Search results for: registered nurses

Authors: J. M. Alzate, J. Baena

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This work presents the final results of the ‘Diagnosis of the hydrological and hydrogeological potential in the Mancomojan basin for estimations of offer and demand’ with the purpose of obtaining solutions of domestic supply for the communities of the zone of study. There was realized the projection of population of the paths by three different scenes. The highest water total demand appears with the considerations of the scene 3, with a total demand for the year 2050 of 59.275 m3/year (1,88 l/s), being the path San Francisco the one that exercises a major pressure on the resource with a demand for the same year of the order of 31.189 m3/year (0,99 l/s). As for the hydrogeological potential of the zone and as alternative of supply of the studied communities, the stratigraphic columns obtained of the geophysical polls do not show strata saturated with water that could be considered to be a potential source of supply for the communities. The water registered in the geophysics tests presents very low resistances what indicates that he presents ions, this water meets in the rock interstices very thin granulometries which indicates that it is a water of constitution, and the flow of this one towards more permeable granulometries is void or limited. The underground resource that is registered so much in electrical vertical polls (SEV) as in tomography and that is saturating rocks of thin granulometry (clays and slimes), was demonstrated by content of ions, which is consistent with the abundant presence of plaster and the genesis marinades with transition to continental of the geological units in the zone. Predominant rocks are sedimentary, sandy rocks of grain I die principally, in minor proportion were observed also sandstones of thick grain to conglomerate with clastic rock of quartz, chert and siltstone of the Formation Mess and sandstones (of thin, average and thick grain) alternating with caps conglomerate whose thickness is, in general, between 5 and 15 cm, the nodules of sandstones are frequent with the same composition of the sandstones that contain them, in some cases with calcareous and crossed stratification of the formation Sincelejo Miembro Morroa.

Keywords: hydrological, hydrogeological potential, geotomography, vertical electrical sounding (VES)

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Authors: Eunjoo Lee

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Background: As the number of surgeries increases, the incidence of adverse events is likely to become more prevalent. Patients who are somewhat knowledgeable about surgery-related adverse events are more likely to engage in safety initiatives to prevent them. Objectives: To evaluate the impact of a smartphone application developed during the study to enhance patients’ knowledge of surgery-related adverse events during hospitalization. Design: Non-randomized, one group, measured pre- and post-intervention. Participants: Thirty-six hospitalized patients admitted to the orthopedics unit of a general hospital in South Korea. Methods. First, a smartphone application to enhance patients’ knowledge of surgery-related adverse events was developed through an iterative process, which included a literature review, expert consultation, and pilot testing. The application was installed on participants’ smartphones, and research assistants taught the participants to use it. Twenty-five true/false questions were used to assess patients’ knowledge of preoperative precautions (eight items), surgical site infection (five items), Foley catheter management (four items), drainage management (four items), and anesthesia-related complications (four items). Results: Overall, the percentage of correct answers increased significantly, from 57.02% to 73.82%, although answers related to a few specific topics did not increase that much. Although the patients’ understanding of drainage management and the Foley catheter did increase substantially after they used the smartphone application, it was still relatively low. Conclusions: The smartphone application developed during this study enhanced the patients’ knowledge of surgery-related adverse events during hospitalization. However, nurses must make an additional effort to help patients to understand certain topics, including drainage and Foley catheter management. Relevance to clinical practice: Insufficient patient knowledge increases the risk of adverse events during hospitalization. Nurses should take active steps to enhance patients’ knowledge of a range of safety issues during hospitalization, in order to decrease the number of surgery-related adverse events.

Keywords: patient education, patient participation, patient safety, smartphone application, surgical errors

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Authors: Szu-Yi Chang, Jiin-Ru Rong

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This paper discussed a case involving a young female patient with schizophrenia. The patient's condition was deteriorating, and she was becoming increasingly reliant on her family to take care of her, and as her father did not understand the illness well and was afraid that others will learn about the presence of a mentally ill individual in their family, he and the patient's mother were thus unable to cope with the patient's deteriorating condition, which in turn caused her to suffer from a lack of self-confidence and low self-esteem. The patient received nursing care from July 26th to October 25th, 2017, during which counseling, family visits, and phone interviews were carried out, and her condition was monitored. By referring to the practical ability indicators for community psychiatric mental health nursing that were developed by the psychiatric mental health nurses' association of the Republic of China, defining categories such as 'self-construction,' 'self-management,' 'disease management,' and 'family nursing,' and incorporating indicators for empowerment and various skills into the steps and strategies used for nursing care, we will able to help the patient to construct her own identity, raise her self-esteem, improve her ability to independently perform activities of daily living, strengthen her disease management ability, and gradually build up her life management skills. The patient's family was also encouraged to communicate more among themselves, so as to align them with the nursing care objectives of improving the patient's ability to adapt to community life and her disease. The results indicated that the patient was able to maintain her mental stability within her community. By implementing effective self-management and maintaining a routine life, the patient was able to continue her active participation in community work and rehabilitation activities. Improvements were also achieved with respect to family role issues by establishing mutual understanding among the patient's family members and gaining their support. It is recommended that mental health nurses can leverage their community mental health nursing skills and the related strategies to promote adaptation to community life among mental life patients.

Keywords: community psychiatric mental health nursing, family nursing, schizophrenia, self-management

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Authors: Miroslava Markovic, Snezana Rajkovic, Ljubinko Rakonjac, Aleksandar Lucic

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Oak powdery mildew is a serious problem on seedlings in nurseries as well as on naturally and artificially introduced progeny. The experiments were set on oak seedlings in two nurseries located in Central Serbia, where control of oak powdery mildew Microsphaera alphitoides Griff. et Maubl. had been conducted through alternative protection measures by means of various dosages of AQ-10 biofungicide, with and without added polymer (which has so far never been used in this country for control of oak powdery mildew). Simultaneous testing was conducted on the efficiency of a chemical sulphur-based preparation (used in this area for many years as a measure of suppression of powdery mildews, without the possibility of developing resistance of the pathogen to the active matter). To date, the Republic of Serbia has registered no fungicides for suppression of pathogens in the forest ecosystems. In order to introduce proper use of new disease-fighting agents into a country, certain relevant principles, requirements and criteria prescribed by the Forest Stewardship Council (FSC) must be observed, primarily with respect to measures of assessment and mitigation of risks, the list of dangerous and highly dangerous pesticides with the possibility of alternative protection. One of the main goals of the research was adjustment of the protective measures to the FSC policy through selection of eco-toxicologically favourable fungicides, given the fact that only preparations named on the list of permitted active matters are approved for use in certified forests. The results of the research have demonstrated that AQ-10 biofungicide can be used as a part of integrated disease management programmes as an alternative, through application of several treatments during vegetation and combination with other active matters registered for these purposes, so as to curtail the use of standard fungicides for control of powdery mildews on oak seedlings in nurseries. The best results in suppression of oak powdery mildew were attained through use of AQ-10 biofungicide (dose 50 or 70g/ha) with added polymer Nu Film-17 (dose 1.0 or 1.5 l/ha). If the treatment is applied at the appropriate time, even fewer number of treatments and smaller doses will be just as efficient.

Keywords: oak powdery mildew, biofungicides, polymers, Microsphaera alphitoides

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Authors: A. Kebbeb, M. Mostefai, F. Benmerzoug, Y. Chahir

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The multimodal biometric identification is the combination of several biometric systems. The challenge of this combination is to reduce some limitations of systems based on a single modality while significantly improving performance. In this paper, we propose a new approach to the construction and the protection of a multimodal biometric database dedicated to an identification system. We use a topological watermarking to hide the relation between face image and the registered descriptors extracted from other modalities of the same person for more secure user identification.

Keywords: biometric databases, multimodal biometrics, security authentication, digital watermarking

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Authors: Mahmood Shamshiri

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While visual sensation is the key gate for human-being to understand the world, visual impairment is one of the common cause of disability around the world. There is no doubt about the importance of eye sight in daily life among people, even it is understood the best gift of God to human-beings in many societies. Blind people are admitted to hospital for different health issues. Nurses and other health professionals who provide care for this group of patients need to understand their patients. Understanding the lived experience of blind people helps nurses to expand their knowledge regarding blind patients in order to provide a holistic care and improve the quality of care for blind patients. This phenomenological inquiry aimed to describe the meaning of discipline in daily life of blind people admitted in hospital. An interpretive phenomenology underpinned the philosophical approach of the study. While the interpretive phenomenology played as an umbrella role in the overall point of the study, the six methodical activities which introduced by van Manen helped the researchers to conduct the study. ‘Disciplined care for disciplined patients’ was the main theme emerged from dialogues of blind patients about their daily life in the hospital. Almost all of participants called themselves as disciplined people. The theme ‘disciplined care for disciplined patients’ appeared from four sub-themes including discipline through careful touching and listening, discipline as the ideal way of existence, discipline the preferred way of being independent, desire to take disciplined and detailed care, reactions to the undisciplined caring culture. This phenomenological inquiry to the experiences of patients with blindness in hospital revealed that they commonly are disciplined people and want to be cared in well-organized caring environment. Furthermore, they need to be familiar with the new caring environment. Well-organized and familiar environment help blind patients to increase the level of independency. In addition, blind patients prefer a detail informed and disciplined caring culture. Health professionals have to consider the concept of disciplined care in order to provide a holistic and comprehensive competent care.

Keywords: disciplined people, disciplined care, lived experience, patient with blindness

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Authors: Dimuthu Manage

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Introduction: The prevalence of obesity and obesity-related non-communicable diseases are becoming a massive health concern in the whole world. Physical activity is recognized as an effective solution for this matter. The published data on the effectiveness of High-Intensity Interval Training (HIIT) in improving health parameters in overweight and obese individuals in Sri Lanka is sparse. Hence this study is conducted. Methodology: This is a quasi-experimental study that was conducted at the Sports medicine clinic, General Hospital, Kalutara. Participants have engaged in a programme of HIIT three times per week for six weeks. Data collection was based on precise measurements by using structured and validated methods. Ethical clearance was obtained. Results: Registered number for the study was 48, and only 52% have completed the study. The mean age was 32 (SD=6.397) years, with 64% males. All the anthropometric measurements which were assessed (i.e. waist circumference(P<0.001), weight(P<0.001) and BMI(P<0.001)), body fat percentage(P<0.001), VO2 max(P<0.001), and lipid profile (ie. HDL(P=0.016), LDL(P<0.001), cholesterol(P<0.001), triglycerides(P<0.010) and LDL: HDL(P<0.001)) had shown statistically significant improvement after the intervention with the HIIT programme. Conclusions: This study confirms HIIT as a time-saving and effective exercise method, which helps in preventing obesity as well as non-communicable diseases. HIIT ameliorates body anthropometry, fat percentage, cardiopulmonary status, and lipid profile in overweight and obese individuals markedly. As with the majority of studies, the design of the current study is subject to some limitations. The first is the study focused on a correlational study. If it is a comparative study, comparing it with other methods of training programs would have given more validity. Although the validated tools used to measure variables and the same tools used in pre and post-exercise occasions with the available facilities, it would have been better to measure some of them using gold-standard methods. However, this evidence should be further assessed in larger-scale trials using comparative groups to generalize the efficacy of the HIIT exercise program.

Keywords: HIIT, lipid profile, BMI, VO2 max

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Authors: Michael Campbell, Malaz Elsaddig, Kevin Jones

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Background: Despite encouraging progress, global maternal mortality has remained stubbornly high since the declaration of the Millennium development goals. Sub-Saharan Africa accounts for well over half of maternal deaths with Post-Partum Haemorrhage (PPH) being the lead cause. ‘In house’ simulation training delivered by local doctors may be a sustainable approach for improving emergency obstetric care. The aim of this study was to evaluate the use of a Train-the-Trainer (TtT) model in a rural Ugandan hospital to ascertain whether it can feasibly improve practitioners’ management of PPH. Methods: Three Ugandan doctors underwent a training course to enable them to design and deliver simulation training. These doctors used MamaNatalie® models to simulate PPH scenarios for midwives, nurses and medical students. The main outcome was improvement in participants’ knowledge and confidence, assessed using self-reported scores on a 10-point scale. Results: The TtT model produced significant improvements in the confidence and knowledge scores of the ten participants. The mean confidence score rose significantly (p=0.0005) from 6.4 to 8.6 following the simulation training. There was also a significant increase in the mean knowledge score from 7.2 to 9.0 (p=0.04). Medical students demonstrated the greatest overall increase in confidence scores whilst increases in knowledge scores were largest amongst nurses. Conclusions: This study demonstrates that a TtT model can be used in a low resource setting to improve healthcare professionals’ confidence and knowledge in managing obstetric emergencies. This Train-the-Trainer model represents a sustainable approach to addressing skill deficits in low resource settings. We believe that its expansion across healthcare institutions in Sub-Saharan Africa will help to reduce the region’s high maternal mortality rate and step closer to achieving the ambitions of the Millennium development goals.

Keywords: low resource setting, post-partum haemorrhage, simulation training, train the trainer

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Authors: Ibrahim Yerima Gwalem, Jamila Ahmed Buhari

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In recent years, there has been an alarming rate of increase in the costs of building materials in Nigeria, and this ugly phenomenon threatens the contributions of the construction industry in national development. The purpose of this study was to assess the effects of the rising cost of building materials in Adamawa State Nigeria. Four research questions in line with the purpose of the study were raised to guide the study. Two null hypotheses were formulated and tested at 0.05 level of significance. The study adopted a survey research design. The population of the study comprises registered contractors, registered builders, selected merchants, and consultants in Adamawa state. Data were collected using researcher designed instrument tagged effects of the rising cost of building materials questionnaire (ERCBMQ). The instrument was subjected to face and content validation by two experts, one from Modibbo Adama University of Technology Yola and the other from Federal Polytechnic Mubi. The reliability of the instrument was determined by the Cronbach Alpha method and yielded a reliability index of 0.85 high enough to ascertain the reliability. Data collected from a field survey of 2019 was analyzed using mean and percentage. The means of the prices were used in the calculations of price indices and rates of inflation on building materials. Findings revealed that factors responsible for the rising cost of building materials are the exchange rate of the Nigeria Naira with a mean rating (MR) = 4.4; cost of fuel and power supply, MR = 4.3; and changes in government policies and legislation, MR = 4.2, while fluctuations in the construction cost with MR = 2.8; reduced volume of construction output, MR = 2.52; and risk of project abandonment, MRA = 2.51, were the three effects. The study concluded that adverse effects could result in a downward effect on the contributions of the construction industries on the gross domestic product (GDP) in the nation’s economy. Among the recommendations proffered include that the government should formulate a policy that will play down the agitations on the use of imported building materials by encouraging research in the production of local building materials.

Keywords: effects, rising, cost, building, materials

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Authors: Mustafa Ali Abugila

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A total of 13807 diabetic patients [(males 5893(42.68%), females 7914 (57.32%)] were on the registered in diabetic clinics in the western north of Libya at the end of 2012. Of the total clinic population, 865 patients had Type 1 IDDM (6.26%) and the rest cases had Type 2 NIDDM (93.74%). Diabetes mellitus was higher in females than in males (57.32% , 42.68%), the male to female ratio was (0.74 : 1).

Keywords: Diabetes Mellitus (DM), gestational diabetes mellitus, North Western of Libya,

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Authors: Jaci Marie Mastrandrea, Rosario Haro

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Background: The National Comprehensive Cancer Network (NCCN) recommends that healthcare institutions have established processes for integrating palliative care (PC) into cancer treatment and that all cancer patients be screened for PC needs upon initial diagnosis as well as throughout the entire continuum of care (National Comprehensive Cancer Network, 2021). Early PC screening and intervention is directly associated with improved patient outcomes. The Sky Lakes Cancer Treatment Center (SLCTC) is an institution that has access to PC services yet does not have protocols in place for identifying patients with palliative needs or a standardized referral process. The aim of this quality improvement project was to improve early access to PC services by establishing a standardized screening and referral process for outpatient oncology patients. Method: The sample population included all adult patients with an oncology diagnosis who presented to the SLCTC for treatment during the project timeline. The “Palliative and Supportive Needs Assessment'' (PSNA) screening tool was developed from validated, evidence-based PC referral criteria. The tool was initially implemented using paper forms, and data was collected over a period of eight weeks. Patients were screened by nurses on the SLCTC oncology treatment team. Nurses responsible for screening patients received an educational inservice prior to implementation. Patients with a PSNA score of three or higher received an educational handout on the topic of PC and education about PC and symptom management. A score of five or higher indicates that PC referral is strongly recommended, and the patient’s EHR is flagged for the oncology provider to review orders for PC referral. The PSNA tool was approved by Sky Lakes administration for full integration into Epic-Beacon. The project lead collaborated with the Sky Lakes’ information systems team and representatives from Epic on the tool’s aesthetic and functionality within the Epic system. SLCTC nurses and physicians were educated on how to document the PSNA within Epic and where to view results. Results: Prior to the implementation of the PSNA screening tool, the SLCTC had zero referrals to PC in the past year, excluding referrals to hospice. Data was collected from the completed screening assessments of 100 patients under active treatment at the SLCTC. Seventy-three percent of patients met criteria for PC referral with a score greater than or equal to three. Of those patients who met referral criteria, 53.4% (39 patients) were referred for a palliative and supportive care consultation. Patients that were not referred to PC upon meeting criteria were flagged in EPIC for re-screening within one to three months. Patients with lung cancer, chronic hematologic malignancies, breast cancer, and gastrointestinal malignancy most frequently met the criteria for PC referral and scored highest overall on the scale of 0-12. Conclusion: The implementation of a standardized PC screening tool at the SLCTC significantly increased awareness of PC needs among cancer patients in the outpatient setting. Additionally, data derived from this quality improvement project supports the national recommendation for PC to be an integral component of cancer treatment across the entire continuum of care.

Keywords: oncology, palliative and supportive care, symptom management, outpatient oncology, palliative screening tool

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Authors: Mohammed Amin, Debra Kerr, Yacoba Atiase, Andrea Driscoll

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Background: Physical activity (PA) is a major component of diabetes self-care management; although this is often stressed to patients, many adults with Type 2 Diabetes Mellitus (T2DM)lead sedentary lifestyles, and barriers exist for uptake of PA. Aim: To explore opinions of healthcare professionals about barriers to PA for adults with T2DM in Ghana. Methods: This qualitative descriptive study included 13healthcare professionals (3 Physiotherapists, 3 exercise physiologists, 3 nurses, and 4 physicians) who provide care to individuals with T2DM in Ghana. Data was collected by semi-structured interviews. The social cognitive theory guided the design of the interview schedule. Data was analysed using thematic analysis. Results: Four main themeswere identified: 1) Individual-related factors, 2) Interpersonal factors, 3) Environment-related factors, and 4) Health system-related factors. Fear of injury, existing co-morbidities, and lack of time make it difficult for people with T2DM to engage in PA. Lack of family support, fear of social ridicule, and cultural beliefs prevent uptake of PA. Poorly designed community spaces, including safe walkways and lack of exercise facilities, inhibit PA participation. Few physical therapists and physical therapy centres exist to support PA participation among people with T2DM. Some nurses and doctors lack adequate knowledge to deliver proper PA education to clients, thereby making clients lack the needed support. Conclusion: Adults with T2DM may be restricted from partaking in PA arising from personal and external factors. This study has identified that barriers to exercise need consideration when designing PA programs that aim to improve health outcomes for people with T2DM in Ghana.

Keywords: type 2 diabetes, physical activity, exercise, ghana, qualitative, barriers

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Authors: Vivienne Cloude C. Bersabe, Nuelle Anne Castro, Christy P. Gonzales, Nathalie Ann D. Ocbo, Araceli Chuwaley C. Padcayan, Michelle Gaile Lianne S. Peralta, Cecile A. Perez, Eiden Mae A. Roque, Frances Bea S. Sabaten, Korina Louise A. Saculles, Jada Kristen O. Taska, Jose Reinhard C. Laoingco, Don Leonardo N. Dacumos

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The rationale of the study: Since discussion about sexuality is considered taboo in the Filipino culture, provision of quality holistic care often lacks sexuality aspect. This research was conducted to highlight the need for nurses to incorporate sexuality in their care of older adults. Research Objectives: To measure the levels of older adults’ sexual desire, sexual behavior, and sexual intimacy and relate them to sex, living arrangement, educational level, and presence of chronic illness, whether with or without treatment. Methods: This study is of quantitative descriptive design that utilized purposive sampling. 400 older adults of Baguio City participated. The study used a 30 point researcher-made questionnaire, one-on-one interview and focused group discussion to gather data. Data were treated using weighted mean, t-test, F-test, and Scheffe's test. Results and Conclusions: The overall findings revealed that Filipino older adults have a low level of sexuality expressed by the participants’ sexual desire, behavior, and intimacy. Males have significantly higher level of sexual desire, behavior, and intimacy. Living arrangement does not seem to influence the level of sexuality in all its 3 facets. Sexual desire was significantly higher among those with tertiary education and without chronic illness. Recommendation: It is recommended that nurses carry out their assessment of clients to include the exploration of their sexuality especially the older adults. A similar study may be done to explore other variables like demographic location, i.e., rural or urban setting; socio-cultural factors; and functional performance status. It is also recommended that a similar study may be done exploring the different facets of sexuality among homosexual older persons.

Keywords: geriatrics, older adults, Philippines, sexuality

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Authors: Shammael Selorfia

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The Quality improvement project aimed to improve junior doctors and nurses’ knowledge and confidence in diagnosing and managing delirium on inpatient surgical wards in a tertiary hospital. The study aimed to develop a standardised assessment and management checklist for all staff working with patients who were presenting with signs of delirium. The aim of the study was to increase confidence of staff at dealing with delirium and improve the quality of referrals that were being sent to the Mental Health Liaison team over a 6-month period. A significant proportion of time was being spent by the Mental Health Liaison triage nurses on referrals for delirium. Data showed 28% of all delirium referrals from surgical teams were being closed at triage reflecting a poor standard of quality of those referrals. A qualitative survey of junior doctors in 6 surgical specialties in a UK tertiary hospital was conducted. These specialties include general surgery, vascular, plastic, urology, neurosurgery, and orthopaedics. The standardised checklist was distributed to all surgical wards. A comparison was made between the Mental health team caseload of delirium before intervention was compared and after. A Qualitative survey at end of 3-month cycle and compare overall caseload on Mental Health Liaison team to pre-QIP data with aim to improve quality of referrals and reduce workload on Mental Health Liaison team. At the end of the project cycle, we demonstrated an improvement in the quality of referrals with a decrease in the percentage of referrals being closed at triage by 8%. Our surveys also indicated an increase in the knowledge of official trust delirium guidelines and confidence at managing the patients. This project highlights that a new approach to delirium using multi-component interventions is needed, where the diagnosis of delirium is shared amongst medical and nursing staff, and everyone plays role in management. The key is improving awareness of delirium and encouraging the use of recognized diagnostic tools and official guidelines. Recommendations were made to the trust on how to implement a long-lasting change.

Keywords: delirium, surgery, quality, improvement

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Authors: Swathi Ganesan, Nalinda Somasiri, Rebecca Jeyavadhanam, Gayathri Karthick

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The COVID-19 crisis presents a substantial and critical hazard to worldwide health. Since the occurrence of the disease in late January 2020 in the UK, the number of infected people confirmed to acquire the illness has increased tremendously across the country, and the number of individuals affected is undoubtedly considerably high. The purpose of this research is to figure out a predictive machine learning archetypal that could forecast COVID-19 cases within the UK. This study concentrates on the statistical data collected from 31st January 2020 to 31st March 2021 in the United Kingdom. Information on total COVID cases registered, new cases encountered on a daily basis, total death registered, and patients’ death per day due to Coronavirus is collected from World Health Organisation (WHO). Data preprocessing is carried out to identify any missing values, outliers, or anomalies in the dataset. The data is split into 8:2 ratio for training and testing purposes to forecast future new COVID cases. Support Vector Machines (SVM), Random Forests, and linear regression algorithms are chosen to study the model performance in the prediction of new COVID-19 cases. From the evaluation metrics such as r-squared value and mean squared error, the statistical performance of the model in predicting the new COVID cases is evaluated. Random Forest outperformed the other two Machine Learning algorithms with a training accuracy of 99.47% and testing accuracy of 98.26% when n=30. The mean square error obtained for Random Forest is 4.05e11, which is lesser compared to the other predictive models used for this study. From the experimental analysis Random Forest algorithm can perform more effectively and efficiently in predicting the new COVID cases, which could help the health sector to take relevant control measures for the spread of the virus.

Keywords: COVID-19, machine learning, supervised learning, unsupervised learning, linear regression, support vector machine, random forest

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Authors: Chiedu C. Ifekandu, Olusegun Sangowawa, Jean E. Njab

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Background: Health care providers (HCPs) in Nigeria receive little or no training of the healthcare needs of men who have sex with men (MSM) limiting the quality and effectiveness of comprehensive HIV prevention and treatment services. Consequently, most MSM disguise themselves to access services which limit the quality of care provided partly due to challenges related to stigma and discrimination, and breach of confidentiality. Objective: To assess the knowledge of healthcare providers on effective intervention for MSM. Methods: We trained 122 HIV focal persons drawn from 60 health facilities from twelve Nigerian states. , the participants were requested to complete a pre-training questionnaire to assess their level of working experience with key populations as a baseline. Participants included male and female doctors, nurses and counselors/testers. A test was administered to measure their knowledge on MSM sexual risk practices, HIV prevention and healthcare needs and also to assess their attitudes (including homophobia) and beliefs and how it affects service uptake by key populations particularly MSM prior and immediately after the training to ascertain the impact of the training. Results: The mean age of the HCP was 38 years +/- SD Of the 122 HCPs (45 % female, 55 % male; 85 % counsellor/testers; 15 % doctors and nurses; 92 % working in government facilities) from 42 health facilities were trained, of which 105 attempted the test questions. At the baseline, few HCPs reported any prior sensitivity training on MSM. Most of the HCPs had limited knowledge of MSM sexual health needs. Over 90% of the HCPs believed that homosexuality is a mental illness. 8 % do not consider MSM, FSW and PWID as key populations for HIV infection. 45 % lacked knowledge on MSM anal sexual practices. The post-test showed that homophobic attitudes had decreased significantly by the end of the training; the health care providers have acquired basic knowledge compared to the pre-test. Conclusions: Scaling up MSM sensitivity training for Nigerian HCPs is likely to be a timely and effective means to improve their understanding of MSM-related health issues, reduce homophobic sentiments and enhance their capacity to provide responsive HIV prevention, treatment and care services in a supportive and non-stigmatizing environment.

Keywords: healthcare providers, key population, men who have sex with men, HCT

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Authors: Samah Senbel

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Database Design is a fundamental part of the Computer Science and Information technology curricula in any school, as well as in the study of management, business administration, and data analytics. In this study, we compare the performance of two groups of students studying the same database design and implementation course at Sacred Heart University in the fall of 2018. Both courses used the same textbook and were taught by the same professor, one for seven graduate students and one for 26 undergraduate students (juniors). The undergraduate students were aged around 20 years old with little work experience, while the graduate students averaged 35 years old and all were employed in computer-related or management-related jobs. The textbook used was 'Database Systems, Design, Implementation, and Management' by Coronel and Morris, and the course was designed to follow the textbook roughly a chapter per week. The first 6 weeks covered the design aspect of a database, followed by a paper exam. The next 6 weeks covered the implementation aspect of the database using SQL followed by a lab exam. Since the undergraduate students are on a 16 week semester, we spend the last three weeks of the course covering NoSQL. This part of the course was not included in this study. After the course was over, we analyze the results of the two groups of students. An interesting discrepancy was observed: In the database design part of the course, the average grade of the graduate students was 92%, while that of the undergraduate students was 77% for the same exam. In the implementation part of the course, we observe the opposite: the average grade of the graduate students was 65% while that of the undergraduate students was 73%. The overall grades were quite similar: the graduate average was 78% and that of the undergraduates was 75%. Based on these results, we concluded that having both classes follow the same time schedule was not beneficial, and an adjustment is needed. The graduates could spend less time on design and the undergraduates would benefit from more design time. In the fall of 2019, 30 students registered for the undergraduate course and 15 students registered for the graduate course. To test our conclusion, the undergraduates spend about 67% of time (eight classes) on the design part of the course and 33% (four classes) on the implementation part, using the exact exams as the previous year. This resulted in an improvement in their average grades on the design part from 77% to 83% and also their implementation average grade from 73% to 79%. In conclusion, we recommend using two separate schedules for teaching the database design course. For undergraduate students, it is important to spend more time on the design part rather than the implementation part of the course. While for the older graduate students, we recommend spending more time on the implementation part, as it seems that is the part they struggle with, even though they have a higher understanding of the design component of databases.

Keywords: computer science education, database design, graduate and undergraduate students, pedagogy

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Authors: Brendah Nagula, Omolo Fredrick Okalebo, Ronald Ssengendo, Ivan Bamweyana

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The Kampala Physical Development Plan (KPDP) was developed in 2012 and projected both long term and short term developments within the City .The purpose of the plan was to not only shape the city into a spatially planned area but also to control the urban sprawl trends that had expanded with pronounced instances of informal settlements. This plan was approved by the National Physical Planning Board and a signature was appended by the Minister in 2013. Much as the KPDP plan has been implemented using different approaches such as detailed planning, development control, subdivision planning, carrying out construction inspections, greening and beautification, there is still limited knowledge on the level of conformance towards this plan. Therefore, it is yet to be determined whether it has been effective in shaping the City into an ideal spatially planned area. Attaining a clear picture of the level of conformance towards the KPDP 2012 through evaluation between the planned and the existing land use in Kampala City was performed. Methods such as Supervised Classification and Post Classification Change Detection were adopted to perform this evaluation. Scrutiny of findings revealed Central Division registered the lowest level of conformance to the planning standards specified in the KPDP 2012 followed by Nakawa, Rubaga, Kawempe, and Makindye. Furthermore, mixed-use development was identified as the land use with the highest level of non-conformity of 25.11% and institutional land use registered the highest level of conformance of 84.45 %. The results show that the aspect of location was not carefully considered while allocating uses in the KPDP whereby areas located near the Central Business District have higher land rents and hence require uses that ensure profit maximization. Also, the prominence of development towards mixed-use denotes an increased demand for land towards compact development that was not catered for in the plan. Therefore in order to transform Kampala city into a spatially planned area, there is need to carefully develop detailed plans especially for all the Central Division planning precincts indicating considerations for land use densification.

Keywords: spatial plan, post classification change detection, Kampala city, landuse

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Authors: Ramzi Shawahna

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Background: Neonatal intensive care units are high-risk settings where medication errors can occur and cause harm to this fragile segment of patients. This multicenter qualitative study was conducted to describe medication errors that occurred in neonatal intensive care units in Palestine from the perspectives of healthcare providers. Methods: This exploratory multicenter qualitative study was conducted and reported in adherence to the consolidated criteria for reporting qualitative research checklist. Semi-structured in-depth interviews were conducted with healthcare professionals (4 pediatricians/neonatologists and 11 intensive care unit nurses) who provided care services for patients admitted to neonatal intensive care units in Palestine. An interview schedule guided the semi-structured in-depth interviews. The qualitative interpretive description approach was used to thematically analyze the data. Results: The total duration of the interviews was 282 min. The healthcare providers described their experiences with 41 different medication errors. These medication errors were categorized under 3 categories and 10 subcategories. Errors that occurred while preparing/diluting/storing medications were related to calculations, using a wrong solvent/diluent, dilution errors, failure to adhere to guidelines while preparing the medication, failure to adhere to storage/packaging guidelines, and failure to adhere to labeling guidelines. Errors that occurred while prescribing/administering medications were related to inappropriate medication for the neonate, using a different administration technique from the one that was intended and administering a different dose from the one that was intended. Errors that occurred after administering the medications were related to failure to adhere to monitoring guidelines. Conclusion: In this multicenter study, pediatricians/neonatologists and neonatal intensive care unit nurses described medication errors occurring in intensive care units in Palestine. Medication errors occur in different stages of the medication process: preparation/dilution/storage, prescription/administration, and monitoring. Further studies are still needed to quantify medication errors occurring in neonatal intensive care units and investigate if the designed strategies could be effective in minimizing medication errors.

Keywords: medication errors, pharmacist, pharmacology, neonates

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Authors: Ahmed Sami Hammami, Mohamed Jellazi

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Background: The aim of the study is to evaluate the magnitude of different psychological outcomes among Tunisian health care professionals (HCP) during the COVID-19 pandemic and to identify the associated factors. Methods: HCP completed a cross-sectional questionnaire from April 4th to April, 28th 2020. The survey collected demographic information, factors that may interfere with the psychological outcomes, behavior changes and mental health measurements. The latter was assessed through 3 scales; the 7-item questions Insomnia Severity Index, the 2-item Patient Health Questionnaire and the 2-item Generalized Anxiety Disorder. Multivariable logistic regression was conducted to identify factors associated with psychological outcomes. Results: A total of 503 HCP successfully completed the survey; among those, n=493 consented to enroll in the study, 411 [83.4%] were physicians, 323 [64.2%] were women and 271 [55%] had a second-line working position. A significant proportion of HCP had anxiety 35.7%, depression 35.1% and insomnia 23.7%. Females, those with psychiatric history and those using public transport exhibited the highest proportions for overall symptoms compared to other groups e.g., depression among females vs. males: 44,9% vs. 18,2%, P=0.00. Those with a previous medical history and nurses, had more anxiety and insomnia compared to other groups e.g. anxiety among nurses vs. interns/residents vs. attending 45,1% vs 36,1% vs 27,5%; p=0.04. Multivariable logistic regression showed that female gender was a risk factor for all psychological outcomes e.g. female sex increased the odds of anxiety by 2.86; 95% confidence interval [CI], 1, 78-4, 60; P=0.00, whereas having a psychiatric history was a risk factor for both anxiety and insomnia. (e.g. for insomnia OR=2,86; 95% [CI], 1,78-4,60; P=0.00), Having protective equipment was associated with lower risk for depression (OR=0,41; 95% CI, 0,27-0,62; P=0.00) and anxiety. Physical activity was also protective against depression and anxiety (OR=0,41, 95% CI, 0,25-0,67, P=0.00). Conclusion: Psychological symptoms are usually undervalued among HCP, though the COVID-19 pandemic played a major role in exacerbating this burden. Prompt psychological support should be endorsed and simple measures such as physical activity and ensuring the necessary protection are paramount to improve mental health outcomes and the quality of care provided to patients.

Keywords: COVID-19 pandemic, health care professionals, mental health, protective factors, psychological symptoms, risk factors

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Authors: Hiromi Takafuji

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It is a well-known fact that health care and welfare are the foundation of human activities, and human service professionals such as nurses and child care workers support these activities. COVID-19 pandemic has made the severity of the working environment in these fields even more known. It is high time to discuss the work of human service workers for the sustainable development of the human environment. Early turnover has been recognized as a long-standing issue in these fields. In Japan, the attrition rate within three years of graduation for these occupations has remained high at about 40% for more than 20 years. One of the reasons for this is Reality Shock: RS, which refers to the stress caused by the gap between pre-employment expectations and the post-employment reality experienced by new workers. The purpose of this study was to academically elucidate the mechanism of RS among human service professionals and to contribute to countermeasures against it. Firstly, to explore the structure of the relationship between professionalism and workers' RS, an exploratory interview survey was conducted and analyzed by text mining and content analysis. The results showed that the expectation of professionalism influences RS as a pre-employment job expectation. Next, the expectations of professionalism were quantified and categorized, and the responses of a total of 282 human service work professionals, nurses, child care workers, and caregivers; were finalized for data analysis. The data were analyzed using exploratory factor analysis, confirmatory factor analysis, multiple regression analysis, and structural equation modeling techniques. The results revealed that self-control orientation and authority orientation by qualification had a direct positive significant impact on RS. On the other hand, interpersonal helping orientation and altruistic orientation were found to have a direct negative significant impact and an indirect positive significant impact on RS.; we were able to clarify the structure of work expectations that affect the RS of welfare professionals, which had not been clarified in previous studies. We also explained the limitations, practical implications, and directions for future research.

Keywords: human service professional, new hire turnover, SEM, reality shock

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Authors: Lancer Scott

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Purpose: High quality clinical disaster medicine requires providers working collaboratively to care for multiple patients in chaotic environments; however, many providers lack adequate training. To address this deficit, we created a competency-based, 5-hour Emergency Preparedness Training (EPT) curriculum using didactics, small-group discussion, and kinetic learning. The goal was to evaluate the effect of a short course on improving provider knowledge, confidence and skills in disaster scenarios. Methods: Diverse groups of medical university students, health care professionals, and community members were enrolled between 2011 and 2014. The course consisted of didactic lectures, small group exercises, and two live, multi-patient mass casualty incident (MCI) scenarios. The outcome measures were based on core competencies and performance objectives developed by a curriculum task force and assessed via trained facilitator observation, pre- and post-testing, and a course evaluation. Results: 708 participants completed were trained between November 2011 and August 2014, including 49.9% physicians, 31.9% medical students, 7.2% nurses, and 11% various other healthcare professions. 100% of participants completed the pre-test and 71.9% completed the post-test, with average correct answers increasing from 39% to 60%. Following didactics, trainees met 73% and 96% of performance objectives for the two small group exercises and 68.5% and 61.1% of performance objectives for the two MCI scenarios. Average trainee self-assessment of both overall knowledge and skill with clinical disasters improved from 33/100 to 74/100 (overall knowledge) and 33/100 to 77/100 (overall skill). The course assessment was completed by 34.3% participants, of whom 91.5% highly recommended the course. Conclusion: A relatively short, intensive EPT course can improve the ability of a diverse group of disaster care providers to respond effectively to mass casualty scenarios.

Keywords: clinical disaster medicine, training, hospital preparedness, surge capacity, education, curriculum, research, performance, training, student, physicians, nurses, health care providers, health care

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Authors: Siddharudha B. Patil

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Cotton is a premier commercial fibre crop of India subjected to ravages of insect pests. Sucking pests viz thrips, Thrips tabaci,(lind) leaf hopper Amrsca devastance,(dist) miridbug, Poppiocapsidea beseratense (Dist) and bollworms continue to inflict damage Bt Cotton right from seeding stage. Their infestation impact cotton yield to an extent of 30-40 percent. Chemical control is still adoptable as one of the techniques for combating these pests. Presently, growers have many challenges in selecting effective chemicals which fit in with an integrated pest management. Spinetoram has broad spectrum with excellent insecticidal activity against both sucking pests and bollworms. Hence, it is expected to make a great contribution to stable production and quality improvement of agricultural products. Spinetoram is a derivative of biologically active substances (Spinosyns) produced by soil actinomycetes, Saccharopolypara spinosa which is semi synthetic active ingredient representing Spinosyn chemical class of insecticide and has demonstrated higher level of efficacy with reduced risk on beneficial arthropods. The efforts were made in the present study to test the efficacy of Spinetoram against sucking pests and bollworms in comparison with other insecticides in Bt Cotton under field condition. Field experiment was laid out during 2013-14 and 2014-15 at Agricultural Research station Dharwad (Karnataka-India) in a randomized block design comprising eight treatments and three replications. Bt cotton genotype, Bunny BG-II was sown in a plot size of 5.4 m x5.4 m. Recommend agronomical practices were followed. The Spinetoram 12% SC alone and incombination with sulfaxaflore with varied dosages against pest complex was tested. Performance was compared with Spinosad 45% SC and thiamethoxam 25% WG. The results of consecutive seasons revealed that nonsignificant difference in thrips and leafhopper population and varied significantly after 3 days of imposition. Among the treatments, combiproduct, Spinetoram 10%WG + Sulfoxaflor 30% WG@ 140 gai/ha registered lowest population of thrips (3.91/3 leaves) and leaf hoppers (1.08/3 leaves) followed by its lower dosages viz 120 gai/ha (4.86/3 leaves and 1.14/3 leaves of thrips and leaf hoppers, respectively) and 100 gai/ha (6.02 and 1.23./3 leaves of thrips and leaf hoppers respectively) being at par, significantly superior to rest of the treatments. On the contrary, the population of thrips, leaf hopper and miridbugs in untreated control was on higher side. Similarly the higher dosage of Spinetoram 10% WG+ Sulfoxaflor 30% WG (140 gai/ha) proved its bioefficacy by registering lowest miridbug incidence of 1.70/25 squares, followed by its lower dosage (1.78 and 1.83/25 squares respectively) Further observation made on bollworms incidence revealed that the higher dosage of Spinetoram 10% WG+Sulfoxaflor 30% WG (140 gai/ha) registered lowest percentage of boll damage (7.22%), more number of good opened bolls (36.89/plant) and higher seed cotton yield (19.45q/ha) followed by rest of its lower dosages, Spinetoram 12% SC alone and Spinosad 45% SC being at par significantly superior to rest of the treatments. However, significantly higher boll damage (15.13%) and lower seed cotton yield (14.45 q/ha) was registered in untreated control. Thus Spinetoram10% WG+Sulfoxaflor 30% WG can be a promising option for pest management in Bt Cotton.

Keywords: Spinetoram10% WG+Sulfoxaflor 30% WG, sucking pests, bollworms, Bt cotton, management

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Authors: Anna Bjällmark, Victoria Persson, Bodil Karlsson, May Bazzi

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Introduction: Interventional radiology (IR) is a continuously growing discipline that allows minimally invasive treatments of various medical conditions. The IR environment is, in several ways, comparable to the complex and accident-prone operation room (OR) environment. This implies that the IR environment may also be associated with various types of risks related to the work process and communication in the team. Patient safety is a central aspect of healthcare and involves the prevention and reduction of adverse events related to patient care. To maintain patient safety, it is crucial to build a safety culture where the staff are encouraged to report events and incidents that may have affected patient safety. It is also important to continuously evaluate the staff´s attitudes to patient safety. Despite the increasing number of IR procedures, research on the staff´s view regarding patients is lacking. Therefore, the main aim of the study was to describe and compare the IR team members' attitudes to patient safety. The secondary aim was to evaluate whether the WHO safety checklist was routinely used for IR procedures. Methods: An electronic survey was distributed to 25 interventional units in Sweden. The target population was the staff working in the IR team, i.e., physicians, radiographers, nurses, and assistant nurses. A modified version of the Safety Attitudes Questionnaire (SAQ) was used. Responses from 19 of 25 IR units (44 radiographers, 18 physicians, 5 assistant nurses, and 1 nurse) were received. The respondents rated their level of agreement for 27 items related to safety culture on a five-point Likert scale ranging from “Disagree strongly” to “Agree strongly.” Data were analyzed statistically using SPSS. The percentage of positive responses (PPR) was calculated by taking the percentage of respondents who got a scale score of 75 or higher. The respondents rated which corresponded to response options “Agree slightly” or “Agree strongly”. Thus, average scores ≥ 75% were classified as “positive” and average scores < 75% were classified as “non-positive”. Findings: The results indicated that the IR team had the highest factor scores and the highest percentages of positive responses in relation to job satisfaction (90/94%), followed by teamwork climate (85/92%). In contrast, stress recognition received the lowest ratings (54/25%). Attitudes related to these factors were relatively consistent between different professions, with only a few significant differences noted (Factor score: p=0.039 for job satisfaction, p=0.050 for working conditions. Percentage of positive responses: p=0.027 for perception of management). Radiographers tended to report slightly lower values compared to other professions for these factors (p<0.05). The respondents reported that the WHO safety checklist was not routinely used at their IR unit but acknowledged its importance for patient safety. Conclusion: This study reported high scores concerning job satisfaction and teamwork climate but lower scores concerning perception of management and stress recognition indicating that the latter are areas of improvement. Attitudes remained relatively consistent among the professions, but the radiographers reported slightly lower values in terms of job satisfaction and perception of the management. The WHO safety checklist was considered important for patient safety.

Keywords: interventional radiology, patient safety, safety attitudes questionnaire, WHO safety checklist

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Authors: Abdulaziz Alzeban

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This study examines whether internal audit function is indeed greater when audit committee members have industry expertise combined with auditing expertise. Data from a survey of 64 chief internal auditors from companies registered on the Saudi Stock Exchange TADAWL, provides results that suggest that when audit committee members possess both industry expertise and auditing expertise, the committee’s role in improving the quality of internal audit is enhanced. This outcome is concluded as one that can be generalized beyond the Saudi Arabian context.

Keywords: internal audit, audit committee, industry expertise, function

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Authors: S. Ithai, A. Oloo

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The emergence of globalization has cultivated an international consensus that without economic development; it is very unlikely that a country may realize social or political development. It is equally important to note that the economic effect on social development automatically influence the country healthcare services as healthcare systems are improved and adopted. For decades and before 1980's, the colonial and the Governments of Kenya had pursued a goal to provide free healthcare services to its citizen with minimal success; but as population increased, this endeavor became almost a mirage. The challenge called for a change of strategy with introduction of cost sharing which also could not guarantee sustainability of healthcare services in the country due to increased number of poor people and poverty. An involvement of multisectral approach to provision of health individual, collaboration and adoption of all dimensions through globalization provides a ray of hope to not only economic, political and social development but also guaranteed equitable and reliable healthcare systems in Kenya and specifically referral healthcare services at KNH. With the advent of globalization, KNH has made positive strides that have guaranteed patients with reliable healthcare services. These include increased donor funding, collaboration levels, training and research as well as enhanced the hospital relations with international partners. During this period, the hospital has increased number of local doctors and nurses, enhanced transfer of skills, innovations and technologies which are driving forces to quality and efficient healthcare services. The period has also brought in challenges for the hospital which include increased competition, attraction of qualified nurses and doctors to international are some the issues that have made the hospital to spend more resources in research and development in order to stay afloat. This paper reveals the link between globalization and healthcare and its influence on institution policy choice. However, the process is not expected to take place automatically without institutional initiatives if KNH is to reap the benefits of globalization. KNH need to make use of the existing infrastructure, human resources and donor confidence, the opportunities that are indeed important in propelling KNH toward Vision 2030 and achieving the desired Millennium Development Goals (MDGs).

Keywords: globalization, Kenyatta National Hospital, native, healthcare

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Authors: Nejib Turki, Karima Kouki Khalfallah

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The effect of six treatments of organic amendments were evaluated on a sandy soil in the region of Soukra in Tunisia. T1: cattle manure 55 t.ha-1, T2: commercial compost from Germany to 1 t.ha-1, T3: a mixture of 27.5 t.ha-1 of T1 with 0.5 t. ha-1 of T2, T4: commercial compost from France 2 t.ha-1, T5: a Tunisian commercial compost to 10 t.ha-1 and T0: control without treatment. The nitrogen in the soil increase to 0.029 g.kg-1 of soil treatment for the T1 and 0.021 g. kg-1 of soil treatment for the T3. The highest content of P2O5 has been registered by the T3 treatment that 0.44 g kg-1 soil with respect to the control (T0), which shows a content of 0.36 g.kg-1 soil. The soil was initially characterized by a potassium content of 0.8 g kg-1 soil, K2O exchangeable rate varied between 0.63 g.Kg-1 and 0.71 g.kg-1 soil respectively T2 and T1.

Keywords: compost, organic amendement, Ntot, P2O5, K2O

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Authors: Knol Hester, Müller Swantje, Danchenko Natalya

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Objective: Falls in older people cause an autonomy loss and result in an economic burden. LCare is an AI-based application to manage fall risks. The study's aim was to assess the effect of LCare use on patient outcomes in nursing homes in Germany. Methods: LCare identifies and monitors fall risks through a 3D-gait analysis and a digital questionnaire, resulting in tailored recommendations on fall prevention. A study was conducted with AOK Baden-Württemberg (01.09.2019- 31.05.2021) in 16 care facilities. Assessments at baseline and follow-up included: a fall risk score; falls (baseline: fall history in the past 12 months; follow-up: a fall record since the last analysis); fall-related injuries and hospitalizations; gait speed; fear of falling; psychological stress; nurses experience on app use. Results: 94 seniors were aged 65-99 years at the initial analysis (average 84±7 years); 566 mobility analyses were carried out in total. On average, the fall risk was reduced by 17.8 % as compared to the baseline (p<0.05). The risk of falling decreased across all subgroups, including a trend in dementia patients (p=0.06), constituting 43% of analyzed patients, and patients with walking aids (p<0.05), constituting 76% of analyzed patients. There was a trend (p<0.1) towards fewer falls and fall-related injuries and hospitalizations (baseline: 23 seniors who fell, 13 injury consequences, 9 hospitalizations; follow-up: 14 seniors who fell, 2 injury consequences, 0 hospitalizations). There was a 16% improvement in gait speed (p<0.05). Residents reported less fear of falling and psychological stress by 38% in both outcomes (p<0.05). 81% of nurses found LCare effective. Conclusions: In the presented study, the use of LCare app was associated with a reduction of fall risk among nursing home residents, improvement of health-related outcomes, and a trend toward reduction in injuries and hospitalizations. LCare may help to improve senior resident care and save healthcare costs.

Keywords: falls, digital healthcare, falls prevention, nursing homes, seniors, AI, digital assessment

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Authors: Moses Obenade, Francis I. Okpiliya, Gordon T. Amangabara

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According to the 2006 Census of Nigeria, there are 2,525,690 females out of the total population of 5,198,716 of Rivers State. Of that figure, about 90 percent are still within the reproductive age of (0-49). With an annual growth rate of 3.4 percent, the population of Rivers State is estimated to grow to 7,262,755 by 2016. This means an increase of 2,064,039 within a ten year period. From a projected population increase of 182,766 in 2007 only 30,394 live births were registered while an astronomical increase of 543,275 live births were registered in 2008 as against the anticipated increase of 188,980. Preliminary investigations revealed that this exceptional figure in 2008 was occasioned by manpower and logistics support provided by the Rivers State Government for the Port Harcourt office of the National Population Commission (NPC). The mop-up exercise of 2008 by NPC that was engineered from the support provided by the Rivers State Government indicates that the agency needs the co-operation and partnership of the three tiers of government and the communities in performing its statutory duties that is pertinent to national planning, growth and development. Because the incentives received from Rivers State Government did not continue in 2009, live births registration noise-dived to only 60,546 from the expected increase of 195,405. It was further observed that Port Harcourt City and Obio/Akpor Local Government Areas which constitute the state capital have the highest number of live births registration during the period of 2007 to 2014 covered by this paper. This trend of not adequately accounting for or registering all live births in the state has continued till date without being addressed by the authorities concerned. The current situation if left unchecked portend serious danger for the state and indeed Nigeria, as paucity of data could hamper sound economic planning as well as proper allocation of resources to targeted sectors. This paper therefore recommends an innovative multi-stakeholder funding strategy comprising the federal, state, local government and communities. Their participation in an integrated manner will aid the achievement of comprehensive live births registration in the state. It is hoped that investments in education, health and social sectors could help in addressing most of the problems bedeviling the nation as such as lowering of fertility and improving lives.

Keywords: live births registration, population, rivers state, national population commission, Nigeria

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Authors: Mary Katherine Hoth

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Despite racial and ethnic disparities in American psychiatry being well-documented, there remains an apathetic attitude among nurses and providers within the field to engage in active antiracism and provide equitable, recovery-oriented care. It is insufficient to be a “colorblind” nurse or provider and state that call care provided is identical for every patient. Maintaining an attitude of “colorblindness” perpetuates the racism prevalent throughout healthcare and leads to negative patient outcomes. The purpose of this literature review is to highlight the how the historical beginnings of psychiatry have evolved into the disparities seen in today’s practice, as well as to provide some insight on methods that providers and nurses can employ to actively participate in challenging these racial disparities. Background The application of psychiatric medicine to White people versus Black, Indigenous, and other People of Color has been distinctly different as a direct result of chattel slavery and the development of pseudoscience “diagnoses” in the 19th century. This weaponization of the mental health of Black people continues to this day. Population The populations discussed are Black, Indigenous, and other People of Color, with a primary focus on Black people’s experiences with their mental health and the field of psychiatry. Methods A literature review was conducted using CINAHL, EBSCO, MEDLINE, and PubMed databases with the following terms: psychiatry, mental health, racism, substance use, suicide, trauma-informed care, disparities and recovery-oriented care. Articles were further filtered based on meeting the criteria of peer-reviewed, full-text availability, written in English, and published between 2018 and 2023. Findings Black patients are more likely to be diagnosed with psychotic disorders and prescribed antipsychotic medications compared to White patients who were more often diagnosed with mood disorders and prescribed antidepressants. This same disparity is also seen in children and adolescents, where Black children are more likely to be diagnosed with behavior problems such as Oppositional Defiant Disorder (ODD) and White children with the same presentation are more likely to be diagnosed with Attention Hyperactivity Disorder. Medications advertisements for antipsychotics like Haldol as recent as 1974 portrayed a Black man, labeled as “agitated” and “aggressive”, a trope we still see today in police violence cases. The majority of nursing and medical school programs do not provide education on racism and how to actively combat it in practice, leaving many healthcare professionals acutely uneducated and unaware of their own biases and racism, as well as structural and institutional racism. Conclusions Racism will continue to grow wherever it is given time, space, and energy. Providers and nurses have an ethical obligation to educate themselves, actively deconstruct their personal racism and bias, and continuously engage in active antiracism by dismantling racism wherever it is encountered, be it structural, institutional, or scientific racism. Agents of change at the patient care level not only improve the outcomes of Black patients, but it will also lead the way in ensuring Black, Indigenous, and other People of Color are included in research of methods and medications in psychiatry in the future.

Keywords: disparities, psychiatry, racism, recovery-oriented care, trauma-informed care

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