Aiding Screening, Diagnosis, and Management of Prediabetes Among High-Risk Medicare Patients in a Primary Care Setting

Purpose: Encourage prediabetes screening, testing, and referral to a CDC-recognized Diabetes Prevention Program (DPP) as a first-line treatment. Background: The prevalence of diabetes and prediabetes incidence is highest among Medicare-eligible Washingtonian patients, with 19% and 16%, respectively. DPP results in a 71% reduction of diabetes incidence in 65 years and older. However, only 3% of healthcare sites screen, test, and refer to DPP. Design: Quality assessment with a descriptive quantitative evaluation method was conducted using Retrospective Chart Review for patients who visited Franciscan primary clinics from 08/31/2019 to 08/31/2020. A total of 1250 Medicare patients were extracted from a convenient sample. Risk factors for prediabetes were identified for 224 patients, including, a first-degree family history of diabetes, history of hypertension, age, race/ethnicity, physical activity, sex, history of gestational diabetes, height, and weight and were entered into the online American Diabetes Association prediabetes risk-test. The number of patients who fulfilled the criteria for a diagnosis of prediabetes based on Fasting Plasma Glucose, Glycated Hemoglobin A1c and Random Glucose was 685. Four patients had mixed laboratory results and were excluded; the remaining 681 were considered for prediabetes management. The number of patients who did not fulfill laboratory criteria for prediabetes was 565. Results: All the 224 patients (100%) had risk-test scores of at least 5. The prevalence of misdiagnosis of blood glucose was 45.2%. All of the 681 patients (100%) meeting requirements of prediabetes were not referred to DPP. Only 26 patients (3.8%) were managed by either metformin (3.1%) or referral to diabetes education (0.7%). Conclusion: Medicare patients at high risk are not routinely screened, tested, and managed by DPP, metformin, or diabetes education. Implication: Practice change needs assessment of PCP awareness about diabetes risk-test, prediabetes laboratory parameters, and management by referral to DPP

Contribution of Exclosures for Restoration of Woody Species Diversity and Regulating Ecosystem Services in Ethiopia

In Ethiopia Exclosures has been recognized as promising practice in the restoration of degraded land and regulating the environmental services. Though, study on the role of exclosures on rehabilitating of degraded land is very little, fragmented and doesn’t often integrate the regulating environmental services. To scale up this practices insight to the Ethiopian level, I carry out reviewing different research articles on the role of exclosure to biodiversity of woody species and regulating ecosystem services. The review of this study showed that exclosure significantly enhanced woody species diversity; reducing soil erosion, improve Soil nutrient contents and the ecosystem carbon stock potential over the adjacent communal grazing lands. In addition to this establishing exclosures has a high contribution to the livelihood of local communities. As a result the local communities have a positive attitude towards the establishment of exclosures in the degraded lands. Overall review from this study strongly indicates that establishment of exclosures in the degraded lands of Ethiopia are a win-win situation since it is advantageous over the people, natural and climate of the country. However, by involving the key stakeholders the governmental and nongovernmental organizations (NGOs’) should have to expand this practice to whole degraded lands of the country. Keywords: Climate change mitigation, Enclosure, Degradation, Rehabilitations, Restoratio

Review on Contribution of Exclosures for Restoration of Woody Species Diversity and Regulating Ecosystem Services in Ethiopia

In Ethiopia Exclosures has been recognized as promising practice in the restoration of degraded land and regulating the environmental services. Though, study on the role of exclosures on rehabilitating of degraded land is very little, fragmented and doesn’t often integrate the regulating environmental services. To scale up this practices insight to the Ethiopian level, I carry out reviewing different research articles on the role of exclosure to biodiversity of woody species and regulating ecosystem services. The review of this study showed that exclosure significantly enhanced woody species diversity; reducing soil erosion, improve Soil nutrient contents and the ecosystem carbon stock potential over the adjacent communal grazing lands. In addition to this establishing exclosures has a high contribution to the livelihood of local communities. As a result the local communities have a positive attitude towards the establishment of exclosures in the degraded lands. Overall review from this study strongly indicates that establishment of exclosures in the degraded lands of Ethiopia are a win-win situation since it is advantageous over the people, natural and climate of the country. However, by involving the key stakeholders the governmental and nongovernmental organizations (NGOs’) should have to expand this practice to whole degraded lands of the country

DETERMINANTS OF POSTNATAL CARE SERVICE UTILIZATION AMONG REPRODUCTIVE AGE WOMEN IN BASSO LIBEN WOREDA, NORTH WEST ETHIOPIA

Objectives: The objective of the study is to assess the determinants of postnatal care service utilization among reproductive age women in Basso Liben woreda. Methods: The data were collected from a representative sample of 374 populations using systematic sampling technique. The major strategy of the study was mixed approach. In quantitative study, the data were collected using structure questionnaires. The study participants were women of reproductive age (15–49 years) who gave birth in the past 2 years before the study. The dependent variable is utilization of at least one postnatal care visit within 6 weeks of delivery. Bivariate and multivariate analyses were employed to determine the association between dependent and independent variables. Results: From the total respondents, 37.7% of the mother and 20.3% of newborn had gotten postnatal checkup within the first 6 weeks, respectively. From PNC users, 51.1% of the mother and 47.4% of the newborn had utilized PNC 1 time, respectively. Based on multivariate analysis maternal education, number of ANC follow-up, PNC information before delivery, monthly income, place of delivery, and attendant during delivery have statistically significance association with postnatal health-care service utilization. Conclusion: The use of postnatal care service utilization is still limited in the study area. Only 37.7% of the mother and 20.3% of newborn had gotten postnatal checkup. Establishing qualified health facility around the area, expanding transport accessibility, and providing vehicles like ambulances that used to take mothers in the health facility are used to improve postnatal care service utilization

Association Pattern Discovery of Import Export Items in Ethiopia

This paper examines the application of data mining to detect association pattern of customs administration data with market price and currency rate exchange in Ethiopia. The association rule method of data mining is used in this paper to generate the interesting pattern from the data. This study was done to identify the relationships between attributes of custom data and market price to clearly understand the nature of import-export items in Ethiopia. The results of the experiments carried out using association rules revealed that the technique of data mining is applicable to generate knowledge from import and export items in custom administration. Algorithms such as Apriori, Tertius, PredictiveApriori and FliteredApriori were used to generate the associations. One of the resulting associations indicates that there is a strong link between market price and textiles imported. The implication of this research finding is that it clearly identified the association of import-export items with the market price and the effects of those items on the market price and currency rate in Ethiopia

Assessing the implementation of quality assurance policy in Ethiopian higher education institutions

In Ethiopia, quality assurance in higher education is one of the government's top priorities, just like in other developing nations. This thesis assesses the implementation of quality assurance (QA) policies in Ethiopian public higher education. More specifically, it concentrates on determining the effectiveness of quality assurance practices and identifying implementation gaps in line with HERQA/ETA focus areas. The key research questions were: „how and under what conditions do public universities in Ethiopia execute ETA quality assurance policies, and what contextual factors influence QA policy implementation?‟ The study is based on the concept that student learning is at the heart of universities‟ educational purpose, and that focusing on the key educational processes and situations that impact student learning quality makes QA procedures more successful. The study was based on a conceptual framework comprising important concepts in contingency and institutional theories, as well as quality assurance approaches. Two organisational theories, contingency theory, and neo-institutional theory were used to provide a theoretical lens for explaining how internal and external organisational settings impact the implementation of QA policies at HEIs. The study employed a qualitative research approach, which included semi-structured interviews, textual open-ended questions, and document analysis. Purposive sampling was used to choose four public institutions as data sources. The ETA and MoE were also added at the macro level to analyse the impact of institutional contexts on institutional quality audit practices. The findings show that the implementation of QA policies was not conceptualised in public higher education at large and that reality on the ground differs from the literature generated on the science of QA, instead being applied partially in public institutions. They lack proper QA structures, processes, and documented policies. The QA initiatives were carried out without a clear sense of direction and objectives, resulting in ineffective coordination. Self-evaluations were held symbolically at higher levels of institutions, and the outcomes of the evaluations were seldom used in an organised manner to enhance teaching-learning, faculty decision-making and planning processes. It might be inferred that the ETA‟s quality assurance policies appear to be disconnected from internal quality improvement programmes in HEIs. It is suggested that HEIs design institutional quality QA policies, mobilise resources for institutional quality development, construct fully-fledged QA structures at all levels, and staff the structures with the appropriate human resources. HEIs should begin and carry out effective self- assessment of their operations, own it, and strive towards achieving their stated goals. It is critical that the ETA creates accreditation mechanisms for public HEIs, particularly at the institutional level. The ETA should be more independent, with greater autonomy and adequate resources to become a sustainable professional agency supporting the HE sectors.Educational Leadership and ManagementD. Phil. (Education (Education Management)

The von Economo neurons in frontoinsular and anterior cingulate cortex in great apes and humans

The von Economo neurons (VENs) are large bipolar neurons located in frontoinsular (FI) and anterior cingulate cortex in great apes and humans, but not other primates. We performed stereological counts of the VENs in FI and LA (limbic anterior, a component of anterior cingulate cortex) in great apes and in humans. The VENs are more numerous in humans than in apes, although one gorilla approached the lower end of the human range. We also examined the ontological development of the VENs in FI and LA in humans. The VENs first appear in small numbers in the 36th week post-conception, are rare at birth, and increase in number during the first 8 months after birth. There are significantly more VENs in the right hemisphere than in the left in FI and LA in postnatal brains of apes and humans. This asymmetry in VEN numbers may be related to asymmetries in the autonomic nervous system. The activity of the inferior anterior insula, which contains FI, is related to physiological changes in the body, decision-making, error recognition, and awareness. The VENs appear to be projection neurons, although their targets are unknown. We made a preliminary study of the connections of FI cortex based on diffusion tensor imaging in the brain of a gorilla. The VEN-containing regions connect to the frontal pole as well as to other parts of frontal and insular cortex, the septum, and the amygdala. It is likely that the VENs in FI are projecting to some or all of these structures and relaying information related to autonomic control, decision-making, or awareness. The VENs selectively express the bombesin peptides neuromedin B (NMB) and gastrin releasing peptide (GRP) which are also expressed in another population of closely related neurons, the fork cells. NMB and GRP signal satiety. The genes for NMB and GRP are expressed selectively in small populations of neurons in the insular cortex in mice. These populations may be related to the VEN and fork cells and may be involved in the regulation of appetite. The loss of these cells may be related to the loss of satiety signaling in patients with frontotemporal dementia who have damage to FI. The VENs and fork cells may be morphological specializations of an ancient population of neurons involved in the control of appetite present in the insular cortex in all mammals. We found that the protein encoded by the gene DISC1 (disrupted in schizophrenia) is preferentially expressed by the VENs. DISC1 has undergone rapid evolutionary change in the line leading to humans, and since it suppresses dendritic branching it may be involved in the distinctive VEN morphology

Porphyrin binding mechanism is altered by protonation at the loops in G-quadruplex DNA formed near the transcriptional activation site of the human c-kit gene

Background: G-quadruplex DNA structures are hypothesized to be involved in the regulation of gene expression and telomere homeostasis. The development of small molecules that modulate the stability of G-quadruplex structures has a potential therapeutic interest in cancer treatment and prevention of aging. Methods: Molecular absorption and circular dichroism spectra were used to monitor thermal denaturation, acid base titration and mole ratio experiments. The resulting data were analyzed by multivariate data analysis methods. Surface plasmon resonance was also used to probe the kinetics and affinity of the DNA-drug interactions. Results: We investigated the interaction between a G-quadruplex-forming sequence in the human c-kit proto-oncogene and the water soluble porphyrin TMPyP4. The role of cytosine and adenine residues at the loops of G-quadruplex was studied by substitution of these residues by thymidines. Conclusions: Here, we show the existence of two binding modes between TMPyP4 and the considered G-quadruplex. The stronger binding mode (formation constant around 107) involves end-stacking, while the weaker binding mode (formation constant around 106) is probably due to external loop binding. Evidence for the release of TMPyP4 upon protonation of bases at the loops has been observed. General significance: The results may be used for the design of porphyrin-based anti-cancer molecules with a higher affinity to G-quadruplex structures which may have anticancer properties. © 2012 Elsevier B.V.This research was supported by the Spanish Ministerio de Ciencia e Innovación (grant numbers CTQ2009-11572 and CTQ2010-20541-C03-01), and the Generalitat de Catalunya (grant numbers 2009-SGR-45 and 2009- SGR-208).Peer reviewe

Selective Rapid Eye Movement Sleep Deprivation Affects Cell Size and Number in Kitten Locus Coeruleus

Cells in the locus coeruleus (LC) constitute the sole source of norepinephrine (NE) in the brain and change their discharge rates according to vigilance state. In addition to its well established role in vigilance, NE affects synaptic plasticity in the postnatal critical period (CP) of development. One form of CP synaptic plasticity affected by NE results from monocular occlusion, which leads to physiological and cytoarchitectural alterations in central visual areas. Selective suppression of rapid eye movement sleep (REMS) in the CP kitten enhances the central effects of monocular occlusion. The mechanisms responsible for heightened cortical plasticity following REMS deprivation (REMSD) remain undetermined. One possible mediator of an increase in plasticity is continuous NE outflow, which presumably persists during extended periods of REMSD. Tyrosine hydroxylase (TH) is the rate-limiting enzyme in the synthesis of NE and serves as a marker for NE-producing cells. We selectively suppressed REMS in kittens for 1 week during the CP. The number and size of LC cells expressing immunoreactivity to tyrosine hydroxylase (TH-ir) was assessed in age-matched REMS-deprived (RD)-, treatment–control (TXC)-, and home cage-reared (HCC) animals. Sleep amounts and slow wave activity (SWA) were also examined relative to baseline. Time spent in REMS during the study was lower in RD compared to TXC animals, and RD kittens increased SWA delta power in the latter half of the REMSD period. The estimated total number of TH-ir cells in LC was significantly lower in the RD than in the TXC kittens and numerically lower than in the HCC animals. The size of LC cells expressing TH-ir was greatest in the HCC group. HCC cells were significantly larger than TH-ir cells in the RD kittens. These data are consistent with presumed reduction in NE in forebrain areas, including visual cortex, caused by 1 week of REMSD

Intestinal parasitic infections among under-five children and maternal awareness about the infections in Shesha Kekele, Wondo Genet, Southern Ethiopia

Background: Few studies have reported the magnitude of intestinal parasitic infections among under-five children in tropical countries. Moreover, there is little information on maternal awareness about intestinal parasitosis.Objective: To determine the prevalence of intestinal parasitosis among under-five children, and assess maternal awareness about it in Shesha Kebkele, Wondo Genet, Southern Ethiopia.Methods: A cross-sectional study involving 288 under-five children was conducted and stool samples were collected and examined for intestinal parasites using Kato-Katz and formol-ether concentration methods. In addition, a total of 130 mothers of under-five children were interviewed regarding their awareness about intestinal parasitic infections.Results: Of the 288 children, 245 (85.1%) were found infected with one or more intestinal parasites. The prevalence of Trichuris trichiura, Schistosoma mansoni and Ascaris lumbricoides, hookworm, and Hymenolepis nana infections as determined by Kato-Katz were 74.7%, 37.2%, 25.7%, 5.9%, and 4.5%, respectively. On the other hand, theprevalence of Strongyloides stercoralis, Giardia lamblia, Entamoeba histolytica/dispar, and Entamoeba coli infections as determined by formol-ether concentration method were 0.69%, 13.2%, 0.35%, and 2.1%, respectively. Most mothers were reasonably aware of the mode of transmission of ascariasis, amoebiasis and giardiasis while they hadvery limited knowledge of bilharzia and hookworm transmission. Almost all of the respondents reported that infections with intestinal parasites could cause retardation of growth and death in children unless treated.Conclusion: Intestinal parasitic infections were prevalent in varying magnitude among under-five children in Wondo Genet area, Southern Ethiopia. Mothers in the study area had a fairly good knowledge of the impact of infections but limited knowledge of the mode of transmission of intestinal parasitic infections. Improvement of sanitation and healtheducation are required besides preventive chemotherapy to control worms (except for schistosomiasis in under-five which need treatment on an individual basis) and other intestinal parasitic infections in the area