SAGE Open Medicine最新文献

Introduction: Kangaroo Mother Care is a valuable technique recognized for its impact on bonding, breastfeeding, and thermoregulation in newborn infants, transcending considerations of weight, gestational age, or clinical condition.

Objective: This study aimed to assess mothers' feelings and perceptions regarding the implementation of the Kangaroo Mother Care procedure.

Method: In this qualitative investigation, individual interviews were conducted with 25 postnatal mothers who had experienced Kangaroo Mother Care with their infants. While, 12 unique responses were acquired. These interviews served as a means to explore and document the mothers' perspectives on Kangaroo Mother Care. The analysis of field notes identified four themes and one subtheme, which were coded into categorical distinctions.

Results: A total of 25 postnatal mothers, along with their newborns participated in this study. The majority of postnatal mothers fall within the age range of 20-30 years (48%), followed by 30-40 years (40%), Regarding newborn, majority were full-term (64%), followed by premature (28%) The findings revealed several significant outcomes. Mothers reported a marked improvement in their perception of Kangaroo Mother Care, describing reduced pain, enhanced comfort, and an overall positive sentiment. Many expressed that practicing KMC was a novel and delightful experience, marking their first engagement in this procedure. Moreover, a majority expressed a willingness to continue Kangaroo Mother Care in the future, hoping for its continued implementation within hospital settings. This enthusiasm aligns with recognizing Kangaroo Mother Care as a priority in nursing mother care.

Conclusion: In conclusion, the study underscores the potential benefits and positive impact of Kangaroo Mother Care on mother's experience. The findings advocate for the broad implementation of Kangaroo Mother Care as a valuable strategy in neonatal care, offering a holistic approach to improving the well-being of both mothers and newborns. These insights emphasize the importance of promoting and integrating Kangaroo Mother Care into neonatal care protocols, contributing to enhanced neonatal health and maternal satisfaction.

Objectives: There is a lack of indicators to distinguish between interleukin-6 inhibitors responders and tumor necrosis factor inhibitors responders in the treatment of rheumatoid arthritis. Osteoporosis is a complication of rheumatoid arthritis and is closely related to inflammatory pathology. The purpose of this study was to evaluate whether bone mineral density can distinguish interleukin-6 inhibitors responders from tumor necrosis factor inhibitors responders in rheumatoid arthritis.

Methods: Either interleukin-6 inhibitors or tumor necrosis factor inhibitors was introduced as the first biologics to patients naïve to both corticosteroid and osteoporosis treatment. Correlations between baseline bone mineral density and Clinical Disease Activity Index after 3 months were analyzed.

Results: The subjects were 26 rheumatoid arthritis patients with a median age of 60 years old, disease duration of 1.4 years, Clinical Disease Activity Index of 13.7, and C-reactive protein of 1.69 mg/dL. The subjects were divided into two groups (high (H) and low (L)) according to their femoral bone mineral density with a cutoff of young adult mean of 80%. Six in group H and 11 in group L received interleukin-6 inhibitors, and nine in group H received tumor necrosis factor inhibitors. Clinical Disease Activity Index remission rate by interleukin-6 inhibitors was significantly greater in group L (8/11 (72.7%)) than in group H (1/6 (16.7%); p < 0.05). In the whole group H, significantly more patients obtained Clinical Disease Activity Index remission by tumor necrosis factor inhibitors (7/9, 77.8%) than by interleukin-6 inhibitors (1/6 (16.7%); p = 0.04).

Conclusions: In patients with rheumatoid arthritis, interleukin-6 inhibitors may be more beneficial for patients with low femoral bone mineral density, whereas tumor necrosis factor inhibitors may be advantageous for those with preserved bone mineral density.

Objective: We aimed to assess performance parameters in a Hawassa Tuberculosis Culture Laboratory, in the Sidama Regional Public Health Institute.

Methods: A cross-sectional survey was conducted between 27 October 2020 and 31 May 2021, on 439 clinical specimens. The specimens were processed using standard procedures, and the final suspension was inoculated into a Microbial Growth Indicator Tube and Lowenstein-Jensen media slant. Ziehl-Neelsen staining and the Bioline test kit were used to identify and confirm Mycobacterium tuberculosis. The data were analyzed using the IBM Statistical Package for Social Sciences (SPSS, version 26).

Results: Out of a total of 439 specimens that were processed, the recovery rates for smear-positive specimens were 61% (25 out of 41) and 58.5% (24 out of 41) for the Mycobacterial Growth Indicator Tube, and the Lowenstein-Jensen methods, respectively. For smear-negative samples, the recovery rates were 4.5% (18 out of 398) for both methods. Only 4 (0.9%) specimens were rejected. The mean turnaround times to detect mycobacteria from smear-positive samples were 14 and 32 days for the Mycobacterial Growth Indicator Tube and Lowenstein-Jensen methods, respectively. The standard deviations were ±6.3 days and ±9.7 days, respectively. For smear-negative samples, the mean turnaround times were 17.7 and 31 days for the Mycobacterial Growth Indicator Tube and Lowenstein-Jensen methods, respectively. The standard deviations were ±9.2 days and ±9.6 days, respectively. The contamination rates for the Mycobacterial Growth Indicator Tube and Lowenstein-Jensen methods were 9.8% (43 out of 439) and 9.6% (42 out of 439), respectively. The detection rate of nontuberculosis mycobacteria was 1.4% (6 out of 439).

Conclusion: It demands attention to improve the low recovery rate among smear-negative cultures and culture contamination rates.

Objectives: The safe surgery checklist, presented by the World Health Organization in 2008, is an aid to performing surgical interventions safely. Research indicates that the use of checklists in clinical activities leads to a reduced number of adverse events. However, research suggests that the use of checklists differs between different institutions and even between units in the same organisation. The intention of this study is to identify factors regarded by the health personnel in 'the sharp end' as obstacles to using the checklist.

Methods: The study has a qualitative, case-based design. It is performed by the Hazard Identification method, which is a method for revealing safety hazards based on workers' experiences.

Results: Obstacles were identified related to the content of the list, areas of use, distribution of responsibilities connected with the use of the list, and finally the organisation and management of safety efforts related to clinical activities. The use of checklists must be part of a system's perspective, and deviations from checklists must be discussed in the organisation. The informants also claimed that checklists should be implemented for interventions located outside the operating theatres and for emergency treatments.

Conclusions: Even though the majority of employees believe that checklists are necessary, many surrounding factors are perceived as obstacles to their use. Not least, site-specific factors may be revealed by use of the Hazard Identification method.

Background: In the realm of academia, the publication of scientific research is not merely an act of dissemination; it serves as a pivotal milestone that signifies the culmination of rigorous investigation, critical analysis, and intellectual contribution.

Aim: To examine the challenges and barriers encountered by faculty members in the process of publishing their work.

Methods: The study utilized a descriptive cross-sectional design and was conducted from 1 March to 1 May 2022. A convenience sample of 358 faculty members from eight universities in Egypt, representing a diverse range of faculties. These faculties comprised five practical disciplines, namely, Nursing, Medicine, Science, Pharmacy, and Engineering, as well as three theoretical faculties including Al-Alsun (Languages), Arts, and Commerce. The universities involved in the study included Ain Shams, Cairo, Mansoura, Benha, Assiut, 6th of October, British University in Egypt (BUE), among others. Data were collected through an online questionnaire that included staff characteristics and barriers to scientific research and publishing. Hypothesis testing was conducted using appropriate statistical analysis methods (e.g., Chi-square test) to assess the relationships between faculty members' characteristics and barriers to publishing.

Results: The faculty staff in our study reported the highest barriers to publishing scientific research in the domains of the reviewing process (74%), institutional support (67%), and scientific publishing process (60.9%). Conversely, the lowest barriers were found in the domains of frustration after rejection (55.1%), scientific writing barriers (46.1%), and loss of passion and causation of publishing barriers (41.3%).

Conclusions: The results highlighted the need for increased support and resources to overcome these barriers and foster a positive culture of research and publishing in Egyptian universities.

Objective: Hemodialysis patients with chronic kidney disease often exhibit inflammation characterized by elevated levels of C-reactive protein, Interleukin 6 and tumor necrosis factor-alpha, and they are shown to be associated with cardiovascular impairment and enhanced renal failure. This study aims to assess the impact of fish oil intake on inflammation indicators in adult hemodialysis patients.

Methods: From the inception to December 2023, the datasets Cochrane Central, Google Scholar, Science Direct, Embase, and Pubmed were examined. Two authors independently searched, selected, and screened the literature. The pooled results are represented by weighted mean difference (WMD) with 95% confidence intervals. To investigate the causes of heterogeneity, subgroup analysis was done. Sensitivity analysis was then used to evaluate the validity of the combined findings.

Results: Thirteen randomized control trials studies were included. The pooled results showed that fish oil supplementation caused a significant reduction of the C-reactive protein level (WMD, -2.92 mg/L; 95% Confidence interval, -5.23, to -0.61; p = 0.01; I ² = 99%), especially in patients with baseline C-reactive protein ⩾5 mg/L (WMD, -4.39 mg/L; 95% Confidence interval, -5.93 to 2.85; p < 0.00001; I ² = 33%). Subgroup analyses showed that C-reactive protein baseline level (C-reactive protein <5 mg/L) was the main source of heterogeneity. Fish oil intake may not reduce the level of Interleukin 6 (WMD, -2.26; 95% Confidence interval: -19.61 to 15.09; p = 0.80; I ² = 93%), nor will it reduce the level of tumor necrosis factor-alpha (random model: WMD, -2.51; 95% Confidence interval: 6.08 to 1.06; p = 0.17; I ² = 98%).

Conclusion: Hemodialysis patients, especially those with C-reactive protein > 5 mg/L, responded to fish oil supplementation to reduce their C-reactive protein level; however, Interleukin 6 and tumor necrosis factor-alpha levels did not appear to be affected.

Background: Pharmacists are healthcare professionals who frequently encounter individuals struggling with addiction in their day-to-day practice. Studies critique pharmacists' competence in the detection, prevention, and management of substance use disorder.

Objective: This study aimed to get in-depth information about the perception, experience, and practice of Iraqi pharmacists towards substance use disorder.

Methods: A qualitative-study was performed through face-to-face individual-based interviews with community pharmacists in Baghdad/Iraq. Interviews were conducted from July 2023 till the saturation point (September 2023). Data analyzed by thematic-analysis approach.

Results: Interviews were conducted with 21 pharmacists. Most participants reported that substance use disorder is common among young males. Pregabalin is the most commonly requested drug. Availability, euphoric-effect, and low cost are the main reasons for favoring a drug by persons with substance use disorder. Moreover, poverty and social problems are the main reasons for substance use disorder. Drug intoxication signs are the main clues in recognizing substance use disorder. Most participants refuse dispensing drugs without prescription and reported that the barriers for implementing regulations on drugs with high potential for dependence are related to the limited follow-up to pharmacists, presence of outsiders, and fear from reactions of persons with substance use disorder. Pharmaceutical services to persons with substance use disorder were performed by few pharmacists and limited to patient education about the risks of misusing drugs. Most participants reported that enhancing pharmacists' competence in substance use disorder is necessary.

Conclusion: Substance use disorder is common among young Iraqi males. Pregabalin is a commonly requested drug. The current Iraqi regulations are not sufficient to prevent substance use disorder. Pharmaceutical services to persons with substance use disorder are weak and limited to patient education. Enhancing pharmacists' knowledge through educational courses is necessary to improve their role in facing substance use disorder.

Objectives: This scoping review aims to summarize and synthesize research findings on the disparities between audiometrically diagnosed and aided hearing loss versus the individual's own experience of hearing loss.

Methods: A systematic search strategy was employed across multiple databases to identify studies published between 1990 and October 2023 focusing on the experiences of hearing problems among individuals with aided hearing loss. The selected studies underwent screening based on predetermined inclusion and exclusion criteria. These criteria revolved around including papers featuring a population of adult (+18) individuals with audiometrically measured hearing loss who had undergone technological rehabilitation. Data charting was employed to provide an overview of the studies and was additionally utilized to identify key themes. Narrative analysis was used to identify subthemes within the data set.

Results: A total of 11 articles met the inclusion criteria. The analysis identified five themes: "disability experience and discrepancy between measured and self-perceived hearing loss"; "listening effort"; "mental burden/psychological consequences"; "factors that alleviate the consequences of HL"; and "sociodemographic factors."

Conclusions: The scoping review shows that, despite the proliferation of technological options, there is a pressing need for a more concentrated effort to identify and scrutinize the supplementary facets of hearing loss that remain inadequately addressed by current hearing technology. This includes subjective experiences associated with hearing loss that may not be effectively treated solely with hearing aids.

Objective: Chikungunya is a disease caused by Aedes mosquito-borne chikungunya virus infection. This disease is becoming one of the emerging/re-emerging viral diseases in tropical and subtropical countries but is neglected by public health systems. This study assessed the seroprevalence of chikungunya virus infection among patients with acute febrile illness seeking healthcare in a malaria-endemic area in the Afar Region, Northeast Ethiopia.

Methods: An institution-based cross-sectional study was employed from September 2022 to March 2023 to assess the seroprevalence of chikungunya virus infection among malaria-suspected febrile patients attending health institutes in the Afar Region. Sociodemographic, clinical features, and venous blood were collected from each study participant. Blood films were prepared and examined for plasmodium infection using microscopy. Sera were separated and screened for anti-chikungunya virus IgM and IgG antibodies using an enzyme-linked immunosorbent assay. Data were entered into Epi Data 3.1 and analyzed using Stata/SE 14.2.

Results: In this study, 368 malaria-suspected febrile patients (55.4% female, aged 5-80 years old, mean ± SD = 27.28 ± 14.0) participated. The prevalence of anti-chikungunya virus IgM antibodies, indicating acute infection, was 47.8%, while the prevalence of IgG antibodies, indicating previous exposure, was 6.3%. Nonmarried participants were found to be more likely to have acute chikungunya virus infection (AOR = 2.34, 95% CI: 1.141-4.964), and back pain was associated with higher likelihood of acute infection (AOR = 1.785; 95% CI: 1.078-2.954). About 10.6% of the participants tested positive for Plasmodium parasite infection, with P. falciparum (84.6%) being the most common, followed by P. vivax (10.3%) and mixed (5.1%) infections.

Conclusion: The study revealed a high seroprevalence of acute chikungunya virus infection among febrile patients in the Afar Region, highlighting the importance of regular screening for arbovirus infection in febrile patients to control and mitigate chikungunya spread.

Introduction: Tracer medicines are medicines that must be available in sufficient quantities at all times to satisfy the priority health care needs of the population. Inventory mismanagement of these medicines poses significant challenges to public health systems, especially in countries like Ethiopia, where access to healthcare services is already limited.

Objective: This study aims to assess inventory management performance for tracer medicines at public health facilities of the southwest Shewa zone, Oromia region, Ethiopia.

Method: Concurrent triangulation mixed-method study was conducted from 1 to 30 June 2022. The quantitative data were collected using interviewer-administered semistructured questionnaires and observational checklists. The qualitative data were gathered through in-depth interviews with key informants. The quantitative data were analyzed using the SPSS version 26 and Excel spreadsheet version 16. We calculated the stock-out rate, inventory accuracy rate, percentage of facilities that fulfill appropriate storage conditions, percentage of facilities that submitted reports on time, and received the exact quantity of drugs they ordered. Qualitative data were analyzed manually using the thematic content analysis technique.

Results: The inventory accuracy rate for tracer medicines was 76% for hospitals and 72.5% for health centers. The overall mean stock-out rate was 24.99%. Bin card updating practice was 93.3%, and only 25% health facilities met the acceptable storage conditions criteria. Among submitted reports, 88.8% were timely reported, 72.2% were accurate, and 75% were complete. Inventory management challenges include a shortage of supplies from the supplier and in the market, price inflation, inadequate training, lack of supportive supervision, insufficient IT and storage infrastructures, lack of communication, and budget constraints.

Conclusion: From this finding, we concluded that facilities' report quality, inventory record accuracy, storage conditions, and logistics management information system needs improvements. Therefore, Ministry of Health, assessed facilities and Ethiopian pharmaceuticals Supply Services should take measures to improve them.