Experiences of Male Student Nurse Midwives in Malawi During Undergraduate Education

Background: Historically, nursing has evolved from being a feminine profession to a profession accepted by both sexes. In the contemporary world, gender mainstreaming has been instituted as a global strategy in promoting gender equality. Though men continue to join nursing, they face many challenges. It is believed that through proper socialization some of the challenges can be addressed. In Malawi, there is dearth of literature on this subject. This resulted in undertaking the study. Objective: The goal of the study was to describe experiences of male student nurses during undergraduate education in Malawi. Methods: A qualitative descriptive design was utilised. Focus group discussions were conducted with study participants in purposively selected nursing colleges. Findings: Male student nurse midwives faced more negative than positive experiences in nursing. The following three major themes were generated: nursing is a feminine occupation, facing discrimination and socialisation experienced. Conclusion: Malawian male student nurse midwives face both positive and negative experiences during their integration in nursing. Formulation and implementation of gender sensitive policies would help in strengthening male nurse education.<p

South African critical care nurses' views on end-of-life decision-making and practices.

BACKGROUND: Care of patients at the end-of-life (EOL) may be influenced by the experiences, attitudes and beliefs of nurses involved in their direct care. AIM: To investigate South African critical care nurses' experiences and perceptions of EOL care. DESIGN: Cross-sectional survey. METHODS: South African critical care nurses completed a modified version of the 'VENICE' survey tool. Data were collected concerning: attitudes towards EOL care; involvement in EOL decision-making; and beliefs about EOL practices. RESULTS: Of 149 surveys distributed, 100 were returned (response rate 67%). Seventy-six percent stated that they had had direct involvement in EOL care of patients, but a minority (29%) had participated in EOL decision-making processes. Whilst most nurses (86%) were committed to family involvement in EOL decisions, less than two thirds (62%) reported this as routine practice. When withdrawing treatment, around half (54%) of the respondents indicated they would decrease the inspired oxygen level to room air, and the majority (84%) recommended giving effective pain relief. Continued nutritional support (84%) and hydration (85%) were advocated, with most nurses (62%) indicating that they were against keeping patients deeply sedated. Most respondents (68%) felt patients should remain in intensive care at the end of life, with the majority (72%) supporting open-visiting, no restriction on number of family members visiting (70%), and the practising of religious or traditional cultural EOL rituals (93%). CONCLUSIONS: The involvement of Johannesburg critical nurses in EOL care discussions and decisions is infrequent despite their participation in care delivery and definite views about the process. RELEVANCE TO CLINICAL PRACTICE: Use of formal guidelines and education is recommended to increase the nurses' involvement in and their confidence in participating in EOL decisions. Educators, managers, senior nurses and other members of the multi-disciplinary team should collaborate to enable critical care nurses to become more involved in EOL care

Does respiratory syncytial virus lower respiratory illness in early life cause recurrent wheeze of early childhood and asthma?:Critical review of the evidence and guidance for future studies from a World Health Organization-sponsored meeting

Respiratory syncytial virus (RSV) is a leading cause of lower respiratory tract infection (LRTI) and hospitalization in infants and children globally. Many observational studies have found an association between RSV LRTI in early life and subsequent respiratory morbidity, including recurrent wheeze of early childhood (RWEC) and asthma. Conversely, two randomized placebo-controlled trials of efficacious anti-RSV monoclonal antibodies (mAbs) in heterogenous infant populations found no difference in physician-diagnosed RWEC or asthma by treatment group. If a causal association exists and RSV vaccines and mAbs can prevent a substantial fraction of RWEC/asthma, the full public health value of these interventions would markedly increase. The primary alternative interpretation of the observational data is that RSV LRTI in early life is a marker of an underlying predisposition for the development of RWEC and asthma. If this is the case, RSV vaccines and mAbs would not necessarily be expected to impact these outcomes. To evaluate whether the available evidence supports a causal association between RSV LRTI and RWEC/asthma and to provide guidance for future studies, the World Health Organization convened a meeting of subject matter experts on February 12-13, 2019 in Geneva, Switzerland. After discussing relevant background information and reviewing the current epidemiologic evidence, the group determined that: (i) the evidence is inconclusive in establishing a causal association between RSV LRTI and RWEC/asthma, (ii) the evidence does not establish that RSV mAbs (and, by extension, future vaccines) will have a substantial effect on these outcomes and (iii) regardless of the association with long-term childhood respiratory morbidity, severe acute RSV disease in young children poses a substantial public health burden and should continue to be the primary consideration for policy-setting bodies deliberating on RSV vaccine and mAb recommendations. Nonetheless, the group recognized the public health importance of resolving this question and suggested good practice guidelines for future studies

Respiratory syncytial virus seasonality in three epidemiological zones of Kenya

Understanding respiratory syncytial virus (RSV) circulation patterns is necessary to guide the timing of limited‐duration interventions such as vaccines. We describe RSV circulation over multiple seasons in three distinct counties of Kenya during 2006‐2018. Kilifi and Siaya counties each had consistent but distinct RSV seasonality, lasting on average 18‐22 weeks. Based on data from available years, RSV did not have a clear pattern of circulation in Nairobi. This information can help guide the timing of vaccines and immunoprophylaxis products that are under development

Editorial Comments

Perusing the contents of this edition of Health SA Gesondheid, one is struck by the incredible depth and range as well as the complexity of health problems which present themselves for intervention in this country. Opsomming Wanneer ‘n mens die inhoud van hierdie uitgawe van Health SA Gesondheid deurkyk, tref die ongelooflike diepte en omvang van die ingewikkeldheid van gesondheidsprobleme wat hulle vir die tussentrede in hierdie land voordoen, ‘n mens. *Please note: This is a reduced version of the abstract. Please refer to PDF for full text

Editorial Comments/ Redaksionele Kommentaar

The diversity and complexity of South Africa presents particular challenges to health care. Opsomming Die diversiteit en kompleksiteit van Suid-Afrika rig besondere uitdagings aan gesondheidsorg. *Please note: This is a reduced version of the abstract. Please refer to PDF for full text