures common support from vendor and contractors to some extent. - The two fields have similar gas profiles and water depth. The project team determined that these factors would result in minimal modification at both FLNG and up-stream facilities to meet minimum shut-down from project sanction until first LNG cargo was produced. Pre-Execution and Engineering Studies To fast-track the project, an evaluation was conducted of the new feed-gas composition and modification of both up-stream and FLNG facilities. Long-lead items (LLIs) were identified, and studies were conducted to secure the items. One of the identified LLIs was the flexible pipeline from the upstream facilities to the FLNG. A flow-assurance study covered the steady-state and transient operation for the flexible line. This study confirmed the size of the pipeline and defined the functional requirement for the flexible pipeline procurement. Among the key parameters identified were the pipeline’s thermal conductivity and design pressure. During the feasibility stage, a steady-state study was conducted to determine the length of the flexible line in order to meet the landing pressure and temperature at the FLNG. Instead of requiring additional cooler, the flexible line was extended 2 km to take advantage of the Joule-Thomson cooling effect resulting from the pressure drop across the pipeline. In addition to defining the LLI properties, the flow-assurance study also examined the transient operation for both upstream and FLNG upon the closure of the riser shutdown valve. The study assessed flow-assurance issues, such as hydrates and adequacy of the slug receiver during the transient operation, that might arise, and defined the start-up and commissioning sequence for the facilities.

Effect of Foundation Pit With Different Support and Excavation Methods on Adjacent Buried Hydrogen Pipe

Support and excavation methods have a great effect on the supporting role of the foundation pit. To investigate the effect of foundation pit with different support and excavation methods on adjacent buried hydrogen pipe, a pipe–soil coupling model was established. Deformation, strain, and stress of the pipe near the foundation pit with different support and excavation methods were analyzed. The results show that stress concentration appears on the upper and lower surfaces of the middle part of the pipe after the foundation pit excavation. The high stress areas on the upper and lower surfaces are distributed symmetrically about the pipe center. Upper surface of the pipe's middle section is pressed and the lower surface is pulled, but the strain distribution of the pipe at the pit edge is opposite. Vertical displacement of the pipe is bigger than its horizontal displacement. The underground continuous wall as the most common support structure can effectively reduce the pipe deformation. Supporting methods have different effects on buried pipe's mechanical behavior. Lateral reinforcement, inner support, and bolt support can effectively reduce the pipe deformation, but the mitigating effect of lateral reinforcement is less than inner support and bolt support. The pipe is also affected by time and space of the foundation pit excavation. The slope excavation can greatly reduce the pipe deformation, but the effects of island excavation and basin excavation are not obvious. Those results can provide references for pipe safety assessment and protection.

Early public adherence with and support for stay-at-home COVID-19 mitigation strategies despite adverse life impact: a transnational cross-sectional survey study in the United States and Australia

Background Governments worldwide recommended unprecedented measures to contain the coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). As pressure mounted to scale back measures, understanding public priorities was critical. We assessed initial public adherence with and support for stay-at-home orders in nations and cities with different SARS-CoV-2 infection and COVID-19 death rates. Methods Cross-sectional surveys were administered to representative samples of adults aged ≥18 years from regions with different SARS-CoV-2 prevalences from April 2–8, 2020. Regions included two nations [the United States (US—high prevalence) and Australia (AU—low prevalence)] and two US cities [New York City (NY—high prevalence) and Los Angeles (LA—low prevalence)]. Regional SARS-CoV-2 and COVID-19 prevalence (cumulative SARS-CoV-2 infections, COVID-19 deaths) as of April 8, 2020: US (363,321, 10,845), AU (5956, 45), NY (81,803, 4571), LA (7530, 198). Of 8718 eligible potential respondents, 5573 (response rate, 63.9%) completed surveys. Median age was 47 years (range, 18–89); 3039 (54.5%) were female. Results Of 5573 total respondents, 4560 (81.8%) reported adherence with recommended quarantine or stay-at-home policies (range of samples, 75.5–88.2%). Additionally, 29.1% of respondents screened positive for anxiety or depression symptoms (range of samples, 28.6–32.0%), with higher prevalences among those of younger age, female gender, and those in quarantine or staying at home most of the time versus those who did not report these behaviours. Despite elevated prevalences of adverse mental health symptoms and significant life disruptions, 5022 respondents (90.1%) supported government-imposed stay-at-home orders (range of samples, 88.9–93.1%). Of these, 90.8% believed orders should last at least three more weeks or until public health or government officials recommended, with support spanning the political spectrum. Conclusions Public adherence with COVID-19 mitigation policies was highly prevalent, in both highly-affected (US, NY) and minimally-affected regions (AU, LA). Despite disruption of respondents’ lives, the vast majority supported continuation of extended stay-at-home orders. Despite common support, these two countries diverged in stringent mitigation implementation, which may have contributed to subsequent outcomes. These results reveal the importance of surveillance of public support for and adherence with such policies during the COVID-19 pandemic and for future infectious disease outbreaks.

Different Countries, Common Support for Climate Change Mitigation: The Case of Germany and Poland

There are numerous studies assessing the influence of individual sociological, political, and demographic factors on attitudes towards climate change. However, there is still a need for a deeper understanding of the reasons behind these attitudes and for research based on results from more than one country. This study empirically examines a range of psychosocial and demographic determinants of support for climate policy (renewable energy, energy efficiency and carbon tax) in Germany and Poland (n = 1969). The results show that the societies of both countries, despite significant differences in income, culture and political stance on climate change, similarly support implementation of climate policies. For both countries valid predictors of support are: awareness, emotional response to climate crisis, sense of control, and belief in effectiveness of solutions; the study also shows predictors relevant in only one country. Factor analysis identified similar dimensions of attitudes toward climate change in both countries. The main findings show that support for climate policy is high in both countries and that the public is ready to accept more ambitious climate goals. Despite the differences between the countries, a coherent climate policy seems justified. The study also shows differences between the countries and provides recommendations for policymakers.