The role of modelling in the policy decision making process for cancer screening : Example of prostate specific antigen screening

Funding Information: This publication was made possible by Grant Number U01 CA199338 from the National Cancer Institute as part of the Cancer Intervention and Surveillance Modeling Network, which supported the underlying development of the simulation model utilised. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the National Cancer Institute.Peer reviewe

Concentration Levels of Heavy Metals and Selected Ions in the Irrigation Water: The Case of Little Akaki River, Addis Ababa, Ethiopia

Irrigable water resources have been challenged by the contamination of heavy metals and unwanted ions that impair plant growth and human health. It impaired the quality of edible fruit & vegetables. The objective of this study was to determine the concentration of heavy metals (Pb, Cd, Cr, and Cu) and selected ions (chloride, Na, Mg, Ca), and to evaluate its suitability for irrigation use. Water samples were collected from three various locations (the upstream, middle stream, and downstream) of the river. Temperature (T), EC, pH, and total dissolved solids (TDS) were tested onsite using handheld multiparameter testing equipment, while the heavy metals (Pb, Cd, Cr, and Cu) and selected ions (Chloride, Na, Mg, and Ca) of the water sample were analyzed using (ICP-OES). ANOVA test was conducted to examine the concentration variations of heavy metals and selected ions between the sampling locations along the river. The concentrations of (Pb and Cd) were found (2.5–3.9), (0.03–0.4) mg/L respectively, and (Cr and Cu) were below the detectible limit of the (ICP-OES) equipment. Cadmium (Cd) was found to be higher than the permissible limit of FAO (0.01mg/L) for irrigation water. There was no significant variation of heavy metals and selected ions between the sampling locations

Global Antiretroviral Therapy: The Hope Within Pandora’s Box?

The vast numbers of individuals now infected with the HIV-1 virus and its spread to all corners of the globe have been well chronicled. It is difficult to convey, however, the desperation and hopelessness of the majority of those HIV-1-infected individuals that live in regions where resources are sparse. Pursuit of the unique and complex medical and societal issues relating to the HIV pandemic is globally creating a discrete area within the field of infectious disease. The consequences of the severe immunologic compromise resulting from HIV-1 infection vary from those seen in the West, both in terms of entities and their frequency. While a number of antiretroviral distribution programs are in place, the development of guidelines that simplify antiretroviral regimens, enrollment in treatment programs, and monitoring remain difficult. Furthermore, the epidemiology, response to antiretroviral therapy, and resistance patterns of non-B sybtypes await further elucidation. The goals that have been set may be compromised by concomitant endemic diseases (such as tuberculosis and malaria), unpreventable mother-to-child transmission, malnutrition, poor sanitation, inadequate public health systems, and, especially, the lack of an adequate healthcare workforce. However, awareness of these impediments is growing. The understanding of the complex and diverse economic, political and cultural forces entwined with and driving the epidemic is evolving. Finally, the need for a long-term, multifaceted response to the broad crisis in underdeveloped nations where AIDS is but one of a number of critical elements is becoming appreciated.

Maternal and perinatal mortality and morbidity of uterine rupture and its association with prolonged duration of operation in Ethiopia: A systematic review and meta-analysis.

BACKGROUND: Uterine rupture is the leading cause of maternal and perinatal morbidity and it accounts for 36% of the maternal mortality in Ethiopia. The maternal and perinatal outcomes of uterine rupture were inconclusive for the country. Therefore, this systematic review and meta-analysis aimed to estimate the pooled maternal and perinatal mortality and morbidity of uterine rupture and its association with prolonged duration of operation. METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist was used for this systematic review and meta-analysis. We systematically used PubMed, Cochrane Library, and African Journals online databases for searching. The Newcastle- Ottawa quality assessment scale was used for critical appraisal. Egger's test and I2 statistic used to assess the check for publication bias and heterogeneity. The random-effect model was used to estimate the pooled prevalence and odds ratios with 95% confidence interval (CI). RESULTS: The pooled maternal mortality and morbidity due to uterine rupture in Ethiopia was 7.75% (95% CI: 4.14, 11.36) and 37.1% (95% CI: 8.44, 65.8), respectively. The highest maternal mortality occurred in Southern region (8.91%) and shock was the commonest maternal morbidity (24.43%) due to uterine rupture. The pooled perinatal death associated with uterine rupture was 86.1% (95% CI: 83.4, 89.9). The highest prevalence of perinatal death was observed in Amhara region (91.36%) and the lowest occurred in Tigray region (78.25%). Prolonged duration of operation was a significant predictor of maternal morbidity (OR = 1.39; 95% CI: 1.06, 1.81). CONCLUSIONS: The percentage of maternal and perinatal deaths due to uterine rupture was high in Ethiopia. Uterine rupture was associated with maternal morbidity and prolonged duration of the operation was found to be associated with maternal morbidities. Therefore, birth preparedness and complication readiness plan, early referral and improving the duration of operation are recommended to improve maternal and perinatal outcomes of uterine rupture

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

The comparative effectiveness of mpMRI and MRI-guided biopsy vs regular biopsy in a population-based PSA testing: a modeling study

The benefit of prostate cancer screening is counterbalanced by the risk of overdiagnosis and overtreatment. The use of a multi-parametric magnetic resonance imaging (mpMRI) test after a positive prostate-specific antigen (PSA) test followed by magnetic resona

Does voluntary family planning contribute to food security? : evidence from Ethiopia

This study aims to explore the effects of voluntary family planning (FP) utilization on food security in selected districts of Ethiopia. Quantitative research methods were used to conduct a community-based study among a sample of 737 women of reproductive age. The data were analyzed using a hierarchical logistic regression constructed in three models. The findings showed 579 (78.2%) were using FP at the time of the survey. According to the household-level food insecurity access scale, 55.2% of households experienced food insecurity. The likelihood of food security was lower by 64% for women who used FP for less than 21 months (AOR = 0.64: 95%CI: 0.42–0.99) in comparison to mothers who used FP for more than 21 months. Households having positive adaptive behaviors were three times more likely (AOR = 3.60: 95%CI 2.07–6.26) to have food security in comparison to those not having positive adaptive behaviors. This study also revealed that almost half of the mothers (AOR: 0.51: 95%CI: 0.33–0.80) who reported being influenced by other family members to use FP had food security, in comparison to their counterparts. Age, duration of FP use, positive adaptive behaviors, and influence by significant others were found to be independent predictors of food security in the study areas. Culturally sensitive strategies need to be considered to expand awareness and dispel misconceptions that lead to hesitancy around FP utilization. Design strategies should take into account households’ resilience in adaptive skills during shocks, natural disasters, or pandemics which will be invaluable for food security

Overcoming Recruitment Challenges: A Pilot Study in Arab Americans

While diabetes prevalence and cardiovascular risk factors have been increasing among Arab populations worldwide, few studies of Arab Americans have been conducted because of the difficulty in recruiting Arab American participants. Cultural sensitivity and social awareness of different immigrant groups could ensure successful recruitment and retention in clinical studies. While the primary objective of our overall research project was to determine the prevalence of metabolic syndrome in Arab Americans, the focus of this article is to describe the methodology used to overcome challenges in recruiting and enrolling Arab Americans for a community-based study. We used novel methods, including open houses, religious-based venues, and engagement of community leaders, to encourage participation in this clinical and epidemiological study. A community-based approach involving community leaders and educators was useful in recruiting and encouraging participation in this study. As a result, we were able to collect clinical and anthropometric data from 136 Arab American men and women living in the Washington, DC, area and obtain information regarding their chronic diseases, mental health, and acculturation into U.S. culture and lifestyle. Our sampling methodology may serve as a model of a successful recruitment and enrollment strategy, and may assist other researchers to ensure sufficient power in future studies. Engagement of minority participants in clinical studies will enable the creation of targeted clinical intervention and prevention programs for underrepresented and understudied populations

Text Messages With Financial Incentives for Men With Obesity : A Randomized Clinical Trial

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