Implementation of Tuberculosis and Human Immune-Deficiency Virus Programs Collaborative Services in Public-Private Mix Direct Observed Therapy Short Course Facilities in Addis Ababa, Ethiopia: Cross Sectional Facility Based Mixed Method

Background: Ethiopia is one of the countries with the highest Human Immune-deficiency Virus (HIV) and Tuberculosis (TB) infection rates in the world. To improve TB/HIV Programs outcomes through Public Private Partnership Mix (PPM) approach was in place since 2006. But the status of its implementation has never been assessed. Methods: In this cross sectional study we employed mixed methods;we interviewed 272 tuberculosis patients, reviewed their records, and facilitated six in-depth interviews and four focus group discussions. The survey was conducted from January through March 2014 in Addis Ababa. Result: Among the interviewees 51.5% were males and the mean age was (32.7 ± SD 12.4) years. PPM facilities were offering HIV counseling for all TB patients;whereas 87.5% of TB patients have received HIV testing services. The TB/HIV co-infection rate was 45.4%. And only 72.2% TB/HIV patients were enrolled into chronic disease care services, 64.8% were put on Cotrimoxazol Preventive Therapy (CPT) and 50% were put on standard highly active anti-retro viral therapy (HAART) services. All PPM facilities don’t have IPT (Isoniazid Prophylaxis Therapy). The TB/HIV collaborative services strongly linked with the public health sector which was documented by developing inclusive work plan which create access to supplies and conducting joint supportive supervisions. However, the majorities of PPM facilities don’t have Multi-Disciplinary Team and lacks some essential supplies. The predictor for uptake of CPT were: being females TB patients was 86% lower than their counter part males (AOR = 0.14;95% CI = 0.04 - 0.92 P = 0.002), patients who has attended their TB/HIV care at private for the profit facilities were 84% lower than those attend in private not for profit facilities (AOR = 0.16;95% CI = 0.49 - 0.55, P = 0.003). Conclusions: The TB/HIV collaborative services at program level are stronger but only half of patients didn’t get the comprehensive TB/HIV collaborative services to achieve recommended quality of care. Strengthening the services and ensuring the availability of essential supplies was highly recommended.

Elastic and Viscoelastic Poisson’s Ratios: The Theoretical Mechanics Perspective

A recent review publication presented an extensive and comprehensive assessment of the phenomenological relations of Poisson’s ratios (PRs) to the behavior and responses of contemporary materials under specific loading conditions. The present review and analysis paper is intended as a theoretical mechanics complement covering mathematical and physical modeling of a single original elastic and of six time and process (i.e. path and stress) dependent viscoelastic PR definitions as well as a seventh special path independent one. The implications and consequences of such models on material characterization are analyzed and summarized. Indeed, PRs based on experimentally obtained 2-D strains under distinct creep and/or relaxation processes exhibit radically different time responses for identical material specimen. These results confirm the PR’s implicit path dependence in addition to their separate intrinsic time reliance. Such non-uniqueness of viscoelastic PRs renders them unsuitable as universal material descriptors. Analytical formulations and experimental measurements also examine the physical impossibility of instantaneously achieving time independent loads or strains or their rates thus making certain PR definitions based on constant state variables, while mathematically valid, physically unrealistic and unachievable. A newly developed theoretical/experimental protocol for the determination of the time when loading patterns reach stead-state conditions based on strain accelerations demonstrates the capability to measure this time from experimental data. Due to the process dependent PRs, i.e. stress and stress history paths, the non-existence of a unique viscoelastic PR and of a universal elastic-viscoelastic correspondence principle or analogy (EVCP) in terms of PRs is demonstrated. Additionally and independently, the required double convolution integral construction of linear viscoelastic constitutive relations with the inclusion of PRs is cumbersome analytically and computationally needlessly highly CPU intensive. Furthermore, there is no theoretical fundamental hint as to what loading path is required to produce a unique universal viscoelastic PR definition necessary for formulating a PR based constitutive relation or an EVCP protocol. The analysis associated with an additional Class VII viscoelastic PR establishes it as a universal representation which is loading path and strain independent while still remaining time dependent. This Class PR can be the one used if it is desired to express constitutive relations in terms of PRs, subject to the caveat applying to all PR Classes regarding the CPU intensiveness in the time space due to triple product and double convolution integral constitutive relations. However, the use PRs is unnecessary since any set of material behavior can be uniquely and completely defined in terms of only moduli and/or compliances. The mathematical model of instantaneous initial loading paths, based on Heavi-side functions, is examined in detail and shown to lead to infinite velocities and accelerations. Additionally, even if non-instantaneous gradual loading functions are employed the resulting PRs are still load and load history dependent. Consequently, they represent specialized PR responses applicable and limited to those particular load and history combinations. Although the analyses contained herein are generalized to non-homogeneous linear viscoelastic materials, the main focus is on PR time and process dependence. The non-homogeneous material results and conclusions presented herein apply equally to homogeneous viscoelasticity and per se do not influence the results or conclusions of the analytical development regarding viscoelastic PRs. In short, these PR analyses apply to all linear viscoelastic material characterization.

Effective Control of Aflatoxin Contamination in Staple Maize Food Crop in Sub-Saharan Africa: A Review of Current Pre- and Postharvest Low-Cost Technologies and Perspectives

Mycotoxins/aflatoxins contaminations in some food commodities seriously impact human and animal health and reduce the commercial value of crops. Mycotoxins are toxic secondary metabolites produced by fungi that colonize agricultural commodities. Pre- and postharvest contamination of aflatoxin is a major health concern in Africa where maize production and consumption have increased significantly over the years. Efforts to reduce aflatoxin in maize through various strategies such as breeding for resistance, improved agronomic practices, cultural harvesting and postharvest handling practices, and the use of bio-control agents are available. Some of these control practices are not well known by smallholder farmers. Important pre- and postharvest practices, in addition to the stringent food safety regulations and monitoring, are not undertaken as a result of various factors such as a lack of awareness and training, and the high cost of awareness and sensitization drives. The climate changes scenarios including El Nino are also factors to be considered. However, continued use of sustainable and effective low-cost management practices by small scale farmers are possible ways of reducing the risk of aflatoxin contamination. This review attempts to highlight low-cost, affordable and practical management options at pre- and postharvest in maize. Sound low-cost management practices are possible ways of reducing the risk for fungal infection and aflatoxin contamination that are relevant to the Africa context. This review would be useful and guided prioritization of development activities, continuous awareness creation and training and future research.

Determinants of Long Acting Reversible Contraception Method Use among Mothers in Extended Postpartum Period, Durame Town, Southern Ethiopia: A Cross Sectional Community Based Survey

Background: After a live birth, there is much unsatisfied interest in, and unmet family planning need for contraception. Waiting at least for 24 months before attempting the next pregnancy was recommended to reduce the risk of adverse maternal, perinatal and infant outcomes. The purpose of this study was to assess the determinants of long acting reversible contraception method use among mothers in extended postpartum period in Durame Town, Southern Ethiopia. Methods: A community based cross sectional study was conducted in Durame Town, Southern Ethiopia in December, 2014. Systematic random sampling technique was employed to recruit a total 460 study participants. Structured and pretested questioner was used to collect the data. Descriptive statistics was employed to characterize the study population using frequencies and proportions. Bivariate logistic regression analysis was conducted to identify all possible factors affecting utilization of LARC method. Multivariable logistic regression model was developed to control the confounding variables. Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) was computed in identifying the real factors associated with use of LARC methods. Results: In this study we found that the prevalence of LARC method use among mothers during their extended postpartum period was 36.7% (95%CI: 32.2, 41.0). The unmet family planning need of mothers in the extended postpartum period was 123 (27.9%). The odds of using LARC by literate mother were four fold higher than their counterpart illiterate mothers (AOR 4.09 95%CI: 1.68, 9.58, P value < 0.001). The odds of mother who had pervious experiences of using LARC were up to eight folds higher than mother never used LARC methods (AOR 7.84 95% CI: 3.78, 16.23, P value< 0.001). Mother who received counseling service on LARC methods during delivery was up to three times more likely to utilize the services than not counseled (AOR 3.29 95% CI: 1.53, 7.03, P value < 0.001). And odds of mothers who received counseling service on LARC during immediate postpartum period were up to five fold more likely to opt method than never got the counseling service (AOR 4.55 95 % CI: 1.94, 10.66, P value < 0.001). Conclusions: In the study area, about one third of mothers utilized LARC methods during their extended postpartum period. Another one third of mother had unmet need for family planning. Participant’s education, previous history of using LARC methods, receiving counseling services on LARC during delivery and immediate postpartum periods were found major determinant for LARC use. Educating women, providing counseling service on LARC methods during antenatal, delivery and postnatal were recommended.

Pulp Revascularization: Future Therapy of Tooth with Open Apex

Introduction: The endodontic management of necrotic permanent immature teeth is a challenge for the practitioner. These teeth are treated by apexification. However, because of the complications associated with this treatment, researchers have developed other therapies. Currently, a new technique called pulp revascularization has emerged. This technique allows the continuation of root completion thanks to a healthy tissue newly formed at the intra root canal level. Material and method: A literature search of articles dealing with pulp revascularization of immature permanent teeth was conducted using two types of search strategy, a literature search using keywords on databases and then a manual “bottom-up” search of references of previously identified articles. Results: 112 articles were identified based on inclusion and exclusion criteria. Discussion: This work showed that pulp revascularization is a new therapy that aims to restart root development on an immature permanent tooth. It is based on the principle of tissue engineering and uses the differentiation potential of stem cells. Conclusion: Currently, the literature values revascularization as it allows root development, sidewall thickening, apical closure and a decrease in periapical lesion and ensures a good sealing. Clinical and radiographic success rates appear to be encouraging, except that factors influencing treatment must be taken into consideration.