It Takes a Village: Bringing Palliative Care to Ethiopia.

In Ethiopia, there is a great need for culturally relevant, sustainable palliative care. Profound poverty and limited health care resources magnify the impact of disease in Ethiopia, one of the poorest countries in the world. The impacts of high burden of disease and poor access to health care include physical suffering, and detrimental economic effects.

Leadership Commitment and the Quality of Adolescent-Friendly Sexual Reproductive Health Services in Public Health Facilities Among Pastoral Districts of Guji Zone, Ethiopia.

Background: Accessible and high-quality sexual and reproductive health services are essential for adolescents. However, there is a need for more knowledge about the role of leadership and the quality of these services in Ethiopia, where a significant proportion of the population consists of adolescents. Inadequate quality of friendly health services may lead to underutilization and higher rates of unintended pregnancies and sexually transmitted infections.

The Effect of School-Linked Module-Based Friendly-Health Education on Adolescents' Sexual and Reproductive Health Knowledge, Guji Zone, Ethiopia - Cluster Randomized Controlled Trial.

Background: Although access to sexual and reproductive health information is the right and a critical component of health policy, it is not well addressed in pastoral communities. This study assessed the effect of School-Lined Module-based friendly health education on adolescents' sexual and reproductive health knowledge in the pastoral community of Guji Zone, Ethiopia.

Methods: A two-arm cluster Randomized control trial study with pre-post evaluation was conducted among interventions (n=375) compared with control (n=384) in Gorodola and Wadara high schools.

Effect of a school-linked life skills intervention on adolescents' sexual and reproductive health skills in Guji zone, Ethiopia (CRT)-A generalized linear model.

Background: Although appropriate life skills are recognized as a fundamental right for adolescents and a critical component of health policy, they are often overlooked and rarely researched in pastoral communities. Life skills encompass the ability to adopt positive behaviors, which enable individuals to effectively deal with the demands and challenges of everyday life. This study aimed to evaluate the effectiveness of a school-linked life skills intervention program on adolescents' sexual and reproductive health skills in the pastoral community of Guji zone.

Additive Manufacturing of SS316L/IN718 Bimetallic Structure via Laser Powder Bed Fusion.

Laser powder bed fusion (LPBF) is a popular additive manufacturing (AM) technique that has demonstrated the capability to produce sophisticated engineering components. This work reports the crack-free fabrication of an SS316L/IN718 bimetallic structure via LPBF, along with compositional redistribution, phase transformations and microstructural development, and nanohardness variations. Constituent intermixing after LPBF was quantitatively estimated using thermo-kinetic coefficients of mass transport and compared with the diffusivity of Ni in the austenitic Fe-Ni system.

Perceptions of Barriers to Using Opioid Analgesics: A Mixed Methods Study.

Background: Availability and accessibility of opioids are a worldwide problem. In low-resource settings, such as Ethiopia, access to opioids is either limited or nonexistent and legally restricted in health care settings. This study aimed to identify barriers for the availability and accessibility of opioids in Ethiopian rural and regional health care settings.

Perceived policy-related barriers to palliative care implementation: a qualitative descriptive study.

Background: Ethiopia has a national palliative care guideline, and palliative care is explicitly recognised in the country's healthcare policy and health sector transformation plans. However, palliative care is not fully delivered in the regional public hospitals and primary health care units.

Objective: This study explores perceived policy barriers to deliver palliative care services in rural and regional healthcare settings, which primary healthcare units largely serve.

Measuring and exploring the barriers to translating palliative care knowledge into clinical practice in rural and regional health-care settings.

Objectives: This study aims to measure and explore the barriers to translating theoretical knowledge of palliative care into clinical practice.

Methods: A mixed-method study, combining a cross-sectional survey and key interviews was conducted. The quantitative data were obtained from 173 nurses and the key interviews were conducted with 42 health professionals drawn from multiple settings.

Co-design and prototype development of the 'Ayzot App': A mobile phone based remote monitoring system for palliative care.

Background: Palliative care, a recognised component of care by the World Health Organization is poorly developed in low- and middle-income countries. Mobile phone technology, an effective way to increase access and sustainability of healthcare systems globally, has demonstrated benefits within palliative care service delivery, but is yet to be utilised in Ethiopia.

Aim: To co-design, develop and evaluate a mobile phone based remote monitoring system for use by palliative care patients in Ethiopia.

Improving teamwork in maternity services: A rapid review of interventions.

Background: Teamwork is essential for providing safe, effective and women-centred maternity care and several high profile investigations have highlighted the adverse conseqences of dysfuntional teamwork. Maternity teams may need support to identify the most relevant intervention(s) for improving teamwork.

Objective: To identify and describe current 'off-the-shelf' teamwork interventions freely or commercially available to support improvements to teamworking in UK maternity services and conduct a gap analysis to identify areas for future development.

Exploring the macro-level, meso-level and micro-level barriers and facilitators to the provision of good quality early inflammatory arthritis (EIA) care in England and Wales.

Background: Evidence from a national clinical audit of early inflammatory arthritis (EIA) shows considerable variability between hospitals in performance, unexplained by controlling for case-mix.

Objective: To explore the macro-level, meso-level and micro-level barriers and facilitators to the provision of good quality EIA care.

Methods: A qualitative study within 16 purposively sampled rheumatology units across England and Wales.

Strategies used to establish palliative care in rural low- and middle-income countries: an integrative review.

Globally, 40 million people need palliative care; about 69% are people over 60 years of age. The highest proportion (78%) of adults are from low- and middle-income countries (LMICs), where palliative care still developing and is primarily limited to urban areas. This integrative review describes strategies used by LMICs to establish palliative care in rural areas.

Caring for Life-Limiting Illness in Ethiopia: A Mixed-Methods Assessment of Outpatient Palliative Care Needs.

Background: Palliative care aims to reduce physical suffering and the emotional, spiritual, and psychosocial distress of life-limiting illness. Palliative care is a human right, yet there are vast disparities in its provision: of the 40 million people globally in need of palliative care, less than 10% receive it, largely in high-income countries. There is a particular paucity of data on palliative care needs across the spectrum of incurable disease in Ethiopia.

Transforming growth factor-β signaling in systemic sclerosis.

Systemic sclerosis (SSc) is a complex, multiorgan autoimmune disease of unknown etiology. Manifestation of the disease results from an interaction of three key pathologic features including irregularities of the antigen-specific immune system and the non-specific immune system, resulting in autoantibody production, vascular endothelial activation of small blood vessels, and tissue fibrosis as a result of fibroblast dysfunction. Given the heterogeneity of clinical presentation of the disease, a lack of universal models has impeded adequate testing of potential therapies for SSc.

An ethnography of managing emotions when talking about life-threatening illness.

Aim: This ethnographic study was concerned with how dying patients, palliative care staff and family caregivers communicate about life-threatening illness in a palliative care setting in Ethiopia.

Background: Ethiopia, as a developing country, had few resources for caring for those requiring end-of-life care. However, palliative care was supported by local champions in Ethiopia and by the Federal Ministry of Health.

Successful use of blunt microdissection catheter in a chronic total occlusion of a celiomesenteric artery.

Chronic mesenteric ischemia is often a disabling condition associated with intestinal angina, weight loss, and sitophobia (a morbid aversion of food). Significant stenosis of two of the three main arteries of the gut is usually required to produce symptoms. Surgical therapy has included reimplantation and bypass grafting, usually with synthetic conduits and occasionally endarterectomy.

Induction of immunoglobulin heavy-chain transcription through the transcription factor Bright requires TFII-I.

Bright/ARID3a/Dril1, a member of the ARID family of transcription factors, is expressed in a highly regulated fashion in B lymphocytes, where it enhances immunoglobulin transcription three- to sixfold. Recent publications from our lab indicated that functional, but not kinase-inactive, Bruton's tyrosine kinase (Btk) is critical for Bright activity in an in vitro model system, yet Bright itself is not appreciably tyrosine phosphorylated. These data suggested that a third protein, and Btk substrate, must contribute to Bright-enhanced immunoglobulin transcription.

Evaluating the effect of setting up a nurse-led heart failure service.

In the UK 880,000 people have definite or probable chronic heart failure with 63,000 new cases being identified each year (Department of Health, 2003). Heart failure and its management have become a national and governmental priority. A specialist nurse was recruited to establish and manage a nurse-led service for this client group.

The transcription factor, Bright, is not expressed in all human B lymphocyte subpopulations.

Bright is an ARID family transcription factor that increases immunoglobulin heavy chain transcription. In the mouse, Bright expression is tightly regulated and B cell-restricted and the Bright protein associates with Bruton's tyrosine kinase (Btk), the defective enzyme in X-linked immunodeficiency. Human X-linked agammaglobulinemia results from defects in Btk and leads to early blocks in B lymphocyte development.

High frequency of matrix attachment regions and cut-like protein x/CCAAT-displacement protein and B cell regulator of IgH transcription binding sites flanking Ig V region genes.

A major component in controlling V(D)J recombination is differential accessibility through localized changes in chromatin structure. Attachment of DNA to the nuclear matrix via matrix attachment region (MAR) sequences, and interaction with MAR-binding proteins have been shown to alter chromatin conformation, promote histone acetylation, and influence gene transcription. In this study, the flanking regions of several human and mouse Ig V(H) and Ig Vkappa genes were analyzed extensively for the presence of MARs by in vitro matrix-binding assay, and for interaction with the MAR-binding proteins cut-like protein x/CCAAT-displacement protein (Cux/CDP), B cell regulator of IgH transcription (Bright), and special AT-rich sequence-binding protein (SATB1) by EMSA.

Elimination of rabies from red foxes in eastern Ontario.

The province of Ontario (Canada) reported more laboratory confirmed rabid animals than any other state or province in Canada or the USA from 1958-91, with the exception of 1960-62. More than 95% of those cases occurred in the southern 10% of Ontario (approximately 100,000 km2), the region with the highest human population density and greatest agricultural activity. Rabies posed an expensive threat to human health and significant costs to the agricultural economy.