Awareness of Breast Cancer and Its Early Detection Measures Among Female Students, Northern Ethiopia

Globally breast cancer is the most common of all cancers. Since risk reduction strategies cannot eliminate the majority of breast cancers, early detection remains the cornerstone of breast cancer control. This paper, therefore, attempts to assess the awareness of breast cancer and its early detection measures among female students in Mekelle University, Ethiopia. An institution based cross-sectional study was conducted on randomly selected female students. Multistage sampling technique was employed to select the participants. A pre-tested structured questionnaire was used. Data analysis was carried out using SPSS version 16. In this study, 760 students participated making a response rate of 96 percent. Respondents with good knowledge score for risk factors, early detections measures and warning signs of breast cancer were 1.4 percent, 3.6 percent and 22.1 percent respectively. The majority 477 (62.8 percent) of participants practiced self-breast examination. In conclusion the participants had poor knowledge of risk factors, early detection measures and early warning signs of breast cancer.Therefore, the Ministry of health of Ethiopia together with its stalk holders should strengthen providing IEC targeting women to increase their awareness about breast cancer and its early detection measure

Examining the Factors that Mediate the Relationship from Legal Advocacy Satisfaction to Resilience

Sexual assault is a public health issue that can impact one’s resilience. Using a multisystemic approach to resilience, there may be person-level and environment-level factors that can affect one’s resilience, such as one’s coping self-efficacy, satisfaction with the court process, and negative effects associated with court process. Legal advocacy programs, such as those offered by the King County Sexual Assault Resource Center (KCSARC), support clients during the court proceedings. In order to better serve KCSARC’s clientele, it is helpful to understand how the legal advocacy program impacts post-trauma resilience. This dissertation had three phases: (a) evaluating the structural validity of secondary victimization, resilience, and psychological stress measures; (b) conducting a serial mediation to see if court outcome satisfaction, secondary victimization, and sexual assault coping self-efficacy mediated the relationship between legal advocacy satisfaction on resilience; and (c) determining if race/ethnicity moderated the serial mediation. Participants were at least 13 years old, cis-women clients in the KCSARC legal advocacy program who spoke English (N = 87). Although the design of the program evaluation is longitudinal, data was taken from only one of the waves that the participant completed. The psychometric evaluation of the secondary victimization, resilience, and psychological stress measures in this dissertation supported their use in similar settings. Results suggested a significant indirect effect from legal advocacy satisfaction to resilience, through court outcome satisfaction, secondary victimization, and resilience. Even though the moderated serial mediation was statistically non-significant, results indicated that the mechanism was statistically significant for White/Caucasian participants, but not for Racial/Ethnic Minorities. Legal advocates may better serve their clients by having information specifically related to court outcomes and psychoeducation on secondary victimization; and by improving their relationship with their clients to notice the signs of secondary victimization and highlight their client’s coping self-efficacy and resilience. Limitations include self-selection bias, completion rates, artificially inflated fit indices associated with allowing errors to covary, and confounding variables associated COVID-19 pandemic. Future research should focus on validating the measures used across demographic factors and analyzing changes in variables over time

Fibroblast Apoptosis Induced by Porphyromonas Gingivalis is Stimulated by a Gingipain and Caspase-Independent Pathway that Involves Apoptosis-Inducing Factor

Porphyromonas gingivalis is an oral bacterium that causes pathology in a number of dental infections that are associated with increased fibroblast cell death. Studies presented here demonstrated that P. gingivalis stimulates cell death by apoptosis rather than necrosis. Unlike previous studies apoptosis was induced independent of proteolytic activity and was also independent of caspase activity because a pan-caspase inhibitor, Z-VAD-fmk, had little effect. Moreover, P. gingivalis downregulated caspase-3 mRNA levels and caspase-3 activity. The consequence of this downregulation was a significant reduction in tumour necrosis factor-α-induced apoptosis, which is caspase-3-dependent. Immunofluorescence and immunoblot analysis revealed P. gingivalis-induced translocation of apoptosis-inducing factor (AIF) from the cytoplasm to the nucleus. siRNA studies were undertaken and demonstrated that P. gingivalis stimulated cell death was significantly reduced when AIF was silenced (P \u3c 0.05). Treatment of human gingival fibroblasts with H-89, a protein kinase A inhibitor that blocks AIF activation also reduced P. gingivalis-induced apoptosis (P \u3c 0.05). These results indicate that P. gingivalis causes fibroblast apoptosis through a pathway that involves protein kinase A and AIF, is not dependent upon bacterial proteolytic activity and is also independent of the classic apoptotic pathways involving caspase-3

Incidence of neonatal morbidity at Gondar Town, Ethiopia

A CAJM article on rates of infant mortality in Gondar, Ethiopia.Perinatal, neonatal and infant mortality rates are now recognized indicators of child health in many countries and regions of the world. To this effect, there are numerous epidemiological and clinical studies that have focused on the causes of perinatal, neonatal and infant mortality in a given community or country. But, information on neonatal morbidity rates are not generally available.' The very limited data on neonatal morbidity also have problems of definition and are not as unambiguous and comprehensive as are the indices of mortality. Morbidity health interview surveys are widely used in developed countries to obtain information about sickness, disability, and the use of health facilities. An alternative method for collecting morbidity information is a survey based on physical examination where subjects are expected to attend a clinic or to be examined in their dwelling places. Use of clinical medical records also provide information on health as the need arises. Each of these systems of collecting information have their own advantages and disadvantages

Probenecid‐Boosted Tenofovir: A Physiologically‐Based Pharmacokinetic Model‐Informed Strategy for On‐Demand HIV Preexposure Prophylaxis

Multiple doses of tenofovir disoproxil fumarate (TDF) together with emtricitabine is effective for HIV preexposure prophylaxis (PrEP). TDF is converted to tenofovir (TFV) in circulation, which is subsequently cleared via tubular secretion by organic ion transporters (OATs; OAT1 and OAT3). Using in vitro kinetic parameters for TFV and the OAT1 and OAT3 inhibitor probenecid, a bottom‐up physiologically‐based pharmacokinetic model was successfully developed for the first time that accurately describes the probenecid–TFV interaction. This model predicted an increase in TFV plasma exposure by 60%, which was within 15% of the observed clinical pharmacokinetic data, and a threefold decrease in renal cells exposure following coadministration of a 600 mg TDF dose with 2 g probenecid. When compared with multiple‐dose regimens, a single‐dose probenecid‐boosted TDF regimen may be effective for HIV PrEP and improve adherence and safety by minimizing TFV‐induced nephrotoxicity by reducing TFV accumulation in renal cells

Evaluation of pre-service training on integrated management of neonatal and childhood illness in Ethiopia

Background: The Integrated Management of Newborn and Childhood Illness strategy equips health workers with essential knowledge and skills to effectively manage sick children with common neonatal and childhood diseases. Since in-service training is very demanding to achieve the desired coverage of training of health workers, pre-service training is taken as a solution. At the time of the survey, most public and some private health professionals’ training institutions were conducting pre-service training. However, several concerns have been expressed on the training. Therefore, this survey was conducted to assess the status of pre-service Integrated Management of New-born and Childhood Illness training. Methods: A cross sectional survey on health professional training institutes/schools to evaluate pre-service Inte-grated Management of Newborn and Childhood Illness training was conducted in November 2007. Data was col-lected using pre-tested questionnaires, focused group interviews with teachers and students, observation of stu-dents while managing sick children using Integrated Management of Newborn and Childhood Illness guidelines, and reviews of pediatric course outlines and other teaching/learning materials. Data was entered in computer and analyzed using SPSS for Windows version 12.0.1. Results: Twenty nine health professionals’ training institutions (34 academic programs) which have started pre-service training were included in the survey. Of the 34 programs 22 were diploma nursing, 6 Bachelor of Sciences nursing, 4 health officer and the remaining two medicine. Thirty (88.2%) programs have integrated it in their cur-riculum. All academic programs had at least one fulltime staff for Integrated Management of Newborn and Child-hood Illness classroom instruction. Twenty nine (85.3%) programs had staff trained in case management skills. All the 34 academic programs taught health workers skills, 28(82.3%) used mixed approach. Integrated Management of Newborn and Childhood Illness was either incorporated for 21 (61.8%) or added to the previous teaching 11 (32.3%). The instructor to student ratio was low for most of the schools. Main challenges encountered in the pre-service teaching were constraints with trained staff and other resources each by 28 (82.3%) programs. Integrated Management of Newborn and Childhood Illness was included in student evaluation by all programs (100%). All students and instructors (100%) rated that Integrated Management of Newborn and Childhood Illness concept is very relevant or extremely relevant but majority said the time given was short. The over all mean score of students clinical practice was 63.5%. Conclusion: This study demonstrated that Integrated Management of Newborn and Childhood Illness was intro-duced into the teaching programs of most health professional training institutions. The most preferred teaching style was the mixed approach. Group discussion and demonstration were commonly used methods and Integrated Management of Newborn and Childhood Illness questions were included in students’ evaluation in almost all pro-grams. Shortage of IMNCI trained staff and teaching materials were major challenges. The use of teaching materi-als prepared for pre-service training like handbook and model chapter was limited. Instructors and students atti-tude towards IMNCI was very good. The students overall performance in managing sick child as per the IMNCI guidelines was above average. We recommend that the respective bodies at every level make every effort to strengthen IMNCI pre-service teaching through revisiting curricula, facilitating staff training, availing teaching materials and allocating adequate time. Exploring for an alternative/innovative and sustainable training approach is an assignment for all

Clinical and educational impact of pharmacogenomics testing: a case series from the INGENIOUS trial

Pharmacogenomic testing has become increasingly widespread. However, there remains a need to bridge the gap between test results and providers lacking the expertise required to interpret these results. The Indiana Genomics Implementation trial is underway at our institution to examine total healthcare cost and patient outcomes after genotyping in a safety-net healthcare system. As part of the study, trial investigators and clinical pharmacology fellows interpret genotype results, review patient histories and medication lists and evaluate potential drug-drug interactions. We present a case series of patients in whom pharmacogenomic consultations aided providers in appropriately applying pharmacogenomic results within the clinical context. Formal consultations not only provide valuable patient care information but educational opportunities for the fellows to cement pharmacogenomic concepts

Retrospective Assessment of Malnutrition Among Under-five Children in Ayder Referral Hospital, Tigray Ethiopia

Currently worldwide there are about 60 million children with moderate acute and 13 million with severe acute malnutrition. About 9% of sub-Saharan African and 15%of south Asian children have moderate acute malnutrition and about 2% of children in developing countries have severe acute malnutrition. The objective of aim the study was to assess the magnitude of malnutrition in under five children in Ayder referral hospital using a retrospective cross-sectional study design. This study showed that male children, 168(58.1%), were higher than female, 121(41.9%).. Majority, 133(46%), were in the age group b/n 12 to 24 months .More than half, 186(64.4%) were rural dwellers. The types of malnutrition identified were Marasmus, kwashiorkor, Marasmic kwash and underweight which account for 116(40.1%), 69(23.9%), 54(18.7%) and 50(17.5%) respectively. Marasmus was the predominant type of malnutrition in all age groups of under five malnourished children with prevalence of 40.1% where as underweight was the prevalent type of malnutrition (17.3%). More over the infant feeding practices such as exclusive breast feeding, timely initiation of complementary feeding, and having history of breast feeding once in their life during infancy were relatively higher among the children as compared with other studies