Interplay between Swelling Kinetics and Nanostructure in Perfluorosulfonic Acid Thin-Films: Role of Hygrothermal Aging

Impacts of processing, storage, and operation on thin-film perfluorosulfonic acid (PFSA) ionomer coatings used in electrodes of electrochemical devices remains unestablished. In this work, alteration of structure-function relationship in ionomers is achieved via exposure to elevated temperature and humidity (hygrothermal aging). Findings reflect a strong inverse correlation between aging-induced ionomer thin-film domain orientation and water-transport kinetics evaluated from swelling. Impact of aging is shown to be more pronounced on platinum due to interactions with PFSA, as evidenced by greater increase in nanodomain orientation parallel to substrate accompanied by reduced water transport, in contrast to silicon support

Using community conversation in the fight against HIV and AIDS

While promoting participatory communication approaches in the fight against HIV and AIDS and a myriad other problems continues, empirical research into its effects has been dismal. This study endeavoured to assess the impact community conversation (CC) in curbing the HIV and AIDS pandemic in Bahir Dar, Ethiopia. Data were collected from twenty-one participants, six facilitators and a coordinator of the CC project using in-depth interviews and focus group discussions (FGD).The study found that the selection of facilitators from the community; the willingness and their positive approach to the programme by participants, facilitators and Kebele administrators were the positive factors that contributed to the proper implementation of CCs. However, the overwhelming number of participants, some facilitators’ limited skills in moderating discussions, the absence of relevant stakeholders, overlapping of CCs with other programmes of the Kebeles, lack of follow up, and interference of Kebele administrators were found to be the major limitations to the success of the CC interventions. Key Words: Community Conversation, Participatory Communication, Alternative Media, HIV and AID

Khat Chewing and Mental Distress: A Community Based Study, in Jimma City, Southwestern Ethiopia

BACKGROUND: Khat (Catha edulis) contains a psychoactive substance, cathinone, which produces central nervous system stimulation analogous to amphetamine. It is believed that khat chewing has a negative impact on the physical and mental health of individuals as well as the socioeconomic condition of the family and the society at large. There is lack of community based studies regarding the link between khat use and poor mental health. The objective of this study was to evaluate the association between khat use and mental distress and to determine the prevalence of mental distress and khat use in Jimma City. METHODS: A cross-sectional community-based study was conducted in Jimma City from October 15 to November 15, 2009. The study used a structured questionnaire and Self Reporting Questionnaire-20 designed by WHO and which has been translated into Amharic and validated in Ethiopia. By multi stage sampling, 1200 individuals were included in the study. Data analysis was done using SPSS for window version 13. RESULTS: The Khat use prevalence was found to be 37.8% during the study period. Majority of the khat users were males (73.5%), age group 18-24 (41.1%), Muslims (46.6%), Oromo Ethnic group (47.2%), single (51.4%), high school students (46.8%) and employed (80%). Using cut-off point 7 out of 20 on the Self Reporting Questionnaire-20, 25.8% of the study population was found to have mental distress. Males (26.6%), persons older than 55 years (36.4%), Orthodox Christians (28.4%), Kefficho Ethnic groups (36.4%), widowed (44.8%), illiterates (43.8%) and farmers (40.0%) had higher rates of mental distress. We found that mental distress and khat use have significant association (34.7% Vs 20.5%,

Pattern and treatment outcome of patients with achalasia cardia after Modified Heller’s Myotomy: experience from Ethiopia

Background: Although achalasia condition occurs in males and females with equal frequency, there are studies reporting that there is a male predominance even in Ethiopia. There appears to be striking international variations with significant differences between countries with respect to prevalence, occurrence in different sex and age groups and clinical features. The main objective of this study was to determine the pattern of clinical presentation and demographic characteristics and to assess the surgical treatment outcome of patients with achalasia. Methods: This was a 5-year retrospective review of medical records and theatre operation register notes of patients operated for achalasia of cardia at Tikur Anbessa Specialized Hospital, Addis Ababa. Selected socio- demographic variables, clinical presentations, radiologic imaging, post-operative course and final outcome were recorded on a structured format. Data was entered, cleaned and edited using EPI info version 3.5.1 for windows and analyzed using SPSS version 15 for windows. Frequencies, percentages, Mann-Whitney U test and Chi-square test were applied to describe and compare the difference between sex, age and dysphagia scores. Wilcoxon Signed Ranks test was used to evaluate the surgical treatment outcome after patients underwent Modified Heller’s Myotomy (MHM). Results: A total of 46 patients’ records that were operated for achalasia were reviewed, of whom 56.5% were males, 52.2% were of younger age (52.2%) with a mean of 26.4 years (Range: 14 – 65 years). Thirty eight (82.6%) patients suffered from grade 3-4 dysphagia. Higher dysphagia score, with no significant statistical difference, was predominantly seen among the young (87.5%) and female (95%) patients. Severity of symptoms of dysphagia was significantly reduced after Modified Heller’s Myotomy (P<0.0001). Conclusion: Slight predominance of male sex and younger age group was found among patients operated for achalasia. Modified Heller’s Myotomy was found to be effective in alleviating symptoms of achalasia

Induced Second Trimester Abortion and Associated Factors at Debre Markos Referral Hospital: Cross-Sectional Study.

BACKGROUND:Although most induced abortions in Ethiopia are performed in the first trimester, many women will still require second trimester abortions. While access to abortion in Ethiopia is limited, few data are being available concerning the demand for and associated outcomes of second trimester abortions. This knowledge is important for planning the health service response to abortion. OBJECTIVE:The main objective of this study was to determine the proportion and associated factors of second trimester abortion among women presenting for abortion care services at Debre Markos Referral Hospital, Debre Markos, Northwest Ethiopia. METHODS:An institution-based cross-sectional study was conducted at Debre Markos Referral Hospital on a sample of 262 calculated using the single population proportion formula. Women who sought abortion services were interviewed consecutively from 12 February 2017 to 14 March 2017. Data were collected in a face-to-face exit interview and document review and analyzed using SPSS version 24.0 software. Bivariate and multivariable analyses were undertaken to identify factors. RESULT:Of the women who presented for abortion care services in Debre Markos Referral Hospital, 73 (29.6%) had induced second trimester abortion. Unmarried women (adjusted odds ratio = 4.93, 95% confidence interval = 1.41-17.16) and women employed at private business (adjusted odds ratio = 6.17, 95% confidence interval = 1.16-32.76) were associated with induced second trimester abortion. CONCLUSION:This study revealed that almost one-third of women who presented for abortion care services at Debre Markos Referral Hospital had induced second trimester abortions. Raising awareness of the health consequence of second trimester abortion at community levels and counseling to avoid further occurrences are helpful to minimize the problem. Furthermore, early management of induced second trimester abortion is very crucial to prevent further complications

Neuropsychological diagnostics in Ethiopia - challenges and chances among considerations regarding differential diagnosis (literature overview)

Background Neuropsychological tests can provide crucial information regarding the consideration of psychiatric differential diagnosis. This is especially important in developing countries like Ethiopia where advanced imaging is not widely available.Methods A detailed literature search was conducted using the search engines Pubmed, Science Direct, Web of Science and Google Scholar from February 2013 until May 2014. Selecting the identified studies pragmatically depending on the content, twenty-six studies were included.Results The administration of tests developed in Western-European settings to the African culture presents enormous challenge. Among these are especially the influence of low level of literacy, familiarity with the testing material, cultural aspects regarding social behavior and sense of time, cultural differences regarding cognitive functions and lack of norms. At the same time, there are opportunities for different fields of application, especially when considering the diagnosis of dementia and in the assessment of frontal lobe lesions. Assessment of cognitive flexibility appears to be an important way to differentiate between affective disorders and schizophrenia.Conclusions In conclusion, we suggest a „basic set of neuropsychological tests“ for application in psychiatric facilities in low income countries like Ethiopia, which mostly includes nonverbal tests. By using these tests, some of the challenges found during the literature search can be overcome. Additionally, they might provide extra information for diagnostic issues. However, they might have to be adapted to the Ethiopian culture.Key words: Cognition; Culture-fair; Ethiopian; Low-Income; Neuropsychology; Psychiatr

Responding to the maternal health care challenge: The Ethiopian Health Extension Program

Background: Responding to challenges in achieving Millennium Development Goals (MDG), the Ethiopian government initiated the Health Extension Program in 2003 as part of the Health Sector Development Program (HSDP) to improve equitable access to preventive, promotive and select curative health interventions through paid community level health extension workers.Objective: To explore Ethiopia’s progress toward achieving MDG 5 that focuses on improved maternal health through the Health Extension Program.Methods: This paper reviews available survey data and literature to determine the feasibility of reaching the targets specified for MDG 5 and for HSDP.Important findings: Achieving the set targets is a daunting task despite reaching the physical targets of two health extension workers per kebele. The 2015 MDG target for the Maternal Mortality Ratio (MMR) is 218 while the 2005 MMR estimate is 673. The HSDP target is 32% skilled birth attendant use by 2010 but only about 12% use was found in the four most populated regions of the country in 2009.Conclusions: Accelerating progress towards these targets is possible through the Health Extension Program at the worker level through improved promotion of family planning and specific maternal interventions, such as misoprostol for active management of third stage of labor, immediate postpartum visits, and improved coordination from community to referral level. [Ethiop. J. Health Dev. 2010;24 Special Issue 1:105-109

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

Spatio-temporal expression patterns of Arabidopsis thaliana and Medicago truncatula defensin-like genes

Plant genomes contain several hundred defensin-like (DEFL) genes that encode short cysteine-rich proteins resembling defensins, which are well known antimicrobial polypeptides. Little is known about the expression patterns or functions of many DEFLs because most were discovered recently and hence are not well represented on standard microarrays. We designed a custom Affymetrix chip consisting of probe sets for 317 and 684 DEFLs from Arabidopsis thaliana and Medicago truncatula, respectively for cataloging DEFL expression in a variety of plant organs at different developmental stages and during symbiotic and pathogenic associations. The microarray analysis provided evidence for the transcription of 71% and 90% of the DEFLs identified in Arabidopsis and Medicago, respectively, including many of the recently annotated DEFL genes that previously lacked expression information. Both model plants contain a subset of DEFLs specifically expressed in seeds or fruits. A few DEFLs, including some plant defensins, were significantly up-regulated in Arabidopsis leaves inoculated with Alternaria brassicicola or Pseudomonas syringae pathogens. Among these, some were dependent on jasmonic acid signaling or were associated with specific types of immune responses. There were notable differences in DEFL gene expression patterns between Arabidopsis and Medicago, as the majority of Arabidopsis DEFLs were expressed in inflorescences, while only a few exhibited root-enhanced expression. By contrast, Medicago DEFLs were most prominently expressed in nitrogen-fixing root nodules. Thus, our data document salient differences in DEFL temporal and spatial expression between Arabidopsis and Medicago, suggesting distinct signaling routes and distinct roles for these proteins in the two plant species

Diabetic Neuropathies: Update on Definitions, Diagnostic Criteria, Estimation of Severity, and Treatments

Preceding the joint meeting of the 19th annual Diabetic Neuropathy Study Group of the European Association for the Study of Diabetes (NEURODIAB) and the 8th International Symposium on Diabetic Neuropathy in Toronto, Canada, 13–18 October 2009, expert panels were convened to provide updates on classification, definitions, diagnostic criteria, and treatments of diabetic peripheral neuropathies (DPNs), autonomic neuropathy, painful DPNs, and structural alterations in DPNs