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RATIONALE: Research studies typically quantify acute respiratory exacerbation episodes (AECOPD) among people with chronic obstructive pulmonary disease (COPD) based on self-report elicited by survey questionnaire. However, AECOPD quantification by self-report could be inaccurate, potentially rendering it an imprecise tool for identification of those with exacerbation tendency. OBJECTIVE: Determine the agreement between self-reported and health records-documented quantification of AECOPD and their association with airway inflammation. METHODS: We administered a questionnaire to elicit the incidence and severity of respiratory exacerbations in the three years preceding the survey among current or former heavy smokers with or without diagnosis of COPD. We then examined electronic health records (EHR) of those with COPD and those without (tobacco-exposed persons with preserved spirometry or TEPS) to determine whether the documentation of the three-year incidence of moderate to very severe respiratory exacerbations was consistent with self-report using Kappa Interrater statistic. A subgroup of participants also underwent bronchoalveolar lavage (BAL) to quantify their airway inflammatory cells. We further used multivariable regressions analysis to estimate the association between respiratory exacerbations and BAL inflammatory cell composition with adjustment for covariates including age, sex, height, weight, smoking status (current versus former) and burden (pack-years). RESULTS: Overall, a total of 511 participants completed the questionnaire, from whom 487 had EHR available for review. Among the 222 participants with COPD (70 ± 7 years-old; 96% male; 70 ± 38 pack-years smoking; 42% current smoking), 57 (26%) reported having any moderate to very severe AECOPD (m/s-AECOPD) while 66 (30%) had EHR documentation of m/s-AECOPD. However, 42% of those with EHR-identified m/s-AECOPD had none by self-report, and 33% of those who reported m/s-AECOPD had none by EHR, suggesting only moderate agreement (Cohens Kappa = 0.47 ± 0.07; P

Abstract Background South-South Cooperation (SSC) is recognized as a vital component of goal 17 – ‘Partnerships for the goals’ within the SDGs and countries in the global south has been utilizing this cooperation mainly in research. We report the first health care professional exchange program through this south-to-south collaboration focusing on advancing quality of abortion care in the Sub-Saharan region. Methods We conducted a comprehensive mixed method study, incorporating both quantitative and qualitative approaches, to assess the impact of health care professionals’ exchange program within the obstetrics and gynecology departments of two teaching institutions in Ethiopia and Rwanda over the course of a year (February 1, 2023-January 31,2024). Our methodology involved administering a self-administered questionnaire on Google Form to health professionals who participated in the exchange program. Qualitative data were collected through an in-depth interview with representative subjects from these professionals. Simple descriptive statistics using SPSS version 23 was employed to analyze the quantitative data. For the qualitative data, recruitment of participants continued until thematic saturation was achieved, signifying no emergence of new themes. Thematic analysis, following initial coding and inter-coder agreement, was employed to identify key themes from the interviews. Finally, triangulation of qualitative and quantitative data was performed to provide a comprehensive understanding of the program’s impact. Results Among 60 health care professionals whom we have approached for this survey, 55 consented and participated in the survey, representing a response rate of 92%. Among them, 35 (63.6%) were from Rwanda, 20 (36.4%) were from Ethiopia, 23.6% were females, 80.0% were residents and 16.4% were midwives. The overall mean scores for knowledge, attitude, and practice transformation on safe abortion care by Rwandese professionals were 84.9%, 84.5%, and 84.6%, respectively. From the Ethiopian side, the overall score for knowledge and attitude, and intent to practice demonstration were 81.3, 83.4%. Essentially, they expressed that it allowed them to inspire Rwandese counterparts on the importance of women’s reproductive rights and implementation of global best practice (89%). On analysis of the qualitative data, we identified 3 overarching themes: 1) Opportunities created by the exchange 2) Inputs on safe abortion care quality improvement 3) Recommendations for future exchange programs. Most participants indicated that the exchange program was very helpful in advancing knowledge, attitude, and intent to practice quality abortion care. Participants from both sides agreed that the safe abortion care services provided in Ethiopia is far advanced, which can be reproduced in Rwanda by implementing the lessons learned from the exchange program. Conclusion South-to-south collaboration through health care professionals exchange programs among developing countries (including Sub-Saharan Africa) is feasible and helpful in transforming the level of reproductive health practice (mainly safe abortion care) as well as advocating for better reproductive health rights in these countries.

Abstract Background Ovarian cancer is a leading cause of mortality worldwide. The third most prevalent gynecological cancer globally, following cervical and uterine cancer, and the third leading cause of cancer-related mortality among women in Sub-Saharan Africa, including Ethiopia. The time ovarian cancer patients have to wait between diagnosis and initiation of treatment are the indicators of quality in cancer care and influence patient outcomes. Despite extensive studies in the field, little is known about the strength of the association between ovarian cancer survival and waiting time. So, the main purpose of this study is to assess the effect of waiting time on ovarian cancer survival in oncology centers in Addis Ababa, Ethiopia. Methods A facility-based retrospective cohort study was conducted with a total of 561 study participants included. The main outcome of interest for this study was death due to ovarian cancer. The authors compared the ovarian cancer patients with waiting times ≤ 10 weeks and waiting times > 10 weeks for overall survival rate using the log rank test. The incidence density rate of mortality was calculated for each group variable. The effect of waiting time on ovarian cancer mortality was estimated using the Cox proportional hazards model at the 5% level of significance. Results The incidence density rate of mortality among ovarian cancer patients for waiting time ≤ 10 weeks was found to be 10.85 (95%CI, 9.10-12.98) per 1,000 person years observation, while for waiting time > 10 weeks the mortality rate was found to be 18.05 (95%CI, 15.33–21.23) per 1,000 person years observation. In the Cox regression analysis after full adjustments for confounder variables, the mortality event risk was 36% higher among waiting time > 10 weeks women (AHR = 1.36; 95%CI = 1.05–1.75) as compared to waiting time ≤ 10 weeks. Conclusions We have found that the incidence density rate of mortality among ovarian cancer patients was significantly higher in waiting time > 10 weeks groups. Therefore, future policy and clinician programmers should consider the impact of waiting time from diagnosis until to get the first treatment more carefully.

Abstract Background The Sustainable Development Goals Target 2.2 aims to eliminate all forms of malnutrition, including anemia, while the World Health Assembly targets a 50% reduction in anemia among women of childbearing age by 2025. Despite these efforts, global anemia prevalence among women has only slightly decreased from 31% to 30% between 2000 and 2019. Therefore, identifying modifiable risk factors for anemia among women of childbearing age in Africa is crucial for developing evidence-based interventions and achieving these goals. Methods We conducted an analysis of the most recent Demographic and Health Surveys datasets from 21 Sub-Saharan Africa (SSA) countries, which were carried out between 2015 and 2023. Using multilevel multinomial regression models, we calculated the Adjusted Odds Ratio (AOR) with a 95% Confidence Interval, and subsequently estimated the Population Attributable Fraction (PAF) based on these AOR values. Results The study consisted of 168,417 women of childbearing age [–] (15-49) from 21 SSA. The highest proportion of moderate to severe anemia was linked to the type of contraceptive method used (PAF = 53.11%). This was followed by the lack of health insurance coverage (PAF = 37.92%). Other significant factors included poverty (PAF = 11.50%), no formal education (PAF = 18.01%), high parity (PAF = 5.78%), and the use of unimproved drinking water sources (PAF = 3.88%). These 5 modifiable risk factors were associated with 80.60% (95%CI, 77.60-83.40%) moderate/severe anemia in SSA. Conclusion In a cross-sectional study involving 21 SSA nations, we identified 5 modifiable risk factors associated with anemia among women of childbearing age in SSA. These factors should be a priority for policymakers when planning future interventions to address anemia in SSA’s women’s health.

Service structures could be built from different materials and concrete is commonly used in construction due to its beneficial mechanical properties, such as its superior compressive strength, long-lasting durability, and ability to resist fire. Structures are anticipated to withstand the various loads they encounter during their operational lifespan, which can typically be determined based on factors such as the type of service, geographical location, and dimensions. These loads can be accurately modeled using advanced software tools that are continuously evolving. However, fire incidents are difficult to predict, making it challenging to foresee their location, timing, and the extent of their impact on structures, resulting reductions in strength and unexpected stress. Therefore, in this study, to examine the performance of concrete of different strength grades and reinforced concrete (RC) beam specimens exposed to fire at different temperatures, an experimental investigation was carried out. During the test, the maximum duration of fire exposure taken is four hours and maximum concrete surface temperature considered is limited to 246°C. For the RC beams, test was conducted under onepoint loading with different specimens of 25 mm and 35 mm concrete covers. The results showed that, the strength of RC beam after fire exposure reduces up to 18% and the compression strength of concrete at 246°C of fire exposure temperature with 25 MPa and 30 MPa were observed to drop by 32%, and 48%, respectively as compared to initial strength. Moreover, comparison of experimental results with numerical models were made. The results revealed that the predicted values of the residual compressive strength proposed by Hertz's model are in good agreement with the experimental values.

Introduction The global measles incidence has decreased from 145 to 49 cases per 1 million population from 2000 to 2018, but evaluating the economic benefits of a second measles-containing vaccine (MCV2) is crucial. This study reviewed the evidence and quality of economic evaluation studies to guide MCV2 introduction.Methods The systematic review of model-based economic evaluation studies was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The search yielded 2231 articles, with 876 duplicates removed and 1355 articles screened, with nine studies included for final analysis.Results Six studies reported a positive benefit–cost ratio with one resulting in net savings of $11.6 billion, and two studies estimated a 2-dose MMR vaccination program would save $119.24 to prevent one measles case, and a second dose could prevent 9,200 cases at 18 months, saving $548.19 per case. The most sensitive variables were the discount rate and vaccination administration cost.Conclusions Two MCV doses or a second opportunity with an additional dose of MCV were highly cost-beneficial and resulted in substantial cost savings compared to a single routine vaccine. But further research using high-quality model-based health economic evaluation studies of MCV2 should be made available to decision-makers.PROSPERO Registration CRD42020200669

Coffee is the foundation of Ethiopia's economy with a quarter of the population dependent on coffee production and exports for livelihood. However, most empirical research in coffee production focuses on the productivity factors like yields rather than socio-economic factors that can significantly influence the level of coffee production. Thus, this essay explores the determinants of smallholders' coffee production in Wolaita zone, Ethiopia by applying the ordered logistic regression model. This model estimates the coffee production status of smallholders by combining the effect of multiple productivity related biophysical and socio-economic factors. Using a multistage sample procedure, two farmers associations from each district were chosen for the research. Overall sample sizes of 250 households were interviewed door-to-door to generate quantitative data. Data was analyzed by using SPSS software and descriptive statistical techniques were applied in order to determine the coffee production status of the farm households. The results indicated that about 88.8% of the smallholder farm households fell under the yield category of 'low producer', which is an indicator that numerous variables provide challenges to the smallholder coffee production in the studied area. The results of the regression study showed that of the eighteen variables in the model, seven variables including irrigation access, pruning practice, household farm land size, training access, pesticide utilization, manure application, and cultivated land allocation were discovered to be the important predictors of farm families' coffee production status in the research region. It can be recommended that establishment of government sponsored irrigation systems, empowerment on utilization of appropriate coffee farm technologies and inputs for the areas, enhancing extension services to improve farmers' skill and knowledge on coffee production system and risk alleviating mechanisms, developing soil fertility mechanisms, establishment of farmers training centers in the vicinities of producers, building capacity of institutions are vital to motivate coffee producers and increase productivity and coffee output in the research area and areas with similar situations. Key words: coffee, Ethiopia, ordered logit production, yields, smallholder farmers, INTRODUCTION Ethiopia, an agriculture-dependent nation, is the birthplace of the world-famous Arabica Coffee and is one of the largest coffee producers [1]. Coffee is the foundation of Ethiopia's economy, with [...]

BackgroundThis issue represents a major global public health concern, accounting for approximately 703,000 deaths each year. Despite Mozambique having the 9th highest suicide rate in the world and the highest in Africa, there is no national data quantifying the burden of suicide attempts. Therefore, this study aimed to assess the prevalence of suicide attempts and identify individual and community-level factors associated with them using mixed-effects logistic regression. This study is crucial for developing early interventions, which can help reduce the risk of suicide and enhance overall mental health outcomes for young people.MethodThe data used in this study were drawn from the 2022/2023 Mozambique Demographic and Health Survey (MDHS). A weighted sample of 10,909 individuals (7,716 males and 3,149 females) aged 15-29 was included. The fitted model was evaluated using AIC and BIC, with the model having the lowest Akaike Information Criterion (AIC) and Bayesian Information Criterion (BIC) is another statistical measure used to assess the quality of a model, similar to the Akaike Information Criterion (AIC). The results of the final model were presented as Adjusted Odds Ratios (AOR) with 95% confidence intervals (CI). Variables were considered statistically significant if their p-value was less than 0.05 in the multivariable analysis.ResultsAbout 3.60% (95% CI: 3.33%-4.03%) of participants were seriously considered suicide attempt in the past 12 months of before the survey. Educational status, occupation, marital status, depression, anxiety, and geographic region were significant factors associated with suicidal attempt.ConclusionThe findings of this study enhance our understanding of the intricate relationships between suicide attempts and their predictors. Additionally, the results highlight the need for targeted interventions and mental health promotion strategies that consider the identified individual and community-level factors to reduce suicide rates in Mozambique.

Fibrodysplasia ossificans progressiva is an ultrarare disorder of endochondral ossification. It is unfamiliar to most care providers in low-income countries such as Ethiopia. Even though the clinical presentation is typical, most cases remain misdiagnosed in our region. Moreover, we hypothesize that many such cases undergo unnecessary or harmful interventions for a painless lump. In Ethiopia, with a population of approximately 120 million, only one case has been reported in the literature so far. We present two cases that were referred to our institution for a biopsy of a mass. This report is aimed at summarizing the typical presentation of the disease and at highlighting the harmful interventions one should avoid in such patients. We also hope that this report serves as an entry point to try to find more patients with this similar condition early in their clinical course. Furthermore, we believe that in order to lessen the overall impact of the illness, it is crucial to provide caregivers with health education about the causes of disease flare-ups.

Crops respond differently to soil nutrients because of climate, soil, and management. This study aimed to determine the most important nutrients for tef production. The experiment was conducted over two production seasons. All (NPKSZnB), All-B, All-Zn, All-S, All-K, All-P, All-N, RNP, RNP+Sx1, and no fertilizer treatments were applied. The pre-planning soil status of the study sites, available P concentrations during the rainy season are between 5.1 and 8.9 mg kg-1, however, 21.4 mg kg-1 of available P is observed during irrigation. In rain-fed production systems, the mean soil N concentrations are 0.12% in nitisols and 0.15% in vertosols, whereas in irrigation production systems, it is 0.14% in nitiosols. The grain yield significantly (p ≤ 0.01) varied with the omission of nutrients during the production season. However, there was no significant (p

Background Sexually transmitted infections (STIs) are a significant global health challenge, demanding attention and intervention. Despite many STIs being manageable, their asymptomatic nature poses a formidable threat to both mental and physical well-being. This silent impact can lead to substantial morbidity and mortality, which is particularly pronounced in East Africa.Objective To investigate the prevalence and factors associated with self-reported STIs among sexually active men in East Africa.Design Cross-sectional study design.Setting 10 East African countries.Participants 66 833 sexually active men.Primary outcome measure Self-reported STI in the 12 months preceding the survey. A multilevel mixed-effects logistic regression model was fitted to identify factors associated with self-reported STIs. An adjusted OR with the corresponding 95% CI was used to estimate the strength of the association, and statistical significance was set at a p value

Objective To explore awareness and acceptance of menstrual cups and associated factors among healthcare professionals in Wolaita Zone, South Ethiopia.Design Institution-based cross-sectional study.Setting The current study was carried out among governmental health facilities in Wolaita Zone, South Ethiopia Regional State between 1 September and 30 September 2023.Participants Using a simple random sampling technique, 425 healthcare providers were selected. Data were collected using a self-administered, pre-tested questionnaire.Outcome measures The data were entered using Epi-data version 3.1, and after being exported, were analysed using SPSS version 25. Bivariate and multivariable logistic regression analyses were carried out to identify relevant components. An adjusted OR and a 95% CI were used to report the relationship between the covariates and the outcome variable.Results The level of awareness towards menstrual cups was 16.2% (95% CI 12.9% to 19.8%). Type of healthcare profession 5.75 (aOR=5.75, 95% CI 1.94 to 17.01), the use of broadcast media 4.40 (aOR=4.40, 95% CI 1.80 to 10.70), and social media use (aOR=3.24, 95% CI 1.53 to 6.88) were significantly associated with awareness towards menstrual cups.Conclusion The awareness of menstrual cups among female healthcare providers was incredibly low. Type of healthcare profession, broadcast media, and social media use were the main determinants of menstrual cup awareness. Therefore, both government and non-governmental organisations should focus on promoting and providing menstrual cups nationwide.

BackgroundPublic healthcare practices, particularly disease prevention, screening, diagnosis, treatment, and rehabilitation of patients, heavily rely on the availability and functionality of medical equipment. The absence of sufficient medical equipment and the malfunctioning of existing equipment impede the ability to provide effective healthcare services and directly affect patient rehabilitation, while the challenges related to medical equipment utilization are huge, especially in countries with limited resources such as Ethiopia. Therefore, this study aimed to assess the availability, functionality, and barriers associated with the use of medical equipment at public comprehensive specialized hospitals in Amhara Regional State, Ethiopia.MethodsA cross-sectional study design involving both quantitative and qualitative methods was conducted. Eight (n = 8) comprehensive specialized hospitals in the Amhara region were selected purposefully and included in this study. The data used to assess the availability and functionality of medical equipment items (n = 78) listed by the Ethiopian Ministry of Health that are supposed to be available in all of the comprehensive specialized hospitals were collected from 29 May to 18 June 2023. Self-administered structured questionnaires, observational checklists, and key informant interview guides were used to collect the necessary data. To analyze the quantitative data, descriptive statistics were employed, and qualitative data were analyzed using a thematic approach.ResultsThe study revealed that the availability of medical equipment in at least one hospital was 55.93% on average, and the availability of at least one piece of medical equipment in the surveyed hospitals was only 25.6%. The overall functional status of medical equipment was 74.68%. The present study also indicated that 75% of the surveyed facility's biomedical engineers did not receive on-the-job training regularly. Of the eight surveyed facilities, only one had spare parts and accessories for their medical equipment and the majority (87.5%) of the facilities did not have enough medical equipment storage space and did not have medical equipment policies. The qualitative findings of this study showed that issues with the utilization of the Medical Equipment Management Information System, a lack of spare parts and accessories, the absence of a well-equipped and standardized maintenance workshop, and insufficient operator training were the major challenges.ConclusionThis study revealed critical deficiencies in medical equipment availability, functionality, and barriers to maintenance at the surveyed facilities. Therefore, to improve healthcare service delivery, collaborative efforts and targeted interventions are essential in optimizing the availability and functionality of medical equipment at each and every health facility.

Introduction: Postpartum depression is a non-psychotic depressive illness that affects women who have recently given birth. Symptoms of the illness include thoughts of suicide, low self-worth, guilt about not being able to care for their newborn, blaming themselves thoughts, and nervousness. Despite there being many studies conducted at the hospital level there are limited studies conducted at the national level to determine the individual and community level factors. Depression during childbirth can have several detrimental effects, including increased risk of complication and decreased satisfaction with birth, decreased trust in medical facilities, and decreased women's participation in maternity and newborn healthcare units.Therefore, this study amid to reveal the prevalence of postpartum depression and associated factors at individual and community levels among women who give birth in Mozambique's recent data Demographic and Health Survey (DHS). Method: Multilevel logistic regression analysis was carried out from the recent Demographic and Health Survey data. A total of 5,468 sample sizes of Mozambique DHS data were used for this secondary data analysis. At individual and community level factors were assessed to determine the burden of postpartum depression at a p-value of 0.05 with a 95 % CI with AOR. Results: The prevalence of postpartum depression among women who give birth from the recent Mozambique DHS data was 24.60 % with a CI of 23.47 %–25.75 %. No education [AOD = 1.37: 95 % CI; (1.26, 1.68)] at individual level and [AOR = 3.14:95 % CI; (2.39, 5.18)] at the community level, widowed/divorced [AOR = 1.73: 95%CI; (1.14, 3.61)], and No occupation [AOR = 1.35:95 % CI; (1.19, 1.64)] were the associated variables with postpartum depression. Conclusion: Nearly three women out of ten women who give birth develop postpartum depression. Low education status, widowed/divorced, and no occupation were the associated factors with postpartum depression. Therefore, enhancing education, creating job opportunities, and keeping married will reduce the burden of postpartum depression. This study indicates maternal depression post-delivery should be given attention by the National Health Office and other police makers. Educational level should be improved to have a continuous and sharp change in maternal depression after delivery.

Tomato (Solanum lycopersicum L.) is one of the most important vegetable crops, and it is a source of daily diet and cash crop in Ethiopia. However, its production is affected by nutrient application methods of which foliar fertilization is a popular method. The objective of this review paper is to synthesize literatures on the effects of foliar fertilization on growth, yield and quality of tomato cultivars. Both macro and micronutrient concentrations were evaluated. The articles addressing that foliar fertilization effectively increased growth, yield and quality of tomato cultivars. Foliar fertilization to be effective and maximize crop yield and nutrient uptake, the "right type," "right rate," "right time “and” right place" are essential. The right nutrient selection satisfies crop requirements, and the optimal rate of application avoids stunted development. Applications should be timed for optimal absorption conditions to maximize efficacy and avoid waste by focusing on absorbent plant sections. These elements work together to promote sustainable and effective crop management. Over all, the results showed that with 10,000 ppm of urea fertilization, the Marglobe tomato cultivar achieved a plant height of 155.63 cm, fruit weight of 151 g, and a yield of 63.69 t/ha. Additionally, the findings indicated 9.05 ± 0.32% total soluble solids (TSS) and a chlorophyll content of 51.6 ± 1.31 SPAD values with 100 ppm of ZnO nanoparticles. In conclusion, foliar fertilization of nutrients increased growth, yield and quality of tomato cultivars however, the result vary from cultivar to cultivar. The foliar fertilization depends on appropriate time, weather condition, genotypes of tomato, leaf area index, amount of foliar fertilization, type of nutrient, and stage of crop.

BackgroundThe time during labor and delivery is crucial for the survival of both women and their infants, as complications that occur during this period can significantly increase the risk of morbidity and mortality. In developing nations, women of reproductive age and their infants are still at risk of morbidity and death from complications associated with pregnancy and childbirth. Morbidity and death from complications of pregnancy and childbirth can be prevented through the utilization of quality care during labor and delivery. However, there is limited evidence on the magnitude and factors associated with quality intrapartum care in East Africa. Therefore, this study assessed the magnitude and associated factors of quality intrapartum care among women in East Africa.MethodsIn this study, we used the most recent Demographic and Health Survey (DHS) dataset from 2015 to 2023, covering 11 East African countries. STATA version 18 software was used for data analysis. Multi-level modeling was applied due to the hierarchical or nested structure of DHS data. Variables with a p-value of less than 0.25 in the bivariate multi-level logistic regression model were included in the multivariable multi-level logistic regression analysis. Variables with p-values less than 0.05 were considered significant factors associated with receiving quality intrapartum care.ResultsThe prevalence of receiving quality intrapartum care in East Africa was 56.38% [95% confidence interval (CI): 56.03, 56.7]. Women with primary education [Adjusted Odds Ratio (AOR) = 1.39, 95% CI: 1.33, 1.46], secondary education (AOR = 1.62, 95% CI: 1.53, 1.62), and higher education (AOR = 1.46, 95% CI: 1.33, 1.60), those in the middle (AOR = 1.28, 95% CI: 1.23, 1.34) and rich (AOR = 1.36, 95% CI: 1.31, 1.43) wealth index categories, women with one (AOR = 1.17, 95% CI: 1.09, 1.25) or 2–4 (AOR = 1.22, 95% CI: 1.16, 1.28) living children, those who perceived the distance from the health facility as not a big problem (AOR = 1.28, 95% CI: 1.24, 1.33), and women living in Rwanda (AOR = 1.30, 95% CI: 1.19, 1.41) had higher odds of receiving quality intrapartum care. Residing in rural areas (AOR = 0.82, 95% CI: 0.78, 0.86), and being from Ethiopia, Kenya, Madagascar, Malawi, Mozambique, Tanzania, Uganda, Zambia, or Zimbabwe, were factors negatively associated with receiving quality intrapartum care.Conclusion and recommendationsNearly half of the women in East African countries did not receive quality intrapartum care. Both individual and community-level variables were significantly associated with receiving quality intrapartum care in East Africa. Improving the quality of intrapartum care requires enhancing women's education, addressing socioeconomic challenges, and increasing access to health facilities through targeted interventions.

Background: Mental health problems, particularly anxiety and depression, are indeed among the leading health challenges worldwide, affecting individuals across all age groups and geographic locations. The relationship between mental health and socioeconomic factors, including household wealth status, is well-documented. However, there are currently no studies demonstrating a causal relationship between household wealth and common mental disorders, such as anxiety and depression. Therefore, this study aimed to assess the effect of household wealth status on anxiety and depression through Propensity Score Matching analysis (PSM) analysis. Methods: This study used the recent 2022 Nepal Demographic and Health Survey (NDHS). A weighted sample of 7411 reproductive-age (aged 15–49 years) women who were interviewed for mental health conditions were included in this study. Anxiety and depression were the dependent variables of this study. The NDHS utilized the Generalized Anxiety Disorder 7-item scale (GAD-7) to assess levels of anxiety among participants and the Patient Health Questionnaire 9 (PHQ-9) to evaluate depression. PSM analysis was employed to examine the causal connection between household wealth and women's anxiety and depression by controlling for confounding variables. Results: The average treatment effects (ATE) of non-poor household status on anxiety and depression were −0.015 and −0.052 respectively, indicating that non-poor household status reduces women's anxiety and depression. It implies the difference in risks of anxiety and depression that would be observed if everyone in the population were from non-poor households, versus if everyone in the population were from poor households were 1.5 % and 5.2 % respectively. The average treatment effect on treated (ATT) result showed that women from non-poor wealth status households reduced the risk of anxiety and depression by 1.1 % and 9.2 % respectively among treated groups. Conclusion: This study evidenced that causal relationship between household wealth status and common mental health conditions as such anxiety and depression. This suggests, it is better to focus on improving the wealth status of households to enhance the mental health of reproductive-age women. By understanding the multidimensional aspects of poverty and their links to mental health, stakeholders can create more effective strategies to support affected individuals and communities. This can contribute to breaking the cycle of poverty and improving overall well-being.

AbstractIn this article, an optimal controller is proposed to extract maximum wind energy from the available wind speed. The very fluctuating nature of wind speed has made the process of extracting wind energy complicated. To extract and optimize such a complicated system, a dynamic programming-based optimal control approach is well suited to non-linear wind turbine system models and restrictions. The performance of this control method is tested via MATLAB software. The outcomes of the system have a 7 up to 8.5 tip speed ratio optimal value and the aerodynamic efficiency has a 0.411 conversion value. With the proposed controller, the energy captured is improved by 13.841% and 1.15% for piecewise step input and randomly generated wind speed respectively compared to standard torque control. The lower percentage improvement, in this case, is due to the limited range of the wind speed value given for the simulation. Generally, the optimal control method is globally maximizing wind energy capture for each time step via forward and backward recursion of dynamic programming rather than normal torque control.

Agriculture plays a key role in nutrition security by enabling farm households to access micronutrient-rich foods through their income. This study evaluated the impact of crop diversity on nutrition security among rural households in Sinana Woreda, Oromia Region. Using multi-level and random sampling, data were collected through structured questionnaires, focus group discussions, and key informant interviews. Anthropometric measurements were taken for children in the study. The analysis employed Pearson Correlation coefficients, bivariate, and multivariate logistic regression to assess the relationship between crop diversification and child nutrition. Findings indicated that greater crop diversity improved child diets and reduced malnutrition rates stunting (23.81%), underweight (21.16%), and wasting (9.52%). Crop diversification was negatively correlated with stunting and underweight while positively correlating with wasting and dietary diversity scores. Factors influencing child nutrition included household head age, parental education, farmland size, livestock units, water availability, child sex, sanitation access, income, and health services. The study suggests that promoting crop diversification can enhance nutrition security, emphasizing the need for policies that consider economic and agro-ecological contexts.

Buildings that require mechanical and electrical services must have utility pipes and ducts. The services include air conditioning, power supply, telephone lines, network cables, sewerage lines, water supply and etc. A reinforced concrete (RC) deep beam with web openings experiences excessive cracking and deflection, as well as a decrease in beam stiffness. Enlargement of these openings near supports would reduce beams’ capacity for shear. Hence, analysis and design of such beams require careful consideration, particularly with regard to their performance. In addition, design compliance to relevant codes and standards, and selection of suitable material properties and construction techniques are needed. When such an enlargement is unavoidable, strengthening of beam for shear and flexure is necessary. In this study, the use of GFRP (Glass-Fiber Reinforced Polymer) composites for strengthening of RC beams with openings is experimentally investigated. As compared to the control beam, test results showed that using GFRP was found to be effective in increasing the shear strength of beams with openings by 40% to 60%. Test results of beams with web openings exhibited higher shear strength than the predicted values whereas for strengthened beams with GFRP, code predictions are found conservative.

Introduction: Delaying in seeking abortion services causes adverse public health outcomes, which increases maternal mortality rates due to complications from abortion. However, evidence shows that there are limited factors associated with delayed abortion. Therefore, the study aims to determine the magnitude and identify factors associated with delayed seeking abortion among reproductive-aged women in Ethiopia. Methods: Secondary cross-sectional data analysis was conducted on the Ethiopian Demographical and Health Survey dataset. A total weighted sample of 2198 reproductive-aged women was considered in this study. All data processing and statistical analyses were performed using R-software version 4.2.3. Multilevel binary logistic regression analysis was used to identify a significant predictor for delays in seeking abortion. An adjusted odds ratio with a 95 % confidence interval was used to measure a statistical association. Result: The prevalence of delays in seeking abortion among women in Ethiopia was 32 %. Educational status (AOR = 0.63; 95 % CI: 0.37–0.78), marital status (AOR = 2.12; 95 % CI: 1.38–3.74), wealth index (AOR = 0.54; 95 % CI: 0.41–0.75), frequency of listening a radio (AOR = 0.61; 95 % CI: 0.45–0.75), live births (AOR = 0.43; 95 % CI: 0.25–0.72), pregnancy wanted status (AOR = 0.59; 95 % CI: 0.4–0.79), contraceptive use (AOR = 0.46; 95 % CI: 0.34–0.69), and place of residence (AOR = 2.31; 95 % CI: 1.67–3.19) were statistically significantly variables associated with delays in seeking abortion. Conclusions: Delayed seeking abortion remains high in Ethiopia. The study is vital for policymakers, healthcare providers, and advocates to improve training on the importance of early abortion care, develop targeted interventions for better accessibility to abortion services, expand health education programs to raise awareness about reproductive rights and empower women with information for informed reproductive health decisions. Health education programs, specifically targeting uneducated women, poorer women, rural resident women, and women who do not use contraceptives, would decrease delays in accessing abortion services.

BackgroundIntimate partner violence (IPV) is a significant public health problem, with serious consequences on women's physical, mental, sexual, and reproductive health, as well as birth outcomes. Women who encounter IPV are more likely to experience adverse birth outcomes such as low birth weight, premature delivery, and stillbirth. Although numerous studies are exploring the association between IPV and adverse birth outcomes, they merely used classical models and could not control for potential confounders. The purpose of this study was to ascertain whether there was a causation between IPV and adverse birth outcomes in sub-Saharan Africa (SSA) using a quasi-experimental statistical technique [i.e., propensity score matching (PSM) analysis].MethodThis study used the most recent (2015–22) Demographic and Health Survey (DHS) data from 20 SSA countries. A total weighted sample of 13,727 women was included in this study. IPV (i.e., sexual, physical, emotional, and at least one form of IPV) was the exposure/treatment variable and adverse birth outcomes (preterm delivery, low birth weight, stillbirth, and macrosomia) were the outcome variables of this study. PSM was employed to estimate the impact of IPV on adverse birth outcomes.ResultsThe average treatment effects (ATE) of sexual, physical, emotional, and at least one form of IPV were 0.031, 0.046, 0.084, and 0.025, respectively. Sexual, physical, emotional, and at least one form of IPV increased adverse birth outcomes by 3.1%, 4.6%, 8.4%, and 2.5%, respectively. Findings from the average treatment effect on treated (ATT) showed that women who experienced sexual, physical, emotional, and at least one form of IPV had an increased risk of adverse birth outcomes by 3.6%, 3.7%, 3.3%, and 3.0%, respectively, among treated groups.ConclusionThis study demonstrates a causal relationship between IPV and adverse birth outcomes in SSA countries, indicating a need for programs and effective interventions to mitigate the impact of IPV during pregnancy to reduce related adverse pregnancy outcomes. Furthermore, we suggest further research that investigates the causal effect of IPV on adverse birth outcomes by incorporating additional proximal variables not observed in this study.

Background According to the WHO, obstetric fistula (OBF) is an abnormal connection between the genital tract and the urinary tract that occurs as the result of obstetric trauma, typically from prolonged obstructed labour. In 2018, globally, 50 000 and 100 000 cases of OBF are reported each year. The core of activities focused on reducing fistulas depends on a review of the disorder’s knowledge and the features of women at risk of having a lack of understanding. The effect of community-level factors on awareness of OBF was not yet known in Nepal. Therefore, we aimed to investigate the community-level and individual-level factors of awareness of OBF among childbearing-aged women in Nepal.Methods The 2022 Nepal Demographic and Health Survey data were used for this study. It included 14 845 childbearing-aged women. Because of the clustering effects of Demographic and Health Survey data and the binary nature of the outcome variable, a multilevel binary logistic regression model was applied. An adjusted OR (AOR) with a 95% CI was reported to declare the statistical significance. In addition, the model that had the lowest deviance was the one that best fit the data.Results The overall prevalence of awareness of OBF among childbearing women in Nepal was 35.9% (95% CI 35.1%, 36.7%). Educational status (women who attended secondary education (AOR=1.65; 95% CI 1.41, 3.03) and higher education (AOR=4.29; 95% CI 1.14, 36.70)), currently working status (AOR=1.85; 95% CI 1.04, 3.30), birth history (AOR=2.23; 95% CI 1.48, 4.10), media exposure (AOR=1.54; 95% CI 1.07, 3.09) and women’s age from 30 to 39 (AOR=3.38; 95% CI 1.35, 8.93) and 40 to 49 years old (AOR=4.68; 95% CI 1.60, 13.67) at the individual level, as well as urban residence (AOR=1.53; 95% CI 1.99, 2.87) and high community-level media exposure (AOR=2.05; 95% CI 1.67, 2.64) at the community level were statistically significant factors with awareness of OBF.Conclusion Our study revealed that awareness of OBF among childbearing-aged women in Nepal was low (35.9%). The findings of this study will assist policymakers and public health programmers in understanding the magnitude of OBF awareness and the contributory factors. In addition, it will be useful to increasing awareness of OBF in the communities and promoting primary prevention approaches through education and motivation efforts.

Soil erosion and sediment buildup are the factors that speed up the decline in capacity and function of reservoirs, agricultural products, and water resources. In order to simulate sediment and runoff and map high sediment-yielding sub-basins in the Gibe Gojeb catchment in southwest Ethiopia, this study used the Soil and Water Assessment Tool (SWAT) model. Using data on sediment and river flow, calibration and validation were carried out. Between 2003 and 2016, the catchment produced an average annual sediment loading of 62.5 tons ha−1 yr−1, with loading fluctuations ranging from 0.2 to 108.4 tons ha−1 yr−1. The acceptable sediment yield threshold value ranges from 12.3 to 108.4 tons ha−1 yr−1 for 56 sub-basins, and from 0.2 to 10 tons ha−1 yr−1 for 5 sub-basins. The most significant sub-basins with very high to extremely severe sediment yields were sub-basins 1 to 30, 32 to 44, 47, 48, 50, 51, and 53 to 61. After thirteen years of operation, the yearly amount of 58,802 tons of sediment transferred from the catchment and deposited into Gibe One reservoir has decreased the capacity by 5.7 %. The accumulation of sediment in a reservoir has an impact on its functionality, power production, and capacity, affecting the safety of dams and the environment. The study's findings enhanced our comprehension of sediment accumulation in reservoirs and furnished us with the necessary information regarding reservoir safety, integrated soil, and water management.

IntroductionHuman rights violations and violence against women are serious public health issues that have numerous detrimental repercussions on one’s physical, emotional, sexual, and reproductive health. According to studies, women’s perceptions and traits of violence are highly predictive of their likelihood of seeking help against violence. Even though intimate partner violence is a huge challenge nowadays in Africa, there is a low level of help-seeking behavior. Conducting this study at the East African level on help-seeking behavior can provide a clue for policy-makers. Therefore, this study aimed to reveal the prevalence of help-seeking behavior against intimate partner violence and determinant factors among women in East Africa.MethodMultilevel logistic regression analysis was carried out among East Africans using recent demographic and health survey data. A total of 7,387 participants aged 15 to 49 years were included in this study from East African countries. Individual- and community-level variables were considered to determine the associated factors with help-seeking behaviors against intimate partner violence with 95% CI and AOR.ResultsThe prevalence of help-seeking behavior against intimate partner violence among women was 38.07% with 95% CI (36.96%, 39.18%). Husbands drink alcohol [AOR = 1.46: 95% CI (1.33, 1.61)], women who have work [AOR = 1.33: 95% CI (1.19, 1.50)], and women with higher educational status [AOR = 1.36: 95% CI (1.16, 1.59)] were factors associated with help-seeking behavior against intimate partner violence.ConclusionApproximately four out of 10 women were seeking help for intimate partner violence in East Africa. Husbands drinking alcohol, women’s high educational status, and women having occupations were the factors that were associated with help-seeking behaviors against intimate partner violence.

BackgroundDespite the wealth of scientific information on the health effects of air pollution, the adult public's lifestyle continues to be largely detrimental towards the environment.ObjectiveThe purpose of the study was to determine whether a short interactive teaching session on air pollution could shift reported behavioral choices of adolescents towards environmentally friendlier options.MethodsWe performed a pilot randomized control trial in which eighth-grade students were randomized to receive a one-hour script-based teaching on either the effects of air pollution on lung health (intervention group) or the role of vaccination in public health (active control group). The enrolled students completed a survey (15 multiple-choice questions; five targeting understanding (score range 5 to 20); ten targeting behavioral choices (score range 10 to 38) newly designed for this study to evaluate their understanding and predict their future behavior towards air pollution immediately before, immediately after, and one month after the teaching sessions.ResultsSeventy-seven students (age = 13.5±0.6 years; 50.4% female; median annual family income = $25K-$50K with 70.1%