Background: The migration of healthcare staff from developing to developed countries has caused deleterious effects to already crumbling healthcare systems in many third world countries. In eSwatini, 80 nurses graduate each year from training institutions but more than a third of these nurses are lost to the diaspora. Methods: A cross-sectional descriptive qualitative survey was conducted among 48 emaSwati nurses working in the UK to explore their perceptions and future plans concerning their own migration. Questionnaires were mailed to nurses that consented to participate and responses were also mailed back in self-addressed and stamped envelopes. Results: Findings from this study suggest that nurses in eSwatini are motivated by the higher pay and strength of the pound to emigrate (pull factors). Lack of accountability by the system of governance, equipment shortage, poor supervision, high work load and lack of training opportunities were other push factors identified by the participants. The eSwatini Government, through the Ministry of Health, engaged several strategies to reduce overseas migration of nurses. However, with the slow improvement of the country’s political and economic developments, the crisis may remain or recur. Conclusion: Increased remuneration, investment in healthcare infrastructure, purchase of appropriate equipment and reduction in work loads could improve working conditions and reduce the loss of nurses to overseas countries. Development of inclusive policies to address migration of all citizens of this country could greatly benefit the practice economically, socially and otherwise, and ensure input of knowledge into the healthcare system from personnel returning with experience from overseas exposure.
{"title":"Perceptions of Emaswati Nurses Working in The United Kingdom (UK) About International Migration: Experiences and Plans","authors":"","doi":"10.33140/jnh.07.01.02","DOIUrl":"https://doi.org/10.33140/jnh.07.01.02","url":null,"abstract":"Background: The migration of healthcare staff from developing to developed countries has caused deleterious effects to already crumbling healthcare systems in many third world countries. In eSwatini, 80 nurses graduate each year from training institutions but more than a third of these nurses are lost to the diaspora. Methods: A cross-sectional descriptive qualitative survey was conducted among 48 emaSwati nurses working in the UK to explore their perceptions and future plans concerning their own migration. Questionnaires were mailed to nurses that consented to participate and responses were also mailed back in self-addressed and stamped envelopes. Results: Findings from this study suggest that nurses in eSwatini are motivated by the higher pay and strength of the pound to emigrate (pull factors). Lack of accountability by the system of governance, equipment shortage, poor supervision, high work load and lack of training opportunities were other push factors identified by the participants. The eSwatini Government, through the Ministry of Health, engaged several strategies to reduce overseas migration of nurses. However, with the slow improvement of the country’s political and economic developments, the crisis may remain or recur. Conclusion: Increased remuneration, investment in healthcare infrastructure, purchase of appropriate equipment and reduction in work loads could improve working conditions and reduce the loss of nurses to overseas countries. Development of inclusive policies to address migration of all citizens of this country could greatly benefit the practice economically, socially and otherwise, and ensure input of knowledge into the healthcare system from personnel returning with experience from overseas exposure.","PeriodicalId":302843,"journal":{"name":"Journal of Nursing & Healthcare","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134317884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A comparative study was conducted to assess the knowledge and practice on Oral Rehydration Therapy (ORT) among mothers of under six year children in selected urban and rural areas of District Fatehabad.” The sample size of the study comprised of 100 mothers (50 urban and 50 rural mothers). Systematic random sampling technique was considered appropriate for this study. The collected data was analyzed using descriptive and inferential statistics. Findings reveals that Mean Knowledge Score of Rural was (14.44) and Mean Knowledge Score of Urban was (17.34) and Mean Pre-test Practice Score of Rural was (5.26) and Mean Pre Test Practice score of Urban is (5.56). The „t‟ Value calculated is greater than „t‟ Value tabulated. Findings related to association between knowledge& practice score of mothers regarding oral rehydration therapy with selected demographic variables. The statistical outcome of association between demographic variables of mothers with their knowledge & practice score regarding oral rehydration therapy. In order to examine the association between these variables the chi-square test was worked out. The difference was found to be statistically significant in all cases EXCEPT in three cases at p<0.05 level of significance.
{"title":"Diarrheal illnesses and Oral Rehydration therapy Comparative study on oral rehydration therapy among urban and rural mother.","authors":"","doi":"10.33140/jnh.07.01.03","DOIUrl":"https://doi.org/10.33140/jnh.07.01.03","url":null,"abstract":"A comparative study was conducted to assess the knowledge and practice on Oral Rehydration Therapy (ORT) among mothers of under six year children in selected urban and rural areas of District Fatehabad.” The sample size of the study comprised of 100 mothers (50 urban and 50 rural mothers). Systematic random sampling technique was considered appropriate for this study. The collected data was analyzed using descriptive and inferential statistics. Findings reveals that Mean Knowledge Score of Rural was (14.44) and Mean Knowledge Score of Urban was (17.34) and Mean Pre-test Practice Score of Rural was (5.26) and Mean Pre Test Practice score of Urban is (5.56). The „t‟ Value calculated is greater than „t‟ Value tabulated. Findings related to association between knowledge& practice score of mothers regarding oral rehydration therapy with selected demographic variables. The statistical outcome of association between demographic variables of mothers with their knowledge & practice score regarding oral rehydration therapy. In order to examine the association between these variables the chi-square test was worked out. The difference was found to be statistically significant in all cases EXCEPT in three cases at p<0.05 level of significance.","PeriodicalId":302843,"journal":{"name":"Journal of Nursing & Healthcare","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124888088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-11-12DOI: 10.21203/rs.3.rs-103008/v1
M. Yaron, Ilan Baram, Zvi Peled
Objective: The aim of the study was to assess efficacy, safety and patient acceptability of the intrauterine ball (IUB) Ballerine MIDI copper intrauterine device (IUD), using real-world data collected from users and physicians.Study design: Retrospective analysis of two cross-sectional survey studies conducted in seven private clinics in Israel or Switzerland, and in one Swiss hospital between January and October 2018. Participants were healthy women who had the non-hormonal IUB Ballerine MIDI inserted >12 months before enrolment. In total, 382 participants and their 19 physicians completed questionnaires relating to device insertion, user experience and performance.Results: Mean age at insertion was 31.8±7.1 years, the survey was answered 16.0±4.7 months following IUB insertion. Most women were married (56.8%) and multigravid (83.5%). In 20 (5.2%) cases premature removal was due to desire to conceive. Excluding these women, the >12-month continuation rate was 71%. The expulsion rate was 17 (4.5%) and pregnancy rate was 4 (1.1%). The IUB was associated with high tolerability, 31% of current users reported no menstrual cramps/pain or light (34%) to moderate (20%) dysmenorrhea. The majority of women (69%) reported moderate to high satisfaction with the device, and 79% said they would recommend it to friends and relatives. Physicians reported in 87% of procedures the device was simple to deploy, with no difficulties encountered.Conclusions: The IUB Ballerine MIDI was demonstrated to be safe, effective and highly accepted in a cohort of women in different clinical settings and among a socioeconomically and demographically diverse population of contraception seekers.
{"title":"Real-World Experience Using the IUB Ballerine MIDI Copper IUD: A Multicenter, Multinational Observational Study","authors":"M. Yaron, Ilan Baram, Zvi Peled","doi":"10.21203/rs.3.rs-103008/v1","DOIUrl":"https://doi.org/10.21203/rs.3.rs-103008/v1","url":null,"abstract":"\u0000 Objective: The aim of the study was to assess efficacy, safety and patient acceptability of the intrauterine ball (IUB) Ballerine MIDI copper intrauterine device (IUD), using real-world data collected from users and physicians.Study design: Retrospective analysis of two cross-sectional survey studies conducted in seven private clinics in Israel or Switzerland, and in one Swiss hospital between January and October 2018. Participants were healthy women who had the non-hormonal IUB Ballerine MIDI inserted >12 months before enrolment. In total, 382 participants and their 19 physicians completed questionnaires relating to device insertion, user experience and performance.Results: Mean age at insertion was 31.8±7.1 years, the survey was answered 16.0±4.7 months following IUB insertion. Most women were married (56.8%) and multigravid (83.5%). In 20 (5.2%) cases premature removal was due to desire to conceive. Excluding these women, the >12-month continuation rate was 71%. The expulsion rate was 17 (4.5%) and pregnancy rate was 4 (1.1%). The IUB was associated with high tolerability, 31% of current users reported no menstrual cramps/pain or light (34%) to moderate (20%) dysmenorrhea. The majority of women (69%) reported moderate to high satisfaction with the device, and 79% said they would recommend it to friends and relatives. Physicians reported in 87% of procedures the device was simple to deploy, with no difficulties encountered.Conclusions: The IUB Ballerine MIDI was demonstrated to be safe, effective and highly accepted in a cohort of women in different clinical settings and among a socioeconomically and demographically diverse population of contraception seekers.","PeriodicalId":302843,"journal":{"name":"Journal of Nursing & Healthcare","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117081356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-11-02DOI: 10.20944/preprints202011.0042.v1
A. Anand
We report a very frugal microscope building method from easily realizable parts. We show a highly portable field ready compound type microscope with bright field, dark field and projection microscopy capabilities. It has good resolution and magnification for multiple aspects of education and diagnosis. We demonstrate that such a system can be built from simple lenses in laser pointers and camera modules with no specific 3d printed parts or costly lenses. We show all the parts of the system like stage, coarse and fine focussing system, microscope body, even slides can be built from commonly available materials like soda bottle and DVD disks. We list alternate, safer and easily available staining methods and chemicals. The microscope is developed with a target that it can be self-developed even in rural areas of the world with only resources at one’s disposal with very little education. This features a stable focussing and panning system for comfortable viewing through eyes and also easy imaging with a smartphone. We show its utility for microorganism analysis and potential for clinical diagnosis.
{"title":"Frugal compound microscopy for microbiological analysis and education","authors":"A. Anand","doi":"10.20944/preprints202011.0042.v1","DOIUrl":"https://doi.org/10.20944/preprints202011.0042.v1","url":null,"abstract":"\u0000 We report a very frugal microscope building method from easily realizable parts. We show a highly portable field ready compound type microscope with bright field, dark field and projection microscopy capabilities. It has good resolution and magnification for multiple aspects of education and diagnosis. We demonstrate that such a system can be built from simple lenses in laser pointers and camera modules with no specific 3d printed parts or costly lenses. We show all the parts of the system like stage, coarse and fine focussing system, microscope body, even slides can be built from commonly available materials like soda bottle and DVD disks. We list alternate, safer and easily available staining methods and chemicals. The microscope is developed with a target that it can be self-developed even in rural areas of the world with only resources at one’s disposal with very little education. This features a stable focussing and panning system for comfortable viewing through eyes and also easy imaging with a smartphone. We show its utility for microorganism analysis and potential for clinical diagnosis.","PeriodicalId":302843,"journal":{"name":"Journal of Nursing & Healthcare","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121588199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Maru, D. Dagne, Addisu Tesfie, Asefa Missaye, Gizachew Yismaw, A. Mulu
Background Antiretroviral treatment (ART) is aimed for complete suppression of viral replication but it fails for a variety of reasons. The aim of this study was to determine the prevalence and associated factors of treatment failure among people on first line ART in Amhara region, North east Ethiopia.Methods A cross sectional study was conducted from March, 2018 to July, 2018. Questionnaire survey using a pre-structured questionnaire was taken focusing on demographic data and possible risk factors of antiretroviral treatment failure. Clinical history including baseline characteristics was extracted by reviewing medical records using data abstraction sheet and data was analyzed using STATA version 14.Results A total of 640 clients of all age from 16 health facilities were enrolled in the study. The overall antiretroviral treatment failure was 16.45% from which clinical, immunologic and virologic failure were 0.47%, 13.59% and 3.13% respectively. The viral suppression was 91.09%, but more than half, 29 (50.88%) study participants with high first viral load (>1000copies/ml) were defaulted and not tested for the 2 nd viral load testing. Binary and multivariable logistic regression analysis showed significance association of treatment failure with age at treatment initiation (OR, 1.029), duration on ART (OR, 0.87) and adherence (AOR, 4.22). High proportion of treatment failure was also found in females (62.75%) and in those below primary education (76.47%).Conclusions In conclusion increased viral suppression is observed but the rate of default during 3 month of enhanced adherence counseling is high. The overall magnitude of treatment failure in Amhara region is 16.45%. Fair/poor adherence, older age at treatment initiation and shorter duration on ART are significantly independent factors of treatment failure. Therefore improving client follow up to adherence to treatment should be strengthened.
抗逆转录病毒治疗(ART)旨在完全抑制病毒复制，但由于各种原因而失败。本研究的目的是确定埃塞俄比亚东北部阿姆哈拉地区一线抗逆转录病毒治疗人群中治疗失败的患病率和相关因素。方法于2018年3月至2018年7月进行横断面研究。采用预结构问卷进行问卷调查，重点关注人口统计数据和抗逆转录病毒治疗失败的可能危险因素。通过使用数据提取表查看病历，提取包括基线特征在内的临床病史，并使用STATA version 14对数据进行分析。结果来自16家卫生机构的640名不同年龄的患者被纳入研究。抗逆转录病毒治疗总失败率为16.45%，其中临床、免疫和病毒学失败率分别为0.47%、13.59%和3.13%。病毒抑制率为91.09%，但超过一半(29名(50.88%))的研究参与者首次病毒载量高(>1000拷贝/ml)是默认的，没有进行第二次病毒载量检测。二元和多变量logistic回归分析显示，治疗失败与开始治疗时年龄(OR, 1.029)、抗逆转录病毒治疗持续时间(OR, 0.87)和依从性(AOR, 4.22)有显著相关。女性(62.75%)和小学以下儿童(76.47%)的治疗失败率也较高。结论在3个月的强化依从性咨询中，病毒抑制作用有所增强，但违约率较高。阿姆哈拉地区总体治疗失败率为16.45%。一般/较差的依从性、开始治疗时年龄较大和抗逆转录病毒治疗持续时间较短是治疗失败的重要独立因素。因此，应加强对病人治疗依从性的随访。
{"title":"Increased viral suppression among people on first line antiretroviral treatment in Ethiopia: Meeting the third 90’s","authors":"M. Maru, D. Dagne, Addisu Tesfie, Asefa Missaye, Gizachew Yismaw, A. Mulu","doi":"10.21203/rs.2.20431/v1","DOIUrl":"https://doi.org/10.21203/rs.2.20431/v1","url":null,"abstract":"\u0000 Background Antiretroviral treatment (ART) is aimed for complete suppression of viral replication but it fails for a variety of reasons. The aim of this study was to determine the prevalence and associated factors of treatment failure among people on first line ART in Amhara region, North east Ethiopia.Methods A cross sectional study was conducted from March, 2018 to July, 2018. Questionnaire survey using a pre-structured questionnaire was taken focusing on demographic data and possible risk factors of antiretroviral treatment failure. Clinical history including baseline characteristics was extracted by reviewing medical records using data abstraction sheet and data was analyzed using STATA version 14.Results A total of 640 clients of all age from 16 health facilities were enrolled in the study. The overall antiretroviral treatment failure was 16.45% from which clinical, immunologic and virologic failure were 0.47%, 13.59% and 3.13% respectively. The viral suppression was 91.09%, but more than half, 29 (50.88%) study participants with high first viral load (>1000copies/ml) were defaulted and not tested for the 2 nd viral load testing. Binary and multivariable logistic regression analysis showed significance association of treatment failure with age at treatment initiation (OR, 1.029), duration on ART (OR, 0.87) and adherence (AOR, 4.22). High proportion of treatment failure was also found in females (62.75%) and in those below primary education (76.47%).Conclusions In conclusion increased viral suppression is observed but the rate of default during 3 month of enhanced adherence counseling is high. The overall magnitude of treatment failure in Amhara region is 16.45%. Fair/poor adherence, older age at treatment initiation and shorter duration on ART are significantly independent factors of treatment failure. Therefore improving client follow up to adherence to treatment should be strengthened.","PeriodicalId":302843,"journal":{"name":"Journal of Nursing & Healthcare","volume":"51 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121743222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Background Sexual and gender-based violence (SGBV), including rape and child sexual abuse, remains a significant challenge in post-conflict northern Uganda, including within refugee settlements. Many victims have never sought help from health-related services. Consequently, the scale of the problem is unknown, and SGBV victims’ injuries, both psychological and physical, remain undetected and unaddressed. We hypothesized that health workers in rural Reproductive Health Services could provide a valuable resource for SGBV screening and subsequent referral for support. Methods Our project had three elements. First, Reproductive Health Service workers were trained in the knowledge and skills needed to screen for and identify women who had experienced SGBV, using a questionnaire-based approach. Second, the screening questionnaire was used by reproductive health workers over a 3-month period, and the data analysed to explore the scale and nature of the problem. Third, victims detected were offered referral as appropriate to hospital services and/or the ActionAid SURGE (Strengthening Uganda’s Response to Gender Equality) shelter in Gulu. Results 1656 women were screened. 778 (47%) had a history of SGBV, including 123 victims of rape and 505 victims of non-sexual violence. 1,254 (76%) had been directly or indirectly affected by conflict experiences; 1066 had lived in IDP camps. 145 (9%) were referred at their request to Gulu SGBV Shelter under SURGE. Of these, 25 attended the shelter and received assistance, and a further 20 received telephone counselling. Conclusion Undetected SGBV remains a problem in post-conflict northern Uganda. Reproductive Health Service workers, following specific training, can effectively screen for and identify otherwise unreported and unassisted cases of SGBV. Future work will explore scaling up to include screening in hospital A&E departments, incorporate approaches to screening for male victims, and the impact of taking both screening and support services to rural communities through local clinics with mobile teams.
{"title":"Using reproductive health services to address sexual and gender-based violence in post-conflict northern Uganda.","authors":"Keneth Opiro, F. P. Pebalo, N. Scolding, C. Hardy","doi":"10.21203/rs.2.14293/v1","DOIUrl":"https://doi.org/10.21203/rs.2.14293/v1","url":null,"abstract":"\u0000 Abstract Background Sexual and gender-based violence (SGBV), including rape and child sexual abuse, remains a significant challenge in post-conflict northern Uganda, including within refugee settlements. Many victims have never sought help from health-related services. Consequently, the scale of the problem is unknown, and SGBV victims’ injuries, both psychological and physical, remain undetected and unaddressed. We hypothesized that health workers in rural Reproductive Health Services could provide a valuable resource for SGBV screening and subsequent referral for support. Methods Our project had three elements. First, Reproductive Health Service workers were trained in the knowledge and skills needed to screen for and identify women who had experienced SGBV, using a questionnaire-based approach. Second, the screening questionnaire was used by reproductive health workers over a 3-month period, and the data analysed to explore the scale and nature of the problem. Third, victims detected were offered referral as appropriate to hospital services and/or the ActionAid SURGE (Strengthening Uganda’s Response to Gender Equality) shelter in Gulu. Results 1656 women were screened. 778 (47%) had a history of SGBV, including 123 victims of rape and 505 victims of non-sexual violence. 1,254 (76%) had been directly or indirectly affected by conflict experiences; 1066 had lived in IDP camps. 145 (9%) were referred at their request to Gulu SGBV Shelter under SURGE. Of these, 25 attended the shelter and received assistance, and a further 20 received telephone counselling. Conclusion Undetected SGBV remains a problem in post-conflict northern Uganda. Reproductive Health Service workers, following specific training, can effectively screen for and identify otherwise unreported and unassisted cases of SGBV. Future work will explore scaling up to include screening in hospital A&E departments, incorporate approaches to screening for male victims, and the impact of taking both screening and support services to rural communities through local clinics with mobile teams.","PeriodicalId":302843,"journal":{"name":"Journal of Nursing & Healthcare","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128981074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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