Nucleation of a crystalline phase almost always occurs at interfaces. However, the lack of fundamental understanding of the impact of interfacial properties on nucleation hinders the design of nucleation active materials for regulating crystallization in practice. In particular, the role of intermolecular interactions is often neglected in nucleation under confinement such as those provided by nano- and microporous materials. Herein, we report the use of a novel material, polymer microgels with tunable microstructure and chemistry, for understanding the role of intermolecular interactions in nucleation under confinement and for controlling crystallization from solution in general. We demonstrate that by tuning the polymer–solute interactions, solute nucleation kinetics were promoted by up to 4 orders of magnitude. Moreover, the effect of polymer–solute interactions was manifested by the split of nucleation time scales due to the presence of nucleation sites of distinct chemical compositions in the microgels, characterized by small angle neutron scattering. Our mechanistic investigations suggest that the polymer matrix facilitates nucleation by enhancing effective solute–solute interactions due to solute adsorptive partitioning and by promoting molecular alignment inferred from preferred crystal orientations on polymer surfaces. Our results provide new insights into nucleation at interfaces and help enable a rational material design approach for directing nucleation of molecular crystals from solution.
ObjectivesThis study aimed to assess the accuracy of pregnant women’s perceptions of maternity facility quality and the association between perception accuracy and the quality of facility chosen for delivery.DesignA cohort study.SettingNairobi, Kenya.Participants180 women, surveyed during pregnancy and 2 to 4 weeks after delivery.Primary outcome measuresWomen were surveyed during pregnancy regarding their perceptions of the quality of all facilities they were considering during delivery and then, after delivery, about their ultimate facility choice. Perceptions of quality were based on perceived ability to handle emergencies and complications. Delivery facilities were assigned a quality index score based on a direct assessment of performance of emergency ‘signal functions’, skilled provider availability, medical equipment and drug stocks. ‘Accurate perceptions’ was a binary variable equal to one if a woman’s ranking of facilities based on her quality perception equalled the index ranking. Ordinary least squares and logistic regressions were used to analyse associations between accurate perceptions and quality of the facility chosen for delivery.ResultsAssessed technical quality was modest, with an average index score of 0.65. 44% of women had accurate perceptions of quality ranking. Accurate perceptions were associated with a 0.069 higher delivery facility quality score (p=0.039; 95% CI: 0.004 to 0.135) and with a 14.5% point higher probability of delivering in a facility in the top quartile of the quality index (p=0.015; 95% CI: 0.029 to 0.260).ConclusionsPatient misperceptions of technical quality were associated with use of lower quality facilities. Larger studies could determine whether improving patient information about relative facility quality can encourage use of higher quality care.
Background The global incidence of man-made crises has increased in the last decade. Evidence on deviations in service uptake during conflict is needed to better understand the link between conflict and adverse neonatal outcomes. We assessed the association between conflict intensity in the occupied Palestinian territory (oPt) at time of birth and (i) utilization patterns for childbirth across different providers; and (ii) neonatal mortality. Methods We combined data on conflict intensity with four demographic and health surveys (2004, 2006, 2010 and 2014) that included nationally representative samples of women of childbearing age. Our exposure variable was casualties per 100 000 population in defined sub-regions of the oPt. Our outcome specifications were a binary variable for neonatal deaths and a categorical variable for childbirth location. We used multivariate logistic and multinomial regressions to assess the associations. Results High conflict intensity was associated with fewer childbirths in the private sector (RR=0.97, P=0.04), and non-governmental organizations (RR=0.95, P=0.03) compared to public facilities. Conflict intensity was not associated with higher neonatal mortality beyond 2004. Conclusions Policy implications include better preparedness in the public sector for childbirth during conflict and exploring reasons for the slow decline in neonatal mortality in the territory beyond conflict at time of birth.
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