Ethiopian refugees in the UK: migration, adaptation and settlement experiences and their relevance to health.

Aim: The study explores Ethiopian refugees’ and asylum seekers’ experiences of migration, adaptation and settlement in the UK and their health beliefs and practices. Design: Data was collected using semi-structured depth interviews and a semi-structured questionnaire. The sample consisted of 106 Ethiopians resident in the UK. Results: The majority of the participants fled Ethiopia due to political reasons. Whilst 65% of them had lived in the UK for over five years only 7% had full refugee status. Many of the participants faced difficulties with the immigration system, housing and social services and felt socially isolated. Many also had problems with gaining employment or employment appropriate to their qualifications, and 29% were unemployed. The majority of the participants believe that happiness is a prerequisite to healthiness and also an indication of healthiness. On the other hand the majority believed that sickness is caused by disease and mental illness is caused by both supernatural and psychosocial causes. Most of the participants sought the help of their GP in the first instance of illness although some had experienced difficulties accessing health services due to language problems and poor understanding of the primary health care system. The participants also believed that the stress of adaptation and settlement affected their mental health and led to stress and depression. Conclusion: Migration, adaptation and settlement experiences impact on the health of refugees and are dependent on a number of barriers and enablers, both at a personal and societal level. These should be taken into account in the provision of health and social care services, in particular services should be provided in a culturally competent manner

Food Safety Practice and Associated Factors of Food Handlers Working in Substandard Food Establishments in Gondar Town, Northwest Ethiopia, 2013/14

Introduction: Food borne illnesses comprise a broad spectrum of diseases and are responsible for substantial morbidity and mortality worldwide. The global incidence of food borne disease is difficult to estimate, but it has been reported that 2.1 million people died each year from diarrheal diseases and contaminated food contributes to 1.5 billion cases of diarrhea in children each year, resulting in more than three million premature deaths. In developing countries, up to an estimated 70% of cases of diarrheal diseases are associated with the consumption of contaminated foods. Approximately 10 to 20% of food-borne disease outbreaks are due to contamination by the food handler. Objective: This study was conducted to assess food safety practices and associated factors of food handlers working in substandard food establishments of Gondar town, Northwest Ethiopia, 2013/14. Methods: Institution based cross sectional study design was conducted to assess food safety practices and associated factors of food handlers. Four hundred three food handlers were taken randomly as study subjects and data were collected by observation by using standardized questionnaire and observational check lists. Ordinal logistic regression model was fitted to analyze the predictor variables. Results: The overall level of food safety practices (good – 30.30%, fair- 47.60% and poor – 22.10%) was reported. Of a number of predictor variables analyzed age, marital status, service year, monthly income, food hygiene and safety training, attitude, knowledge and depth of knowledge were identified as factors affecting food safety practices. Conclusion and recommendations: Compared to other similar studies, Low level of food safety practice (good – 30.30%, fair- 47.60% and poor – 22.10%) was reported. Therefore, Environmental health practitioners, the local Medias and the managers should do a lot to improve food safety practices of the food handlers. They should also design and implement food safety awareness creation programs

Experimental estimation of one-parameter qubit gates in the presence of phase diffusion

We address estimation of one-parameter qubit gates in the presence of phase diffusion. We evaluate the ultimate quantum limits to precision, seek for optimal probes and measurements, and demonstrate an optimal estimation scheme for polarization qubits. An adaptive method to achieve optimal estimation in any working regime is also analyzed in details and experimentally implemented.Comment: revised version, to appear on PR

Unintended pregnancy among female sex workers in Mekelle city, northern Ethiopia: a cross-sectional study

BACKGROUND: Unintended pregnancy is a significant public health concern in the world. Particularly, female sex workers are exposed to the risk of unintended pregnancy, abortion and their consequences. The aim of this study was, therefore, to assess unintended pregnancy and associated factors among female sex workers in Mekelle city, northern Ethiopia. METHODS: A community based cross-sectional study was conducted among 346 female sex workers from five Kebelles (smallest administrative units in Ethiopia) of Mekelle city from March-April, 2014. Sex workers were selected with simple random sampling technique using sampling frame obtained from urban health extension program. Epi-data version 3.1 was used to enter data and analysis was done using SPSS version 20. Bivariate and multivariate logistic regressions were performed to identify factors associated with unintended pregnancy using odds ratio and 95% confidence interval with P-value of 0.05. RESULTS: The magnitude of unintended pregnancy among female sex workers in the past two years was 28.6%. During this period, 59 women had abortion which represents three-fifths, (59.6%), of those who had unintended pregnancies, and 17.1% of all female sex workers. Female sex workers who gave birth and had history of abortion formerly had 3.1 (AOR = 3.07, 95% CI: [1.54, 6.09]) and 15.6 (AOR = 15.64 95% CI: [8.03, 30.47]) times higher odds of unintended pregnancy compared to their counterparts, respectively. Sex workers who had steady partners had 2.9 (AOR = 2.87, 95% CI: [1.47, 5.61]) times higher odds of have unintended pregnancy than those who hadn't. Drug users had 2.7 (AOR = 2.68, 95% CI: [1.30, 5.52]) times higher odds of unintended pregnancy than those who hadn't use. Sex workers who had 60-96 months of duration in sex work were 67% less likely to have unintended pregnancy than those with <12 months (AOR = 0.33, 95% CI: [0.11, 0.95]). CONCLUSIONS: High level of unintended pregnancy and a range of associated factors were identified among sex workers. Improving utilization of effective pregnancy prevention methods in a consistent manner can avert the existing high level of unintended pregnancy among female sex workers.Rishan Weldegebreal, Yohannes Adama Melaku, Mussie Alemayehu, and Tesfay Gebregzabher Gebrehiwo

Diarrhea prevalence and sociodemographic factors among under-five children in rural areas of North Gondar zone, Northwest Ethiopia

Published 3 June 2018Background. Diarrheal disease remains one of the principal causes of morbidity and mortality in infants and children in developing countries, including Ethiopia. Risk factors for diarrhea vary by settings and have important implications for developing intervention strategies to reduce the burden of the disease. Thus, the aim of this study was to assess diarrhea prevalence and sociodemographic factors among under-five children in rural areas of North Gondar Zone. Methods. A community-based cross-sectional study was conducted from April to June 2016 among 736 randomly selected households with one child under five years old. A structured questionnaire was used for collecting information on sociodemographic characteristics and diarrheal occurrence. Data was analyzed using SPSS version 20. The bivariate and multivariable logistic regression analysis were used to determine the association between risk factors and diarrheal occurrence, and a p value < 0.05 was taken as statistically significant. Results. A total of 736 under-five children and their respondents were enrolled during the study period. Almost all respondents were biological mothers 96.4% (709/736), married 94.2% (693/736), and house wives 86% (632/736). The overall prevalence of diarrheal disease among under-five children was 22.1% (163/743). Of these, children with age group of less than one year old, 7.7 % (57/736), were commonly infected with diarrheal diseases. Children less than or equal to one year [AOR=1.82, 95% CI= (1.39, 4.63)], guardians [AOR=4.37, 95% CI= (1.73, 11.1)], and children with no breast feeding practice [AOR=3.13, 95% CI= (1.62, 6.03)] were the major risk factors for the occurrence of diarrhea. Conclusion. Childhood diarrhea remains an important health concern in the study area. Occurrence of diarrhea was statistically associated with child age less than or equal to one year, educational status of mother/guardians, and breast feeding. To minimize the magnitude childhood diarrhea, various designing and implementing strategies, such as health education, child care, breast feeding, and weaning practice, integrated with the existing national health extension are quite essential.Atalay Getachew, Tadesse Guadu, Alebachew Tadie, Zemichael Gizaw, Mulat Gebrehiwot, Daniel Haile Cherkos, Martha Alemayehu Menberu, and Teklay Gebrecherko

Genetic diversity and effective population sizes of thirteen Indian cattle breeds

Background: The genetic structure of a diverse set of 15 Indian indigenous breeds and non-descript indigenous cattle sampled from eight states was examined, based on 777 k single nucleotide polymorphism (SNP) genotypes obtained on 699 animals, with sample sizes ranging from 17 to 140 animals per breed. To date, this is the largest and most detailed assessment of the genetic diversity of Indian cattle breeds. Results: Admixture analyses revealed that 109 of the indigenous animals analyzed had more than 1% Bos taurus admixture of relatively recent origin. Pure indigenous animals were defined as having more than 99% Bos indicus ancestry. Assessment of the genetic diversity within and between breeds using principal component analyses, F statistics, runs of homozygosity, the genomic relationship matrix, and maximum likelihood clustering based on allele frequencies revealed a low level of genetic diversity among the indigenous breeds compared to that of Bos taurus breeds. Correlations of SNP allele frequencies between breeds indicated that the genetic variation among the Bos indicus breeds was remarkably low. In addition, the variance in allele frequencies represented less than 1.5% between the Indian indigenous breeds compared to about 40% between Bos taurus dairy breeds. Effective population sizes (Ne) increased during a period post-domestication, notably for Ongole cattle, and then declined during the last 100 generations. Although we found that most of the identified runs of homozygosity are short in the Indian indigenous breeds, indicating no recent inbreeding, the high FROH coefficients and low FIS values point towards small population sizes. Nonetheless, the Ne of the Indian indigenous breeds is currently still larger than that of Bos taurus dairy breeds. Conclusions: The changes in the estimates of effective population size are consistent with domestication from a large native population followed by consolidation into breeds with a more limited population size. The surprisingly low genetic diversity among Indian indigenous cattle breeds might be due to their large Ne since their domestication, which started to decline only 100 generations ago, compared to approximately 250 to 500 generations for Bos taurus dairy cattle

Impact of landscape management scenarios on ecosystem service values in Central Ethiopia

This study aimed at modeling scenarios of future land use and land cover (LULC) change and estimating ecosystem service (ES) values for the year 2051 compared to 2021 in Central Ethiopia. The future LULC changes for the year 2051 were simulated for four scenarios, namely Business-as-Usual (BAU), Rapid Agricultural Expansion (RAE), Ecosystems Protection and Agricultural Development (EPAD) and Landscape Ecosystems Restoration and Conservation (LERC). The four LULC change scenarios were simulated based on anticipated assumptions that were derived from existing spatial policies, a consultation workshop report on scenarios of agricultural development in Ethiopia, suitability analysis, population growth analysis and expert knowledge of the study area characteristics. We used a Multi-Layer Perceptron–Artificial Neuron Network (MLP–ANN) model-based projected LULC for the BAU scenario and the Integrated Valuation of Ecosystem Services and Tradeoffs (InVEST) model to generate RAE, EPAD and LERC scenarios in the study landscape. The benefit transfer method was used to estimate the total ES values and for trade-off analysis. The result showed that LULC changes in the study area varied across simulated scenarios compared to the base year 2021. Under the BAU and RAE scenarios, cultivated land increased by 146,548 ha (22%) and 193,965 ha (29%), whereas forest, water body, wetland and shrub-bush land were reduced. However, forest cover increased by 31,725 ha and 100,080 ha but bare land was reduced by 8466 ha (21%) and 10,379 ha (25%) under the EPAD and LERC scenarios. The forest cover annual rate of change was 3.2% and 6% under the EPAD and LERC scenarios. As a result, the total ES value increased by USD 24.5 and 78.5 million under the EPAD and LERC scenarios for the year 2051, whereas the total ES value was reduced under the BAU and RAE scenarios by USD 27.1 and 73.2 million. The trade-offs among ecosystem services were significantly synergized under the LERC scenario compared to RAE. Therefore, EPAD and LERC could be used as a reference for sustainable landscape planning and management. Landscape ecosystems restoration integrated with a sustainable agricultural intensification approach would enable us to ensure the sustainability of both agricultural production and ecosystem service synergies without negatively affecting the natural environment

Ecosystem service valuation along landscape transformation in Central Ethiopia

Land degradation and discontinuation of ecosystem services (ES) are a common phe nomenon that causes socio-economic and environmental problems in Ethiopia. However, a dearth of information is known about how ES are changing from the past to the future with regard to land use land cover (LULC) changes. This study aimed at estimating the values of ES based on the past and future LULC changes in central Ethiopia. Maximum likelihood classifier and cellular automata artificial neuron network (CA-ANN) models that integrate the module for land use change evaluation (MOLUSE) were used to classify and predict LULC. The CA-ANN model learning and validation was employed to predict LULC of 2031 and 2051. Following LULC change detection and prediction, the total ES values were estimated using the benefit transfer method. Results revealed that forests, wetlands, grazing lands, shrub-bush-woodlands, and water bodies were reduced by 9755 ha (37%), 4092 ha (38.4%), 21,263 ha (81%), 63,161 ha (25.7%), and 905 ha (1%), respectively, between 1986 and 2021. Similarly, forests, wetlands, grazing lands, shrub-bush lands, and water bodies will experience a decline of 1.5%, 0.5%, 2.6%, 19.6%, and 0.1%, respectively. Meanwhile, cultivated lands, bare-lands, and built-up areas will experience an increase between 1986 and 2051. The estimated total ES values were reduced by US$58.3 and 85.4 million in the period 1986–2021 and 1986–2051. Food production and biological control value increased while 15 other ES decreased throughout the study periods. Proper land use policy with strategic actions, including enforcement laws for natural ecosystems protection, afforestation, ecosystems restoration, and conservation practices, are recommended to be undertaken to enhance multiple ES provision

Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015

SummaryBackground The Global Burden of Diseases, Injuries, and Risk Factors Study 2015 provides an up-to-date synthesis of the evidence for risk factor exposure and the attributable burden of disease. By providing national and subnational assessments spanning the past 25 years, this study can inform debates on the importance of addressing risks in context. Methods We used the comparative risk assessment framework developed for previous iterations of the Global Burden of Disease Study to estimate attributable deaths, disability-adjusted life-years (DALYs), and trends in exposure by age group, sex, year, and geography for 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks from 1990 to 2015. This study included 388 risk-outcome pairs that met World Cancer Research Fund-defined criteria for convincing or probable evidence. We extracted relative risk and exposure estimates from randomised controlled trials, cohorts, pooled cohorts, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. We developed a metric that allows comparisons of exposure across risk factors—the summary exposure value. Using the counterfactual scenario of theoretical minimum risk level, we estimated the portion of deaths and DALYs that could be attributed to a given risk. We decomposed trends in attributable burden into contributions from population growth, population age structure, risk exposure, and risk-deleted cause-specific DALY rates. We characterised risk exposure in relation to a Socio-demographic Index (SDI). Findings Between 1990 and 2015, global exposure to unsafe sanitation, household air pollution, childhood underweight, childhood stunting, and smoking each decreased by more than 25%. Global exposure for several occupational risks, high body-mass index (BMI), and drug use increased by more than 25% over the same period. All risks jointly evaluated in 2015 accounted for 57·8% (95% CI 56·6–58·8) of global deaths and 41·2% (39·8–42·8) of DALYs. In 2015, the ten largest contributors to global DALYs among Level 3 risks were high systolic blood pressure (211·8 million [192·7 million to 231·1 million] global DALYs), smoking (148·6 million [134·2 million to 163·1 million]), high fasting plasma glucose (143·1 million [125·1 million to 163·5 million]), high BMI (120·1 million [83·8 million to 158·4 million]), childhood undernutrition (113·3 million [103·9 million to 123·4 million]), ambient particulate matter (103·1 million [90·8 million to 115·1 million]), high total cholesterol (88·7 million [74·6 million to 105·7 million]), household air pollution (85·6 million [66·7 million to 106·1 million]), alcohol use (85·0 million [77·2 million to 93·0 million]), and diets high in sodium (83·0 million [49·3 million to 127·5 million]). From 1990 to 2015, attributable DALYs declined for micronutrient deficiencies, childhood undernutrition, unsafe sanitation and water, and household air pollution; reductions in risk-deleted DALY rates rather than reductions in exposure drove these declines. Rising exposure contributed to notable increases in attributable DALYs from high BMI, high fasting plasma glucose, occupational carcinogens, and drug use. Environmental risks and childhood undernutrition declined steadily with SDI; low physical activity, high BMI, and high fasting plasma glucose increased with SDI. In 119 countries, metabolic risks, such as high BMI and fasting plasma glucose, contributed the most attributable DALYs in 2015. Regionally, smoking still ranked among the leading five risk factors for attributable DALYs in 109 countries; childhood underweight and unsafe sex remained primary drivers of early death and disability in much of sub-Saharan Africa. Interpretation Declines in some key environmental risks have contributed to declines in critical infectious diseases. Some risks appear to be invariant to SDI. Increasing risks, including high BMI, high fasting plasma glucose, drug use, and some occupational exposures, contribute to rising burden from some conditions, but also provide opportunities for intervention. Some highly preventable risks, such as smoking, remain major causes of attributable DALYs, even as exposure is declining. Public policy makers need to pay attention to the risks that are increasingly major contributors to global burden. Funding Bill & Melinda Gates Foundation