Divorce Mediation: A New Solution to Old Problems

The American Bar has traditionally operated as if the practice of law was a profession unto itself, totally unrelated to other disciplines. Fortunately, there is today a growing recognition that the law can be neither developed nor applied in a vacuum. In order to best serve the needs of one\u27s clients and of the legal system as a whole it is necessary to draw upon knowledge evolved in other fields such as economics, history, sociology and psychology. Divorce, for example, is a phenomenon with not only legal but also broad sociological and psychological implications which must be considered in any attempt at problem solving and reflected in the solution. The recent development of divorce mediation as a viable alternative to traditional divorce processes is an example of this philosophy at its best

Bridging the Gap: Using Microsociological Theory to Understand How Expressed Emotion Predicts Clinical Outcomes

Research has shown that EE among families is a strong predictor of relapse for people with severe mental illness. Recent studies have also found the presence of EE in consumer-provider relationships. Despite high consistency in the findings related to EE and relapse, the concept has weak validity as little is known about how exactly it triggers relapse. Microsociological theory provides a framework with which to analyze social interaction and, more specifically, understand how interactions relate to the emotions of pride and shame. By identifying the components of interaction rituals, the theory provides insight into the key processes underlying EE and demonstrates how methodologies based on direct observation have the potential to measure EE with greater validity. This article describes how microsociological theory can be applied to the concept of expressed emotion (EE)

Political Ambition: Where Are All the Women?

Why do so few women hold elected office on local government bodies? The answer to this question encompasses a combination of barriers to running for office. The research discussed in this article involved two surveys conducted in Wisconsin. The findings indicate that in addition to systemic barriers, such as time away from work, many women are hesitant to serve on local governing bodies for other reasons, including concerns related to confidence and potentially inaccurate perceptions. This cautiousness was not as evident in male potential candidates. Understanding the barriers women face may inform how Extension educators work to address skewed compositions of local governing bodies as part of capacity-building efforts

Economic Contribution of Forest Leafy Vegetables Marketing in Uyo, Nigeria

Forest leafy vegetable (FLV) are edible part of indigenous plant which are harvested from within and on the fringes of natural, manipulated or disturbed forest. But little is known and documented about their commercial performance and developmental linkages. This study therefore examines the economic contribution of forest leafy vegetables to the livelihood of dwellers in Uyo LGA of Akwa Ibom State. Structure questionnaire was used to elicit information from 105 purposefully selected marketers from six (6) markets namely Akpan andeme, Ikot oku, Itam, Ikpa junction, Nung udoe and Itak uyo. Information gathered was subjected to descriptive statistical analysis of simple proportions and percentages, while simple cost analysis of profit and rate of return on investment was also carried out for economic evaluation.Result showed that startup capital rang between N1, 000- N10, 000. Among the nine (9) FLV marketed Gnetum africana has the highest profit per kg (N191.50) and Vernonia amygdalina has the lowest profit margin per kg (N79.19). The most traded FLV are Gnetum africana (Afang) and Lasianthera africana (Editan). The highest rate of return on investment was found at Itam market with a rate of 51.52% while Akpan andeme has (47.76%), Ikot oku (50.73), Ikpa junction (49.55%), Itak uyo (49.81%), and Nung udoe (45.99%).The threats to the marketing of FLVs are seasonality and perishability of products as well as sustainability of production because most FLV are collected from the wild and not planted. In other to sustain this livelihood activity, it is recommended that domestication of FLVs be encourage among farmers and home gardens in the community. Keywords: Forest Leafy Vegetables (FLVs), Marketing, Profitability and livelihood

Clinical profile and initial treatment of non-small cell lung cancer: a retrospective cohort study at the Uganda Cancer Institute

Introduction: Lung cancer is a major global public health burden constituting 11.6% of all new cancer diagnoses and 18.4% of all cancer-related mortality. Purpose: To describe the clinical profile and initial treatment of non-small cell lung cancer in Uganda. Methods: We reviewed charts of a cohort of patients with a histologically confirmed diagnosis of non-small cell lung cancer, treated between January 2013 and November 2015 at the Uganda Cancer Institute. Results: A total of 74 patients met the inclusion criteria. The median age was 56 years (IQR 47-70), with 16.2% below the age 45 years, and 51% were female. Only 10 percent were active smokers and the most frequent histological subtype was adenocarcinoma (71%). The majority (91.9%) had stage IV disease at diagnosis and frequent metastases to contralateral lung, liver, and bones. Twenty-seven (27) patients received platinum-based chemotherapy, while 27 patients received erlotinib, and only 4 patients received palliative thoracic radiotherapy. The median survival time was 12.4 months, and the overall response rate was 32.7%. There was no survival difference by type of systemic treatment, and on multivariate analysis, poor performance status was predictive of adverse outcomes (p < 0.001). Conclusions: Patients with non-small cell lung cancer in Uganda frequently presented with late-stage disease at diagnosis. The majority of patients were female, never-smokers, and had predominantly adenocarcinoma subtype. Keywords: Non-small cell lung cancer; Uganda; erlotinib; lung cancer; Uganda Cancer Institute

Anthracycline induced cardiotoxicity in adult cancer patients: a prospective cohort study from a specialized oncology treatment centre in Uganda

Purpose: To determine the cumulative incidence of anthracycline induced cardiotoxicity (AIC), its predictors, and associated electrocardiographic and echocardiographic manifestations in adult cancer patients at Uganda Cancer Institute (UCI). Methods: We enrolled 160 participants between June 2013 and April 2014 and followed them up for a median of 146 days. Data on clinical, electrocardiographic and echocardiographic findings was obtained at baseline, and at completion of chemotherapy. The Pearson chi square test was used to identify the predictors associated with cardiotoxicity. Results: Of the 64 patients who were accessible for follow-up electrocardiography (ECG) and echocardiography (ECHO), fourteen participants developed cardiotoxicity hence a cumulative incidence rate of 21.9% with 95% CI 13.5%- 33.43%. The predictors of AIC were female gender (p=0.025), LVEF (p=0.014) and LVFS (P=0.019). Anthracycline therapy was associated with shortening of the QRS duration (84.3\ub17.9 Vs 82.1\ub111.8 ms, p=0.005), prolongation of the QTc interval (411.9\ub130.7 Vs 447.2\ub139.4 ms, p=<0.001) and reduction in the LVEF (66.4\ub17.7 Vs 63.9\ub18.4%, p=0.026) and LVFS (36.9\ub16.2 Vs 35.1\ub16.6%, p=0.03). Conclusion: The cumulative incidence of AIC in this study cohort was high. Our findings emphasize the need for early monitoring for AIC. DOI: https://dx.doi.org/10.4314/ahs.v19i1.40 Cite as: Kibudde S, Mondo CK, Kibirige D, Walusansa V, J O. Anthracycline induced cardiotoxicity in adult cancer patients: a prospective cohort study from a specialized oncology treatment centre in Uganda. Afri Health Sci. 2019;19(1). 1647-1656. https://dx.doi.org/10.4314/ahs. v19i1.4

Anthracycline induced cardiotoxicity in adult cancer patients: a prospective cohort study from a specialized oncology treatment centre in Uganda.

PURPOSE: To determine the cumulative incidence of anthracycline induced cardiotoxicity (AIC), its predictors, and associated electrocardiographic and echocardiographic manifestations in adult cancer patients at Uganda Cancer Institute (UCI). METHODS: We enrolled 160 participants between June 2013 and April 2014 and followed them up for a median of 146 days. Data on clinical, electrocardiographic and echocardiographic findings was obtained at baseline, and at completion of chemotherapy. The Pearson chi square test was used to identify the predictors associated with cardiotoxicity. RESULTS: Of the 64 patients who were accessible for follow-up electrocardiography (ECG) and echocardiography (ECHO), fourteen participants developed cardiotoxicity hence a cumulative incidence rate of 21.9% with 95% CI 13.5%-33.43%. The predictors of AIC were female gender (p=0.025), LVEF (p=0.014) and LVFS (P=0.019). Anthracycline therapy was associated with shortening of the QRS duration (84.3±7.9 Vs 82.1±11.8 ms, p=0.005), prolongation of the QTc interval (411.9±30.7 Vs 447.2±39.4 ms, p=<0.001) and reduction in the LVEF (66.4±7.7 Vs 63.9±8.4%, p=0.026) and LVFS (36.9±6.2 Vs 35.1±6.6%, p=0.03). CONCLUSION: The cumulative incidence of AIC in this study cohort was high. Our findings emphasize the need for early monitoring for AIC