IMPACT OF RISK AVERSE BEHAVIOR ON FERTILIZER DEMAND FOR TAME FORAGES

Risk and Uncertainty,

Launch of the Ethiopian Digital AgroClimate Advisory Platform (EDACaP) Progress Report on EDACaP Development and Hosting

This brief outlines progress achieved with the establishment of the Ethiopian Digital AgroClimate Advisory Platform (EDACaP) under the CCAFS project P263 (Regional and national engagement, synthesis and strategic research) with support from P1605 (Capacitating African Stakeholders with Climate Advisories and Insurance Development). EDACaP aims to build farmers' resilience through agro-climate advisories that digitally integrate climate, soil, crop and agronomic data and are delivered through SMS, IVRS and radio to development agents and farmers in local languages. It builds on a partnership between the Ethiopian Institute of Agricultural Research (EIAR), the Ministry of Agriculture (MoA), the National Meteorological Agency, CIAT, ILRI, CIMMYT with additional support from ICRISAT, IRI, and University of Florida

Vascular risk factors and diabetic neuropathy

Background: Other than glycemic control, there are no treatments for diabetic neuropathy. Thus, identifying potentially modifiable risk factors for neuropathy is crucial. We studied risk factors for the development of distal symmetric neuropathy in 1172 patients with type 1 diabetes mellitus from 31 centers participating in the European Diabetes (EURODIAB) Prospective Complications Study. Methods: Neuropathy was assessed at baseline (1989 to 1991) and at follow-up (1997 to 1999), with a mean (±SD) follow-up of 7.3±0.6 years. A standardized protocol included clinical evaluation, quantitative sensory testing, and autonomic-function tests. Serum lipids and lipoproteins, glycosylated hemoglobin, and the urinary albumin excretion rate were measured in a central laboratory. Results: At follow-up, neuropathy had developed in 276 of 1172 patients without neuropathy at baseline (23.5 percent). The cumulative incidence of neuropathy was related to the glycosylated hemoglobin value and the duration of diabetes. After adjustment for these factors, we found that higher levels of total and low-density lipoprotein cholesterol and triglycerides, a higher body-mass index, higher von Willebrand factor levels and urinary albumin excretion rate, hypertension, and smoking were all significantly associated with the cumulative incidence of neuropathy. After adjustment for other risk factors and diabetic complications, we found that duration of diabetes, current glycosylated hemoglobin value, change in glycosylated hemoglobin value during the follow-up period, body-mass index, and smoking remained independently associated with the incidence of neuropathy. Cardiovascular disease at baseline was associated with double the risk of neuropathy, independent of cardiovascular risk factors. Conclusions: This prospective study indicates that, apart from glycemic control, the incidence of neuropathy is associated with potentially modifiable cardiovascular risk factors, including a raised triglyceride level, body-mass index, smoking, and hypertension

Neuropsychological diagnostics in Ethiopia - challenges and chances among considerations regarding differential diagnosis (literature overview)

Background Neuropsychological tests can provide crucial information regarding the consideration of psychiatric differential diagnosis. This is especially important in developing countries like Ethiopia where advanced imaging is not widely available.Methods A detailed literature search was conducted using the search engines Pubmed, Science Direct, Web of Science and Google Scholar from February 2013 until May 2014. Selecting the identified studies pragmatically depending on the content, twenty-six studies were included.Results The administration of tests developed in Western-European settings to the African culture presents enormous challenge. Among these are especially the influence of low level of literacy, familiarity with the testing material, cultural aspects regarding social behavior and sense of time, cultural differences regarding cognitive functions and lack of norms. At the same time, there are opportunities for different fields of application, especially when considering the diagnosis of dementia and in the assessment of frontal lobe lesions. Assessment of cognitive flexibility appears to be an important way to differentiate between affective disorders and schizophrenia.Conclusions In conclusion, we suggest a „basic set of neuropsychological tests“ for application in psychiatric facilities in low income countries like Ethiopia, which mostly includes nonverbal tests. By using these tests, some of the challenges found during the literature search can be overcome. Additionally, they might provide extra information for diagnostic issues. However, they might have to be adapted to the Ethiopian culture.Key words: Cognition; Culture-fair; Ethiopian; Low-Income; Neuropsychology; Psychiatr

Stress and resilience during pregnancy:A comparative study between pregnant and non-pregnant women in Ethiopia

BackgroundStress during pregnancy is associated with perturbances in maternal psychology and physiology,and results in adverse pregnancy and birth outcomes. However, little attention hasbeen given to understand maternal stress and its potential negative consequences in manylow- and middle-income countries. We aimed to investigate whether pregnancy is associatedwith greater stress and lower psychological resilience among women living in Jimma,Southwest Ethiopia.MethodAn institution-based comparative cross-sectional study design was implemented in JimmaUniversity Medical Center and Jimma health centers from 15 September to 30 November2021. Women attending antenatal care and family planning services were invited to participatein the study. Participants were interviewed using the Perceived Stress Scale (PSS-10),Brief Resilience Scale (BRS), distress questionnaire-5, and the Household Food InsecurityAccess Scale (HFIAS). Linear regression analysis was used to test associations betweenpregnancy (exposure) and outcomes of interest (stress and resilience scores), while adjustingfor potential confounders. Stress and resilience were mutually adjusted for one anotherin the final model.ResultsA total of 166 pregnant and 154 non-pregnant women participated, with mean age of 27.0SD 5.0 and 29.5 SD 5.3 years respectively. Pregnancy was associated with increasedstress score by 4.1 points (β = 4.1; 95% CI: 3.0, 5.2), and with reduced resilience by 3.3 points (β = -3.3; 95% CI: -4.5, -2.2) in a fully adjusted model. In mutually-adjusted models,pregnancy was independently associated with greater stress (β = 2.9, 95% CI 1.8, 3.9) andlower resilience (β = -1.3, 95% CI: -2.5, -0.2) compared to non-pregnant women.ConclusionIn this low income setting, pregnancy is associated with greater vulnerability in the mentalhealth of women, characterized by greater perceived stress and diminished resilience. Context-relevant interventions to improve resilience and reduce stress could help improve thehealth and wellbeing of mothers, with potential benefits for their offspring

Medication Adherence, Burden and Health-Related Quality of Life in Adults with Predialysis Chronic Kidney Disease: A Prospective Cohort Study

This study examines the associations between medication adherence and burden, and health-related quality of life (HRQOL) in predialysis chronic kidney disease (CKD). A prospective study targeting adults with advanced CKD (estimated glomerular filtration rate (eGFR) < 30 mL/min/1.73 m2 ) and not receiving renal replacement therapy was conducted in Tasmania, Australia. The actual medication burden was assessed using the 65-item Medication Regimen Complexity Index, whereas perceived burden was self-reported using a brief validated questionnaire. Medication adherence was assessed using a four-item Morisky-Green-Levine Scale (MGLS) and the Tool for Adherence Behaviour Screening (TABS). The Kidney Disease and Quality of Life Short-Form was used to assess HRQOL. Of 464 eligible adults, 101 participated in the baseline interview and 63 completed a follow-up interview at around 14 months. Participants were predominantly men (67%), with a mean age of 72 (SD 11) years and eGFR of 21 (SD 6) mL/min/1.73 m2 . Overall, 43% and 60% of participants reported medication nonadherence based on MGLS and TABS, respectively. Higher perceived medication burden and desire for decision-making were associated with nonadherent behaviour. Poorer HRQOL was associated with higher regimen complexity, whereas nonadherence was associated with a decline in physical HRQOL over time. Medication nonadherence, driven by perceived medication burden, was prevalent in this cohort, and was associated with a decline in physical HRQOL over time

Stress and resilience during pregnancy:A comparative study between pregnant and non-pregnant women in Ethiopia

BackgroundStress during pregnancy is associated with perturbances in maternal psychology and physiology,and results in adverse pregnancy and birth outcomes. However, little attention hasbeen given to understand maternal stress and its potential negative consequences in manylow- and middle-income countries. We aimed to investigate whether pregnancy is associatedwith greater stress and lower psychological resilience among women living in Jimma,Southwest Ethiopia.MethodAn institution-based comparative cross-sectional study design was implemented in JimmaUniversity Medical Center and Jimma health centers from 15 September to 30 November2021. Women attending antenatal care and family planning services were invited to participatein the study. Participants were interviewed using the Perceived Stress Scale (PSS-10),Brief Resilience Scale (BRS), distress questionnaire-5, and the Household Food InsecurityAccess Scale (HFIAS). Linear regression analysis was used to test associations betweenpregnancy (exposure) and outcomes of interest (stress and resilience scores), while adjustingfor potential confounders. Stress and resilience were mutually adjusted for one anotherin the final model.ResultsA total of 166 pregnant and 154 non-pregnant women participated, with mean age of 27.0SD 5.0 and 29.5 SD 5.3 years respectively. Pregnancy was associated with increasedstress score by 4.1 points (β = 4.1; 95% CI: 3.0, 5.2), and with reduced resilience by 3.3 points (β = -3.3; 95% CI: -4.5, -2.2) in a fully adjusted model. In mutually-adjusted models,pregnancy was independently associated with greater stress (β = 2.9, 95% CI 1.8, 3.9) andlower resilience (β = -1.3, 95% CI: -2.5, -0.2) compared to non-pregnant women.ConclusionIn this low income setting, pregnancy is associated with greater vulnerability in the mentalhealth of women, characterized by greater perceived stress and diminished resilience. Context-relevant interventions to improve resilience and reduce stress could help improve thehealth and wellbeing of mothers, with potential benefits for their offspring

Assessing Acceptability of COVID-19 Vaccine Booster Dose Among Adult Americans: A Cross-Sectional Study

Given the emergence of breakthrough infections, new variants, and concerns of waning immunity from the primary COVID-19 vaccines, booster shots emerged as a viable option to shore-up protection against COVID-19. Following the recent authorization of vaccine boosters among vulnerable Americans, this study aims to assess COVID-19 vaccine booster hesitancy and its associated factors in a nationally representative sample. A web-based 48-item psychometric valid survey was used to measure vaccine literacy, vaccine confidence, trust, and general attitudes towards vaccines. Data were analyzed through Chi-square (with a post hoc contingency table analysis) and independent-sample t-/Welch tests. Among 2138 participants, nearly 62% intended to take booster doses and the remaining were COVID-19 vaccine booster hesitant. The vaccine-booster-hesitant group was more likely to be unvaccinated (62.6% vs. 12.9%) and did not intend to have their children vaccinated (86.1% vs. 27.5%) compared to their non-hesitant counterparts. A significantly higher proportion of booster dose hesitant individuals had very little to no trust in the COVID-19 vaccine information given by public health/government agencies (55% vs. 12%) compared to non-hesitant ones. The mean scores of vaccine confidence index and vaccine literacy were lower among the hesitant group compared to the non-hesitant group. Compared to the non-hesitant group, vaccine hesitant participants were single or never married (41.8% vs. 28.7%), less educated, and living in a southern region of the nation (40.9% vs. 33.3%). These findings underscore the need of developing effective communication strategies emphasizing vaccine science in ways that are accessible to individuals with lower levels of education and vaccine literacy to increase vaccination uptake

Randomized Placebo-Controlled Double-Blind Clinical Trial of Cannabis-Based Medicinal Product (Sativex) in Painful Diabetic Neuropathy: Depression is a major confounding factor

Objective: To assess the efficacy of Sativex, a cannabis-based medicinal extract, as adjuvant treatment in painful diabetic peripheral neuropathy (DPN). Research design and methods: In this randomized controlled trial, 30 subjects with painful DPN received daily Sativex or placebo. The primary outcome measure was change in mean daily pain scores, and secondary outcome measures included quality-of-life assessments. Results: There was significant improvement in pain scores in both groups, but mean change between groups was not significant. There were no significant differences in secondary outcome measures. Patients with depression had significantly greater baseline pain scores that improved regardless of intervention. Conclusions: This first-ever trial assessing the efficacy of cannabis has shown it to be no more efficacious than placebo in painful DPN. Depression was a major confounder and may have important implications for future trials on painful DPN

Climate change impacts and potential benefits of heat-tolerant maize in South Asia

Article Purchased; Published online: 14 September 2016Maize is grown by millions of smallholder farmers in South Asia (SA) under diverse environments. The crop is grown in different seasons in a year with varying exposure to weather extremes, including high temperatures at critical growth stages which are expected to increase with climate change. This study assesses the impact of current and future heat stress on maize and the benefit of heat-tolerant varieties in SA. Annual mean maximum temperatures may increase by 1.4–1.8 °C in 2030 and 2.1–2.6 °C in 2050, with large monthly, seasonal, and spatial variations across SA. The extent of heat stressed areas in SA could increase by up to 12 % in 2030 and 21 % in 2050 relative to the baseline. The impact of heat stress and the benefit from heat-tolerant varieties vary with the level of temperature increase and planting season. At a regional scale, climate change would reduce rainfed maize yield by an average of 3.3–6.4 % in 2030 and 5.2–12.2 % in 2050 and irrigated yield by 3–8 % in 2030 and 5–14 % in 2050 if current varieties were grown under the future climate. Under projected climate, heat-tolerant varieties could minimize yield loss (relative to current maize varieties) by up to 36 and 93 % in 2030 and 33 and 86 % in 2050 under rainfed and irrigated conditions, respectively. Heat-tolerant maize varieties, therefore, have the potential to shield maize farmers from severe yield loss due to heat stress and help them adapt to climate change impacts