Neurocognitive impairment in a large sample of homeless adults with mental illness.

OBJECTIVE: This study examines neurocognitive functioning in a large, well-characterized sample of homeless adults with mental illness and assesses demographic and clinical factors associated with neurocognitive performance. METHOD: A total of 1500 homeless adults with mental illness enrolled in the At Home Chez Soi study completed neuropsychological measures assessing speed of information processing, memory, and executive functioning. Sociodemographic and clinical data were also collected. Linear regression analyses were conducted to examine factors associated with neurocognitive performance. RESULTS: Approximately half of our sample met criteria for psychosis, major depressive disorder, and alcohol or substance use disorder, and nearly half had experienced severe traumatic brain injury. Overall, 72% of participants demonstrated cognitive impairment, including deficits in processing speed (48%), verbal learning (71%) and recall (67%), and executive functioning (38%). The overall statistical model explained 19.8% of the variance in the neurocognitive summary score, with reduced neurocognitive performance associated with older age, lower education, first language other than English or French, Black or Other ethnicity, and the presence of psychosis. CONCLUSION: Homeless adults with mental illness experience impairment in multiple neuropsychological domains. Much of the variance in our sample's cognitive performance remains unexplained, highlighting the need for further research in the mechanisms underlying cognitive impairment in this population.

Cognitive function and fatigue after diagnosis of colorectal cancer.

BACKGROUND: Cognitive impairment and fatigue have been associated with cancer and its treatment. We present baseline data from a large longitudinal study that evaluates cognitive function, fatigue, and potential underlying mechanisms following diagnosis of colorectal cancer (CRC). PATIENTS AND METHODS: We evaluated CRC patients with stage I-III disease before or after surgery, participants with limited metastatic disease and healthy controls (HC). Neuropsychological evaluation included clinical and computerised tests. Participants completed questionnaires for fatigue and quality of life (QOL)-(FACT-F), anxiety/depression, and cognitive symptoms (FACT-Cog). Ten cytokines, clotting factors, sex hormones, carcinoembryonic antigen (CEA), and apolipoprotein E genotype were evaluated. Primary end points were cognitive function on clinical tests evaluated by a Global Deficit score (GDS) and fatigue. Associations between test results, demographic, and disease related factors were explored. RESULTS: We assessed 291 participants with early-stage disease [median age 59 (23-75) years, 63% men], 72 with metastatic disease, and 72 HC. Using GDS, 45% (126/281) of participants with early-stage CRC had cognitive impairment versus 15% (11/72) of HC (odds ratio 4.51, 95% confidence interval 2.28-8.93; P < 0.001), with complex processing speed, attention/working memory, and verbal learning efficiency being most affected. Women with early-stage CRC had greater cognitive impairment than men [55/105 (52%) versus 71/176 (40%), P < 0.050]. Cognitive symptoms were self-reported by 21% (59/286) of early-stage patients versus 17% (12/72) of HC; fatigue by 52% (149/287) of early-stage patients and 26% (19/72) of HC (P < 0.0001). Women reported more fatigue than men (P = 0.003). Fatigue, QOL, anxiety/depression, and cognitive symptoms were associated with each other (r = 0.43-0.71), but not with neuropsychological performance. Most cytokines were elevated in cancer patients. Cognitive function was not associated with cytokines, sex hormones, clotting factors, CEA, or apolipoprotein E genotype. CONCLUSIONS: The incidence of cognitive impairment was three to five times higher in CRC patients than HC, with women having higher impairment rates than men. The cognitive impairment profile suggests dysfunction primarily in fronto-subcortical brain systems. TRIAL REGISTRATION: NCT00188331.

Laboratory reference values of complete blood count for apparently healthy adults in Ethiopia.

BACKGROUND: The objective of this study was to evaluate reference intervals for complete blood cell count parameters among apparently healthy 1,807 adults from Addis Ababa, Ethiopia. METHODS: Blood specimens were collected from each participant using standard procedures. The collected aliquots were processed according to standard operating procedures to determine participants' complete blood counts. Non-parametric methods were employed to calculate the reference intervals and 90% confidence intervals for complete blood counts. RESULTS: Overall the results show that reference ranges for women are lower than men. The white blood cell count, neutrophil, lymphocyte, monocyte, eosinophil, and basophil reference values appear to be lower than values reported elsewhere. CONCLUSIONS: Our study is the first comprehensive study on reference intervals of complete blood count among apparently healthy adults in Ethiopia. Future studies that assess other hematological parameters and studies that assess reference values for African pediatric populations are warranted.

Milk production and feeding behavior in the camel (Camelus dromedarius) during 4 watering regimens.

Camels survive and produce milk during recurrent prolonged hot and dry periods. The objective was to evaluate how different watering intervals affected milk production and feeding. Eight lactating camels (Camelus dromedarius) were recruited and subjected to 4 watering regimens in a Latin square design experiment performed at Haramaya University in Ethiopia. Each regimen lasted 16 d with 5 d of daily watering between periods: water was offered at 1,315 h once daily (W1); on d 4, 8, 12, and 16 (W4); on d 8 and 16 (W8); and on d 16 (W16). One camel became sick in the second period and its results were excluded. Camels were kept in a pen with minimal shade and a noon temperature of 30.9±0.1°C. They had free access to hay and were offered 2 kg of concentrates 3 times daily. At noon on d 1, 4, 8, 12, and 16, a blood sample was taken from the jugular vein before watering. All calves were kept together in a separate pen. Morning and afternoon calves stimulated milk let-down before the camels were hand-milked, after which the calves suckled, emptying the udder. Camels maintained the milk volume during water deprivation for about 1 wk, but they produced less milk during the second week during W16. Morning milk osmolality increased from 315±3 on d 1 to 333±3 mosm/kg on d 4 during W4 and from 321±3 on d 1 to 342±3 mosm/kg on d 8 during W8. After watering at 1315 h, milk osmolality decreased to 316±3 and 323±3 mosm/kg, respectively, the same afternoon and then increased during recurrent water deprivation to 338±3 (W4) and 347±3 mosm/kg (W8) on d 16, respectively. During W16, osmolality increased from 318±3 to 336±3 mosm/kg during the first 4 d of water deprivation, but during the remaining 12 d the further rise in osmolality was not higher compared with that on d 4. The change in milk osmolality was linearly correlated to plasma osmolality (r=0.8), but milk lactose content did not increase. Contrary to widespread belief, camels did not dilute their milk when dehydrated. Instead milk osmolality increased in parallel to blood osmolality. This study provides further support to earlier observations on camels' adaptation to their environment.

School-age children's safety attitudes, cognitions, knowledge, and injury experiences: how do these relate to their safety practices?

BACKGROUND: A variety of factors affect the safety and risk practices of school-age children, but rarely have multiple factors been considered simultaneously. OBJECTIVE: To examine children's safety attitudes and cognitions more thoroughly and assess how these factors, along with children's safety knowledge and injury experiences, relate to children's safety practices. METHODS: Over several classroom sessions, boys and girls in two age groups (7-9, 10-12 years) completed a psychometrically sound questionnaire that indexes their behaviors, attitudes, cognitions, knowledge, and injury experiences. RESULTS: Fewer safety practices were reported by older than younger children and boys than girls. Children's attitudes, cognitions, knowledge, and injury experiences each correlated with safety practices, but only safety attitudes and injury experiences predicted practices in a multivariate model. CONCLUSION: Exploring the relative influence of numerous factors on safety practices highlights the important role that attitudes play in predicting children's safety practices. Implications of these results for injury prevention programming are discussed.

The effects of enoximone on renal function in patients with congestive heart failure.

Enoximone is an investigational cardiotonic agent with positive inotropic and vasodilatory properties. In this protocol the effects of enoximone on parameters of renal function in patients (n = 14) with New York Heart Association class II or III congestive heart failure were determined after intravenous (IV) treatment (2 mg/kg) and after chronic oral administration (150 mg t.i.d.), either alone or with added furosemide (40 mg b.i.d.). Glomerular filtration rate (GFR), effective renal plasma flow (ERPF), filtration fraction, mean arterial pressure (MAP), renal blood flow (RBF), and renal vascular resistance (RVR) were determined each time. Plasma volume (PV) was determined at baseline and after oral enoximone and after oral enoximone plus furosemide. Significant reductions in GFR (18%) and ERPF (20%) were observed after IV treatment but not after oral treatment with or without furosemide. MAP also was lowered significantly by 14% after IV administration but not after oral treatments. PV after oral enoximone plus furosemide was reduced significantly (31%) compared with baseline. These results demonstrate that enoximone produces acute reductions in GFR and ERPF when given intravenously but has no effect on parameters of renal function when given orally, either alone or with furosemide.

Repeatability of measurements of packed cell volume and egg count as indicators of endoparasite load and their relationship with sheep productivity.

Monthly measurements of packed cell volume (PCV) and nematode and trematode eggs per gram (EPG) were made in Ethiopian highland sheep at Debre Berhan, Dejen, Deneba, Tulu Meko and Wereilu from June 1988 to December 1989. High frequencies of low PCV, high nematode EPG and high trematode EPG were found at Tulu Meko. Among the productivity traits examined, body condition scores and live-weights were significantly (P less than 0.05) associated with differences in PCV and nematode and trematode EPG levels at most sites. The lambing interval was, however, not significantly (P greater than 0.05) affected by these variables. Monthly repeatabilities of PCV, body weight and body condition scores were 0.44 +/- 0.01, 0.71 +/- 0.01 and 0.35 +/- 0.01, respectively, while those of nematode (0.09 +/- 0.01) and trematode EPGs (0.20 +/- 0.02) were much lower. The high repeatability for PCV indicates that it was less affected by the variable factors influencing egg output, and hence it could be utilized in conjunction with nematode and trematode EPG levels for endoparasite monitoring. Repeatability of the lambing interval across parities was 0.43 +/- 0.14.

Factors affecting morbidity and mortality on-farm and on-station in the Ethiopian highland sheep.

Factors affecting morbidity and mortality of the Ethiopian highland sheep were studied both on-farm and on-station at Debre Berhan between 1989 and 1990. Primary causes of infectious origin resulted in high proportional morbidity (88.4% on-farm) and mortality (72.9% on-farm and 71.8% on-station) rates. Nutritional and managemental factors were also responsible for mortalities in lambs. The most frequent secondary causes of morbidity and/or mortality were ectoparasites and nasal myiasis. Health management interventions on-station were not high enough to produce performance improvements above the on-farm levels. However, the occurrence of gastrointestinal parasites significantly (P < 0.05) differed between the two management systems. The frequency of some of the major causes of morbidity and mortality such as pneumonia, fasciolasis and enteritis were significantly (P < 0.01) affected by season and age of an animal. In order to alleviate the major health constraints identified in this study, a proper health management intervention involving vaccination, strategic anthelmintic treatment and feeding management are suggested.

Pharmacodynamics of enoximone during intravenous infusion.

Twenty-one patients with heart failure (NYHA class II-IV) received a 24-hour infusion of enoximone, followed by a 12-hour washout period. Patients were randomly assigned to one of four treatment groups. Groups I-III received a 0.5 mg/kg bolus, followed by a maintenance infusion of 2.5, 5.0 or 10.0 micrograms/kg/minute. Group IV patients received a maintenance infusion of 5.0 micrograms/kg/minute without the bolus. Serial assessments of haemodynamics, plasma levels of enoximone and enoximone sulphoxide, and ventricular ectopy were performed. Enoximone produced a significant increase in cardiac index (28.1-46.7%) and a decrease in mean pulmonary artery wedge pressure (6.4-35.7%) and systemic vascular resistance (34.7-78.9%). Enoximone had minimal effect on heart rate and blood pressure. In patients who did not receive an initial bolus of 0.5 mg/kg, haemodynamic changes were delayed by approximately 1 hour. Significant haemodynamic improvement was noted at even the lowest infusion rate and did not increase in linear fashion at higher infusion rates. During infusion of enoximone at 10.0 micrograms/kg/minute, both enoximone and its sulphoxide accumulated non-linearly and did not achieve a steady state. No significant adverse effects were noted in these patients. Enoximone infusion at rates greater than 5.0 micrograms/kg/minute may confer minimal additional haemodynamic benefit, while resulting in significant accumulation of enoximone and enoximone sulphoxide. Ventricular ectopy did not increase significantly in most patients.

Epidemiological studies on gastrointestinal helminths of dromedary (Camelus dromedarius) in semi-arid lands of eastern Ethiopia.

A total of 752 dromedaries were examined and 75% were found to be harbouring nematode eggs. The mean EPG was 1831 and the range was from 100 to 21,200. The prevalence rates in the four-age groups examined were 59.6% (3-7 years), 72.4% (8-12 years), 76.1% (13-17 years) and 83.9% (18-22 years). The prevalence rate for females and males were 77.6 and 64.8%, respectively and for long dry, short rainy, short dry and long rainy seasons were 66, 80, 69 and 82.6%, respectively. The mean EPG of faeces was significantly (P<0.01) higher for older animals compared to other group of younger animals (3-7 years), for females compared to males, and for rainy compared to dry season. Sixteen dromedary gastrointestinal organs were used for identification and counts of helminths. Among the adult worms identified, from the abomasum, Haemonchus longistipes had a 94% prevalence rate. From the small intestine Trichostrongylus colubriformis, Trichostrongylus probolurus, Impalaia tuberculata and Strongyloides papillosus were identified with prevalence rates of 75, 25, 63 and 20%, respectively. Moreover, cestodes such as Moniezia benedeni, Moniezia expansa, Avitellina spp. and Stilesia globipunctata with prevalence rates of 31, 13, 25 and 19%, respectively, were identified. I. tuberculata was identified for the first time in this country from a dromedary.The pathological lesions were more pronounced in higher infestations. Infestation level over approximately 1000 of H. longistipes and 15,000 in mixed infection of T. colubriformis and I. tuberculata, caused gross lesions of ulcerated and hyperaemic mucosa, and the odour of the fluid were fetid. The microscopic lesions observed were sloughing of epithelium, necrosis of glands, atrophy and loss of villi, haemorrhages and cellular infiltration mainly of eosinophiles and lymphocytes.

The prevalence of cysticercosis and hydatidosis in Ethiopian sheep.

Five hundred and sixty sheep, slaughtered at an Addis Ababa abattoir, were examined for cysticercosis and hydatidosis. The prevalence of the metacestodes of Taenia hydatigena was 37.1% and that of Echinococcus granulosus 16.4%. In addition, the age and sex prevalences of hydatid cysts, their organ distribution and the ratio of fertile cysts were determined.

Iodine concentration in salt at household and retail shop levels in Shebe town, south west Ethiopia.

OBJECTIVES: To determine the level of iodine in the salt at the retail shop and consumption levels and assess the knowledge, attitude and practice (KAP) of food caterers and shopkeepers about iodized salt and iodine deficiency disorders (IDD). DESIGN: Cross-sectional community based. SETTING: Retail shops and households in Shebe town-Jimma zone, southwest Oromiya region. SUBJECTS: Thirty three shopkeepers and 299 food caterers of households in Shebe town. RESULTS: The iodine content of household salt samples ranged, from 0-75 PPM and that of the shop samples ranged from 0.1-75 PPM. Eighty one per cent of household salt samples and 82% of shop salt samples have iodine levels below the minimum standard set by the Quality and Standard Authority of Ethiopia. Knowledge about iodized salt was fairly lower for food caterers (21%) than shopkeepers (57.6%). More (80%) of shopkeepers have favourable attitude than household food caterers (50.6%). Improper practices of food caterers related to iodized salt were found to be associated with female sex (P<0.01), Amhara ethnicity (P<0.001), Orthodox religion (P=0.008), literacy status (P=0.04) and occupation (P=0.01). Good knowledge, about iodized salt was significantly associated with favourable attitude among food caterers (P<0.001). CONCLUSION: This study demonstrated that high proportions of residents in Shebe town were consuming inadequately iodized salt. There is a marked loss of iodine from salt by the time it reaches to consumption level in that some households were found to use salt with zero iodine content, whereas, all salt samples collected from the shops have at least some iodine. Poor awareness about iodized salt among food caterers and even in shopkeepers was also disclosed in this study. Socio-demographic factors such as ethnicity, religion, sex, lower educational level of food caterers might have an influence on poor, household practices like exposure of salt to sunlight. Information, education and communication on the importance consuming iodized salt and its proper handling in the house and regular monitoring of the salt iodine level at consumer level is essential for elimination of IDD.

Toxoplasmosis in sheep, goats and cattle in central Ethiopia.

In a seroepidemiological survey using an indirect haemagglutination assay, the prevalence rate of toxoplasmosis in central Ethiopia was 22.9% of 899 sheep, 11.6% of 753 goats and 6.6% of 785 cattle. There were high titres of 1:256 or more which suggest current infections. These results indicate that toxoplasmosis may be an important cause of reproductive wastage in small ruminants. The public health significance of this disease is discussed. Improved hygiene and management could reduce the prevalence of the disease.

Causes of lamb morbidity and mortality in the Ethiopian highlands.

A study was conducted to investigate causes of lamb morbidity and mortality on farms and on-station at Debre Berhan during 1989 and 1990. It showed pneumonia (bacterial and/or verminous), starvation-mismothering exposure (SME) complex, gastrointestinal parasites, enteritis, abomasal impaction and physical injuries to be important health constraints on productivity. Neonatal mortalities were 51.5% and 46.3% on farms and on-station respectively and occurred owing to management problems such as SME, abomasal impaction and physical injuries. On the farms the lamb birth weight was 2.56 +/- 0.25 kg and was significantly (p < 0.05) affected by the dam's age, lambing weight, litter size, sex of lamb and year of lambing, but not by the season of lambing. Birth weight significantly (p < 0.05) influenced lamb mortality. Lambs with a low birth weight tended to die from SME. Morbidities and mortalities due to infectious causes increased in older lambs, suggesting that infections were acquired with age when resistance was lowered owing to inadequate nutrition and poor management. Heavy loss of lambs could be overcome by such health management interventions as foster mothering, warming lambs during the cold season and vaccination with polyvalent vaccines against pasteurellosis, clostridial infection and Dictyocaulus filaria.

The effect of handling methods on subsequent plasma progesterone levels in sheep.

The mean progesterone concentration in the plasma of 10 adult Ethiopian Highland sheep obtained immediately after slaughter was 10.56 +/- 3.98 ng/ml. Samples were subsequently incubated at 4 degrees C, room temperature (19-22 degrees C) or 26 degrees C as either plasma or intact but citrated blood. Failure to separate plasma affected the progesterone content at 2-72 h at room temperature or 26 degrees C (p less than 0.01 - p less than 0.0001). Incubation temperature affected the plasma concentration at 18 h (p less than 0.05) and 24 h (p less than 0.001). Although progesterone values were generally higher in separated plasma, disparity with the values from plasma separated from incubated citrated blood was small (r = 0.76-0.98). Progesterone concentration declined haphazardly after collection but sometimes exceeded the initial readings. This kept the average concentration of progesterone in plasma separated immediately after collection fairly constant and within 15% of zero time samples during the first 48 h.

Prevalence of Metabolic Syndrome among Working Adults in Ethiopia.

Objective. To evaluate the prevalence of metabolic syndrome (MetS) according to the International Diabetes Federation (IDF) and Adult Treatment Panel (ATP) III criteria among working East African adults. Design. This cross-sectional study of 1,935 individuals (1,171 men and 764 women) was conducted among working adults in Addis Ababa, Ethiopia. The study was conducted in accordance with the STEPwise approach of the World Health Organization. Results. According to ATP III and IDF definitions, the overall prevalence of MetS was 12.5% and 17.9%, respectively. Using ATP III criteria, the prevalence of MetS was 10.0% in men and 16.2% in women. Application of the IDF criteria resulted in a MetS prevalence of 14.0% in men and 24.0% in women. The most common MetS components among women were reduced high-density lipoprotein-cholesterol (HDL-C) (23.2%) and abdominal obesity (19.6%); whilst reduced HDL-C concentrations (23.4%) and high blood pressure (21.8%) were most common among men. Conclusion. MetS and its individual components are prevalent among an apparently healthy working population in Ethiopia. These findings indicate the need for evidence-based health promotion and disease prevention programs; and more robust efforts directed towards the screening, diagnosis and management of MetS and its components among Ethiopian adults.