The Association of Beliefs About Heredity with Preventive and Interpersonal Behaviors in Communities Affected by Podoconiosis in Rural Ethiopia

Little is known about how beliefs about heredity as a cause of health conditions might influence preventive and interpersonal behaviors among those individuals with low genetic and health literacy. We explored causal beliefs about podoconiosis, a neglected tropical disease (NTD) endemic in Ethiopia. Podoconiosis clusters in families but can be prevented if individuals at genetically high risk wear shoes consistently. Adults (N = 242) from four rural Ethiopian communities participated in qualitative assessments of beliefs about the causes of podoconiosis. Heredity was commonly mentioned, with heredity being perceived as (1) the sole cause of podoconiosis, (2) not a causal factor, or (3) one of multiple causes. These beliefs influenced the perceived controllability of podoconiosis and in turn, whether individuals endorsed preventive and interpersonal stigmatizing behaviors. Culturally informed education programs that increase the perceived controllability of stigmatized hereditary health conditions like podoconiosis have promise for increasing preventive behaviors and reducing interpersonal stigma.     

Evaluation of antiretroviral treatment in two private medical centers in Addis, Ethiopia

Ethiopia is one of the countries affected severely by the HIV/AIDS epidemic in sub-Saharan Africa. The disease is gradually fatal without antiretroviral therapy (ARV). The experience with antiretroviral therapy is limited in this country. This study is the first of its kind that has evaluated the status and implication of the clinical use of ARV drugs in Ethiopia. The guidelines for the initiation of treatment, the strengths and weaknesses of such treatment and the implications of similar intervention in a wider scale were assessed. Clinical records of 33 patients under follow-up and treatment with ARV in Hayat Hospital and Bethezatha Medical Center were identified. Data were collected from the medical records using a tool designed for the purpose. All 33 patients were receiving ARV for a mean duration of about 4 months. Twenty- three (69.7%) were males and 10 (30.3%) were females and the mean age was 38 years. Fifteen (45.5%) were married, fourteen (40.7%) were single, one (3%) divorced and there was no record for three (9.1%). Fifteen (45.5%) were businessmen, seven (21.2%) were private employees, four (12.1%) civil servants and in the remaining seven (21.2%) their occupation was not recorded. The decision to initiate ARV therapy was entirely based on the presence of symptomatic HIV disease. CD4+ lymphocyte count was done in 24 (72.7%) and basic hematological tests were done for all. However, biochemical investigations were incomplete in all of them. Triple therapy was started for all patients and the cost of the drugs was covered by their family in eleven (33.3%), by the patients in twenty-two (66.7%). Side effects of the drugs were noted in ten (30.3%) that resulted in change of the regimen in two and drug interruption in one. Response to treatment was entirely based on clinical parameters only. Twenty-three patients (69.7%) were noted to improve while nine (27.3%) remained the same and death occurred in one (3%). Standard triple therapy was used in all patients in this study and symptomatic HIV disease was the reason for the initiation of treatment. The improvement observed was not substantiated by immunological or virological parameters. Thus, the impacts of ARVs cannot be measured and the response documented in this study can be due to the effective treatment of opportunistic infections. Hence a standard protocol should be developed based on the minimum set-up required for the initiation of ARV therapy.     

Violence en route: Eritrean women asylum-seekers experiences of sexual violence while migrating to Israel

Migrating irregularly, without access to support, may increase female asylum-seekers’ vulnerability to sexual violence. In this study, the authors applied a public health lens to explore the risk for sexual violence experienced by female asylum-seekers en route from Eritrea to Israel. The study team conducted 13 in-depth interviews and 8 focus groups with Eritreans in Israel between April and September of 2013. Participants in the study described their experiences occurring in three segments. The combination of irregular movement through dangerous, difficult and often isolated terrain, dependence on human smugglers, and vulnerability to traffickers led to the systematization and normalization of sexual violence en route. Such factors heighten vulnerability to sexual violence among these Eritrean women asylum-seekers, as well as others who find themselves in similar circumstances.     

Systematic Review on Effectiveness of shoulder taping in Hemiplegia

BackgroundShoulder pain and subluxation are the commonly encountered problems among subjects with hemiplegia. Rehabilitating the shoulder following stroke is a challenging task among physiotherapists in rehabilitation set up. There is a need to validate the effectiveness of externally applied taping materials in hemiplegic shoulder.ObjectiveThis systematic review analyses the efficacy of taping on hemiplegic shoulder in terms of alleviating pain and managing subluxation.MethodsSystematic review of randomized controlled trials (RCTs) was conducted to determine the effects of taping on hemiplegic shoulder. Articles were electronically searched from the year 2000 to 2017 in the 4 databases, Google scholar, CINAHL, Pubmed, and Pedro. Reviewers graded the papers according to Lloyd-Smith's hierarchy of evidence scale. Papers were quality appraised using a systematic review of RCT tool developed by National Heart, Lung and Blood Institute (United States), named as quality assessment of controlled intervention studies tool.ResultsEight papers were included, totaling 132 participants. All the RCT's included in this review were good quality. There was a significant effect on taping method for reduction of pain and subluxation among subjects with stroke.ConclusionsThis systematic review provides sufficient evidence to suggest taping is a beneficial method for reducing pain and shoulder subluxation among stroke subjects.     

Barriers to contraceptive careseeking: the experience of Eritrean asylum-seeking women in Israel

ABSTRACT

Objectives: In recent years, there has been a mass migration of Eritreans (many seeking political asylum) into Israel after precarious irregular movement across international borders. This study qualitatively explores the structural barriers to family planning (i.e. contraceptive services) for Eritrean women in Israel that are rooted in their temporary legal status and the patchwork of family planning services.

Design/Methods: From December 2012 to September 2013, we interviewed 25 key informants (NGO workers, researchers, Eritrean community activists, International NGO representatives and Ministry of Health officials) and 12 Eritrean asylum seekers. We also conducted 8 focus groups with Eritrean asylum seekers. Data were analyzed using both inductive and deductive coding.

Results: We identified 7 main barriers to accessing family planning services: (1) distance to health facilities; (2) limited healthcare resources; (3) fragmentation of the healthcare system; (4) cost of contraceptive services; (5) low standard of care in private clinics; (6) discrimination; and (7) language barriers.

Conclusion: The political, economic and social marginalization of Eritrean asylum-seeking women in Israel creates structural barriers to family planning services. Their marginalization complicates providers’ efforts (NGO and governmental) to provide them with comprehensive healthcare, and hinders their ability to control their sexual and reproductive health. Failure to act on this evidence may perpetuate the pattern of unwanted pregnancies and social and economic disparities in this population.     

Controlling the electronic and optical properties of HfS2 mono-layers via lanthanide substitutional doping: a DFT+U study

Two dimensional HfS₂ is a material with potential applications in the field of photo-catalysis and advanced solid state devices. Density functional theory with the Hubbard U parameter (DFT+U) calculations were carried out to investigate the structural, electronic and optical properties of lanthanide dopant atoms (LN = La, Ce, Pr, Nd, Pm, Sm, Eu, Gd, Tb, Dy, Ho, Er, Tm, Yb and Lu) in the HfS₂ mono-layer. The calculated electronic band gap for a pristine HfS₂ mono-layer is 1.30 eV with a non-magnetic ground state. The dopant substitutional energies under both Hf-rich and S-rich conditions were evaluated, with the S-rich condition for the dopant atoms being negative. This implies that the incorporation of these LN dopant atoms in the HfS₂ is feasible and experimental realization possible. The introduction of LN dopant atoms in the HfS₂ mono-layer resulted in a significant change of the material properties. We found that the presence of LN dopant atoms in the HfS₂ mono-layer significantly alters its electronic ground states by introducing defect states as well as changes in the overall density of states profile resulting in a metallic ground state for the doped mono-layers. The doped mono-layers are all magnetic with the exception of La and Lu dopant atoms. We found that LN dopant atoms in the HfS₂ mono-layer influence the absorption and reflectivity spectra with the introduction of states in the lower frequency range (<1.30 eV). Furthermore, we showed that the applicability of doped HfS₂ mono-layers as photo-catalysts is very different compared with the pristine HfS₂ mono-layer.

Density functional theory with the Hubbard U parameter calculations were carried out to investigate the structural, electronic and optical properties of lanthanide dopant atoms in the HfS₂ mono-layer..     

Dietary behaviour,food and nutrient intake of women do not change during pregnancy in Southern Ethiopia

Although pregnant women are required to increase food and nutrient intake to accommodate for the increased nutritional demands, information on dietary behaviour and nutrient intake is limited. This study aimed to identify the adequacy and differences in intake between pregnant and non‐pregnant women in a rural community of Butajira district, Southern Ethiopia. Simple random sampling was used to recruit 159 pregnant and 164 non‐pregnant women. An interactive multiple pass 24‐h recall survey was used to evaluate the food and nutrient intake of the study participants. Except for iron, vitamin A and C, intakes of macro and micronutrient were below the recommendations. Almost all study participants were deficient in energy, protein, calcium, folate and niacin intakes. There was no significant difference in the mean dietary intake of all nutrients between pregnant and non‐pregnant women (p > 0.05). The prevalence of inadequacy was comparable between pregnant and non‐pregnant women in all of the nutrient intakes except for Zn, where the prevalence of inadequacy was much higher among the pregnant women. Nearly all (99.0%) of the pregnant women were deficient in niacin, folate and calcium. Although all pregnant women considered it important to increase food intake during pregnancy, only a quarter of women reported to do so. In conclusion, pregnant women in the rural community of Butajira district do not make significant dietary intake adjustments to account for increased nutrient needs during pregnancy. In food insecure areas, such as ours, nutritional counselling complemented with supplementary feeding programmes could be key to ensure adequate dietary intake. © 2016 John Wiley & Sons Ltd