Effect of energetic materials wettability on their outdoor effective elution rate

Acceptability of community-based mentor mothers to support HIV-positive pregnant women on antiretroviral treatment in western Kenya: a qualitative study

Background

Option B+ is a comprehensive antiretroviral treatment (ART) designed for HIV-infected pregnant/ postpartum women. However, barriers to implementing Option B+ and establishing long-term ART adherence while facilitating retention in prevention of mother to child transmission of HIV (PMTCT) services remain. Community-based mentor mothers (cMMs) who can provide home-based support for PMTCT services may address some of the barriers to successful adoption and retention in Option B+. Thus, we evaluated the acceptability of using cMMs as home-based support for PMTCT services.

Methods

Gender-matched in-depth interviews were conducted between September–November 2014 for HIV-infected pregnant/postpartum women and their male partners living in southwestern Kenya (n = 40); additionally, we conducted four focus groups involving 30 health workers (n = 70) within four health facilities. Audio-recordings were transcribed, translated, and then coded using a thematic analytical approach in which data were deductively and inductively coded with support from prior literature, identified themes within the interview guides, and emerging themes from the transcripts utilizing Dedoose software.

Results

Overall, the study results suggest high acceptability of cMMs among individual participants and health workers. Stigma reduction, improvement of utilization of health care services, as well as ART adherence were most frequently discussed potential benefits of cMMs. Participants pictured a cMM as someone acting as a role model and confidant, and who was over 30 years old. Many respondents raised concerns about breaches of confidentiality and inadvertent disclosure. Respondent suggestions to overcome these issues included the cMM working in different communities than where she lives and attending home-visits with no identifying clothing as an HIV-related health worker.

Conclusions

The home-based cMM approach may be a beneficial and acceptable strategy for promoting ART adherence and retention within PMTCT services for pregnant/postpartum women living with HIV. Considering the risks of inadvertent disclosure of HIV-infected status and related negative consequences for pregnant/postpartum women living with HIV, similar cMM program designs may benefit from recognizing and addressing these risks.

Trial registration

The MOTIVATE! study was registered on July 7, 2015 at the ClinicalTrials.gov (NCT02491177).

Electronic supplementary material

The online version of this article (10.1186/s12884-019-2419-z) contains supplementary material, which is available to authorized users.

The effect of soil type on the extraction of insensitive high explosive constituents using four conventional methods

Explosive contamination is commonly found at military and manufacturing sites (Hewitt et al., 2005; Clausen et al., 2004; Walsh et al., 2013). Under current environmental legislation the extent of the contamination must be characterized by soil sampling and subsequent separation of the explosive contaminants from the soil matrix by extraction to enable chemical analysis and quantification (Dean, 2009). It is essential that the extraction method can consistently recover explosive residue from a variety of soil types i.e. all materials that have not degraded or irreversibly bound to the matrix, so that any resultant risk is not underestimated. In this study, five different soil types with a range of organic content, particle size and pH, were spiked with a mixture of RDX, DNAN, NQ and NTO at 50 mg/kg and were extracted using one of four one-step extraction methods: stirring, shaking, sonication, and accelerated solvent extraction (ASE). Analysis of the extraction efficiencies of the four methods found that they were broadly successful for the extraction of all IHE constituents from all five soils (an average of 84% ± 14% recovery across 80 extractions). However, soils with high organic content (Total Organic Content (TOC) ≥ 2%) were found to significantly affect extraction efficiency and reproducibility. NTO and DNAN were the least consistent in extraction efficiency with poorest recovery of NTO as low as 37% ± 2%. Of the four tested methods shaking was found to be the most reproducible, though less efficient than stirring (64%-91%). ASE was found to have the most variable results for extraction of IHE constituents suggesting that ASE was the most affected by the different soil types. Therefore, it is recommended that the efficiency and reproducibility of the selected extraction method should be validated by extracting known concentrations of the IHE from the soil of interest and that any required correction factors are reported.