Five-year mortality in a cohort of people with schizophrenia in Ethiopia

<p>Abstract</p> <p>Background</p> <p>Schizophrenia is associated with a two to three fold excess mortality. Both natural and unnatural causes were reported. However, there is dearth of evidence from low and middle income (LAMIC) countries, particularly in Africa. To our knowledge this is the first community based report from Africa.</p> <p>Methods</p> <p>We followed a cohort of 307 (82.1% males) patients with schizophrenia for five years in Butajira, rural Ethiopia. Mortality was recorded using broad rating schedule as well as verbal autopsy. Standardized Mortality Ratio (SMR) was calculated using the mortality in the demographic and surveillance site as a reference.</p> <p>Result</p> <p>Thirty eight (12.4%) patients, 34 men (11.1%) and 4 women (1.3%), died during the five-year follow up period. The mean age (SD) of the deceased for both sexes was 35 (7.35). The difference was not statistically significant (p = 0.69). It was 35.3 (7.4) for men and 32.3 (6.8) for women. The most common cause of death was infection, 18/38 (47.4%) followed by severe malnutrition, 5/38 (13.2%) and suicide 4/38 (10.5%). The overall SMR was 5.98 (95% CI = 4.09 to7.87). Rural residents had lower mortality with adjusted hazard ratio (HR) of 0.30 (95% CI = 0.12-0.69) but insidious onset and antipsychotic treatment for less than 50% of the follow up period were associated with higher mortality, adjusted HR 2.37 (95% CI = 1.04-5. 41) and 2.66(1.054-6.72) respectively.</p> <p>Conclusion</p> <p>The alarmingly high mortality observed in this patient population is of major concern. Most patients died from potentially treatable conditions. Improving medical and psychiatric care as well as provision of basic needs is recommended.</p

Repurposing NGO data for better research outcomes: A scoping review of the use and secondary analysis of NGO data in health policy and systems research

Background Non-government organisations (NGOs) collect and generate vast amounts of potentially rich data, most of which are not used for research purposes. Secondary analysis of NGO data (their use and analysis in a study for which they were not originally collected) presents an important but largely unrealised opportunity to provide new research insights in critical areas including the evaluation of health policy and programmes. Methods A scoping review of the published literature was performed to identify the extent to which secondary analysis of NGO data has been used in health policy and systems research (HPSR). A tiered analytic approach provided a comprehensive overview and descriptive analyses of the studies which: 1) used data produced or collected by or about NGOs; 2) performed secondary analysis of the NGO data (beyond use of an NGO report as a supporting reference); 3) used NGO-collected clinical data. Results Of the 156 studies which performed secondary analysis of NGO-produced or collected data, 64% (n=100) used NGO-produced reports (e.g. to critique NGO activities and as a contextual reference) and 8% (n=13) analysed NGO-collected clinical data.. Of the studies, 55% investigated service delivery research topics, with 48% undertaken in developing countries and 17% in both developing and developed. NGO-collected clinical data enabled HPSR within marginalised groups (e.g. migrants, people in conflict-affected areas), with some limitations such as inconsistencies and missing data. Conclusion We found evidence that NGO-collected and produced data are most commonly perceived as a source of supporting evidence for HPSR and not as primary source data. However, these data can facilitate research in under-researched marginalised groups and in contexts that are hard to reach by academics, such as conflict-affected areas. NGO–academic collaboration could help address issues of NGO data quality to facilitate their more widespread use in research. Their use could enable relevant and timely research in the areas of health policy, programme evaluation and advocacy to improve health and reduce health inequalities, especially in marginalised groups and developing countries

Effect of doping Ca on polaron hopping in LaSr2Mn2O7

From the transport studies in the bilayer manganites LaSr2-xCaxMn2O7, we have found the variable-range hopping model proposed by Viret et al to be inadequate to describe the transport of charge in these materials. The polarons appear to hop to their nearest neighbors with an activation energy, which in part is dependent on the magnetic interactions in the lattice

Effects of quenched disorder on Griffiths phase and EPR line width in La0.67-2xNd2xCa0.33-xSrxMnO3 manganites

It is widely accepted that there is Griffiths phase (GP) present in the paramagnetic phase in doped manganites. We studied the effect of quenched disorder on the region of GP in connection with the temperature dependence of the line width (Delta H) of the electron paramagnetic resonance (EPR) in La0.67-2xNd2xCa0.33-xSrxMnO3 (x = 0, 0.1, 0.15, 0.2 and 0.25). With this approach it is found that Delta H(T), the minimum in the line width (Delta H-min) and T-min are reproduced. With increasing values of the quenched disorder the values of Delta H-min are found to increase. A numerical relation that correlates the temperature range in which GP exists and the cation size disorder is obtained and found to be in agreement with some reported data. (C) 2008 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim

Evidence for the Griffiths phase in pure and Y-, Ca- and Cr-doped LaSr2Mn2O7 manganites

The paramagnetic susceptibility measured on La1−xYxSr2−yCay Mn2O7 (x, y or z=0, 0.03 and 0.1) manganites does not obey the Curie–Weiss law. The Curie constant exceeds the expected values by more than order of magnitude. Based on strong disorder we have compared the experimental data with predictions based on Griffith's singularity model. We find that this model allows for consistent interpretation of the data in contrary to a model assumes that magnetic polarons make contribution akin to cluster to susceptibility. In particular the values of Curie constant agree excellently with those theoretically expected, whereas the magnetic polarons model is less satisfactory.© Elsevie