Exploring the contribution of indigenous medicine to primary healthcare in West Belesa District in northwestern Ethiopia: A qualitative analysis

Background: This study explores the contribution made by indigenous medicine to primary healthcare services in West Belesa Woreda (District) in northwestern Ethiopia. Objective: The study aims to examine the practices of indigenous medicine in three communities in West Belesa Woreda, the perceptions of its use and efficacy among indigenous medical practitioners and biomedical healthcare practitioners, and their views on its role in primary healthcare. Methods: Qualitative research, including in-depth interviews, focus group discussions and direct observation, using an ethnographic design, was conducted from February to April 2017. In total, 16 key informants were interviewed and six focus group discussion sessions were held. Thematic analysis was undertaken to analyze the data. Results: The local pluralistic healthcare system employs both indigenous medicine and biomedicine, often in combination. However, indigenous healing is generally the first choice due to its greater availability, affordability, and cultural acceptability. Malaria, intestinal worms, diarrhea, stomach ache, gastritis, wounds, snake bites, and epilepsy are commonly treated by herbalists with medicines prepared from plants and plant products. Illnesses that are perceived to be due to buda (evil eye) and spirit possession are mostly treated with tsebel (holy water), prayers and spirit exorcism. The findings also show that most modern healthcare providers have negative perceptions towards indigenous medicine, mainly because it lacks standards for prescribing medications. On the other hand, some beneficiaries of indigenous medicine asserted that indigenous healers provide better primary healthcare for spiritual illnesses and bone fractures. Conclusions: Understanding the cultural context of health, illness, and healing, and the involvement of indigenous healers in primary healthcare, may facilitate the provision of compatible treatments consistent with Amhara cultural and religious traditions and the integration of indigenous medicine and biomedicine. [Ethiop. J. Health Dev. 2020; 34(3):191-204] Key words: Indigenous medicine, primary healthcare, qualitative analysis, Ethiopi

A STUDY OF THE PERCEPTIONS OF THE EFFECTIVENESS OF TRADE AND INDUSTRIAL EDUCATION IN THE PREPARATION OF GRADUATES FOR EMPLOYABILITY AND POST-SECONDARY EDUCATION

This dissertation was a mixed method study that examined the perceptions of the effectiveness of trade and industrial education of graduates' employability and post-secondary education. The purpose of this study was to research the following questions: To what extent did graduates perceive that the trade and industrial courses taken at the Robeson County Career Center contributed to their employment potential? To what extent did graduates perceive that the trade and industrial courses taken at the Robeson County Career Center added to their post-secondary educational potential? To what extent did Career-Technical educators at the Robeson County Career Center perceive that graduates who completed trade and industrial courses or received credentials were prepared for the workforce? To what extent did business professionals perceive that graduates who completed Robeson County Career Center trade and industrial courses were employable? Data were collected from the 2013-14 Graduate Concentrator Feedback Surveys. Teachers and business professionals' data were collected with the same survey adapted to each audience. The findings indicated that teachers and business professionals perceived that trade and industrial courses had a positive impact on graduate employability and post-secondary education. The conclusion suggested a disconnect of the graduates' perceptions of what is learned in trade and industrial courses in relation to future employment and post-secondary education. The need to establish partnerships between the business/industrial communities and educational institutions and the necessity of educating students on the benefits of earning credentials were among the recommendations to improve the effectiveness of the Robeson County Career Center programs and specifically, how the center's graduates perceived these programs

Addressing Intimate Partner Violence Among Female Clients Accessing HIV Testing and Counseling Services: Pilot Testing Tools in Rakai, Uganda.

The World Health Organization recommends that HIV counseling and testing (HCT) programs implement strategies to address how intimate partner violence (IPV) influences women's ability to protect themselves from and seek care and treatment for HIV infection. We discuss the process used to adapt a screening and brief intervention (SBI) for female clients of HCT services in Rakai, Uganda-a setting with high prevalence of both HIV and IPV. By outlining our collaborative process for adapting and implementing the SBI in Rakai and training counselors for its use, we hope other HCT programs will consider replicating the approach in their settings

Dissecting Complex Traits Using the Drosophila Synthetic Population Resource

For most complex traits we have a poor understanding of the positions, phenotypic effects, and population frequencies of the underlying genetic variants contributing to their variation. Recently, several groups have developed multi-parent advanced intercross mapping panels in different model organisms in an attempt to improve our ability to characterize causative genetic variants. These panels are powerful and are particularly well suited to the dissection of phenotypic variation generated by rare alleles and loci segregating multiple functional alleles. We describe studies using one such panel, the Drosophila Synthetic Population Resource, and the implications for our understanding of the genetic basis of complex traits. In particular, we note that many loci of large effect appear to be multiallelic. If multiallelism is a general rule, analytical approaches designed to identify multiallelic variants should be a priority for both genome wide association studies and multi-parental panels

Genetic Dissection of the Drosophila melanogaster Female Head Transcriptome Reveals Widespread Allelic Heterogeneity

Modern genetic mapping is plagued by the “missing heritability” problem, which refers to the discordance between the estimated heritabilities of quantitative traits and the variance accounted for by mapped causative variants. One major potential explanation for the missing heritability is allelic heterogeneity, in which there are multiple causative variants at each causative gene with only a fraction having been identified. The majority of genome-wide association studies (GWAS) implicitly assume that a single SNP can explain all the variance for a causative locus. However, if allelic heterogeneity is prevalent, a substantial amount of genetic variance will remain unexplained. In this paper, we take a haplotype-based mapping approach and quantify the number of alleles segregating at each locus using a large set of 7922 eQTL contributing to regulatory variation in the Drosophila melanogaster female head. Not only does this study provide a comprehensive eQTL map for a major community genetic resource, the Drosophila Synthetic Population Resource, but it also provides a direct test of the allelic heterogeneity hypothesis. We find that 95% of cis-eQTLs and 78% of trans-eQTLs are due to multiple alleles, demonstrating that allelic heterogeneity is widespread in Drosophila eQTL. Allelic heterogeneity likely contributes significantly to the missing heritability problem common in GWAS studies.This work was supported by NIH R01 RR024862/OD010974 to SJM and ADL, an American Recovery and Reinvestment Act (ARRA) administrative supplement to this award, and F32 GM099382 to EGK. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript

The Genetic Architecture of Methotrexate Toxicity Is Similar in Drosophila melanogaster and Humans

The severity of the toxic side effects of chemotherapy varies among patients, and much of this variation is likely genetically based. Here, we use the model system Drosophila melanogaster to genetically dissect the toxicity of methotrexate (MTX), a drug used primarily to treat childhood acute lymphoblastic leukemia and rheumatoid arthritis. We use the Drosophila Synthetic Population Resource, a panel of recombinant inbred lines derived from a multiparent advanced intercross, and quantify MTX toxicity as a reduction in female fecundity. We identify three quantitative trait loci (QTL) affecting MTX toxicity; two colocalize with the fly orthologs of human genes believed to mediate MTX toxicity and one is a novel MTX toxicity gene with a human ortholog. A fourth suggestive QTL spans a centromere. Local single-marker association scans of candidate gene exons fail to implicate amino acid variants as the causative single-nucleotide polymorphisms, and we therefore hypothesize the causative variation is regulatory. In addition, the effects at our mapped QTL do not conform to a simple biallelic pattern, suggesting multiple causative factors underlie the QTL mapping results. Consistent with this observation, no single single-nucleotide polymorphism located in or near a candidate gene can explain the QTL mapping signal. Overall, our results validate D. melanogaster as a model for uncovering the genetic basis of chemotoxicity and suggest the genetic basis of MTX toxicity is due to a handful of genes each harboring multiple segregating regulatory factors

Developing approaches to the collection and use of evidence of patient experience below the level of national surveys

National approaches to collecting patient feedback provide trust level information which although can provide a benchmark for trusts often doesn’t provide information about specific services or patients experiences of pathways of care. This more granular level of data could be more informative for local service development and improvement. This research explored the feasibility and usefulness of such approaches. A conceptual model and standard questionnaire of patient experience was developed that might work across a range of services and pathways of care. Seven trusts were recruited as collaborating sites in which the model and survey instrument was tested. These were from different geographical locations and settings. The impact of the pilot and survey results on the improvement and development of services was evaluated. The service- line approach to capturing patient feedback was generally more feasible and considered of value for service improvement. The collection of patients’ experiences across pathways of care was more challenging in terms of the development of the survey and interpretation of results. However, many sites identified specific actionable areas for improvement. This study has shown that it is possible to develop and apply a standardised survey in a range of services and provides evidence that a consistent unified approach to monitoring patient experiences is feasible. However several methodological problems are acknowledged such as the availability of resources and capacity for improvements to services and care. Evidence is now particularly needed to establish how best to produce positive impact from patient feedback

Perceptions on tailored messages from a values clarification tool: a mixed-methods study of older adults with cancer

The purpose of this study was to assess whether varying input communication factors impacted participants’ perceived confidence, motivation, and likelihood to act (i.e., share or discuss their preferences and values with their clinician or family/caregiver) when receiving tailored communication from a values-clarification tool. This study was conducted over a two-month period at the North Carolina Basnight Cancer Hospital. Patients with hematologic malignancies participated in evaluating three distinct messages that varied on three input communication factors. Results from this study indicate that most study participants preferred messages that were moderately direct, contained succinct question prompts, and that were empowering. Results also indicate that diverse perspectives and external influences may impact confidence and motivation toward discussing preferences with their clinicians. Our findings suggest the importance of validating the input communication factors within values-clarification tools before presenting results to patients and the need to evaluate potential disparities in patients’ participation toward discussing their preferences. Evidence from this study provides direction for future research efforts focused on improving shared decision-making among older adults

Generation of mice with a conditional allele of the p120 Ras GTPase-activating protein

p120 Ras GTPase-activating protein (RasGAP) encoded by the rasa1 gene in mice is a prototypical member of the RasGAP family of proteins involved in negative-regulation of the p21 Ras proto-oncogene. RasGAP has been implicated in signal transduction through a number of cell surface receptors. In humans, inactivating mutations in the coding region of the RASA1 gene cause capillary malformation arteriovenous malformation. In mice, generalized disruption of the rasa1 gene results in early embryonic lethality associated with defective vasculogenesis and increased apoptosis of neuronal cells. The early lethality in this mouse model precludes its use to further study the importance of RasGAP as a regulator of cell function. Therefore, to circumvent this problem, we have generated a conditional rasa1 knockout mouse. In this mouse, an exon that encodes a part of the RasGAP protein essential for catalytic activity has been flanked by loxP recognition sites. With the use of different constitutive and inducible Cre transgenic mouse lines, we show that deletion of this exon from the rasa1 locus results in effective loss of expression of catalytically-active RasGAP from a variety of adult tissues. The conditional rasa1 mouse will be useful for the analysis of the role of RasGAP in mature cell types. genesis 45:762–767, 2007. © 2007 Wiley-Liss, Inc.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/57536/1/20354_ftp.pd