Systematic Sampling Research Articles

Magnitude and Associated Factors of Gestational Excessive Weight Gain Among Pregnancy Women at St Paul’s Hospital, Addis Ababa, Ethiopia 2024, a Crosse-Sectional Study

<i>Background:</i> Women invariably gain weight during pregnancy due to fat deposition, fluid retention, and the weight attributed to the growth of the fetus, uterus, and breasts. Gestational weight gain can influence pregnancy outcomes as well as the long-term health of both the mother and child. It is reported that nearly 50 percent of mothers worldwide experience excessive weight gain during pregnancy. Suboptimal weight gain during pregnancy is also a recognized risk factor for adverse delivery outcomes. <i>Objective:</i> To assess the magnitude of excess maternal gestational weight gain and the associated factors influencing pregnancy complications among pregnant women at St. Paul’s Hospital, Addis Ababa, Ethiopia, in 2024. <i>Methods and Materials:</i> An institutional-based descriptive cross-sectional quantitative approach was used to conduct the study. Data were collected using both primary and secondary sources. Well-organized interviewer-administered questionnaires and a checklist were utilized. The sample size was determined using a single population formula Considering the proportion to be 50% to get the maximum possible sample size. A total of 422 mothers participated in the study, and a systematic random sampling technique was employed to select the study population. Data were collected, summarized, tabulated, and analyzed using the Statistical Package Epi-Info version 7 and SPSS version 26 software. Frequencies, proportions, and dispersions were estimated to describe the variables. Multivariate analysis was used to determine the association between explanatory variables and gestational weight gain. <i>Results:</i> A total of 422 pregnant mothers participated in the study, resulting in a 100% response rate. The majority, 201 (47.6%), were in the age group of 20 to 25 years, and 179 (42.4%) had delivered two children. Additionally, 112 (26.5%) ate more than four times per day, and 303 (71.8%) consumed carbohydrates daily. Of the participants, 375 (88.9%) gained adequate weight, 35 (8.3%) gained excessive weight, and 12 (2.8%) gained inadequate weight during their current pregnancy. Being employed and consuming fruits and vegetables were associated with a lower likelihood of excessive gestational weight gain, while high carbohydrate consumption was linked to a higher risk of excessive weight gain. <i>Conclusion and Recommendation: </i>A significant proportion of women (35%) gained excessive weight. Unemployment and daily carbohydrate and fruits consumption were significantly associated with excessive weight gain. Women of childbearing age should be informed about the importance of consuming fruits and vegetables and reducing carbohydrate intake during pregnancy to prevent excessive weight gain.

Low knowledge levels and high willingness to use oral Pre-Exposure Prophylaxis (PrEP) among Key Populations in Kampala, Uganda: Implications for targeted educational interventions.

Preexposure prophylaxis (PrEP) reduces new human immunodeficiency virus(HIV) infections by up to 96% and is recommended for key populations by the World Health Organization. Understanding the knowledge and willingness to use PrEP is essential for effective implementation. This study assessed these factors and identifiedcharacteristics associated with differences in knowledge among key populations in Kampala, Uganda. We administered a cross-sectional survey to a systematic sample of 497 participants from fisherfolk (283, 56.9%), men who have sex with men (MSM) (93, 18.7%), and female sex worker (FSW) (121, 24.4%) communities in Kampala Central, where PrEP had not yet been rolled out. Data on sociodemographic characteristics, PrEP awareness, and HIV-related behavioralfactors were collected. Knowledge about PrEP was measured using an adopted questionnaire comprising five key questions about PrEP knowledge, graded as no knowledge, some knowledge and good knowledge. Ordered probit regression models were used to analyze the associations of independent factors with PrEP knowledge levels. Participants had a mean age of 29±7.6 years. Ofthese, 257 (51.7%) reported having sex with women, 157 (31.6%) with men and 83 (16.7%) with both men and women. Self-reported HIV-positive status was 6.4% in fisherfolk, 11.8% in MSM and 27.3% in FSW. PrEP awareness stood at 62.4% overall, with the highest awareness in FSW (73.6%) and the lowest in fisherfolk (54.1%). Willingness to use PrEP was high across all groups (77.7%), although it was lower among FSW (66.9%). Multivariate probit analysis highlighted key independent factors associated with PrEP knowledge among fisherfolks and HIV-related concerns (Adj. Coeff = 0.54, 95% CI: 0.11, 0.97) and lack of PrEP awareness (Adj. Coeff = -0.99, 95% CI:-1.28, -0.70); among MSM, lack of PrEP awareness (Adj. Coeff = -1.74, 95% CI:-2.38, -1.10); and in FSW, tertiary education (Adj. Coeff = 1.53, 95% CI: 0.07, 2.99) and marital status (Adj. Coeff = 0.57, 95% CI=0.09, 1.05). MEshighlighted the influence of these independent factors at each knowledge level. Despite the high willingness to use PrEP, significant knowledge gaps exist, particularly concerning dosage and use duration, which are influenced by factors such as HIV concern and educational attainment. Tailored educational initiatives may bridge these gaps and enhance willingness to use PrEP.

Uptake of HIV Testing Services among Refugee Men in Kiryandongo Refugee Settlement Camp, Mid-western Uganda

Aims: HIV testing is a critical checkpoint to late diagnosis and delayed treatment. However, utilization of HIV testing services has not yet reached the desired target, especially for men. This study aimed to determine the level of uptake of HIV testing services and the associated factors among refugee men in the Kiryandongo Refuge Settlement Camp. Study Design: Cross-sectional by mixed methods. Methodology: The study was conducted by mixed methods. A total of 422 men >18 years were selected using systematic random sampling. Interview administered semi-structured - questionnaires and informant interview guides were used to collect quantitative and qualitative data respectively. Results: The level of uptake of HIV testing services was 32%. Key factors negatively associated with the testing included social-cultural status (P=0.006, AOR=3.80) disclosure of positive results and awareness (P=0.002, AOR=0.14 and P=0.000, AOD=0.08) respectively, unemployment (P=0.015, AOR=0.17), religion (P=0.043, AOD=0.37) and multiple sexual partners (P=0.033, AOR=0.23). Conclusion: The level of uptake of HIV testing services among refugee men in the Kiryandongo refugee settlement camp is significantly lower than the national mark. Targeted testing strategies and sensitization are critical to address the negatively associated factors and inform public health policies.

Dietary diversity and associated factors among pregnant women attending antenatal care at public hospitals in North Shewa, Oromia, Ethiopia, 2023.

Adequate consumption of diversified food during pregnancy enables adequate intake of 11 important micronutrients. Pregnant women who consume an inadequate amount of diversified food during pregnancy are at a higher risk of delivering preterm babies, stillbirth, low birth weight, and small for gestational age newborns. This study aimed to assess dietary diversity (DD) and associated factors among pregnant women attending antenatal care (ANC) at public hospitals in North Shewa, Oromia, Ethiopia, 2023. An institution-based cross-sectional study was conducted on 400 pregnant women attending antenatal care. The study participants were selected using a systematic random sampling method. A pre-tested, structured, and interviewer-administered questionnaire was used to collect information about dietary diversity. The questionnaire was adapted from a validated and modified individual dietary diversity guideline, as recommended by the Food and Agriculture Organization (FAO) of the United Nations. The household food security level was determined using a standard set of questions derived from the Household Food Insecurity Access Scale (HFIAS) measurement guide. The data were entered into EpiData version 4.6 software and exported to Statistical Package for the Social Sciences (SPSS) version 24 for analysis. The results from the bivariate analysis of p < 0.25 were moved to the multivariable logistics regression analysis model. Any statistical test with a p < 0.05 at a 95% confidence interval (CI) was considered statistically significant. The study revealed that 55.4% of the pregnant women had adequate dietary diversity. Being an urban dweller [adjusted odds ratios (AOR = 2.4. 95% CI: 1.1, 5.18)], being a housewife (AOR = 3.44, 95% CI: 1.37, 8.68), being employed (AOR = 3.69, 95% CI: 1.12, 12.16), being a merchant (AOR = 3.43, 95% CI: 1.15, 10.24), being a daily laborer (AOR = 3.66, 95% CI: 1.0, 13.45), having a low average monthly household income of <500 Ethiopian birr (ETB) (AOR = 0.25, 95% CI: 0.07, 0.83), practicing home gardening (AOR = 2.5, 95% CI: 1.39, 4.5), meal frequency being three or more times per day (AOR = 2.9, 95% CI: 1.64, 5.09), and receiving dietary counseling during antenatal care (AOR = 3.56, 95% CI: 2.0, 6.35) were factors associated with the dietary diversity of the pregnant women. This study found that 55.4% of the pregnant women had adequate dietary diversity. Place of residence, women's occupation, average monthly household income, practicing home gardening, meal frequency per day, and receiving dietary counseling during antenatal care were strong predictors of adequate dietary diversity among pregnant women. Therefore, attention should be paid to pregnant women's diet by healthcare providers during antenatal care.

Assessment of the Quality of Life and Family Function in Attention Deficit Hyperactivity Disorder Caregivers in Al-Ahsa, Saudi Arabia.

Background Attention deficit hyperactivity disorder (ADHD) is the most prevalent neurobehavioral disorder in children and teenagers. The condition is debilitating, affecting numerous cognitive and behavioral processes and leading to substantial long-term consequences. Affected individuals, their families, and society as a whole bear a heavy functional, psychological, and financial cost. Aim The objective of this study was to evaluate the quality of life (QOL) among parents of children with ADHD diagnoses, as well as the burden and level of dysfunction in the family. Additionally, to ascertain the sociodemographic factors that influence these issues. Methods This cross-sectional study used an online survey to collect data from caregivers of children with a confirmed diagnosis of any type of ADHD who were exhibiting symptoms before the age of seven, speaking Arabic fluently and consented to take part in the study. The Arabic version questionnaire of the World Health Organization Quality of Life instrument (WHOQOL-BREF) was used to assess the QOL, and the Zarit Burden Interview questionnaire was employed to assess the degree of the experienced burden. Participants were recruited by a systematic random sampling method. Results A total of 103 ADHD caregivers were included in the study. A total of 89 out of 103 (86.4%) participants reported having various degrees of burden. There was a significant relation between the marital status of the caregiver and the degree of burden (p=0.024). Divorced caregivers were (4, 57.1%) severely burdened. Ninety out of 103 participants (87.4%) reported having dysfunctional families, and the majority of them (60, 60.1%) reported moderate family dysfunction. All quality-of-life domains were negatively impacted, with the environmental domain experiencing the most disruption. The overall four subdomains of QOLdid not differ significantly with various sociodemographic characteristics. Conclusion There was a high prevalence of burden and family dysfunctionamong caregivers of ADHD children. Marital status was associated with a significant impact on the level of burden.In addition, there was a detrimental influence on every aspect of quality of life, with the environmental domain suffering the most. It is important to take into account family therapy and other interventions that strengthen caregivers' and families' relationships.

Transitions in lung microbiota landscape associate with distinct patterns of pneumonia progression.

The precise microbial determinants driving clinical outcomes in severe pneumonia are unknown. Competing ecological forces produce dynamic microbiota states in health; infection and treatment effects on microbiota state must be defined to improve pneumonia therapy. Here, we leverage our unique clinical setting, which includes systematic and serial bronchoscopic sampling in patients with suspected pneumonia, to determine lung microbial ecosystem dynamics throughout pneumonia therapy. We combine 16S rRNA gene amplicon, metagenomic, and transcriptomic sequencing with bacterial load quantification to reveal clinically-relevant pneumonia progression drivers. Microbiota states are predictive of pneumonia category and exhibit differential stability and pneumonia therapy response. Disruptive forces, like aspiration, associate with cohesive changes in gene expression and microbial community structure. In summary, we show that host and microbiota landscapes change in unison with clinical phenotypes and that microbiota state dynamics reflect pneumonia progression. We suggest that distinct pathways of lung microbial community succession mediate pneumonia progression.

Types of nasal deformities in individuals seeking rhinoplasty at governmental hospital in Saudi Arabia.

This study explores the profound impact of nasal structure on individuals' self-image and emotional well-being, emphasizing the increasing popularity of rhinoplasty in Saudi Arabia, influenced by societal beauty standards portrayed on social media. The investigation aims to unravel the complex interplay between demographic factors, such as gender and age distribution, and prevalent nasal deformities in a cohort of 293 participants. This retrospective study at the University of Hail and King Khalid Hospital, Saudi Arabia, investigated nasal deformities in 293 participants aged 15-54. Ethical approval was obtained, and data, including bio-demographics and nasal deformities, were retrospectively reviewed. Statistical analyses, utilizing chi-square and Fisher exact tests, assessed associations, enhancing internal validity. The study targeted a diverse population, emphasizing ethical guidelines and systematic sampling. Our study of 293 participants revealed a prevalence of common nasal deformities. Dorsal hump deformity (59.0%) was the most prevalent, followed by external nasal deviation (54.6%). Significant gender differences were observed, with males more prone to external nasal deviation (65.6%), while decreased nasal tip rotation was more common in females (40.6%). Variations in nasal tip shape were statistically significant, with broad nasal tip shape more prevalent in females (35.2%). In conclusion, our study highlights the prevalence of common nasal deformities, emphasizing significant gender variations. These findings contribute to a deeper understanding of nasal anatomy, essential for informed decision-making in rhinoplasty.

Stable isotopic evidence of cadmium enrichment in soils of black shale distribution areas

Black shale-derived soils exhibit significant heavy metal enrichment, notably cadmium (Cd) enrichment. This study pioneered the reporting of δ114/110Cd isotopic values within a black shale-soil system, offering novel insights into the geochemical behaviors and enrichment mechanisms of Cd during soil formation processes influenced by weathering. Systematic rock‒soil sampling was conducted on the lower Cambrian Hetang Formation in western Zhejiang, China, which is characterized by Cd-rich black shale. Employing analytical methods, including principal component analysis and multiple linear regression, we investigated the factors influencing heavy metal content in soil, such as element dissolution during weathering, soil pH, and the presence of iron-manganese oxides, sulfides, organic matter, and clay minerals. Our findings revealed a compositional range of δ114/110Cd in black shale (1.93‰–3.31‰) contrasting with that in adjacent soils (0.31‰–1.82‰), illustrating significant Cd isotopic fractionation during weathering, where heavier Cd isotopes are preferentially leached, and lighter isotopes are enriched in the soil in association with iron-manganese oxides. This research not only deepens the understanding of Cd enrichment mechanisms within the rock‒soil system against a black shale geological background but also elucidates the formation processes of soil Cd pollution in areas with a high geochemical background.

Quality of life and associated factors among primary caregivers of children and adolescents with neurodevelopmental disorders attending public hospitals in Addis Ababa, Ethiopia: a cross-sectional study.

Neurodevelopmental disorders are a set of disorders that negatively affect the acquisition of skills in a variety of developmental domains, including motor function, learning, socialization, language and cognition. However, there is no information available on the standard of living of Ethiopian primary caregivers of children and adolescents with neurodevelopmental disorders. Therefore, this study aimed to assess the quality of life (QOL) and associated factors among primary caregivers of children and adolescents with neurodevelopmental disorders in Addis Ababa, Ethiopia. A cross-sectional study was conducted during 1-30 May 2022. Systematic random sampling was used to obtain 352 samples. QOL was measured using the WHO Quality of Life Brief. The gathered information was coded, entered into EpiData 4.6.0.2 and analyzed with SPSS version 26. Multiple linear regression analysis was used to identify the correlates of QOL and the strength of the correlation was measured by β coefficient with 95% CI. The mean score of the overall QOL was 62.61 with a SD of 5.17. The mean (±SD) scores for the physical health, psychological, environmental and social relationship domains of primary caregivers were 57.36±9.98, 66.98±9.39, 66.06±12.91 and 60.02±9.14, respectively. Age was significantly associated with physical domain (β=-0.25, 95% CI -0.43 to -0.07) and with environmental domain (β=-4.57, 95% CI -9.06 to -0.09). Being divorced/widowed was negatively associated with psychological health (β=-2.99, 95% CI -5.82 to -0.17) and social health (β=-0.62, 95% CI -1.33 to -0.10). The presence of medical illness was negatively associated with the physical health domain (β=-4.32, 95% CI -7.64 to -2.91) and the environmental domain (β=-3.11, 95% CI -5.71 to -0.51). Poor social support was negatively associated with psychological health (β=-3.25, 95% CI -5.89 to -0.61) and the social health domain (β=-3.39, 95% CI -11.3 to 4.6), and moderate social support (β=8.62, 95% CI 3.15 to 14.09) was positively associated with physical health. Depression (β=-6.32, 95% CI -11.96 to -0.67) and anxiety (β =-3.07, 95% CI -5.80 to -0.34) were negatively associated with physical health and the psychological health domain, respectively. The findings from this study indicate that all dimensions of QOL of primary caregivers of children and adolescents with neurodevelopmental disorders in this study setting were compromised. Being divorced or widowed, lack of formal education, age, average monthly income, poor social support, depression, anxiety and the presence of medical illness were factors associated with QOL in all domains. This requires integrating a bio-psychosocial perspective, a positive mental health strategy and pharmaceutical therapies to enhance QOL for caregivers of children and adolescents with neurodevelopmental disorders.

Perception-Based Assessment of the Water Supply System in Bhimdatta Municipality, Sudurpashchim Province, Nepal

Safe and adequate water supply is one of the serious and significant challenges for local governments in Nepal. The main objective of this study is to explore the community perception on existing water supply systems, its quality, and quantity alongside with associated problems in the Bhimdatta Municipality. The study adopted qualitative and quantitative methods with Systematic random sampling and purposive sampling techniques for data collection in 2024. A total of 379 households were selected across the 19 wards of municipality. The findings reveals that 44.9% of households use groundwater as their primary drinking water source, 31.9% rely on public supply, and the rest use both sources. The majority of respondents rated the water quality as good with 56.2%, while 26.4% rated as excellent, 10.8% as fair, 6.1% as poor, and 0.5% as very poor. Most of the respondents reported a lower incidence of diseases stemming from drinking water source, they noted problems such as taste, odor, turbidity, and color. Over the past decade, groundwater levels have declined, making access more difficult across all wards. This study provides vital insights for policymakers and stakeholders to address these challenges and improve water quality and accessibility.

The Efficacy of Balance Training to Reduce Fall Risk in Older Adults

The study was carried out to find out the role of Occupational Therapy intervention in quality of life of women suffering from premenstrual syndrome among different age groups. Women with premenstrual syndrome in two age groups (18-30) years and (31-45) years were selected using systematic random sampling method. Both age groups were assessed for premenstrual syndrome using Premenstrual syndrome Questionnaire. Quality of life were assessed in two age groups (18-30) years and (31- 45) years using Short Form-36 (SF-36) health survey. To study the impact of OT intervention on quality of life (QOL) of both age groups with PMS, OT intervention Performa was explained to both age groups with practical implementation. As this study would be pre and post study design , so both age groups again will be assessed on PMS Questionnaire and Short Form-36 (SF-36) health survey after implementation of OT intervention for the fulfillment of all objectives. The data gathered from these assessment measures were then be subjected to statistical analysis to find whether there are differences in the quality of life of both age groups women suffering from Premenstrual syndrome after implementation of OT intervention. As Occupational Therapy intervention has shown significant results towards diminishing PMS symptoms of females in both groups. It was concluded that Occupational Therapy Intervention plays an important role in the improvement for the condition in PMS among females. Keywords: Pre-Menstrual Syndrome, Quality of life, Occupational Therapy, Relaxation Therapy, Females.

Analysis of the factors influencing local employment in the mining sector in the Benishangul-Gumuz Regional state of Ethiopia

This article aims to analyze the factors that determine local employment in the mining sector and identify ways to improve the annual income of employed households in the Benishangul-Gumuz Regional State (BGR) of Ethiopia. The research design used for this study was cross-sectional. Quantitative data were collected from a sample of 162 households affected by mining operations, using systematic random sampling. Additionally, four focus group discussions (FGD) and eight key informant interviews (KII) were conducted to gather qualitative data. The quantitative data was analyzed using descriptive statistics and the Heckman two-stage model, while the qualitative data was analyzed using narrative analysis. The descriptive results indicate that most of the jobs created by the mining industries were temporary, and the small-scale mining sector employed more workers than the large-scale sector. Furthermore, migrant laborers benefited more from employment opportunities than indigenous households. The first result of the Heckman two-stage model reveals that the educational level of the household head, the size of the farmland, and membership in a farmer's organization have significant negative effects on local employment. On the other hand, the sex of the household head, the size of the nearest mining project, access to information, access to transport, and access to credit have significant positive effects on local employment. The second-stage results of the Heckman two-stage model show that the age of the household head, the dependency ratio, and membership in farmers' organizations have statistically significant negative effects on the annual income of employed households. Conversely, non-farm activities have statistically significant positive effects on the annual income of employed households. The findings of this study have implications for identifying the determinants and factors that need to be addressed to promote local employment. We suggest that both the Ethiopian and BGR regional governments should work towards increasing local employment opportunities for indigenous communities in the mining sector.

Screening of Serum Cholesterol Level Amongst Sri Lankan Women in Relation to Waist-Height Ratio (WHtR), Waist Circumference (WC), Body Mass Index (BMI), Waist-Hip Ratio (WHR), and Waist-Thigh Ratio (WTR): A Cross-Sectional Study

Anthropometric measurements give a general reflection of any changes in lipid concentration in the human body. A disturbed lipid profile can be associated with cardiovascular disease risk. Therefore, this study aimed to investigate the relationship between serum total cholesterol level and different anthropometric parameters related to obesity in a female population of two administrative areas in the Southern Province of Sri Lanka. Analytical cross-sectional study was conducted in Boral and Hiththatiya-Meda areas of Matara district, Sri Lanka. The systematic random sampling method was followed to select 314 females aged 18-60 years. Serum total cholesterol concentration was measured on a venous blood sample by Konelab 20XT biochemistry analyser with a commercially available reagent kit. Body Mass Index (BMI), Waist-Height Ratio (WHtR), Waist Circumference (WC), Waist-Hip Ratio (WHR), and Waist-Thigh Ratio (WTR) parameters were calculated for each individual. Pearson correlation test, chi-squared test and t-test were done to analyse data using SPSS, 16 (P&lt;0.05). The serum total cholesterol concentration is positively associated with abdominal obesity while showing a statistically significant positive correlation with BMI, WC, WHR, WTR and WHtR (r=0.217, r=0.590, r=0.315, r=0.347 and r=0.574 respectively; P≤0.05). The prevalence of hypercholesterolemia in the population was 8.6%. These results indicate that all main anthropometric parameters of this study are positively associated with serum total cholesterol levels and an increment of these risk markers can lead to an increase in risk of developing metabolic diseases associated with abdominal obesity among women.

Predictors of depression among caregivers of patients with severe mental illness in Northwest Ethiopia, 2023: an explanatory sequential mixed-method study.

Severe mental illness results in an enormous social and economic burden on affected individuals, their families, and communities, especially in developing countries, such as Ethiopia. The aim of this study was to assess the level of depression among caregivers of patients with severe mental illness in Debre Tabor Town, Northwest Ethiopia in 2023. This institution-based explanatory mixed study was conducted at Debre Tabor Compressive Specialized Hospitals between September 30 to October 30, 2023. A systematic random sampling technique was used to select 260 study participants, and a public health questionnaire was used to assess depression. Epicollect5 was used to collect data, which were then exported to the SPSS-25 for analysis. Variables with a p-value <0.25 were considered candidates for the multivariate logistic regression analysis. The odds ratios with a 95% confidence interval were used to determine the strength of the association. An in-depth interview was conducted with 11 participants, selected using purposive sampling. The prevalence of depression was 31.3% (95% CI = 29.7-38.6). The multivariate analysis showed that being female (AOD = 2.43, CI = 1.42-7.23), divorced/widowed (AOD = 1.8, CI = 1.32-6.34), poor social support (AOD = 2.2, CI = 1.9-5.87), and perceived stigma (AOD = 2.33, CI = 0.24-13.22) were positively associated with depression. The qualitative results suggest that being female, illiterate, severity of the illness, poor social support, and stigma were factors for depression. The prevalence of depression was high among caregivers of patients with severe mental illness. Female sex, being divorced or widowed, being illiterate, poor social support, and perceived stigma were the contributing factors. This implies that a greater focus on caregivers and the government increases mental health literacy and mental health community services.

Isolation and antimicrobial susceptibility profile of Salmonella species from slaughtered cattle carcasses and abattoir personnel at Dessie, municipality Abattoir, Northeast Ethiopia

BackgroundAntibiotic-resistant Salmonella is one of the main public health concerns in the world. Isolation of Salmonella in abattoirs has been considered the core source of infection in the community from meat. Still, there is limited information on the contamination rate of cattle carcasses.ObjectiveThis study aimed to document the occurrence and antimicrobial susceptibility profile of Salmonella species recovered from cattle carcass and abattoir personnel at Dessie, municipality abattoir, Northeast Ethiopia:MethodsA total of 336 carcass swabs of abdomen, neck, and hind limb from cattle carcasses and 24 stool samples were collected from abattoir personnel using a systematic sampling method from February to April 2019. The collected samples were transported using Cary-Blair transport media and cultivated on Selenite cysteine F-broth, Brilliant green agar, and Xylose-lysine deoxycholate agar plates to isolate Salmonella species. Gram stain, colony morphology, and biochemical tests were performed to identify the isolated bacteria. An antimicrobial susceptibility test for Salmonella was performed using the Kirby-Bauer Disc Diffusion method. Descriptive statistics; both bivariable and multivariable logistic regression analysis was performed using SPSS version 25 software. P-value < 0.05 at 95% CI was considered statistically significant.ResultsThe prevalence of salmonella species was 8%(27/336) from all samples.‘The prevalence of Salmonella isolates in cattle carcass and abattoir personnel was 8%(25/312) and 8.3%(2/24) respectively. The antimicrobial test showed that Salmonella species were 100% resistant to ampicillin, 59.3% to trimethoprim-sulfamethoxazole, 59.3% to tetracycline, and 55.6% to amoxicillin/clavulanate. From the total antimicrobial tested bacteria, 81.5%(22/27) were resistant to three and above classes of antibiotics (drug classes). Unwashed knives, carcasses, and hands of butchers during slaughtering were significantly associated (p < 0.05) with Salmonella found in carcasses.ConclusionsSalmonella isolation rates from cattle carcasses were high, with the bacteria showing notable resistance to most tested antibiotics. Poor hygiene practices, unsanitized equipment, and unhygienic beef processing were contributing factors.

The effect of financial skills and strategies toward saving behavior among self-employed workers in retirement planning

This paper aimed to investigate essential factors of financial skills and financial strategies that influence retirement savings behavior among self-employed workers. Many retirement savings schemes are being introduced by regulatory bodies or financial institutions, especially for self-employed workers on a voluntary basis, but many people's efforts to save for retirement are stalled. However, the participation of self-employed workers in those schemes is still low as people have financial instability or lack of knowledge in matters. The quantitative approach is applied by distributing a systematic random sampling of 400 prospective respondents. The outcome was analyzed using Structural Equation Modelling (SEM) indicates that savings behavior financial skill, financial strategies, and demographics positively moderated relationship. This study adds to the existing knowledge on financial skills as well as financial strategies towards saving objectives for self-employed, with practical implications for promoting positive saving habits and improving financial well-being across all age groups. Policymakers might use the data to create targeted programs that specifically target self-employed workers and promote responsible saving and financial security across generations. The authorities should construct a comprehensive fixed retirement scheme for self-employed workers based on these characteristics so that self-employed workers have secure and stable financial security after retirement.

Length of stay and associated factors among pediatric patients in the pediatric emergency unit of the Tikur Anbessa specialized hospital, Addis Ababa, Ethiopia

BackgroundLength of stay in the emergency department is used as a quality indicator to gauge the overall efficiency of emergency care. The performance measure was used to evaluate the quality of care provided in the emergency department.ObjectiveTo assess the length of stay and associated factors among pediatric patients admitted to the pediatric emergency unit of Tikur Anbessa Specialized Hospital in Addis Ababa, Ethiopia.MethodsAn institution-based prospective cross-sectional study design was employed. A systematic random sampling technique was used to select the study participants. Data were collected via semi-structured, interviewer-administered questionnaires and chart reviews. Analysis was performed via the Statistical Package for Social Science software version 27. Binary logistic regression analysis was conducted to identify variables associated with the length of stay. The study was conducted in the Pediatric Emergency Unit of Tikur Anbessa Specialized Hospital in Addis Ababa, Ethiopia, from March 15 to April 15, 2023.ResultsA total of 268 patients participated in the study, with a response rate of 97.81%. The majority of the participants were male (157, 58.6%), with a median age of 3 years. The study revealed that 180 participants (67.2%) experienced a prolonged length of stay. The variables significantly associated with prolonged length of stay included residency (AOR = 2.04, CI: 1.03, 4.025), triage category (AOR = 3.25, CI: 1.08, 5.974), number of investigations (AOR = 2.381, CI: 1.038, 5.462), and waiting for imaging (AOR = 4.230, CI: 1.638, 10.93).ConclusionMany pediatric patients stayed in the emergency room for more than 24 h because of factors such as residency, triage category, number of investigations, and the need for imaging. To address this, we recommend streamlining triage processes, increasing imaging resources, providing additional staff training, developing integrated care pathways, and advocating for policy changes to increase emergency room efficiency and improve patient outcomes.

NGOs' initiatives and grassroots approach for accessing to health care services for the slum people in Dhaka.

This study holds significant importance as it aims to delve into the impactful NGOs' initiatives and grassroots approaches instrumental in providing healthcare services to Dhaka's underserved slum people. It focuses on understanding how these factors influence the use and access to health services, which is a crucial aspect for researchers, policymakers, and healthcare professionals. This study was meticulously designed, utilizing a comprehensive cross-sectional mixed-methods design. By incorporating qualitative and quantitative data collection methods, we ensured a thorough understanding of NGOs' initiatives and grassroots approaches to providing healthcare services to slum dwellers in Dhaka, thereby instilling confidence in the validity of our research for the audience. A face-to-face interview was used to survey the participants (n = 722) using semi-structured questionnaires, following a systematic sampling technique. Four focus group discussions (FGDs) were also conducted with the slum people. Binary logistic regression was performed to know NGOs' initiatives, roles, and grassroots approach as predictors or independent variables and healthcare services as an outcome or dependent variable. The quantitative data were analyzed using SPSS version 23.0. At the same time, thematic analysis was conducted following Philip Adu's Qualitative data analysis process and Braun and Clarke's six steps of the thematic analysis system, integrating the 11 subthemes with the quantitative findings to highlight the interpretative findings of the qualitative data. Major findings revealed that NGOs' initiative roles and grassroots approach had a significant impact on slum dwellers' use and access to healthcare services. The initiatives included affordable health services (OR = 22.86, 95% CI = 3.87, 35.00, P = 0.01), special health services (OR = 5.63, 95% CI = 3.36, 9.42, P = 0.00), engagement of responsible community leaders (OR = 1.72, 95% CI = 1.14, 2.59, P = 0.01), distribution of health and medicine items (OR = 1.92, 95% 2 CI = 1.40, 2.63, P = 0.01), provision of updated information to slum dwellers (OR = 1.37, 95% CI = .99, 1.90, P = 0.05), telehealth and telemedicine (OR = 1.82, 95% CI = 1.55, 2.13, P = 0.01), BCC strategy (OR = 1.26, 95% CI = 1.00, 1.57, P = 0.05), and doorstep services as NGOs' grassroots approach (OR = 1.84, 95% CI = 1.00, 3.38, P = 0.05). Qualitative findings supported the quantitative findings through 2 main themes and 11 sub-themes, which were integrated with quantitative findings to highlight the interpretative findings of qualitative data. Health services and other facilities for urban slum people through NGOs' initiatives and grassroots approaches are highly affordable and practical, special health services with the involvement of special exceptional health professionals, community supportive services, BCC strategies, and doorstep health services may trigger the use and access to health services for slum dwellers. Results suggest and recommend capitalizing and investing in such initiatives and grassroots approaches from the government, policymakers, and donors with NGOs to find accessible, affordable health services for the unprivileged slum people.

SD-MDN-TM: A traceback and mitigation integrated mechanism against DDoS attacks with IP spoofing

Traceback has been very attractive against DDoS attacks with IP spoofing instead of traditional mitigation methods because attacks require removal near attackers, resulting in affecting legitimate traffic as little as possible. There have been some approaches dedicated to achieving effective traceback. However, existing approaches often modify protocols to apply to multi-domain scenarios, and the implemented mitigation usually lags behind traceback. Therefore, this paper proposes the Software-Defined Multi-Domain Network Tracer and Mitigator (SD-MDN-TM) to traceback and mitigate DDoS attacks with IP spoofing in multi-domain SDN scenarios. We apply systematic sampling and flow feature extraction based on the Count-Min Sketch data structure for the lightweight statistics collection of massive DDoS attack traffic. We also design the TracebackTree data structure to construct the traceback paths of attackers of distributed attack sources. The Border Switch Trigger Mechanism is proposed to overcome the drawbacks of the commonly-used packet marking in cross-domain traceback information transfer, achieving no modification of existing network protocols and independent traceback among multiple domains. Mitigation is integrated with traceback for faster removal of attacks from the network. The proposed scheme can traceback DDoS attack sources both inside and outside domains accurately and effectively by constructing traceback path. It can be implemented without modifying the existing protocols, therefore achieving direct application to the existing network architecture. Furthermore, the traceback of attack sources outside domains can maintain independence in multi-domain scenarios. Mitigation integrated with traceback can achieve less impact on legitimate traffic and faster removal of attacks from the network.

Health Literacy in Preventing and Controlling Dengue Hemorrhagic Fever Among Village Health Volunteer, Pattani Province, Thailand

Background: Dengue Haemorrhagic Fever (DHF) is a mosquito-borne viral infection caused by the dengue virus (DENV). The situation of the DHF prevalence rate was still high in the community. One reason for this high rate involves community members, who had less participated in the prevention and control measures of DHF. Objectives: This descriptive study aimed to study factors associated with preventing and controlling DHF among village health volunteer, Pattani Province. Methods: Population consisted of 6,841 village health volunteers registered in Pattani Province, Thailand, in fiscal year 2020, and the sample size was calculated using Daniel formula for 215 cases, and systematic random sampling was carried out for collecting data. Data were collected by questionnaires composed of 3 parts, including characteristics, health literacy factors, and preventing and controlling DHF. In addition to check questionnaire standardization, validity was checked by three experts and try out testing reliability by Cronbach’s coefficient alpha about 0.87. Data were analysed using statistical as Pearson product moment correlation coefficient and Stepwise Multiple Regression Analysis. Results: The analysis found that health literacy factors were associated with preventing and controlling DHF among village health volunteer, Pattani Province such as access skill (r=0.310, p-value&lt;0.001) communication skill (r=0.201, p-value=0.003) media literacy skill (r=0.386, p-value&lt;0.001) decision skill (r=0.349, p-value&lt;0.001) self-management skill (r=0.480, p-value&lt;0.001), respectively. Conversely, cognitive skill had no association (r=0.117, p-value=0.086). Conclusion: The finding showed that health literacy of village health volunteer was associated with the preventing and controlling DHF. Therefore, health workers should encourage the village health volunteers to participate in sustainable prevention and control of DHF.