This report presents a secondary data analysis based on prospectively collected records gathered during a field assessment that was carried out in Rwanda in August 1993. The assessment used service statistics and follow-up interviews to evaluate the efficacy of a modified lactational amenorrhea method (LAM) as a nine-month introductory postpartum natural family planning method. The program, carried out by Action Familiale Rwandaise (AFR), reflects high efficacy of the method in a compliant sample that sought this method followed by another form of family planning. These results are promising and provide guidance for the extended use of LAM past six months. Programmatic findings suggest that studies be conducted of the contribution of extended LAM to improved weaning practices, the high efficacy of continued reliance on substantial lactation and amenorrhea beyond nine months, and male involvement in LAM and breastfeeding.
The significance of the findings is considered in the context of planning reproductive health services in the postpartum period. Decisions about timing of contraceptive use for postpartum women, while arrived at on an individual basis, also result from program strategies that focus counseling immediately postpartum or at a later interval, such as when menses resume. On a national level the impact of postpartum contraception policies on use of commodities may be substantial.
Most floating vessels experience some sea states, not necessarily extreme storms, which cause large volumes of green water to flow across the deck. Due to the location of safety critical equipment on the deck of FPSOs, the determination of the likely occurrences and the magnitudes of such events are critical to safe design and operation. A method for the determination of green water heights on the deck of an FPSO has been presented in references 1–5. This paper examines the long-term distributions of heights implied by these references and the identification of sea states in which extreme events are likely to occur. The method is based upon the long term distribution of sea states at the intended location, combined with the motion characteristics of the vessel. Freeboard exceedance at the bow and at a point along the side is considered for two typical FPSO configurations. The methodology presented is widely applicable to many locations but wave conditions typical of the Central North Sea are used by way of illustration. The results presented include long term probability distributions of green water height on deck at locations of interest. Relative contributions of each combination of significant wave height and peak period to the probability of the largest single event in a defined return period are determined and discussed. It is shown that the wave conditions most likely to give rise to the most severe green water events are seldom those characterized by the largest wave crest heights. Instead, there exists a complex dependence on characteristic periods associated with vessel motions and on the long-term occurrences of particular sea states. The ability to predict conditions in which the largest green water events are most likely to occur offers the possibility of providing improved operational guidelines for FPSOs, allowing action to be taken to avoid unfavourable loading conditions and/or vessel headings in certain sea conditions. However, it is also shown that it may be difficult to identify some severe green water sea states from normally available forecast data and hence it is important that appropriate provision is made at the design stage.
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