The effect of urea fertilizer doses on the chemical characteristics of the Samurai1, Samurai-2, and Pahat mutant sorghum (Sorghum bicolor L.) grain varieties

This research aimed to determine the influence of various doses of urea fertilizer on the chemical characteristics of mutant sorghum (Sorghum bicolor L.) grain varieties Samurai1, Samurai-2, and Pahat. A Fully Randomized Factorial Design was used by employing two factors and three replications. The three varieties of mutant sorghum grain served as the first factor while four doses (i.e., 0, 30, 60, and 90 kg/ha) of urea fertilizer administration served as the second factor. The parameters in the chemical test on the sorghum grain include ash, total protein, amylum, reducing sugar, dissolved protein, and tannin contents. The administration of urea fertilizer significantly influenced the increase in the ash, amylum, reducing sugar, and dissolved protein contents of Samurai-1 but did not significantly do so to such contents of Samurai-2 and Pahat. The urea fertilizer dose of 90 kg/ha gave the best results of the chemical composition of the three types of mutant sorghum grain. Chemically, mutant sorghum flour of the three varieties is qualified as a quality food ingredient with Samurai-1 being the best of the three varieties, in that case, possessing total protein content of 7.90%, amylum (or starch) content of 14.51%, dissolved protein content of 2.38%, reducing sugar content of 2.88%, and tannin content of 0.70%.

Level of Healthcare Providers' Preconception Care (PCC) Practice and Factors Associated with Non-Implementation of PCC in Hawassa, Ethiopia

Background

Healthcare providers (HCPs) are at the forefront of screening and identifying preconception risk factors leading to adverse pregnancy outcomes (APOs). In Ethiopia, there is no published study that assessed the status of the implementation of PCC. This is a study conducted with the aim of determining the level of HCP's PCC practice and factors associated with non-implementation of PCC.

Methods

This institution based cross-sectional study conducted among HCPs working in public health institutions (PHI) of Hawassa. The data was collected using a validated instrument called ‘Andarg-Ethio PCC-KAPQuestionnaire’. A ltistage sampling was applied to draw a sample of 634 HCPs. The data were analyzed using SPSS software, version 20. Descriptive statistics and binary as well as multiple logistic regression analysis models were used to determine the cruds and adjusted odds ratios.

Results

Out of the total study participants, 84.7%(537) were found not totally practising PCC. Those HCPs who do not screen their clients' reproductive life plan (RPL) had 7 times higher odds of not practising PCC (AOR=7.2 95% C.I. 3.6 – 14.5), whereas those HCPs with poor PCC knowledge had 4 times higher odds of not practising PCC (AOR= 4.4, 95% C.I. 2.5–7.6).

Conclusion

The findings of this study demonstrated the absence of standardized and consistent PCC practice which indicates that PCC is not well introduced to the area. Developing of PCC policy and guidelines plus training of HCPs are recommended.

The impact of stressful life events, symptom status, and adherence concerns on quality of life in people living with HIV

Studies concerning persons living with HIV (PLWH) report that stressful life events (SLEs) contribute to an exacerbation of symptoms and reduced antiretroviral (ARV) adherence and quality of life (QOL). Little is known about whether these findings are site-specific. Our study's aims were to characterize the type and frequency of SLEs for PLWH in Puerto Rico, South Africa, and the United States, and to assess the impact of SLEs by national site, symptoms, and ARV adherence concerns on QOL. The sample consisted of 704 participants. The total number of SLEs correlated significantly with the total number of symptoms, adherence concerns, and QOL (p ≤ .001). Overall, 27.2% of the variance in QOL was explained by the aforementioned variables. Although SLEs were of concern to PLWH, worries about ARV adherence were of even greater concern. Routine assessment of ARV concerns and SLEs can promote ongoing ARV adherence and improved QOL.

A randomized controlled trial of an HIV/AIDS Symptom Management Manual for depressive symptoms

Abstract Depressive symptoms are highly prevalent, underdiagnosed, and undertreated in people living with HIV/AIDS (PLWH), and are associated with poorer health outcomes. This randomized controlled trial examined the effects of the HIV/AIDS Symptom Management Manual self-care symptom management strategies compared with a nutrition manual on depressive symptoms in an international sample of PLWH. The sample consisted of a sub-group (N=222) of participants in a larger study symptom management study who reported depressive symptoms. Depressive symptoms of the intervention (n=124) and control (n=98) groups were compared over three months: baseline, one-month, and two-months. Use and effectiveness of specific strategies were examined. Depressive symptom frequency at baseline varied significantly by country (χ (2) 12.9; p=0.04). Within the intervention group there were significant differences across time in depressive symptom frequency [F(2, 207) = 3.27, p=0.05], intensity [F(2, 91) = 4.6, p=0.01], and impact [F(2, 252) = 2.92, p= 0.05), and these were significantly lower at one month but not at two months, suggesting that self-care strategies are effective in reducing depressive symptoms, however effects may be short term. Most used and most effective self-care strategies were distraction techniques and prayer. This study suggests that people living with HIV can be taught and will employ self-care strategies for management of depressive symptoms and that these strategies are effective in reducing these symptoms. Self-care strategies are noninvasive, have no side-effects, and can be readily taught as an adjunct to other forms of treatment. Studies are needed to identify the most effective self-care strategies and quantify optimum dose and frequency of use as a basis for evidence-based practice.

Exploring the contribution of general self-efficacy to the use of self-care symptom management strategies by people living with HIV infection

General self-efficacy (GSE), the expectation that one is able to perform a behavior successfully, may differentiate those who are able to successfully utilize self-care symptom management strategies (SCSMS). This subanalysis (n=569) of an international 12 site longitudinal randomized controlled trial (RCT) (n=775), investigated GSE as an important factor determining symptom burden, SCSMS, engagement with the provider, and medication adherence over time, and identified differences in those with high and low GSE ratings concerning these variables. Parametric and nonparametric repeated-measures tests were employed to assess GSE and the perceived effectiveness of SCSMS for anxiety, depression, diarrhea, fatigue, nausea, and neuropathy. Symptom burden, engagement with the provider, and antiretroviral adherence were analyzed with regard to GSE. Our data indicated that there were differences in the perceived symptom burden over time of HIV infected individuals by GSE. Those individuals with higher GSE had fewer symptoms and these symptoms were perceived to be less intense than those experienced by the low GSE group. There were few meaningful differences in the SCSMS used by those with high versus low GSE other than the use of illicit substances in the low GSE group. The low GSE group was also significantly (p= < 0.001) less engaged with their healthcare providers. Given the difference in substance use by perceived GSE, and the importance of engagement with the healthcare provider, more attention to the resolution of the concerns of those with low GSE by healthcare providers is warranted.

Self-care behaviors and activities for managing HIV-related anxiety

The goal of this study was to identify the baseline prevalence and effectiveness of anxiety self-management strategies in a convenience sample of persons living with HIV (PLWH; n = 343) in the United States, Puerto Rico, Kenya, and South Africa who reported HIV-related anxiety symptoms. Relationships between demographics and anxiety characteristics were determined, as was the effectiveness of self-care activities/behaviors to reduce anxiety. We found that the use of anxiety self-management strategies varied by gender and that ratings of effectiveness varied by country. Highest anxiety intensity scores were found in participants who were taking antiretroviral medications and who had undetectable viral loads. Forty-five percent of the persons with a diagnosis of AIDS reported anxiety symptoms. As HIV increases in areas of the world where self-care is the primary approach to managing HIV, additional research will be needed to address the effectiveness of cross-cultural differences in strategies for self-managing HIV-related anxiety.

Unhealthy substance-use behaviors as symptom-related self-care in persons with HIV/AIDS

Unhealthy substance-use behaviors, including a heavy alcohol intake, illicit drug use, and cigarette smoking, are engaged in by many HIV-positive individuals, often as a way to manage their disease-related symptoms. This study, based on data from a larger randomized controlled trial of an HIV/AIDS symptom management manual, examines the prevalence and characteristics of unhealthy behaviors in relation to HIV/AIDS symptoms. The mean age of the sample (n = 775) was 42.8 years and 38.5% of the sample was female. The mean number of years living with HIV was 9.1 years. The specific self-reported unhealthy substance-use behaviors were the use of marijuana, cigarettes, a large amount of alcohol, and illicit drugs. A subset of individuals who identified high levels of specific symptoms also reported significantly higher substance-use behaviors, including amphetamine and injection drug use, heavy alcohol use, cigarette smoking, and marijuana use. The implications for clinical practice include the assessment of self-care behaviors, screening for substance abuse, and education of persons regarding the self-management of HIV.

Prevalence, self-care behaviors, and self-care activities for peripheral neuropathy symptoms of HIV/AIDS

As part of a larger randomized controlled trial examining the efficacy of an HIV/AIDS symptom management manual (n = 775), this study examined the prevalence of peripheral neuropathy in HIV-infected individuals at 12 sites in the USA, Puerto Rico, and Africa. Neuropathy was reported by 44% of the sample; however, only 29.4% reported initiating self-care behaviors to address the neuropathy symptoms. Antiretroviral therapy was found to increase the frequency of neuropathy symptoms, with an increased mean intensity of 28%. A principal axis factor analysis with Promax rotation was used to assess the relationships in the frequency of use of the 18 self-care activities for neuropathy, revealing three distinct factors: (i) an interactive self-care factor; (ii) a complementary medicine factor; and (iii) a third factor consisting of the negative health items of smoking, alcohol, and street drugs. The study's results suggest that peripheral neuropathy is a common symptom and the presence of neuropathy is associated with self-care behaviors to ameliorate HIV symptoms. The implications for nursing practice include the assessment and evaluation of nursing interventions related to management strategies for neuropathy.

Exploring HIV stigma and quality of life for persons living with HIV infection

The purpose of this study was to explore the potential contribution of perceived HIV stigma to quality of life for people living with HIV infection. A cross-sectional design explored the contribution of demographic variables, symptoms, and stigma to quality of life in an international sample of 726 people living with HIV infection. Stigma independently contributed a significant 5.3% of the explained variance in quality of life, after removing contributions of HIV-related symptoms and severity of illness. This study empirically documents that perceived HIV stigma had a significantly negative impact upon quality of life for a broad sample of people living with HIV infection.

Does "asymptomatic" mean without symptoms for those living with HIV infection?

Throughout the history of the HIV epidemic, HIV-positive patients with relatively high CD4 counts and no clinical features of opportunistic infections have been classified as "asymptomatic" by definition and treatment guidelines. This classification, however, does not take into consideration the array of symptoms that an HIV-positive person can experience long before progressing to AIDS. This short report describes two international multi-site studies conducted in 2003-2005 and 2005-2007. The results from the studies show that HIV-positive people may experience symptoms throughout the trajectory of their disease, regardless of CD4 count or classification. Providers should discuss symptoms and symptom management with their clients at all stages of the disease.

A randomized controlled trial testing the efficacy of an HIV/AIDS symptom management manual

This study investigates whether using an HIV/AIDS symptom management manual with self-care strategies for 21 common symptoms, compared to a basic nutrition manual, had an effect on reducing symptom frequency and intensity. A 775-person, repeated measures, randomized controlled trial was conducted over three months in 12 sites from the United States, Puerto Rico, and Africa to assess the relationship between symptom intensity with predictors for differences in initial symptom status and change over time. A mixed model growth analysis showed a significantly greater decline in symptom frequency and intensity for the group using the symptom management manual (intervention) compared to those using the nutrition manual (control) (t=2.36, P=0.018). The models identified three significant predictors for increased initial symptom intensities and in intensity change over time: (1) protease inhibitor-based therapy (increased mean intensity by 28%); (2) having comorbid illness (nearly twice the mean intensity); and (3) being Hispanic receiving care in the United States (increased the mean intensity by 2.5 times). In addition, the symptom manual showed a significantly higher helpfulness rating and was used more often compared to the nutrition manual. The reduction in symptom intensity scores provides evidence of the need for palliation of symptoms in individuals with HIV/AIDS, as well as symptoms and treatment side effects associated with other illnesses. The information from this study may help health care providers become more aware of self-management strategies that are useful to persons with HIV/AIDS and help them to assist patients in making informed choices.

Symptom Burden of Fatigue in Men and Women Living With HIV/AIDS in Southern Africa

HIV-related fatigue is a debilitating and disabling symptom that persists for months and years. In 743 HIV/AIDS patients from Southern Africa, the authors found ratings of HIV-related fatigue to be highly prevalent. The authors conducted a secondary data analysis within the theoretical context of the University of California, San Francisco Symptom Management Model. The analysis focused on 538 patients who reported fatigue to investigate correlates and predictors of fatigue severity in relationship to demographic and HIV/AIDS illness indicators, as well as HIV-specific physical and psychological symptoms. A hierarchical regression model explored the contributions of those five blocks on fatigue severity. Of the 47% of the total variance in fatigue severity, a combination of variables within the health and illness block (6%), the physical symptoms block (7%) and the psychological symptom block (2%) contributed significantly to the increase in fatigue severity scores. Fatigue severity in Southern Africa was moderate, and the factors contributing to the perceived fatigue were most likely related to symptoms of acute HIV disease (such as fever and gastrointestinal problems). In conclusion, fatigue severity is less impacted by demographic or environmental variables but much more by co-occurring symptoms and HIV disease severity. The results of this study imply the need for more research to understand if improvements in water quality and access to food would prevent infection and diarrhea and whether sufficient access to antiretroviral treatments to manage the HIV infection would improve fatigue and co-occurring symptom profiles.

Quality of life and the concept of "living well" with HIV/AIDS in sub-Saharan Africa

PURPOSE

To increase understanding of the meaning of quality of life for people living with HIV/AIDS in four countries in sub-Saharan Africa: Botswana, Lesotho, South Africa, and Swaziland.

METHODS

Using a cross-sectional design and convenience sample, we administered a survey and collected data on demographic characteristics, measures of severity of illness, and perceptions of quality of life. The purposefully selected sample (N=743) consisted of community-based people living with HIV/AIDS in 2002. Based on the Wilson and Cleary framework for organizing variables related to quality of life, a hierarchical multiple regression was conducted with quality of life as the dependent variable.

RESULTS

The sample of 743 persons was 61.2% female with a mean age of 34 years. Approximately 62 % of the sample reported having received an AIDS diagnosis. Ten predictor variables explained 53.2 % of the variance in life satisfaction. Those participants with higher life satisfaction scores were less educated, had worries about disclosure and finances, did not have an AIDS diagnosis or other comorbid conditions, had lower symptom intensity, had greater functioning, and had fewer health worries. None of these participants was taking antiretroviral medications at the time of this study.

CONCLUSIONS

Several dimensions of the Wilson and Cleary model of quality of life were significantly related to life satisfaction for people living with HIV/AIDS in sub-Saharan Africa. Quality of life for this sample was primarily defined as overall functional ability and control over symptom intensity. These findings are similar to studies in developed countries that have shown the significant relationships among functional abilities, symptom control, and perceived quality of life. As antiretroviral medications become more available in these areas, community members and care providers can help clients realize the possibility of living well with HIV/AIDS, and can work with clients to improve functional ability and control symptom intensity to make living well a reality.

The Symptom Experience of People Living With HIV/AIDS in Southern Africa

This study describes the symptom experience of 743 men and women living with HIV/AIDS in Botswana, Lesotho, South Africa, and Swaziland. Data were obtained in 2002 by using a cross-sectional design. A survey of participants included 17 sociodemographic items and the 64-item Revised Sign and Symptom Checklist for Persons with HIV Disease. Results indicate a strong correlation between the frequency of reported symptoms and their intensity (r = .84, p < .00). Participants who reported having enough money for daily expenses also reported significantly fewer symptoms. There were no significant differences in symptom frequency between men and women or by location of residence. The study showed a complex picture of HIV-related symptoms in all four countries. Because of the high levels of symptoms reported, the results imply an urgent need for effective home- and community-based symptom management in countries where antiretroviral therapy is unavailable to help patients and their families manage and control AIDS symptoms and improve quality of life.

HIV/AIDS symptom management in Southern Africa

We describe self-reported strategies used by persons living with HIV/AIDS in Botswana, Lesotho, South Africa, and Swaziland to manage common HIV-related symptoms. A questionnaire asked participants to list three to six symptoms they had recently experienced, the care strategies they had used to make them better, where they had learned the strategy, and to rate the perceived effectiveness of the strategy. Data were collected in 2002 from 743 persons. The self-care management strategies were coded into eight categories: medications, complementary treatments, self-comforting, changing diet, seeking help, exercise, spiritual care, and daily thoughts/activities. Overall, participants reported medications as the most frequently occurring management strategy and the most effective. A very small inventory of behavioral strategies was available to participants to help them manage their HIV-related symptoms.

Simultaneous occurrence of heritable t(3;7) and t(14;21) in two sibs

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Relationship of self-concepts of three-, four-, and five-year-old children with mother, father, and teacher percepts

Ss were 46 preschool boys and girls, ages three, four, and five years, in a child and family development center. Each child, his mother, father, and teacher were administered, separately, 18 select items from the primary factor in the I Feel-Me Feel self-concept inventory. Results indicated that the childrens' self/social constructs scores were very stable but did not correlate with scores of mother, father, and teacher. The adult percepts of the child's self-concept were highly correlated ( less than .05) among themselves, but they were not in the same system of relationships with the children.