Assessing the feasibility of economic approaches to prevent substance abuse among adolescents: Protocol for a mixed methods study

BACKGROUND: Adolescent alcohol and drug use (ADU) is a significant public health challenge. Uganda, one of the poorest countries in Sub-Saharan Africa (SSA), has the second-highest rate of per capita alcohol consumption in SSA, and over one-third of Ugandan adolescents have used alcohol in their lifetime (over 50% of them engage in heavy episodic drinking). These estimates further increase in fishing villages, a key HIV-vulnerable population, where ADU is normative. However, few studies have assessed ADU among adolescents and youths living with HIV despite their increased risk for ADU and its impact on engagement in HIV care. Moreover, data on risk and resilience factors for ADU are scarce as only few studies evaluating ADU interventions in SSA have reported positive outcomes. The majority have been implemented in school settings, potentially excluding adolescents in fishing communities with high school dropout rates, and none have targeted risk factors including poverty and mental health, which are rampant among adolescents and youths living with HIV and their families, undermine their coping skills and resources, and have been associated with increased risk for ADU among them. OBJECTIVE: We propose a mixed methods study with a sample of 200 adolescents and youths living with HIV (aged 18-24 years) seen at 6 HIV clinics in southwestern Uganda\u27s fishing communities to (1) examine the prevalence and consequences of ADU and identify the multilevel risk and resilience factors associated with ADU among them and (2) explore the feasibility and short-term effects of an economic empowerment intervention on ADU among them. METHODS: This study comprises four components: (1) focus group discussions (FGDs) with adolescents and youths living with HIV (n=20) and in-depth qualitative interviews with health providers (n=10) from 2 randomly selected clinics; (2) a cross-sectional survey with 200 adolescents and youths living with HIV; (3) a randomized controlled trial with a subgroup of adolescents and youths living with HIV (n=100); and (4) 2 postintervention FGD with adolescents and youths living with HIV (n=10 per group). RESULTS: Participant recruitment for the first qualitative phase has completed. As of May 4, 2023, ten health providers from 6 clinics have been recruited, provided written consent to participate, and participated in in-depth qualitative interviews. Two FGDs was conducted with 20 adolescents and youths living with HIV from 2 clinics. Data transcription, translation, and analysis of qualitative data has commenced. The cross-sectional survey will commence shortly after and dissemination of the main study findings is targeted for 2024. CONCLUSIONS: Our findings will advance our understanding of ADU among adolescents and youths living with HIV and inform the design of future interventions to address ADU among them. TRIAL REGISTRATION: ClinicalTrials.gov NCT05597865; https://clinicaltrials.gov/ct2/show/NCT05597865. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/46486

Maternally Orphaned Children and Intergenerational Concerns Associated with Breast Cancer Deaths among Women in Sub-Saharan Africa

Importance: Low breast cancer survival in sub-Saharan Africa's young population increases the likelihood that breast cancer deaths result in maternal orphans, ie, children (<18 years) losing their mother. Objective: To estimate the number of maternal orphans and their ages for every 100 breast cancer deaths in sub-Saharan African settings during 2014-2019 and to describe family concerns about the orphaned children. Design, Setting, and Participants: Deaths occurring between September 1, 2014, and July 1, 2019, in the African Breast Cancer-Disparities in Outcomes (ABC-DO) were examined in a cohort of women diagnosed with breast cancer during 2014-2017 at major cancer treatment hospitals in Namibia, Nigeria, Uganda, and Zambia. The cohort was actively followed up for vital status via a trimonthly mobile phone call to each woman or her next of kin (typically a partner, husband, or child). Main Outcomes and Measures: The number (Poisson counts) and ages of new orphans at the time of maternal death. Results: This cohort study found that a total of 795 deaths resulted in 964 new maternal orphans, with deaths occurring in women younger than 50 years accounting for 85% of the orphans. For every 100 deaths in women younger than 50 years, there were 210 new orphans (95% CI, 196-225) overall, with country-specific estimates of 189 in Nigerian, 180 in Namibian, 222 in Ugandan, and 247 in Zambian Black women. For every 100 deaths of the women at any age, there were 121 maternal orphans, 17% of whom were younger than 5 years, 32% aged 5 to 9 years, and 51% aged 10 to 17 years at the time of maternal death. In follow-up interviews, families' concerns for children's education and childcare were reported to be exacerbated by the financial expenses associated with cancer treatment. Conclusions and Relevance: This study provides evidence that the number of maternal orphans due to breast cancer exceeds the number of breast cancer deaths among women in sub-Saharan Africa. The intergenerational consequences associated with cancer deaths in sub-Saharan Africa appear to be large and support the need for continued action to improve survival

HIV and adolescents: focus on young key populations

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/138345/1/jia20076.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/138345/2/jia20076-sup-0001.pd

The Sophistication and Diversification of the African Agricultural Sector: A Product Space Approach

We use the concept of the product space to analyze the key features of the transformation process in Africa with a focus on the agricultural sector. Between 1962 and 2008, we find that both specialization and diversification occur for the overall economy and across sectors. Our findings also confirm that the transformation of the African economy is driven primarily by the increasing specialization of nonagricultural exports. However, the transformation process is still moving more slowly than that of an emerging economy such as Brazil. The index of specialization of agricultural exports grew at a modest annual rate of 2.1 percent between 1962 and 2008, compared to 5.0 percent for nonagricultural exports and 4.1 percent for the overall economy. Although substantive achievements are observed in terms of product specialization or sophistication, the diversification of agricultural exports is rather insignificant. Compared to Africa, Brazil appears to have experienced a more balanced process in terms of both specialization and diversification of its agriculture. African countries’ specific transformation dynamics are heterogeneous, suggesting that a one-size-fits-all strategy to boost the agricultural sector in Africa is probably not the best option. Therefore, we advocate that the goals and principles of the Comprehensive Africa Agriculture Development Programme (CAADP) be adapted and customized to individual countries and incorporated into their strategies to enhance the transformation process of the African agricultural sector

Assessing the social patterning and magnitude of inequalities in sexual violence among young women in Uganda: Findings from 2016 demographic and health survey

Sexual violence (SV) is a significant global public health problem. To develop effectively targeted interventions to prevent SV and allocate resources equitably requires identifying the most vulnerable groups and the magnitude of these social inequities. However, these data are currently lacking. Using the Uganda Demographic and Health Survey, we examined SV among all young women and ever-married young women. We conducted univariate and bivariate analyses to characterise the prevalence and social patterning of SV, and then utilised the World Health Organization Health Equity Assessment Toolkit (HEAT) to assess the magnitude of social inequities in SV. At the national level, 5.5% among all young women and 20.5% of ever-married young women had experienced SV. For all young women, the largest inequities in SV were based on sub-national region of residence. Among the ever-married young women, we found profound education, wealth and place-based inequities in SV, which favoured young women with higher education, in wealthier households, and within central regions of Uganda. Our findings suggest a need for regionally targeted multi-sectoral interventions that take into consideration that multiple intersecting social dimensions such as education, poverty and the safe built environment, to address young women's risk for SV

Experiments and correlations for single-phase convective heat transfer in brazed plate heat exchangers

Copyright © 2022 The Author(s). This study presents the single-phase heat transfer and pressure drop characteristics of R1233zd(e) in a Brazed Plate Heat Exchanger (BPHE). Experiments on single-phase, water-to-water, were initially conducted and a correlation for the convective heat transfer coefficient of the hot water side was derived by applying the modified Wilson plot method. The experiments covered a range of Reynolds number from 80 to 1600 and Prandtl number from 2.8 to 7.0. Subsequent experiments were conducted with water-to-R1233zd(e) covering a refrigerant range of Reynolds number from 700 to 1450 and Prandtl number from 4.5 to 4.9. The results were used to assess existing correlations in the literature predicting the Nusselt number and Fanning friction factor in BPHEs. Finally, new correlations for both the hot (water) and cold (refrigerant) sides are proposed for single-phase heat transfer for this geometry covering the conditions above. The proposed refrigerant heat transfer correlation predicted 97% of all data within the ± 10% error bands at a mean absolute error value of 5.7%.EPSRC Grant EP/P004709/1

Complete sequence of glycolytic enzymes in the mycorrhizal basidiomycete, Suillus bovinus

Grotjohann N, Kowallik W, Thiemann M, et al. Complete sequence of glycolytic enzymes in the mycorrhizal basidiomycete, Suillus bovinus. ZEITSCHRIFT FUER NATURFORSCHUNG C-A JOURNAL OF BIOSCIENCES. 1998;53(9-10):818-827.Axenic cultures of Suillus bovinus were cultivated in inorganic liquid medium with glucose as a carbon source at 25 degrees C and continuous supply of oxygen by aeration with compressed air in the dark. Exogenous fructose as sole carbon source yielded about 50% less increase in dry weight than glucose. This resulted from different uptake velocities. Sucrose as sole exogenous carbon source yielded no measurable increase in dry weight. In glucose cultures, activities of all glycolytic enzymes were found. Maximum specific activities varied largely (from about 60 [fructose 6-phosphate kinase] to about 20 000 [triosephosphate isomerase] nmoles.mg protein(-1).min(-1)). Apparent K-m-values also varied over more than two orders of magnitude (0.035 mM [pyruvate kinase] to 6.16 mM [triosephosphate isomerase]). Fructose 6-phosphate kinase proved to be the fructose 2,6-bisphosphate-regulated type, aldolase the divalent cation-dependent (class II) type and glyceratephosphate mutase the glycerate 2,3-phosphate-independent type of the respective enzymes. Eight of the 10 enzymes exhibited pH-optima between 7.5-8.0. Triosephosphate isomerase and pyruvate kinase showed highest activities at pH 6.5. Regulatory sites within the glycolytic pathway of Suillus bovinus are discussed, fructose 6-phosphate kinase appears to be its main bottle neck