Association between attachment and mental health symptoms among school-going adolescents in Northern Uganda: the moderating role of war-related trauma

Background: The association between attachment and mental health symptoms in adolescents in a post-conflict low resource setting has not been documented. Methods: We investigated the relationship between parent and peer attachment and posttraumatic stress, depression and anxiety symptoms in a sample of 551 adolescents aged 13-21 years old. Attachment quality was assessed using the Inventory of Parent and Peer Attachment (IPPA). Post-traumatic stress, depression and anxiety symptoms were assessed using the Impact of Events Scale Revised (IESR) and Hopkins Symptom Checklist for Adolescents (HSCL-37A) respectively. Gender differences in attachment relationships were determined using independent t-tests. Multivariate logistic regression was used to assess whether attachment relationships were independently associated with posttraumatic stress, depression and anxiety symptoms. Hierarchical linear regression analyses were conducted to explore the moderating role of war-related trauma. Results: Our analyses revealed gender differences in attachment to parents, with males reporting stronger attachment than females. Parental attachment was protective against depression and anxiety symptoms but not posttraumatic stress symptoms after adjusting for potential confounders. Alienation by parents was independently associated with an increase in these mental health symptoms while peer attachment was not associated with any of these symptoms. However, in situations of severe trauma, our analyses showed that peer attachment was significantly protective against post-traumatic stress symptoms. Conclusions: Secure parental attachment is associated with better psychosocial adjustment in adolescents affected by war. Further, adolescents with secure peer attachment relationships in situations of severe war trauma may be less likely to develop posttraumatic stress symptoms. Interventions to enhance peer support in this post conflict setting would benefit this vulnerable population

SMEs and Business Information Provision Strategies: Analytical Perspective

The purpose of this article is to provide an overview of business information provision mechanism for SMEs with a view of highlighting aspects critical in any business information provision modalities. It makes a reflection on SMEs as information user groups, highlights notable challenges faced in the business information chain and gives an account of the ICTs impact on business information provision to SMEs. To inform decision making regarding appropriate business provision, some aspects from three countries are highlighted. The guiding principles for developing effective business development services are outlined. The article concludes by a call for the adoption of serious information provision strategies and makes useful recommendations for business information providers, academicians and policy makers. The provision of business information to the SMEs is crucial. However, this must be based on a clear understanding of the basic ingredients crucial for any meaningful design to take place. This review highlights important issues that business information providers should take into consideration. It provides a platform for business information providers and policy makers, academicians in LIS profession to rethink best practices to curtail challenges in business information provision to SMEs

Uptake of Antenatal Care Services among Women of Reproductive Age in Mandera County, Kenya

Background: Antenatal care is an opportunity for prevention and management of existing and potential causes of maternal and newborn mortality and morbidity. The new WHO antenatal care model, stipulates that, the first antenatal care visit takes place within the first trimester (gestationalage of <12 weeks) and then, additional seven visits. Only 37% of women in Mandera County had utilized the recommended minimum four ANC visits.Objectives: There was need to assess the critical factors influencing the uptake of ANC in Mandera County Kenya, in order to enlighten stakeholders on the development of appropriate ANC Service Provision Program. This study took the intiative of bridging the gap.Methodology: The study adopted cross-sectional design using both quantitative and qualitative methods. Stratified and Sample random sampling were used to get a quantity of 348 respondents. Data was collected using questionnaire, FGDs and KIIs guides and Pearson’s Chi-square test. Multivariate analysis using logistic regression was summarized to establish the strengths of the association. Odds Ratio (OR) and 95% Confidence Interval (CI) were used and threshold for statistical significance was set at p<0.05. Qualitative data was transcribed and analyzed thematically.Results: The proportion of women who utilized ANC was 83.0% and only 60.3% had attended recommended visits. Individual factors that influenced ANC uptake were; age, level of education, monthly income, gravida, parity and complications during pregnancy. Contextual factors that influenced ANC were; time taken to reach health facilities, source of maternal information and local discouragements. There was no significant relationship  between Religion, marital status, age at first pregnancy with ANC uptake.Conclusion: The negative perception can change by; improving culturally sensitive ANC services accessibility by; increasing the number of female  skilled health workers and reducing traveling time to the health facilities by conducting regular outreach services targeting villages with no close  facility to pastoral communities. It will be important to strengthen CHVs' capacity to emphasize primary health care and accelerate progress towards UHC in the County. Provide health education and promotion targeting older mothers with high parity, women inclined to harmful culturalpractices and their partners. In spite of a wide range of literature on ANC topics in most parts of Kenya, it was limited pertaining Mandera County.Recomandations: Meticulous understanding of local barriers and facilitating factors of ANC utilization is prerequisite for designing and implementing interventions that aim to improve ANC uptake. Well developed infrastructure is a basic need that falls in the category of basic wants for Mandera County. Key words: Antenatal care (ANC), Mandera, FGDs, immunization

Awareness, Knowledge, and Perceptions Regarding Rabies Prevention Among Rural Communities in Masaka District, Central Uganda: A Qualitative Study.

Rabies is a zoonotic disease that is mainly transmitted to humans through dog bites. It remains a major public health threat in many Asian and African countries, including Uganda. The main objective of this study was to investigate awareness, knowledge, and perceptions of communities toward human and dog health related to rabies prevention, as well as dog management practices within Masaka district, central Uganda. Data collection involved nine key informant interviews (KIIs) and six focus group discussions (FGDs). Methods used during focus group discussions included qualitative interviews (using open-ended questions), simple ranking, and proportional piling. Data from KIIs and FGDs were analyzed using content analysis in NVivo (version 12.0). This study reveals that community members in the rural settings uses herbal concoctions in replacement or as an alternative to dog vaccination. Furthermore, the study reveals that dogs play the vital roles in the households like as they offer protection to people and household properties, despite being ranked second least among the household animals. The commonest livelihood activity was a small-scale mixed farming. Most of the households kept dogs, but they are ranked at second lowest in terms of economic value among all domestic animals. Free roaming and tethering were the common dog-keeping systems, and home-based feed (food leftovers, bones) was provided mainly to the tethered dogs. Rabies, also locally known as "Eddalu Lyembwa" (that can be translated as "madness of the dogs"), was ranked as the disease of most important among dogs, besides other common diseases such as skin diseases, venereal diseases, worm infestations, and tick infestations. Inadequate vaccination services for both humans and dogs were reported, and dog bite victims traveled a long distance to seek for post-exposure prophylaxis after dog bites. It can be concluded that there is a clear request for periodic mass vaccination campaigns against rabies among dogs, and access to vaccines within reasonable distances by humans after a rabies exposure, but also pre-emptive vaccination for those at high risk, such as veterinarians, needs to be improved

Social incentives as nudges for agricultural knowledge diffusion and willingness to pay for certified seeds: Experimental evidence from Uganda

A transition from low-input subsistence farming in Sub-Saharan Africa will require the use of yield-increasing agricultural technologies. However, in developing countries, most farmers continue to rely heavily on pest-infested and disease-infected recycled seed from own or local sources leading to low yields. This study used a field experiment to examine the effect of a social incentive combined with goal setting on the diffusion of agricultural knowledge and uptake of quality certified seed by farmers. We relaxed the seed access and information/knowledge constraints by introducing improved varieties of sweetpotato in the study villages and providing training to carefully selected progressive farmers who were then linked to co-villagers. We find that social incentives combined with goal setting reduced the likelihood of the trained progressive farmers reaching out to co-villagers to share information and discuss farming. Further, social incentive combined with goal setting had no significant effect on knowledge and experimentation by progressive farmers, and on willingness to pay for improved seed – as elicited through auctions, our proxy for experimentation, by co-villagers. These findings suggest that the combination of goal setting and public recognition acted to crowd-out diffusion effort. We conclude that social incentive combined with goal setting by established progressive farmers already enjoying a certain degree of public recognition is not sufficient to induce effort in learning and experimentation with agricultural innovations. These results have implications for design of policy and extension services to promote adoption of agricultural technologies with proven food and nutrition security benefits in developing countries

Contextualization of psychological treatments for government health systems in low-resource settings: group interpersonal psychotherapy for caregivers of children with nodding syndrome in Uganda.

BACKGROUND: Evidence for the effectiveness of psychological treatments in low- and middle-income countries is increasing. However, there is a lack of systematic approaches to guide implementation in government health systems. The objective of this study was to address this gap by employing the Replicating Effective Programs (REP) framework to guide contextualization of a psychological treatment in the Uganda public health system for caregivers of children affected by nodding syndrome, a neuropsychiatric disorder endemic to Sub-Saharan Africa associated with high morbidity and disability. METHODS: To contextualize a psychological treatment, we followed the four components of the REP framework: pre-conditions, pre-implementation, implementation, and maintenance and evolution. A three-step process involved reviewing health services available for nodding syndrome-affected families and current evidence for psychological treatments, qualitative formative research, and analysis and documentation of implementation activities. Stakeholders included members of affected communities, health care workers, therapists, local government leaders, and Ministry of Health officials. Detailed written, audio, and video documentation of the implementation activities was used for content analysis. RESULTS: During the pre-condition component of REP, we selected group interpersonal therapy (IPT-G) because of its feasibility, acceptability, effectiveness in the local setting, and availability of locally developed training materials. During the pre-implementation component, we adapted the training, logistics, and technical assistance strategies in conjunction with government and stakeholder working groups. Adaptations included content modification based on qualitative research with caregivers of children with nodding syndrome. During the implementation component, training was shortened for feasibility with government health workers. Peer-to-peer supervision was selected as a sustainable quality assurance method. IPT-G delivered by community health workers was evaluated for fidelity, patient outcomes, and other process-level variables. More than 90% of beneficiaries completed the treatment program, which was effective in reducing caregiver and child mental health problems. With the Ministry of Health, we conducted preparatory activities for the maintenance and evolution component for scale-up throughout the country. CONCLUSIONS: The REP framework provides a systematic approach to guide contextualization of psychological treatments for delivery in low-resource public health systems. Specific recommendations are provided for REP\u27s application in global mental health. TRIAL REGISTRATION: ISRCTN11382067 ; 08/06/2016; retrospectively registered

Interference Mitigation for WCDMA using QR Decomposition and a CORDIC-based Reconfigurable Systolic Array

This paper presents implementation and performance of QR Decomposition based Recursive Least-Squares (QRD-RLS) for interference mitigation in Wideband CDMA (WCDMA). The implementation is carried on CORSAEngine which is a new Software-Defined Radio (SDR) processor developed by NEC Corporation and highly optimized for MIMO-OFDM systems. It is shown how QRD-RLS can be mapped on its rectangular CORDIC-based reconfigurable systolic array, hence demonstrating its capability to process WCDMA. In addition, the performance of CORSAEngine is compared to that of other architectures and it is found to achieve at least 91% of the performance of dedicated hardware in terms of computational density

Collaborative autoethnography and reclaiming an African episteme: investigating “customary” ownership of natural resources

Collaborative autoethnography can function as a means of reclaiming certain African realities that have been co-opted by colonial epistemes and language. This can be significant in very concrete ways: northern Uganda is suffering a catastrophic loss of tree cover, much of which is taking place on the collective family landholdings that academia and the development sector have categorized as “customary land.” A collaboration by ten members of such landholding families, known as the Acholi Land Lab, explores what “customary ownership” means to them and their relatives, with a view to understanding what may be involved in promoting sustainable domestic use of natural resources, including trees

Interactions among poverty, gender, and health systems affect women's participation in services to prevent HIV transmission from mother to child: A causal loop analysis

Retention in care remains an important issue for prevention of mother-to-child transmission (PMTCT) programs according to WHO guidelines, formerly called the ªOption B+º approach. The objective of this study was to examine how poverty, gender, and health system factors interact to influence women's participation in PMTCT services. We used qualitative research, literature, and hypothesized variable connections to diagram causes and effects in causal loop models. We found that many factors, including antiretroviral therapy (ART) use, service design and quality, stigma, disclosure, spouse/partner influence, decision- making autonomy, and knowledge about PMTCT, influence psychosocial health, which in turn affects women's participation in PMTCT services. Thus, interventions to improve psychosocial health need to address many factors to be successful. We also found that the design of PMTCT services, a modifiable factor, is important because it affects several other factors. We identified 66 feedback loops that may contribute to policy resistanceÐthat is, a policy's failure to have its intended effect. Our findings point to the need for a multipronged intervention to encourage women's continued participation in PMTCT services and for longitudinal research to quantify and test our causal loop model