Clinical outcomes of postpartum intrauterine devices inserted by midwives in Tanzania.

OBJECTIVE: To assess the rate of complications following immediate postpartum insertion of intrauterine devices (IUDs) by trained midwives in Tanzania. METHODS: A prospective cohort study of women who underwent immediate postpartum IUD (PPIUD) insertions provided by midwives between December 31, 2016 and October 15, 2017. Midwives received standardized training via the FIGO initiative. Women who returned 6 weeks after delivery were evaluated for complications. Outcomes of interest were uterine infection, IUD expulsion, medical removal of IUD, and method discontinuation. RESULTS: There were 40 470 deliveries, 2347 (5.8%) PPIUD insertions, and 1013 (43.2%) women with a PPIUD who returned for a follow-up visit in the program-affiliated clinics. Midwives were providers in 596 (58.8%) of these follow-up cases and clinicians in 417 (41.2%) cases. All PPIUD insertions by midwives were transvaginal and among them 43 (7.2%) had PPIUD-related complications by the end of sixth week. These complications included 16 (2.7%) cases of uterine infection, 14 (2.3%) IUD expulsions, 26 (4.4%) IUD removals, and 33 (5.5%) with overall method discontinuation. Only one case had uterine infection severe enough to warrant hospitalization. CONCLUSION: PPIUD insertion by trained midwives in Tanzania compares favorably with results reported from other settings.

Why rate when you could compare? Using the "EloChoice" package to assess pairwise comparisons of perceived physical strength.

We introduce "EloChoice", a package for R which uses Elo rating to assess pairwise comparisons between stimuli in order to measure perceived stimulus characteristics. To demonstrate the package and compare results from forced choice pairwise comparisons to those from more standard single stimulus rating tasks using Likert (or Likert-type) items, we investigated perceptions of physical strength from images of male bodies. The stimulus set comprised images of 82 men standing on a raised platform with minimal clothing. Strength-related anthropometrics and grip strength measurements were available for each man in the set. UK laboratory participants (Study 1) and US online participants (Study 2) viewed all images in both a Likert rating task, to collect mean Likert scores, and a pairwise comparison task, to calculate Elo, mean Elo (mElo), and Bradley-Terry scores. Within both studies, Likert, Elo and Bradley-Terry scores were closely correlated to mElo scores (all rs > 0.95), and all measures were correlated with stimulus grip strength (all rs > 0.38) and body size (all rs > 0.59). However, mElo scores were less variable than Elo scores and were hundreds of times quicker to compute than Bradley-Terry scores. Responses in pairwise comparison trials were 2/3 quicker than in Likert tasks, indicating that participants found pairwise comparisons to be easier. In addition, mElo scores generated from a data set with half the participants randomly excluded produced very comparable results to those produced with Likert scores from the full participant set, indicating that researchers require fewer participants when using pairwise comparisons.

The influence of visual flow and perceptual load on locomotion speed.

Visual flow is used to perceive and regulate movement speed during locomotion. We assessed the extent to which variation in flow from the ground plane, arising from static visual textures, influences locomotion speed under conditions of concurrent perceptual load. In two experiments, participants walked over a 12-m projected walkway that consisted of stripes that were oriented orthogonal to the walking direction. In the critical conditions, the frequency of the stripes increased or decreased. We observed small, but consistent effects on walking speed, so that participants were walking slower when the frequency increased compared to when the frequency decreased. This basic effect suggests that participants interpreted the change in visual flow in these conditions as at least partly due to a change in their own movement speed, and counteracted such a change by speeding up or slowing down. Critically, these effects were magnified under conditions of low perceptual load and a locus of attention near the ground plane. Our findings suggest that the contribution of vision in the control of ongoing locomotion is relatively fluid and dependent on ongoing perceptual (and perhaps more generally cognitive) task demands.

Exploring the impact of living with dyslexia: The perspectives of children and their parents.

PURPOSE: A small but growing body of literature indicates that children with dyslexia are at elevated risk of internalising and externalising mental health problems. However, little research addresses why this might be the case, particularly from the point of view of the children or their parents. This study therefore aimed to explore the lived experiences of children with dyslexia, and their parents. METHOD: Drawing on a phenomenological approach, 13 children with dyslexia and 21 parents were interviewed. The semi-structured interviews were analysed thematically. RESULT: Dyslexia was seen to impact at the individual, family and community level. Children's accounts of their experiences were ecologically situated at both the micro and mesosystem levels of Bronfenbrenner's ecological model, while parent's accounts extended to include the exosystem. Both also reflected on "difference", a theme related to cultural and attitudinal views at the level of the macrosystem. CONCLUSION: Presentation of the themes contrasts the experiences of children and parents, illustrating that the experience of dyslexia is indicative of broader challenges associated with societal values and attitudes that privilege perceived ability and shame difference. This study provides information that could be used to inform and educate families and teachers about the impact of living with dyslexia.