Conectar
by Tadesse Tarik Tamir, Berhan Tekeba, Alebachew Ferede Zegeye, Deresse Abebe Gebrehana, Mulugeta Wassie, Gebreeyesus Abera Zeleke, Enyew Getaneh Mekonen
IntroductionSolitary childbirth—giving birth without any form of assistance—remains a serious global public health issue, especially in low-resource settings. It is associated with preventable maternal complications such as hemorrhage and sepsis, and poses significant risks to newborns, including birth asphyxia, infection, and early neonatal death. In Ethiopia, where many births occur outside health facilities, understanding the spatial and socio-demographic patterns of solitary childbirth is vital for informing targeted interventions to improve maternal and child health outcomes. This study aims to identify and map the spatial distribution of solitary childbirth across Ethiopia and to analyze its determinants using data from the 2019 national Interim Demographic and Health Survey.
MethodWe analyzed data from the 2019 Interim Ethiopian Demographic and Health Survey to determine the spatial distribution and factors of solitary birth in Ethiopia. A total weighted sample of 3,884 women was included in the analysis. Spatial analysis was used to determine the regional distribution of solitary birth, and multilevel logistic regression was employed to identify its determinants. ArcGIS 10.8 was used for spatial analysis, and Stata 17 was used for multilevel analysis. The fixed effect was analyzed by determining the adjusted odds ratio with a 95% confidence interval.
ResultThe prevalence of solitary childbirths in Ethiopia was 12.73%, with a 95% confidence interval spanning from 11.71% to 13.81%. The western and southern parts of Oromia, all of Benishangul-Gumuz, most parts of the SNNPR, and the west of Amhara regions were hotspot areas for solitary birth. Having no formal education, not attending ANC visits, and residing in pastoral regions were significantly associated with higher odds of solitary birth in Ethiopia.
CocnlusionA notable proportion of women are experiencing childbirth alone, which highlights a significant aspect of maternal health in the country, reflecting both the challenges and improvements in childbirth practices. The distribution of solitary births exhibited spatial clustering with its hotspot areas located in western and southern parts of Oromia, all of Benishangul-Gumuz, most parts of the SNNPR, and west of Amhara regions. Lack of education, not having an ANC visit, and being a resident of pastoral regions were significant determinants of solitary birth. The implementation of maternal and child health strategies in Ethiopia could benefit from considering the hotspot areas and determinants of solitary birth.
To assess cervical cancer screening positivity rates, follow-up rescreening uptake 1 year after treatment and persistent positivity among women with initial positive screening results in Ethiopia. The study also explored reasons for loss to follow-up and preferences for reminder strategies.
Longitudinal cross-sectional study.
10 primary healthcare facilities in Oromia and southern and central Ethiopia.
From November 2022 to April 2024, 17 586 women screened for cervical cancer. Of these 768 (4.4%) had positive screening results, and 515 women treated at the primary level were included to assess follow-up rescreening uptake. An additional 139 women who did not return for follow-up were interviewed to identify reasons for non-uptake and reminder preferences.
Of the 515 women included in the analysis, 179 (34.8%, 95% CI: 30.6% to 38.8%) returned for follow-up rescreening. Among those re-screened, the persistent visual inspection with acetic acid (VIA) positivity rate was 16.1% (95% CI: 11.0% to 21.7%). Factors significantly associated with follow-up rescreening uptake included age over 40 (adjusted OR (AOR): 2.5; 95% CI: 1.34 to 5.00), urban residence (AOR: 1.7; 95% CI: 1.15 to 2.58), secondary or higher education (AOR: 2.0; 95% CI: 1.06 to 4.12) and HIV-positive status (AOR: 2.4; 95% CI: 1.27 to 4.87). Among the 139 women contacted, the main reasons for non-uptake were lack of time, forgetting appointments, visiting another facility and pregnancy. Regarding preferred reminders, 93% favoured text messages and all agreed to phone calls or home visits.
One-third of women adhered to follow-up rescreening after a positive cervical cancer screening in Ethiopia, revealing a considerable gap since those women had a three times higher chance of being VIA positive compared with the first screening. Older age, urban residence, higher education and HIV-positive status were significantly linked to follow-up rescreening uptake. Addressing barriers such as time constraints and forgotten appointments through tailored reminder strategies is essential for improving the follow-up rescreening uptake. Contextualised interventions can strengthen rescreening for finding those women at very high risk for cervical lesions and strengthen cervical cancer prevention in Ethiopia.
by Lilien Schewski, Mathew Magimai Doss, Guido Beldi, Sandra Keller
Speech analysis offers a non-invasive method for assessing emotional and cognitive states through acoustic correlates, including spectral, prosodic, and voice quality features. Despite growing interest, research remains inconsistent in identifying reliable acoustic markers, providing limited guidance for researchers and practitioners in the field. This review identifies key acoustic correlates for detecting negative emotions, stress, and cognitive load in speech. A systematic search was conducted across four electronic databases: PubMed, PsycInfo, Web of Science, and Scopus. Peer-reviewed articles reporting studies conducted with healthy adult participants were included. Thirty-eight articles were reviewed, encompassing 39 studies, as one article reported on two studies. Among all features, prosodic features were the most investigated and showed the greatest accuracy in detecting negative emotions, stress, and cognitive load. Specifically, anger was associated with elevated fundamental frequency (F0), increased speech volume, and faster speech rate. Stress was associated with increased F0 and intensity, and reduced speech duration. Cognitive load was linked to increased F0 and intensity, although the results for F0 were overall less clear than those for negative emotions and stress. No consistent acoustic patterns were identified for fear or anxiety. The findings support speech analysis as a useful tool for researchers and practitioners aiming to assess negative emotions, stress, and cognitive load in experimental and field studies.Impostor syndrome (IS) is a psychological state whereby individuals doubt their abilities despite evidence of competence. Though IS has been studied in specific medical groups, no review to date compares findings across groups. This study aimed to: (1) determine the range of IS rates among medical undergraduates versus postgraduates and (2) examine associated factors across both groups.
This scoping review used the Joanna Briggs Institute methodology for scoping reviews, using a five-step framework.
PubMed, Scopus and PsycINFO databases were searched from inception until September 2024.
Studies were included if they were (1) empirical studies with a defined IS rating scale, (2) involving medical undergraduates, residents or clinicians and (3) published in English.
Three independent reviewers used standardised methods to screen and review selected studies, and extract key variables.
54 studies (77.8% from the West) were included. There was equal study distribution between undergraduates (46.3%, 25 studies) and postgraduates (46.3%, 25 studies), with the rest covering both groups. IS prevalence was substantial across all groups when assessed using the Clance Impostor Phenomenon Scale, ranging from 30.6% to 75.9% among undergraduates, 33.0% to 75.0% among residents and 23.5% to 50.0% among faculty and clinicians. In undergraduates, IS was associated with learning breaks, transition periods and poor academic performance. Among postgraduates, IS was correlated with younger age, junior ranking, fewer work years, inadequate faculty support or self-perceived poor clinical and teaching skills. Additionally, IS affected physical and psychological well-being (stress, anxiety, depression, burnout) and was associated with sociodemographic factors (single status, females), personality (neuroticism, perfectionistic traits, with conscientiousness, agreeableness and extraversion as protective) and interpersonal issues (conflicts, poor sense of belonging).
Given the high IS prevalence and associations with specific factors, practical measures are recommended to address IS and optimise learning and care for medical undergraduates and professionals.
This study was carried out to identify individual-level and community-level factors influencing the number of antenatal care (ANC) visits in Ethiopia’s emerging regions (Afar, Somali, Benishangul-Gumuz and Gambella).
Cross-sectional study design.
Ethiopia’s emerging regions (Afar, Somali, Benishangul-Gumuz and Gambella) from the 2016 Ethiopian Demographic and Health Survey (EDHS).
The analysis included a total weighted sample of 441 women from the EDHS dataset who had given birth within the 5 years before the survey.
The number of ANC visits.
In this study, 20.5% (95% CI: 16.7%, 24.5%) of pregnant women received four minimum recommended visits. Women with secondary (incidence rate ratio, IRR 1.3; 95% CI: 1.1, 1.5), and higher (IRR 1.3; 95% CI: 1.1, 1.5) education, terminated pregnancy (IRR 2.3; 95% CI: 1.9, 3.1), wanted pregnancy (IRR 1.4; 95% CI: 1.3, 2.3), high community poverty (IRR 0.5; 95% CI: 0.4, 0.7), community media exposure (IRR 1.3; 95% CI: 1.3, 1.8) and high community illiteracy (IRR 0.6; 95% CI: 0.5, 0.9) were significant predictors of many ANC visits in Ethiopia’s emerging regions.
According to the findings of our study, more than three-quarters of pregnant mothers in Ethiopia’s emerging region did not receive the adequate number of visits recommended by the WHO. Pregnancy desirability, history of a terminated pregnancy, maternal education, community poverty level, community literacy and community media exposure were significantly associated with the number of ANC visits. Therefore, promoting interpectoral actions would be vital in improving maternal health.
This study conducted a comprehensive probabilistic cost-effectiveness analysis comparing robotic exoskeleton therapy to conventional physiotherapy for stroke rehabilitation in Singapore, focusing on three patient groups categorised by their Functional Ambulation Category (FAC) scores.
A probabilistic cost-effectiveness analysis was conducted alongside a non-randomised controlled study. Costs and Quality-Adjusted Life Years (QALYs) for both interventions were calculated and compared over a 6 month period.
The study was carried out at Alexandra Hospital, Jurong Community Hospital and St Luke’s Hospital in Singapore.
Individuals requiring inpatient gait rehabilitation from acute to subacute stages of stroke recovery, with FAC scores of 0–1, were included in the analysis.
The primary outcome measure was QALYs, a composite measure combining the length and quality of life into a single value.
Robotic exoskeleton therapy was found to be cost-effective compared with conventional physiotherapy across all patient groups, with Group 2 (FAC 0) showing the most favourable cost-effectiveness profile (incremental cost-effectiveness ratio (ICER): US$ 28 259.62 per QALY gained). The probabilistic sensitivity analysis demonstrated the robustness of the results, with QALY gains and the cost of the robotic exoskeleton having the largest impact on the ICER.
The findings suggest that robotic exoskeleton therapy is likely to be cost-effective for stroke rehabilitation in Singapore, particularly for patients with severe mobility impairments (FAC 0). The results have important implications for clinical practice, resource allocation and future research in the field of stroke rehabilitation in Singapore.
To examine the number of patients screening positive for depression, while self-completing an automated check-in screen prior to a general practice consultation.
A descriptive cross-sectional study.
10 general practices in the West Midlands, England. Recruitment commenced in March 2023 and concluded in June 2023.
All patients aged 18 years and over, self-completing an automated check-in screen for any general practice prebooked appointment, were invited to participate during a 3-week recruitment period.
The number of patients screening positive for depression using the Whooley case finding research questions was the primary outcome measure. Secondary outcome measures included: demographic and (general practice level) deprivation differences in completion responses.
73.5% (n=3666) of patients self-completing an automated check-in screen participated in the CAse-fInding foR depressiOn in primary care (CAIRO) study, (61.1% (n=2239) female, mean age 55.0 years (18–96 years, SD=18.5)).
28.3% (n=1039) of participants provided a positive response to at least one of the two Whooley research questions (31.2% female and 23.8% male). Significantly more positive responses were obtained from females, those aged between 35 years and 49 years and those from more deprived practices.
Over a quarter of CAIRO participants provided a positive response to at least one of the two Whooley questions, suggesting possible unmet need in the population studied. A follow-up study could investigate whether responses provided at the point of check-in are raised and addressed in the subsequent consultation.
To evaluate the impact and acceptability of a tailored, gender-responsive behavioural activation (BA) intervention for improving depression and anxiety in male National Health Service (NHS) frontline workers.
Pre-post intervention study.
Three NHS organisations in the North of England.
45 men aged ≥18 years working in a frontline NHS role scoring in the subclinical range (5–14) on the Patient Health Questionnaire-9 (PHQ-9) (depression) and/or the Generalised Anxiety Disorder-7 (GAD-7) (anxiety) at baseline.
A tailored BA treatment programme consisting of up to eight telephone support sessions over a period of 4–6 weeks, accompanied by a BA self-help manual.
Self-reported symptom severity of depression, assessed by PHQ-9, and anxiety, assessed by GAD-7, at baseline and 4 and 6 months. Acceptability from the perspectives of male study participants and coaches who delivered the intervention was assessed in a nested qualitative study using the theoretical framework of acceptability (TFA).
PHQ-9 and GAD-7 scores decreased from baseline to 4 months on both the PHQ-9 and GAD-7. While scores increased from 4 months to 6 months, the 6-month scores remained below those of the baseline scores. Acceptability of the intervention was high across all constructs of the TFA. The practical and action-oriented strategies of the intervention, and the confidential, flexible, convenient mode of delivery, worked to support men’s engagement with the intervention.
Delivery of a tailored, gender-responsive BA intervention was appealing to, and beneficial for, men working in frontline NHS roles with less severe depression and anxiety. The BALM intervention offers promise as a tailored workplace mental health programme that is aligned with men’s needs and preferences and can help overcome a reticence to engage with mental health support in NHS staff and beyond.
Sarcopenia and frailty have been identified as negative predictors of health outcomes. Patients with stroke, traumatic brain injury (TBI), knee osteoarthritis (OA) and breast cancer commonly experience low physical activity levels in the chronic phase of recovery. This prospective study aims to explore the feasibility of multimodal screening and longitudinal tracking of various biomarkers from the acute to chronic phase of disease to determine the relationship with frailty outcomes.
A prospective longitudinal observational cohort study involving Asian populations is planned over 3 years. Enrolled participants with index conditions of acute stroke, TBI, knee OA and breast cancer will be recruited from rehabilitation hospitals and clinics and followed longitudinally. Reference thresholds from the Asian Working Group on Sarcopenia will be used. Variables include self-reported questionnaires, disease and comorbidity characteristics, anthropometric measurements, appetite questionnaires, muscle ultrasound (MUS), muscle/bone mass, blood biomarkers and markerless gait motion systems. In particular, physical performance (short physical performance battery and hand grip strength), sarcopenia (SARC-F questionnaire) and frailty assessment (FRAIL score, clinical frailty scale), four-region MUS, body composition analysis, dual X-ray absorptiometry, bone mineral densitometry, physical activity levels (International Physical Activity Questionnaire for the elderly [IPAQ-E], fitness trackers) and health-related quality of life assessment (EuroQoL-5D questionnaire five level [EQ5D-5L]) will be used. Blood biomarkers measuring metabolic health (eg, glycated haemoglobin, cholesterol, fasting glucose and 25-OH vitamin D) and inflammation (eg, Tumor Necrosis Factor-alpha [TNF-α] and Monocyte Chemoattractant Protein-1 [MCP-1]) will be measured at baseline. Data collection will take place at postrecruitment baseline (hospital admission), 1, 6 months, 12 months and 2 years postrecruitment (inpatient) and at postrecruitment baseline, 6 months, 12 months and 2 years postrecruitment (outpatient).
Ethical approval has been obtained from the National Healthcare Group Domain Specific Review Board (2023/00105). Findings will be disseminated through conference presentations and publication in scientific journals.
To determine wealth-based inequality and the dropout rate in the completion of the maternal continuum of care (CoC) in Ethiopia.
Ethiopian Demographic and Health Survey-2019.
Reproductive-age women (15–49 years) in Ethiopia.
Completion of the maternal CoC services is the primary outcome. Maternal CoC is defined as a situation where women have at least four antenatal care (ANC) visits, deliver their babies at a health facility and receive at least one postnatal care service for both mother and newborn baby.
We analysed the 2019 Mini demographic and health survey data using STATA V.17. Multilevel logistic regression analysis was employed for the factors associated with the maternal CoC. The concentration index was used to measure equity.
Overall, 24% (95% CI: 21.6 to 26.5) of women completed the maternal CoC. There was wealth-based inequality in the completion of maternal CoC in Ethiopia (concentration index: 0.25 (95% CI: 0.18 to 0.31, p≤0.001)), rural residents (concentration index: 0.15 (95% CI: 0.09 to 0.21, p≤0.001)) and urban residents (concentration index: 0.15 (95% CI: 0.05 to 0.26, p≤0.01)). Being an urban resident (adjusted OR (AOR)=1.59, 95% CI: 1.09 to 2.33), attaining secondary (AOR=1.67, 95% CI: 1.19 to 2.33) or higher education (AOR=1.93, 95% CI: 1.30 to 2.87) and early initiation of ANC (AOR=1.97, 95% CI: 1.61 to 2.41) were positively associated with the completion of maternal CoC. However, belonging to a pastoral region (Afar or Somali) (AOR=0.46, 95% CI: 0.28 to 0.77), belonging to the poorest (AOR=0.58, 95% CI: 0.37 to 0.92) or middle (AOR=0.62, 95% CI: 0.40 to 0.96) wealth quintile, not being informed about obstetric danger signs (AOR=0.54, 95% CI: 0.43 to 0.66) and blood pressure not being measured (AOR=0.53, 95% CI: 0.32 to 0.85) were negatively associated with maternal CoC.
We concluded that completion of the maternal CoC was low in Ethiopia. There was significant inequality in the completion of maternal CoC across wealth status, place of residence and educational status. Strategies and interventions that target the disadvantaged group of women are needed to improve the utilisation of maternal healthcare services. Tailored and multisectoral intervention considering women with poor or middle wealth, women in pastoralist regions and women with no information on obstetric danger signs improves the CoC practice in the country.
The involvement of male partners in the care and treatment of HIV-positive pregnant women is essential for improving health outcomes and ensuring optimal adherence to antiretroviral therapy (ART). Although ART has been shown to be effective in preventing mother-to-child transmission of HIV, maintaining adherence to the prescribed triple ART regimen remains a significant challenge. However, there has been a lack of research on the role of male partners in supporting ART adherence during pregnancy.
To assess male partner involvement in triple ART drug adherence and associated factors among HIV-positive pregnant women in government hospitals of the North Gojjam Zone, Amhara Region, Northwest Ethiopia, 2023.
An institution-based cross-sectional study was conducted.
The study was carried out in hospitals located in the North Gojjam Zone of Northwest Ethiopia.
The study was conducted among 410 male partners of HIV-positive pregnant women from 1 April 2023 to 30 May 2023.
The primary outcome was to assess the involvement of male partners in triple ART adherence, while the secondary outcome was to identify factors associated with the involvement of male partners on triple ART adherence among HIV-positive pregnant women. The association between variables was assessed using bivariate and multivariable logistic regression models, and a p value
A total of 410 participants were included, with a response rate of 97.2%. The prevalence of male partner involvement in triple ART drug adherence among HIV-positive pregnant women was 21.2%. Multivariable logistic regression showed that educational status (AOR (Adjusted Odds Ratio)=2.5, 95% CI 1.26 to 4.96), place of residence (AOR=4.8, 95% CI 3.17 to 7.27), and the time taken to travel from home to the facility (AOR=3.1, 95% CI 1.51 to 6.36) were significantly associated with male partner involvement.
This study demonstrates that compared with a study conducted in Malawi, male partner involvement in triple ART drug adherence was lower. Male partner involvement in triple ART adherence among HIV-positive pregnant women was strongly associated with educational status, place of residence and the time taken to travel from home to the health facility. Empowering men to actively participate in healthcare decisions and treatment plans for their partners can foster a sense of responsibility and enhance commitment to adherence.
by Biniyam Tedla Mamo, Zelalem Tazu Bonger, Feyissa Regassa Senbato, Tadesse Eguale, Kibrewossen Kiflu Akililu, Samuel Muluye Welelaw, Eden Dagnachew Zeleke, Asrat Demtse, Turegne Assefa, Ruth Woldeyohannes Yirgu, Zelalem Mekuria, Joan-Miquel Balada-Llasat, Shu-Hua Wang
BackgroundNeonatal sepsis is a leading cause of mortality and morbidity. To improve the clinical outcomes of neonates with sepsis, treatment should be based on bacteriological identification and antibiotic susceptibility. This study aims to assess the proportion of culture-positive gram-negative bacteria (GNB), the antibiotic susceptibility patterns, and treatment outcomes of neonatal sepsis at two neonatal intensive care units (NICUs) in Addis Ababa.
MethodsA retrospective observational study was conducted among gram-negative sepsis suspected neonates admitted at Zewditu Memorial Hospital and Tikur Anbessa Specialized Hospital NICUs from January to December 2023. All neonates who were suspected of having sepsis were included in this study. Standard microbiological culture and biochemical tests were used to identify bacterial species and the Kirby-Bauer disc diffusion assay using Mueller-Hinton agar was employed to test the antimicrobial susceptibility of bacterial isolates as per Clinical Laboratory Standard Institute guidelines. Descriptive statistics were used to describe the study variables. Bivariable and multivariable logistic regression analyses were used to identify the factors associated with the treatment outcomes of neonatal sepsis. A p-value Results
A total of 933 neonates were diagnosed with sepsis during the study period, of which 166 neonates were enrolled in the study for gram-negative sepsis: 84 (51%) were female and 97 (58%) had early onset sepsis. The median length of hospital stay was nine days with interquartile range of 16 days. The predominant GNB identified was Klebsiella spp. (n = 89; 49%), followed by Acinetobacter spp. (n = 38; 21%) and Escherichia coli (n = 19; 11%). In both hospitals, Klebsiella spp. was resistant to most of the routinely prescribed antibiotics: (n = 68; 89%) were resistant to ceftriaxone, (n = 56, 89%) cefepime and (n = 60; 75%) to gentamicin. Lower rates of resistance were recorded for other antibiotics such as ciprofloxacin (n = 12; 18%), ertapenem (n = 11; 16%), meropenem (n = 9; 13%), and amikacin (n = 3; 4%). A total of 92 (55%) neonates with the GNB isolated in the current study had multidrug-resistant (MDR) organisms. The study found that newborns with MDR infections were five times more likely to experience poor treatment outcomes compared to those with non-resistant strains (AOR, 5.23 95% CI [2.59, 11.11]). In addition, newborns who stayed less than seven days, compared to those who spent seven or more days in the hospital was four times (AOR: 4.16, 95% CI (2.0–9.01) more likely to experience poor health outcomes.
ConclusionKlebsiella spp. was the most common GNB isolated from the NICUs. More than half neonatal sepsis was caused by MDR organisms and associated with significant poor treatment outcomes. high prevalence of MDR-gram-negative bacteremia is alarming and highlights the need for the implementation of routine surveillance and infection control measures to decrease morbidity and mortality and to combat the development of antimicrobial resistance.
This study aims to synthesise evidence on the pooled level of exit knowledge among outpatients served in public hospital pharmacies and private pharmacies in Ethiopia and to identify the associated factors associated with medication knowledge by conducting a systematic review and meta-analysis of primary articles focused on this area.
This systematic review and meta-analysis study employed the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach.
Three electronic databases—MEDLINE, Scopus and Google Scholar—were searched for all English-language articles published from 2010 until 18 December 2024.
The review exclusively included studies that reported original data, were freely accessible in full text and were written in English, as well as those investigating the level of knowledge among outpatients and associated factors, irrespective of study design. Studies lacking abstracts and full texts, reports, qualitative research, and conference summaries were excluded from the analysis.
Data from selected studies were extracted by three independent reviewers using a standardised data extraction format created using Microsoft Excel. Their results were cross-checked by two additional reviewers for consistency.
Of the 521 identified studies, 9 met the inclusion criteria. The overall pooled knowledge level was 45%. Factors associated with knowledge included residence (OR=0.67, 95% CI: 0.27 to 0.71), adequacy of information provided (OR=0.87, 95% CI: 0.24 to 0.90), education level (OR=0.70 CI: 0.39 to 0.89), clarity of instructions (OR=0.80 CI: 0.14 to 0.99) and pharmacist politeness (OR=0.72 CI: 0.46 to 0.77).
The systematic review and meta-analysis showed that pooled patient knowledge regarding their dispensed medications in Ethiopia is about 45%. Key determinant factors of knowledge included education level, quality of pharmacist communication, urban versus rural residence and pharmacist politeness. Recommendations for improvement include enhancing pharmacist training, developing educational materials in local languages, outreach programmes for rural areas and implementing patient-centred care policies.
PROSPERO number: CRD42024560816
by Bewketu Mehari, Tarekegn Fentie Yimer, Tihitna Beletkachew, Eyob Alem, Worku Negash, Mengistu Mulu, Dereje Yenealem, Ayalnesh Miretie
Sesame (Sesamum indicum L.) is a major oilseed crop globally, and white sesame is a key contributor to the foreign exchange earnings of Ethiopia. The main production districts of white sesame in Ethiopia are Humera, Metema, Tegedie, Mirab-Armachiho and Tachi-Armaciho. This study assessed the levels of trace metals (Fe, Cu, Zn, Mn and Ni) in white sesame seeds from these regions and evaluated the associated health risks to consumers. A total of 53 samples were collected from 19 farmer villages across the five districts. Homogenized samples from each village were analyzed using the acid digestion method followed by flame atomic absorption spectroscopy (FAAS). The limit of detection of the method ranged from 0.75 to 865 mg/kg, and the limit of quantitation ranged from 2.55 to 28.8 mg/kg for the different elements analyzed. The recovery of the method was in the range of 90.9‒99.6%. The results showed trace metal levels ranging from 164 ± 6 to 381 ± 4 mg/kg for Fe, 94.0 ± 1.9 to 126 ± 0.8 mg/kg for Zn, 11.8 ± 0.4 to 14.2 ± 0.4 mg/kg for Cu, 11.9 ± 0.9 to 15.0 ± 0.7 mg/kg for Mn and 16.2 ± 1.1 to 21.0 ± 1.2 mg/kg for Ni across the production districts. One-way ANOVA revealed significant differences (pTo examine nurses' knowledge, attitude and practice regarding nutrition management in hospitalised adults and explore their views on it.
A mixed-method approach combining cross-sectional and descriptive qualitative methods.
379 enrolled/registered nurses working in acute or intensive units of a tertiary hospital were recruited between 24th August 2023 and 3rd December 2023. Participants completed a questionnaire on their sociodemographic profile, knowledge, attitude and practice (KAP) regarding nutrition management. Data analysis was conducted using R software, reporting levels of KAP and its associations with sociodemographic factors. Mann–Whitney U and Kruskal–Wallis tests were used for non-normally distributed knowledge and practice scores (reported as median and interquartile range). Two-sample t-tests and ANOVA were used for normally distributed attitude scores (reported as mean and standard deviation). 21 of the participants from the quantitative study were either purposively sampled or snowballed from the quantitative study to undergo semi-structured interviews (physically or virtually face-to-face), which were transcribed verbatim and analysed using content analysis.
The mean scores on KAP were 61.6, 19.4 and 22.8, respectively. Knowledge varied significantly by educational level (p < 0.001), while attitudes also differed based on education (p = 0.001) and years of employment (p = 0.019). Practice scores showed differences based on subspeciality (p = 0.032), nursing rank (p < 0.001) and years of employment (p = 0.004). Findings identified barriers to effective nutrition management, including prioritisation issues, varying professional roles, limited autonomy and resource shortages. It also emphasises nurses' roles in nutrition management and strategies such as nurses' autonomy and family members involvement to improve nutrition management.
Sociodemographic factors significantly influence nurses' KAP in nutrition management, revealing knowledge deficits, low prioritisation and time constraints. Tailored education and training, increased autonomy, resource expansion and greater family involvement can enhance nurses' KAP in nutrition management.
by Tirualem Asmare Fenta, Gizachew Tadele Tiruneh, Nebiyou Fasil Ayele
IntroductionTimely and safe blood transfusion services are crucial for saving lives in emergencies. Previous studies have focused on hospital inpatient care access but have overlooked blood transfusion service readiness. This study examined the readiness of blood transfusion services in health facilities across Ethiopia and its determinants.
MethodsThis study used Service Availability and Readiness Assessment (SARA) 2018 data from 632 facilities. Readiness was measured based on seven components: the presence of at least one trained staff for appropriate use of blood and safe transfusion; guidelines for appropriate use and transfusion; blood storage refrigerator; blood typing; cross-match typing; blood supply safety; and blood supply sufficiency. Data were analyzed using descriptive and inferential statistics. Facility characteristics were summarized using frequency tables and summary statistics. Bivariate and multivariable linear regression analyses examined the predictors of service readiness.
ResultsFacilities offering blood transfusion services had a mean readiness score of 4.5 (out of 7), with only 5% having all items. Most facilities performed blood typing, but less than one-third conducted cross-match testing, and over half lacked guidelines and trained staff. Service readiness varied significantly across regions. Facilities in Oromia (Coef.: -0.74; 95% CI: [-1.32, -0.15]) and Somali (Coef.: -1.26; 95% CI: [-2.21, -0.31]) had lower readiness scores compared to Addis Ababa. Increased availability of medical equipment corresponded to a 49% increase in readiness scores (Coef.: 0.49; 95% CI: [0.19, 0.79]).
ConclusionThe study highlights deficiencies in blood transfusion service readiness and regional disparities, emphasizing the need for targeted support to enhance readiness across regions.
by Amare Kassaw, Worku Necho Asferie, Molla Azmeraw, Demewoz Kefale, Gashaw Kerebih, Gebrehiwot Berie Mekonnen, Fikadie Dagnew Baye, Shegaw Zeleke, Biruk Beletew, Solomon Demis Kebede, Tigabu Munye Aytenew, Lakachew Yismaw Bazezew, Muluken Chanie Agimas
BackgroundGlobally, Tuberculosis (TB) is the main cause of morbidity and mortality among infectious disease. TB and Human Immune Virus (HIV) are the two deadly pandemics which interconnected each other tragically, and jeopardize the lives of children; particularly in Sub-Saharan Africa. Therefore, this review was aimed to determine the aggregated national pooled incidence of tuberculosis among HIV- infected children and its predictors in Ethiopia.
MethodsAn electronic search engine (HINARI, PubMed, Scopus, web of science), Google scholar and free Google databases were searched to find eligible studies. Quality of the studies was checked using the Joanna Briggs Institute (JBI) quality assessment checklists for cohort studies. Heterogeneity between studies was evaluated using Cochrane Q-test and the I2 statistics.
ResultThis review revealed that the pooled national incidence of tuberculosis among children with HIV after initiation of ART was 3.63% (95% CI: 2.726–4.532) per 100-person-years observations. Being Anemic, poor and fair ART adherence, advanced WHO clinical staging, missing of cotrimoxazole and isoniazid preventing therapy, low CD4 cell count, and undernutrition were significant predictors of tuberculosis incidence.
ConclusionThe study result indicated that the incidence of TB among HIV- infected children is still high. Therefore, parents/guardians should strictly follow and adjust nutritional status of their children to boost immunity, prevent undernutrition and opportunistic infections. Cotrimoxazole and isoniazid preventive therapy need to continually provide for HIV- infected children for the sake of enhancing CD4/immune cells, reduce viral load, and prevent from advanced disease stages. Furthermore, clinicians and parents strictly follow ART adherence.
To investigate the real-world experiences of nurses' using smart glasses to triage patients in an urgent care centre.
A parallel convergent mixed-method design.
We collected data through twelve in-depth interviews with nurses using the device and a survey. Recruitment continued until no new themes emerged. We coded the data using a deductive-thematic approach. Qualitative and survey data were coded and then mapped to the most dominant dimension of the sociotechnical framework. Both the qualitative and quantitative findings were triangulated within each dimension of the framework to gain a comprehensive understanding of user experiences.
Overall, nurses were satisfied with using smart glasses in urgent care and would recommend them to others. Nurses rated the device highly on ease of use, facilitation of training and development, nursing empowerment and communication. Qualitatively, nurses generally felt the device improved workflows and saved staff time. Conversely, technological challenges limited its use, and users questioned its sustainability if inadequate staffing could not be resolved.
Smart glasses enhanced urgent care practices by improving workflows, fostering staff communication, and empowering healthcare professionals, notably providing development opportunities for nurses. While smart glasses offered transformative benefits in the urgent care setting, challenges, including technological constraints and insufficient organisational support, were barriers to sustained integration.
These real-world insights encompass both the benefits and challenges of smart glass utilisation in the context of urgent care. The findings will help inform greater workflow optimisation and future technological developments. Moreover, by sharing these experiences, other healthcare institutions looking to implement smart glass technology can learn from the successes and barriers encountered, facilitating smoother adoption, and maximising the potential benefits for patient care.
COREQ checklist (consolidated criteria for reporting qualitative research).
No patient or public contribution.
Several studies have reported the prevalence of overweight and obesity in various countries but the global prevalence of nurses with overweight and obesity remains unclear. A consolidation of figures globally can help stakeholders worldwide improve workforce development and healthcare service delivery.
To investigate the global prevalence of overweight and obesity among nurses.
Systematic review with meta-analysis.
29 different countries across the WHO-classified geographical region.
Nurses.
Eight electronic databases were searched for articles published from inception to January 2023. Two independent reviewers performed the article screening, methodological appraisal and data extraction. Methodological appraisal was conducted using Newcastle-Ottawa Scale (NOS). Inter-rater agreement was measured using Cohen's Kappa. Meta-analyses were conducted to pool the effect sizes on overweight, obesity and waist circumference using random effects model and adjusted using generalised linear mixed models and Hartung–Knapp method. Logit transformation was employed to stabilise the prevalence variance. Subgroup analyses were performed based on methodological quality and geographical regions. Heterogeneity was assessed using the I 2 statistic.
Among 10,587 studies, 83 studies representing 158,775 nurses across 29 countries were included. Based on BMI, the global prevalence of overweight and obesity were 31.2% (n = 55, 95% CI: 29%–33.5%; p < .01) and 16.3% (n = 76, 95% CI: 13.7%–19.3%, p < .01), respectively. Subgroup analyses indicated that the highest prevalence of overweight was in Eastern Mediterranean (n = 9, 37.2%, 95% CI: 33.1%–41.4%) and that of obesity was in South-East Asia (n = 5, 26.4%, 95% CI: 5.3%–69.9%). NOS classification, NOS scores, sample size and the year of data collected were not significant moderators.
This review indicated the global prevalence of overweight and obesity among nurses along with the differences between regions. Healthcare organisations and policymakers should appreciate this increased risk and improve working conditions and environments for nurses to better maintain their metabolic health.
Not applicable as this is a systematic review.
PROSPERO (ref: CRD42023403785) https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=403785.
High prevalence of overweight and obesity among nurses worldwide.
FreshRSS 