Development of a tool to measure women’s perception of respectful maternity care in public health facilities

BACKGROUND: Maternal mortality continues to be the biggest challenge facing Ethiopia and other developing countries. Although progress has been made in making maternity services available closer to the community, the rate of deliveries attended by skilled birth attendants has remained very low. Absence of respectful maternity care (RMC) is believed to have contributed to low utilization of facility delivery services. This study outlines steps undertaken to construct and validate a scale that measures women’s perception of respectful maternity care provided in health facilities. METHODS: An inductive item generation process that included a literature review and in-depth interviews with labor and delivery clients, followed by an expert review, assured face validity and content validity of the tool. A draft RMC scale with 37 items and two additional measures of global satisfaction items, measured on a five-point Likert scale, were administered to a developmental sample of 509 postnatal care clients visiting facilities immediately after childbirth to 7 weeks postpartum. IBM SPSS 20 was used to perform exploratory factor analysis (EFA) using principal component analysis (PCA) with oblique rotation method. RESULTS: The final RMC scale with 15 items was loaded on four components. The extracted components were labeled as friendly care, abuse-free care, timely care, and discrimination-free care. The final RMC scale correlated strongly with the global satisfaction measures, indicating criterion-related validity of the scale. Content-related validity was assured by the process of item generation. Construct validity of the RMC scale was confirmed by high average factor loading of the four components ranging from 0.76 to 0.82 and low correlation between the components. Stability of the scale was confirmed by running PCA in a randomly selected split sample of 320 samples from the validation sample. The final 15-item scale showed an adequate reliability with α = 0.845. CONCLUSION: The 15-item RMC scale is a valid and reliable measure of women’s perception of RMC received in health facilities. We recommend that health facilities use the RMC scale in urban public health facilities and that other researchers conduct further exploratory and confirmatory factor analysis in different geographic areas

Visceral leishmaniasis patients display altered composition and maturity of neutrophils as well as impaired neutrophil effector functions

Immunologically, active visceral leishmaniasis (VL) is characterised by profound immunosuppression, severe systemic inflammatory responses and an impaired capacity to control parasite replication. Neutrophils are highly versatile cells, which play a crucial role in the induction as well as the resolution of inflammation, the control of pathogen replication and the regulation of immune responses. Neutrophil functions have been investigated in human cutaneous leishmaniasis, however, their role in human visceral leishmaniasis is poorly understood. In the present study we evaluated the activation status and effector functions of neutrophils in patients with active VL and after successful anti-leishmanial treatment. Our results show that neutrophils are highly activated and have degranulated; high levels of arginase, myeloperoxidase and elastase, all contained in neutrophils’ granules, were found in the plasma of VL patients. In addition, we show that a large proportion of these cells are immature. We also analysed effector functions of neutrophils that are essential for pathogen clearance and show that neutrophils have an impaired capacity to release neutrophil extracellular traps, produce reactive oxygen species and phagocytose bacterial particles, but not Leishmania parasites. Our results suggest that impaired effector functions, increased activation and immaturity of neutrophils play a key role in the pathogenesis of VL

Direct approach to the problem of strong local minima in Calculus of Variations

The paper introduces a general strategy for identifying strong local minimizers of variational functionals. It is based on the idea that any variation of the integral functional can be evaluated directly in terms of the appropriate parameterized measures. We demonstrate our approach on a problem of W^{1,infinity} weak-* local minima--a slight weakening of the classical notion of strong local minima. We obtain the first quasiconvexity-based set of sufficient conditions for W^{1,infinity} weak-* local minima.Comment: 26 pages, no figure

On the variational limits of lattice energies on prestrained elastic bodies

We study the asymptotic behaviour of the discrete elastic energies in presence of the prestrain metric $G$, assigned on the continuum reference configuration $\Omega$. When the mesh size of the discrete lattice in $\Omega$ goes to zero, we obtain the variational bounds on the limiting (in the sense of $\Gamma$-limit) energy. In case of the nearest-neighbour and next-to-nearest-neibghour interactions, we derive a precise asymptotic formula, and compare it with the non-Euclidean model energy relative to $G$

Variability in Ethiopian coriander accessions for agronomic and quality traits

Coriander (Coriandrum sativum L.) is an annual spice herb that belongs to the family of Umbelliferae/Apiaceae. Although Ethiopia is known as a primary diversity for coriander, the knowledge on nature and extent of variation of the indigenous germplasm is limited. Hence, to address the nature and extent of variability on agronomic and chemical traits, test trial was conducted at Kokate and Wondo Genet, Southern Ethiopia, using 49 accessions arranged in randomised complete block design in two replications during the main season of 2007/08. Data for 15agronomic and quality traits were measured and statistically tested. In the combined analysis of variance over locations, accessions varied significantly in all the traits except for basal leaf number, plant height and fatty oil contents. The interaction between accessions and environment was significant for nine of the 15 traits. A range of seed yield (910-3099 kg ha-1), essential oil (0.25-0.85%) and fatty  oil (11.11-16.53%) content was obtained. Overall, highest value of genetic coefficient of variation, broad sense heritability and genetic advance as percent of mean was obtained for longest basal leaf length, days to start 50% flowering, umbels number/plant, umbellets number/umbel, seed number/umbellets, seed number/plant, seed yield/ha and essential oil content

Artemisia annua l. As an alternative potential weed control option

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Married women's decision making power on family planning use and associated factors in Mizan-Aman, South Ethiopia : a cross sectional study

Background: Women's use of family planning service is influenced by many factors, especially by their decision making power. A woman's decision-making power, be it individual or decision made in collaboration with a partner, is the most important factor in the use of family planning in a household. The purpose of this study was to assess the impact of women's decision making power on family planning use and its associated factors. Methods: A community-based cross-sectional study was conducted on married women in the child bearing age. The women who were living in Mizan city were selected using the simple random sampling method. Trained nurses collected the data by interview, using a structured and pre-tested questioner. Bivariable and multivariable binary logistic regression analysis was used to identify the associated factors, and the odds ratio with a 95 % CI was computed to assess the strength of the association. Collinearity was also assessed by looking at standard errors in the final fitted model. Result: Overall, more than two-thirds [67.2 %: 95 % CI (63-71 %)] of the married women were found to be more autonomous to decide family planning use. Secondary education [AOR: 9.04, 95 % CI: (4.50, 18.16)], government employment [AOR: 4.84, 95 % CI: (2.03, 11.52)], being wives of government employed spouses [AOR 2.71, 95 % CI: (1.24, 7.97)], having husbands with college or university education [AOR: 11.29, 95 % CI: (4.66, 27.35)], and being in the younger age [AOR: 0.27, 95 % CI :(0.09, 0.75)] were significantly associated with women's decision-making power on family planning. Conclusions: In this study, women had a high decision making power in family planning use. Age category (34-44-years), formal education, and occupational status had effects on women's decision making power. Promoting parental adult education and engaging women in out of house employment is essential to improve their decision making power in using family planning

World germplasm collections and their potential in crop productivity

Effective and imaginative utilization of the large variability assembled in the collection of genetic resources of cereals and legumes determines the potential and adaptation of future varieties. Modem method of characterization such as restricted fragment length polymorphism (RFLP)…………………….

Risk factors of visceral leishmaniasis: a case control study in north-western Ethiopia

Background Visceral leishmaniasis (VL, also called “kala-azar”), is a life threatening neglected tropical infectious disease which mainly affects the poorest of the poor. VL is prevalent in Ethiopia particularly in the northwest of the country. Understanding the risk factors of VL infection helps in its prevention and control. The aim of the present study was to identify the factors associated with VL. Methods A case–control study was carried out during the period of January-July 2013 in northwest Ethiopia. Cases and controls were diagnosed using clinical presentation, the rk39 rapid diagnostic test and Direct Agglutination Test (DAT). A total of 283 (84.8% males versus 15.2% females) participants were interviewed. 90 cases and 193 controls were involved, matched by age, sex and geographical location with a ratio of 1:2 (case: controls). Univariate and backward multivariate conditional logistic regression were used to identify risk factors of VL. Results Elevated odds of VL was associated with goat ownership (OR = 6.4; 95%: confidence interval [Cl]: 1.5-28.4), living in houses with cracked wall (OR = 6.4; 95% Cl: 1.6-25.6), increased family size (OR = 1.3; 95% Cl: 1.0-1.8) and the number of days spent in the farm field (OR = 1.1; 95% Cl: 1.0-1.2). However, daily individual activities around the home and farm fields, mainly sleeping on a bed (OR = 0.2; 95%: Cl 0.03-0.9), sleeping outside the house under a bed net (OR = 0.1; 95% Cl: 0.02-0.36)] and smoking plant parts in the house during the night time (OR = 0.1; 95% Cl: 0.01-0.6) were associated with decreased odds of being VL case. Conclusion Our findings showed that use of bed net and smoke could be helpful for the prevention of VL in the area particularly among individuals who spend most of their time in the farm. VL control effort could be focused on improving housing conditions, such as sealing cracks and crevices inside and outside houses. Further research is warranted to elucidate the role of goats in the transmission of L. donovani, assess the impact of bed nets and the role of the traditional practice of smoking plants

The role of culture and religion on sexual and reproductive health indicators and help-seeking attitudes amongst 1.5 generation migrants in Australia : a quantitative pilot study

In Australia, 1.5 generation migrants (those who migrated as children) often enter a new cultural and religious environment, with its own set of constructs of sexual and reproductive health (SRH), at a crucial time in their psychosexual development—puberty/adolescence. Therefore, 1.5 generation migrants may thus have to contend with constructions of SRH from at least two cultures which may be at conflict on the matter. This study was designed to investigate the role of culture and religion on sexual and reproductive health indicators and help-seeking amongst 1.5 generation migrants. An online survey was completed by 111 participants who answered questions about their cultural connectedness, religion, sexual and reproductive health and help-seeking. Kruskall-Wallis tests were used to analyse the data. There was no significant difference between ethnocultural groups or levels of cultural connectedness in relation to sexual and reproductive health help-seeking attitudes. The results do suggest differences between religious groups in regard to seeking help specifically from participants’ parents. Notably, participants who reported having ‘no religion’ were more likely to seek help with sexual and reproductive health matters from their parent(s). Managing cross-cultural experiences is often noted in the extant literature as a barrier to sexual and reproductive health help-seeking. However, while cultural norms of migrants’ country of origin can remain strong, it is religion that seems to have more of an impact on how 1.5 generation migrants seek help for SRH issues. The findings suggest that 1.5 generation migrants may not need to adapt their religious beliefs or practices, despite entering a new ethnocultural environment. Given that religion can play a role in the participants’ sexual and reproductive health, religious organizations are well-placed to encourage young migrants to adopt help-seeking attitudes