Utilization of post-abortion care services in three regional states of Ethiopia

Background: In Ethiopia, utilization of post-abortion care service is minimal and it seems that the expanding services are underutilized. The purpose of this study was to assess factors which influence decisions for utilization of abortion related services at community level.Methodology: The study was carried out in six selected districts (woredas) within the three big regions of the country, namely Amhara, Oromiya and SNNPR. The study employed a descriptive cross-sectional design. Both quantitative and qualitative study techniques, including structured interview questionnaires, focus group discussions (FGDs), and in-depth interviews. The study population comprised randomly selected 1,492 women of reproductive age, service providers, and key informants of the sampled districts.Results: Majority of respondents said that they prefer public health facilities. According to the respondents, the reason why women do not visit health facility for PAC services include lack of community support, unavailability of services, services are expensive, facilities are distantly located and lack of means of transportation. From the multivariate analysis it appears that public health facilities are preferred by younger respondents, those with no education, those with no history of unwanted pregnancy and those with better income. The qualitative study indicated that women do not go to health facilities for PAC mainly because of inappropriate treatment by providers at the health facilities. Conclusion: Public health facilities especially health centers are the most preferred but there are barriers that should improve. Introduction of supportive supervision should be considered as a tool for improving quality of care. Amechanism should be in place to obtain community opinion regularly and use it to continuously improve services. To correct some misconceptions and improve community awareness on abortion related issues community providers, including reproductive health agents and health extension workers can teach about availability of services and about abortion related complications. [Ethiop. J. Health Dev. 2010;24 Special Issue 1:123-129

Vascular risk factors and diabetic neuropathy

Background: Other than glycemic control, there are no treatments for diabetic neuropathy. Thus, identifying potentially modifiable risk factors for neuropathy is crucial. We studied risk factors for the development of distal symmetric neuropathy in 1172 patients with type 1 diabetes mellitus from 31 centers participating in the European Diabetes (EURODIAB) Prospective Complications Study. Methods: Neuropathy was assessed at baseline (1989 to 1991) and at follow-up (1997 to 1999), with a mean (±SD) follow-up of 7.3±0.6 years. A standardized protocol included clinical evaluation, quantitative sensory testing, and autonomic-function tests. Serum lipids and lipoproteins, glycosylated hemoglobin, and the urinary albumin excretion rate were measured in a central laboratory. Results: At follow-up, neuropathy had developed in 276 of 1172 patients without neuropathy at baseline (23.5 percent). The cumulative incidence of neuropathy was related to the glycosylated hemoglobin value and the duration of diabetes. After adjustment for these factors, we found that higher levels of total and low-density lipoprotein cholesterol and triglycerides, a higher body-mass index, higher von Willebrand factor levels and urinary albumin excretion rate, hypertension, and smoking were all significantly associated with the cumulative incidence of neuropathy. After adjustment for other risk factors and diabetic complications, we found that duration of diabetes, current glycosylated hemoglobin value, change in glycosylated hemoglobin value during the follow-up period, body-mass index, and smoking remained independently associated with the incidence of neuropathy. Cardiovascular disease at baseline was associated with double the risk of neuropathy, independent of cardiovascular risk factors. Conclusions: This prospective study indicates that, apart from glycemic control, the incidence of neuropathy is associated with potentially modifiable cardiovascular risk factors, including a raised triglyceride level, body-mass index, smoking, and hypertension

Factors determining the degree of commercialization of smallholder agriculture: the case of potato growers in Kombolcha District, East Hararghe, Ethiopia

Potato is one of the most valuable and widely consumed crops in the world in general and in Ethiopia in particular. Similarly, in Kombolcha District, it is among the most important crops grown for sale and consumption by smallholder farmers. Commercializing such crops does have multiple benefits for the smallholder farmers of the district as the district has great potential for commercial vegetable production and there is a growing market opportunity for the products. However, potato growing smallholders in the district are producing at a subsistence level and their participation in the market (degree of commercialization) is not only low but also varies across the district. Hence, this study was initiated to identify factors determining the extent of market participation (degree of commercialization) of potato growers. Five potato growing Peasant Associations (PAs) were selected purposively from a total of 10 Peasant Associations and subsequently 133 respondents were selected using simple random sampling from the sampling frame i.e. potato growers. A formal survey was conducted to collect data, which was supported by focus group discussions and key informant interviews. Both descriptive statistics and Robust OLS model were employed to analyze quantitative 1 Lecturer, Department of Rural Development and Agricultural Extension, Haramaya University, Ethiopia 2 Postdoctoral fellow, International Livestock Research Institute, Addis Ababa, Ethiopia 3 Professor, Department of Rural Development and Agricultural Extension, Haramaya University, Ethiopia JAD 2 (1) 2011 Factors Determining the Degree of Commercialization 19 data; whereas qualitative data were analyzed using narrations and interpretations. The OLS results indicated that farm size allocated to potato, access to irrigation and access to market information were found to be significant in affecting extent of market participation (degree of commercialization) at 1 % probability level. Hence, organizing farmers into groups in order to have better access to irrigation, providing market information through networking and institutions and improving extension service and availing improved varieties, overall, modernizing potato production are therefore crucial in enhancing the extent of market participation (the degree of commercialization)

Additive Main Effects and Multiplicative Interactions (AMMI) and genotype by environment interaction (GGE) biplot analyses aid selection of high yielding and adapted finger millet varieties

Background and justification: Lack of stable high yielding cultivars is one of the major bottlenecks for production and productivity of finger millets in Ethiopia. Identification of adaptable, stable and high yielding genotypes under varying environmental conditions prior to release as a cultivar is the first and foremost steps for plant breedingr and this has direct bearing on the adoption of the variety, its productivity and total production of the crop.Objective: The major objectives of the present study were to (i) assess the stability and yield performance of advanced finger millet genotypes  evaluated in multiple environments, and (ii) identify stable high yieldingcandidate cultivar (s) for possible release using different statistical tools.Material and methods: A total of 30 advanced finger millet genotypes were evaluated against two standard checks (Gute and Taddese) across four locations (Arsi Negele, Assosa, Bako and Gute) in 2012 and 2013 main cropping seasons. The trial was arranged in a randomized complete block design (RCBD) replicated three times.Summary result and application of the study: Additive Main effect and Multiplicative Interaction (AMMI), Genotype and Genotype by Environment interaction (GGE) biplot analysis and, Eberhart and Russellmodel revealed that Acc. 203544 is stable high yielding (3.16 ton ha-1) with a yield advantage of 13.7% over the best standard check, Gute (2.78 ton ha-1), and thus should be recommended for possible release with wider environmental adaptability. Acc. 242111 (3.08 ton ha-1), Acc. BKFM0051 (3.07 ton ha-1) and Acc.229738 (2.99 ton ha-1) were also high yielding, but showed narrow stability and thus should be recommended for verification and possible release for specific environments.Key words/phrases: Additive main effect and multiplicative interaction (AMMI), Finger millet (Eleusine coracana subsp. coracana), Genotype by Environment Interaction (GEI

High Prevalence of Microvascular Complications in Adults With Type 1 Diabetes and Newly Diagnosed Celiac Disease

Objective: The implications of celiac disease (CD) in adult patients with type 1 diabetes are unknown, with respect to diabetes-related outcomes including glycemic control, lipids, microvascular complications, quality of life, and the effect of a gluten-free diet (GFD). We identified CD in adults with type 1 diabetes and investigated the effect of a GFD on diabetes-related complications. Research design and methods: This was a case-control study conducted at a U.K. teaching hospital. Patients with type 1 diabetes aged >16 years (n = 1,000) were assessed for CD. HbA1c, lipid profile, quality of life, retinopathy stage, nephropathy stage, and degree of neuropathy before and after 1 year on a GFD were assessed. Results: The prevalence of CD was 33 per 1,000 subjects (3.3% [95% CI 2.3–4.6]). At diagnosis of CD, adult type 1 diabetic patients had worse glycemic control (8.2 vs. 7.5%, P = 0.05), lower total cholesterol (4.1 vs. 4.9, P = 0.014), lower HDL cholesterol (1.1 vs. 1.6, P = 0.017), and a higher prevalence of retinopathy (58.3 vs. 25%, P = 0.02), nephropathy (41.6 vs. 4.2%, P = 0.009), and peripheral neuropathy (41.6 vs. 16.6%, P = 0.11). There was no difference in quality of life (P > 0.1). After 1 year on a GFD, only the lipid profile improved overall, but in adherent individuals HbA1c and markers for nephropathy improved. Conclusions: Adults with undetected CD and type 1 diabetes have worse glycemic control and a higher prevalence of retinopathy and nephropathy. Treatment with a GFD for 1 year is safe in adults with type 1 diabetes and does not have a negative impact on the quality of life. Long-term microvascular and neurologic complications are responsible for major morbidity and mortality in type 1 diabetes (1). Intensive glycemic control reduces these complications and improves quality of life (1). Even patients with good glycemic control have complications, suggesting that other factors increase the risk (2). Coexisting medical problems may be a confounding factor when managing glycemic control (2). The association between celiac disease (CD) and type 1 diabetes was recognized over 30 years ago, particularly by pediatricians. The prevalence of CD in patients with adult type 1 diabetes has been reported as 1.8–8.4% (3–6). Despite a large number of prevalence studies, other important clinical factors have not been well investigated, including glycemic control, quality of life, microvascular complications, cardiac risk factors, and bone mineral density. Investigations of the effect of CD on glycemic control have been conflicting, with some studies showing improvement (7) and some deterioration (4,8) and others showing no effect (9). The difficulty in interpreting these studies is that most involve pediatric populations and are small, retrospective, and uncontrolled, leaving this question unanswered. There have been no quality-of-life assessments before and after the diagnosis of CD to assess the impact of the diagnosis and a subsequent gluten-free diet (GFD) (3). Adapting to a GFD with the restrictions of a diabetic diet may negatively impact quality of life. Peripheral neuropathy affects up to 30% of patients with adult type 1 diabetes and is a major cause of morbidity (1). Neuropathy is associated with both type 1 diabetes and CD; therefore, patients with both conditions may have a higher prevalence (10,11). In gluten-sensitive neuropathy, the pathophysiological changes lie in the humoral immune response, and a GFD seems to be beneficial (12,13). There are no studies examining neuropathy in patients with type 1 diabetes and CD or the effect of a GFD. One study examined whether CD may contribute to autonomic neuropathy in a cohort of patients with type 1 diabetes. They found no difference in the prevalence of positive antibodies in patients with and without autonomic neuropathy (14). Two previous studies have examined the effect of CD on diabetic nephropathy but were conflicting (15,16). There are currently no studies examining the prevalence of retinopathy in individuals with both type 1 diabetes and CD. Recent data in nondiabetic CD cohorts have shown a reduced risk of ischemic heart disease, possibly attributed to lower cholesterol levels and a lower prevalence of hypertension (17). Reduced bone mineral density has been associated with both CD and type 1 diabetes, but there are little data on people with both conditions (18). The aim of our study was to identify undetected CD in adult patients with type 1 diabetes and investigate the effect on diabetes-related complications before and after a GFD

Surface Hardening Vs. Surface Embrittlement in Carburizing of Porous Steels

Abstract Carburizing increases the contact fatigue resistance of sintered steels, but the surface hardening may result the formation of surface brittle cracks due to the combined effect of high hardness and porosity. The effect of carburizing on the embrittlement of the case of a 7.3 g/cm3 1.5%Mo - 0.25%C sintered steel was studied. The phenomenon was analyzed theoretically and verified by experiments. The resistance of the carburized steel to surface brittle cracking increases with the load bearing surface and the decrease of the maximum pore size, of the surface microhardness and the friction coefficient. The theoretical analysis was implemented in a design procedure for parts subject to contact stresses

Delivering new sorghum and finger millet innovations for food security and improving livelihoods in Eastern Africa

ILRI works with partners worldwide to help poor people keep their farm animals alive and productive, increase and sustain their livestock and farm productivity, and find profitable markets for their animal products. ILRI’s headquarters are in Nairobi, Kenya; we have a principal campus in Addis Ababa, Ethiopia, and 14 offices in other regions of Africa and Asia. ILRI is part of the Consultative Group on International Agricultural Research (www.cgiar.org), which works to reduce hunger, poverty and environmental degradation in developing countries by generating and sharing relevant agricultural knowledge, technologies and policies

Medication Non-Adherence among Adult Psychiatric Out-patients in Jimma University Specialized Hospital, Southwest Ethiopia

Background: Information on adherence of adult psychiatric patients to biological modes of treatment is scarce in Ethiopia. Knowledge on adherence is essential in terms of future prognosis, quality of life and functionality of such patients. This study was conducted to assess the magnitude and associated factors of non-adherence to medication.Methods: A hospital based cross-sectional study was conducted in November 2011 at the psychiatry facility of Jimma University Specialized Hospital, which provides service to more than 10 mill people. A sample of 422 adults with psychiatric illness in the follow-up outpatients was selected consecutively. Data was collected using a pre-tested questionnaire by face-to-face interview and from patient medical records. The four-item Morisky scale was used to assess degree of medication adherence. Data was analyzed using SPSS version 16 and descriptive, chi-square test and logistic regression statistical methods were used. P-Value of less than 0.05 was considered as statistically significant in the final model.Results: Out of the 422 patients, 40.3% were females and 59.7% males. The prevalence rate for nonadherence was 41.2%, non-affective psychoses diagnosis contributing the highest rate (44.5%). From the total non-adherent respondents, 78.2% attributed their non-adherence to forgetting. Irregular follow-up, poor social support and complex drug regimen were independently associated variables with nonadherence.Concluction: The result of the study showed that non-adherence among psychiatric patients in Southwest Ethiopia is high and revealed possible associated factors. Adherence needs integrated efforts in creating a mechanism in enhancing regular follow-up, informal social support system and ongoing awareness creation among professionals.Keywords: mental illness, non-adherence, Jimma University Specialized Hospital, Ethiopi