Underutilization of Cultural Heritages for Tourism Due to Poor Entrance Fee Determination Based on the Travel Cost Framework

Tourism is one of the world’s fastest growing industries and is one of the largest industries in the world. Cultural tourism is often argued to be one of the most important and rapidly growing areas of global tourism. Ethiopia, a country in East Africa can be expressed as a mosaic of people and cultures, encyclopedia of geology, the cradle of humankind and civilization. The natural and interesting landscape, endowed with rich biodiversity, socked in history, culturally hospitable, traditionally sensitive, and intrinsically religious people put together Ethiopia a tourist paradise though the entrance fee, the value and other characteristics of these heritage resources are left unaddressed. The study uses the Individual Travel Cost Method to estimate the use value of RHCL. The truncated negative binomial method (TNBM) was employed to derive the demand function for use value of RHCL. The result of the study showed that the potential annual use value of the RHCL was estimated to be 759,687,113 ETB per annum[1]. Furthermore; the entrance fee that would maximize the use value of the church is 11.32 US Dollars  per four days. which has a significant difference from the existing entrance fee(50 US Dollars per four days) . Future researches are recommended. Keywords: Individual travel cost method; cultural Heritage; economic value [1]1 US Dollar=19.3469 of Ethiopian Birr(ETB) while the study is conducte

Natriuretic Peptides As A Humoral Link Between The Heart And The Gastrointetsinal System

Natriuretic peptides are a family of hormones released by several different tissues and exert various physiological functions by coupling with cell surface receptors and increasing intracellular cyclic gyanylyl monophosphate (cGMP). Atrial Natriuretic Peptide (ANP) and B-type Natriuretic Peptide (BNP) are released in response to mechanical stretch of the atrial or ventricular myocardium, respectively and their plasma level is markedly elevated during myocardial infarction and heart failure. Heart failure in turn is associated with symptoms suggestive of perturbed gastrointestinal function such as nausea, indigestion and malabsorption. Intragastric pressure was monitored using a balloon catheter in anesthetized mice. The pressure before and after treatment with a 10 ng/g intravenous dose of ANP, BNP, CNP or vehicle was compared and analyzed. All the natriuretic peptides significantly decreased intragastric pressure compared to vehicle. These effects were attenuated or absent in natriuretic peptide receptor type-A (NPR-A) knockout mice. Furthermore, the effect of BNP on gastric emptying and intestinal absorption was examined using a meal consisting of fluorescence labeled dextran gavage fed to awake mice. BNP significantly decreased gastric emptying and absorption as compared to vehicle control. Using a cryoinfarction acute myocardial injury model, our investigation showed that mice with acute cryoinfarction had a significantly lower gastric emptying and absorption of a gavage fed meal compared to sham. Circulating BNP levels were significantly higher in the infarcted mice compared to controls. Immunostaining showed amplified distribution of the non-muscle myosin type-II (MCH-II) in BNP treated mice. MCH-II is involved in movement of intestinal villi. In summary, natriuretic peptides in general and BNP in particular, have gastrointestinal effects including reduced gastric contractility, emptying and absorption. In addition to their effect on smooth muscle relaxation mediated by cGMP, natriuretic peptides appear to have an effect on distribution of MHC-II in cells of the intestinal villi. We postulate that these effects are aimed at mediating a \u27communication\u27 between the cardiovascular and gastrointestinal systems. Further characterization of such a link will not only add a dimension to the understanding of the pathophysiology of heart failure but also enhances the search for further therapeutic targets

Livestock Grazing in Afromontane Grasslands in the Northern Bale Mountains, Ethiopia: Implications for Bird Conservation

No Abstrac

Determinants of livelihood diversification and its contribution to food security of rural households in Gozamin Woreda, Ethiopia

This study was conducted to assess the determinants of rural households’ livelihood diversification and its contribution to household food security status in Gozamin Woreda, Amhara region, Ethiopia. A cross-sectional research design and mixed research approach were used. Primary data were collected with the aid of household surveys, key informant interviews, and focus group discussions. A multi-stage stratified random sampling method was used to select 218 households. The Simpson diversity index result showed that 22.94%, 11.93%, 44.5%, and 20.64% of the households were no, low, average, and high livelihood diversifiers. The food consumption score result indicated that 41.28%, 10.09%, and 48.62% of households were found in poor, borderline, and acceptable food security status respectively. In addition, the ordered logistic regression model revealed that education level, agroecology, memberships of cooperative, access to training, access to transport, access to credit, agricultural risk, and total annual income positively affect while sex negatively affect the status of livelihood diversifications. The ordered logistic regression analysis also revealed that the status of livelihood diversification with has a positive and highly significant effect on the status of food security. The study concluded that when the status of households’ livelihood diversification increased, the status of food security also highly increased in the study area. Therefore, to improve the status of food security, extension workers, local governmental and non-governmental organization and policymakers should give higher attention to increasing the status of livelihood diversification of rural households. Finally, policy implications were made according to the finding of the study

Changing Patterns of HIV-TB Coinfection Among Patients in a Public Health Department Ambulatory Care Setting: A 5-Year Experience from a US Metropolitan Area

Background: HIV–TB coinfection leads to a complex set of synergistic interactions in the epidemiology, risk of acquisition, pathogenesis and prognosis of both infections. In the United States, the prevalence of HIV-TB coinfection has been around 6% for the past several years. We present here a 5-year experience at a public health department ambulatory care setting in Tampa, Florida, showing potentially changing patterns. Descriptive data and clinical aspect of coinfected patients is presented. Methods: A retrospective review of tuberculosis cases over the 5-year period ending December 2017 was performed. Those with HIV coinfection were included in the study. Clinical, microbiological and/or PCR based testing methods were used to make the diagnosis. SPSS was used to compile basic descriptive statistics Results: There were a total of 411 TB patients and 33 had HIV, an 8% prevalence of coinfection. The median age was 45 years (range 18–65). The male to female ratio was 21:12. Twenty-four percent (8/33) were homeless and 24% were foreign born. Only one patient admitted to using injection drugs while 27% (9/33) used non-injection illicit drugs. Forty-five percent (15/33) had TB symptoms such as fever, night sweats, weight loss and cough; the rest had radiographic abnormality which led to the diagnosis. Only 12% (4/33) had CT scan abnormality reported as cavitary or miliary while the rest had nonspecific infiltrates. Eighty-eight percent (29/33) had pulmonary TB while 6% had lymph node and 6% serosal (one pleural and one peritoneal) infections. Seventy-nine percent (29/33) were treated with a combination of daily observed and self-administered therapy. Twelve percent (4/33) did not complete therapy, or were lost to follow-up whereas one person was diagnosed post mortem thus not treated. Conclusion: The prevalence of HIV-TB coinfection in our cohort is slightly higher than the recent US average of 6% perhaps signifying the setting and demographics of our patient population. Our cohort was relatively older, most of them US born, and had predominantly pulmonary TB contrary to prior reports. These changing patterns may have been influenced by the overall older age of HIV patients in general or they could be indicators of underlying fundamental changes in the HIV-TB coinfection state at large. Additional study is needed to further elucidate this variance

Changing Patterns of HIV-TB Coinfection Among Patients in a Public Health Department Ambulatory Care Setting: A 5-Year Experience from a US Metropolitan Area

Background: HIV–TB coinfection leads to a complex set of synergistic interactions in the epidemiology, risk of acquisition, pathogenesis and prognosis of both infections. In the United States, the prevalence of HIV-TB coinfection has been around 6% for the past several years. We present here a 5-year experience at a public health department ambulatory care setting in Tampa, Florida, showing potentially changing patterns. Descriptive data and clinical aspect of coinfected patients is presented. Methods: A retrospective review of tuberculosis cases over the 5-year period ending December 2017 was performed. Those with HIV coinfection were included in the study. Clinical, microbiological and/or PCR based testing methods were used to make the diagnosis. SPSS was used to compile basic descriptive statistics Results: There were a total of 411 TB patients and 33 had HIV, an 8% prevalence of coinfection. The median age was 45 years (range 18–65). The male to female ratio was 21:12. Twenty-four percent (8/33) were homeless and 24% were foreign born. Only one patient admitted to using injection drugs while 27% (9/33) used non-injection illicit drugs. Forty-five percent (15/33) had TB symptoms such as fever, night sweats, weight loss and cough; the rest had radiographic abnormality which led to the diagnosis. Only 12% (4/33) had CT scan abnormality reported as cavitary or miliary while the rest had nonspecific infiltrates. Eighty-eight percent (29/33) had pulmonary TB while 6% had lymph node and 6% serosal (one pleural and one peritoneal) infections. Seventy-nine percent (29/33) were treated with a combination of daily observed and self-administered therapy. Twelve percent (4/33) did not complete therapy, or were lost to follow-up whereas one person was diagnosed post mortem thus not treated. Conclusion: The prevalence of HIV-TB coinfection in our cohort is slightly higher than the recent US average of 6% perhaps signifying the setting and demographics of our patient population. Our cohort was relatively older, most of them US born, and had predominantly pulmonary TB contrary to prior reports. These changing patterns may have been influenced by the overall older age of HIV patients in general or they could be indicators of underlying fundamental changes in the HIV-TB coinfection state at large. Additional study is needed to further elucidate this variance

Comparing Trends and Outcomes among HIV-Infected vs. HIV Uninfected Patients with Tuberculosis: A 5-Year Experience Within the Florida Department of Health in Hillsborough County

Background: Although the rate of tuberculosis (TB) has significantly declined in the United States, elimination has plateaued. Florida is one of the states with the greatest number of cases. The majority of cases occur in foreign-born individuals. Human immunodeficiency virus (HIV) is also a major contributor. HIV-TB coinfection leads to reciprocal interactions with significant clinical impact. We aim to compare the risk factors, clinical findings, and outcomes among HIV-infected vs. HIV uninfected patients. Methods: A retrospective cohort study of TB cases over a 5 year period (2012–2017) was conducted. All patients with HIV co-infection with age- and gender-matched HIV negative controls were included. The diagnosis of TB was made via clinical, microbiological, radiological, and/or PCR based methods. SPSS was used for statistical data analysis. Results: A total of 411 TB cases were identified and 66 patients (33 HIV-infected plus 33 HIV un-infected) were eligible for inclusion. The median age was 49 years (range 22–70). The male to female ratio was 21:12 and 50% of patients had TB symptoms; the rest had abnormal imaging or lab finding. Cases were confirmed via positive sputum smear, culture, or PCR (Figures 1–3). Only 11 patients were lost to follow-up, thus 83.3% completed therapy. A total of 5 persons died (Table 1). Conclusion: The rate of HIV-TB coinfection in the United States was 5.3% in 2018; higher among injection drugs users, homeless persons, inmates, and alcoholics. In our study, the rate of HIV-TB coinfection was slightly higher (8%). The difference was not statistically significant in regards to foreign born, homelessness, and incarceration. Only 3 patients admitted to injection drug use and 9 used alcohol (all HIV negative). Traditionally, HIV-TB coinfected patients have extra-pulmonary TB with higher rates of negative sputum and are at increased risk of death. In our cohort, the difference was statistically significant (P = 0.009) only for cavitary TB (predominated in HIV un-infected) but no difference in outcomes was observed between the two groups. These findings suggest changing trends in HIV-TB coinfection which may be partly related to our setting and demographics but may be attributed to better access to care and antiretroviral therapy at large

Antibiotic Resistance and Toxin Production of Clostridium difficile Isolates from the Hospitalized Patients in a Large Hospital in Florida

Clostridium difficile is an important cause of nosocomial acquired antibiotic-associated diarrhea causing an estimated 453,000 cases with 29,000 deaths yearly in the U.S. Both antibiotic resistance and toxin expression of C. difficile correlate with the severity of C. difficile infection (CDI). In this report, a total of 139 C. difficile isolates from patients diagnosed with CDI in Tampa General Hospital (Florida) in 2016 were studied for antibiotic resistance profiles of 12 types of antibiotics and toxin production. Antibiotic resistance determined by broth microdilution method showed that strains resistant to multi-antibiotics are common. Six strains (4.32%) showed resistance to six types of antibiotics. Twenty strains (14.39%) showed resistance to five types of antibiotics. Seventeen strains (12.24%) showed resistance to four types of antibiotics. Thirty-nine strains (28.06%) showed resistance to three types of antibiotic. Thirty-four strains (24.46%) showed resistance to two types of antibiotics. While, all isolates were susceptible to metronidazole, and rifaximin, we found that one isolate (0.72%) displayed resistance to vancomycin (MIC ≥ 8 μg/ml), and another one was resistant to fidaxomicin (MIC >1 μg/ml). The percentage of isolates resistant to cefoxitin, ceftriaxone, chloramphenicol, ampicillin, clindamycin, erythromycin, gatifloxacin, and moxifloxacin was 75.54, 10.79, 5.76, 67.63, 82.70, 45.32, 28.06, and 28.78%, respectively. Toxin profiling by PCR showed the isolates include 101 (72.66%) A+B+CDT-strains, 23 (16.55%) A+B+CDT+ strains, 3 (2.16%) A-B+CDT+ strains, 1 (0.72%) A-B+CDT-strains, and 11 (7.91%) A-B-CDT-strains. Toxin production determined by ELISA using supernatants of bacterial culture harvested at 12, 24, 48, and 72 h of post inoculation (hpi) showed that the toxins were mainly produced between 48 and 72 hpi, and toxin B (TcdB) was produced faster than toxin A (TcdA) during the experimental time (72 hpi). In addition, the binary-positive strains were likely to yield more toxins compared to the binary-negative strains. This work contributes to the current understanding of the antibiotic resistance and virulence of C. difficile clinical strains

Comparing Trends and Outcomes among HIV-Infected vs. HIV Uninfected Patients with Tuberculosis: A 5-Year Experience Within the Florida Department of Health in Hillsborough County

Background: Although the rate of tuberculosis (TB) has significantly declined in the United States, elimination has plateaued. Florida is one of the states with the greatest number of cases. The majority of cases occur in foreign-born individuals. Human immunodeficiency virus (HIV) is also a major contributor. HIV-TB coinfection leads to reciprocal interactions with significant clinical impact. We aim to compare the risk factors, clinical findings, and outcomes among HIV-infected vs. HIV uninfected patients. Methods: A retrospective cohort study of TB cases over a 5 year period (2012–2017) was conducted. All patients with HIV co-infection with age- and gender-matched HIV negative controls were included. The diagnosis of TB was made via clinical, microbiological, radiological, and/or PCR based methods. SPSS was used for statistical data analysis. Results: A total of 411 TB cases were identified and 66 patients (33 HIV-infected plus 33 HIV un-infected) were eligible for inclusion. The median age was 49 years (range 22–70). The male to female ratio was 21:12 and 50% of patients had TB symptoms; the rest had abnormal imaging or lab finding. Cases were confirmed via positive sputum smear, culture, or PCR (Figures 1–3). Only 11 patients were lost to follow-up, thus 83.3% completed therapy. A total of 5 persons died (Table 1). Conclusion: The rate of HIV-TB coinfection in the United States was 5.3% in 2018; higher among injection drugs users, homeless persons, inmates, and alcoholics. In our study, the rate of HIV-TB coinfection was slightly higher (8%). The difference was not statistically significant in regards to foreign born, homelessness, and incarceration. Only 3 patients admitted to injection drug use and 9 used alcohol (all HIV negative). Traditionally, HIV-TB coinfected patients have extra-pulmonary TB with higher rates of negative sputum and are at increased risk of death. In our cohort, the difference was statistically significant (P = 0.009) only for cavitary TB (predominated in HIV un-infected) but no difference in outcomes was observed between the two groups. These findings suggest changing trends in HIV-TB coinfection which may be partly related to our setting and demographics but may be attributed to better access to care and antiretroviral therapy at large