Best practice guideline for the nursing management of women with gestational diabetes mellitus in military health institutions in Ghana

Pregnancy is a normal physiological process for the majority of women. These women, their families and significant others normally expect a successful period of pregnancy, labour, delivery and arrival of a normal and healthy baby. However, some of these pregnant women may develop Gestational Diabetes Mellitus (GDM) during this period and if not managed properly, the mother and the foetus in utero are affected in a negative way: there is a likelihood of the mother and baby developing Type 2 Diabetes in the future and also, other risks such as preterm labour, and foetal macrosomia. In order to prevent such occurrences, I set out to develop a best practice guideline for the nursing management of GDM in military health institutions in Ghana in order to help enhance nursing care. The design for this research was qualitative, explorative, descriptive and contextual in nature. The research is organised in three phases: Phase one deals with the data analysis and discussion of the interviews with professional nurses and midwives and women with a history of GDM. The data collected from the interviews were transcribed, analysed and extracted with Tesch’s eight steps of coding used for the coding. The services of an independent coder were employed to assist with the coding process which led to the formulation of key themes. Semi-structured individual interviews provided a means of exploring the perceptions of professional nurses and midwives on the nursing management of GDM: in addition, women with a history of GDM were interviewed so as to elicit their views on the management they had experienced from professional nurses and midwives before and after being diagnosed with GDM. The trustworthiness of the study was ensured by conforming to Lincoln and Guba’s framework of credibility, transferability, dependability, confirmability and authenticity. An independent coder assisted with the coding process. Phase two deals with the Integrative literature review of available evidence-based clinical practice guidelines for the nursing management of GDM. Evidence-based clinical practice guidelines were searched and appraised with assistance from an independent appraiser and themes were then formulated. In Phase three, the themes from Phase one and Phase two were integrated for the development of a draft best practice guideline for the nursing management of GDM in military health institutions in Ghana. The draft guideline was given to an expert panel of reviewers for their comments and recommendations. These were considered in the development of the final best practice guideline for the nursing management of GDM

'The Money-Making Machines': Creating Awareness on Child labor in Ghana through Art

As an artist, I consider myself as a conversation starter and a conversation changer. My works make comments on important social issues through the use of graphic illustrations. Growing up in Kumasi, the second largest city in Ghana I saw the struggles that the ordinary people had to go through to make a living. But the most heartrending was seeing little children between the ages of four to thirteen years, who struggled and managed to put food on their family’s tables. The notion of this act being the ‘norm’ in my culture and society is what I believe to be unacceptable. In my quest to understand the reasons as to why this situation exists, I create digital illustrations that give my viewers and myself a better understanding through visual story telling. Aside using illustrations, I am open to using any other medium that is available to me to communicate my ideas to my viewers.masters, M.F.A., Art & Design -- University of Idaho - College of Graduate Studies, 201

Patient perspective on barriers in type 2 diabetes self‐management: A qualitative study

Abstract Aim To explore the perceived barriers in Type 2 Diabetes care among patients with diabetes. Design The study adopted a qualitative exploratory‐descriptive design. Methods A semi‐structured interview guide was used to collect data from fifteen (15) purposively sampled patients with Type 2 Diabetes at a primary level health facility in the Bono East region. Participants' ages ranged between 42–72 years. The interviews were audio‐recorded, transcribed verbatim and analysed using thematic content analysis. Results Patients with Type 2 Diabetes encountered a range of barriers in diabetes care. These barriers included lack of knowledge of diabetes dietary management strategies, financial constraints, non‐compliance to treatment, lack of glucometers, lack of social support, and increased waiting time at health care facilities. The findings indicate that more education on diabetes and dietary management is required as well as social support from peers, family, and non‐governmental organizations. Patient or public contribution Diabetes self‐management barriers as revealed by the patients who were participants of this study requires nurses and midwives to ensure that self‐management education is well understood by patients and their relatives. This would empower the patients and bring clarity to their confusion about self‐care practices

Examining the effects of a teacher training system on preschool teachers’ productive and non-productive conversation with children during the free play time: using a multiple baseline experimental design

Research shows that interaction and conversation (gestures, words, expressions, and etc.) with children on a daily basis are crucial for their development. Teachers spend a lot of time with children daily, it is important that teachers plan their interactions intentionally to help children make connections and extend their learning. Observing children and interpreting their thinking processes is a significant factor in intentionally planning curriculum that emerges from children’s thinking. There is a lack of high quality training for preschool teachers in the area of observing and interpreting children’s thinking. The present study investigates the effects of a training (Cycle of Inquiry System) on observation and interpretation of children’s thinking, on teachers’ productive conversation in the Head Start Classroom. The research question guiding this study is: “Does the Cycle of Inquiry Intervention (training teachers to observe, document and interpret their observations of children at play time) increase teachers’ conversations with children?” We hypothesized that the teachers’ productive conversations with children will increase after the training. Using a multiple baseline experimental design two simultaneous studies were conducted. The participants were 6 preschool teachers which included 3 new teachers, and 3 experienced teachers. The permissions were obtained from teachers and the parents of children in their classroom, the children whose parents did not consent were not videotaped during the data collection process. The teachers were videotaped twice a week in their classrooms working with children during the free play time. Each video was 30 minutes. The videos were coded for productive and non-productive conversation, based on the checklist that was used previously in a similar study. All the videos were coded by a research assistant and 30% of videos for each teacher were coded by another research assistant. The interrater reliability was obtained before and during the study. When the first participant reached a baseline (the amount of his/her productive and non-productive conversation approximately remained the same), she went through the Cycle of Inquiry System Training (COI) by the Principle Investigator (PI). The intervention is a one-day training on observing children during the play and interpreting their thinking. The first participant was videotaped twice a week after training and her videos were coded for productive and non-productive conversation, in addition, as a part of the training the teacher received mentoring form the PI bi-weekly during the intervention phase. Meanwhile all the other teachers were being videotaped until they reach a stable baseline and the process of training was the same for every one of them. The research is still ongoing but it is expected that the data will show an increase in teachers’ productive conversation with children after the training. We are in the early phases of the intervention for two participants. Positive results from this intervention, impacting the amount of productive conversation between teachers and children, will indicate that this might be a helpful training for preschool teachers

Teaching Preschool Teachers to Converse Productively with Children: A Single Case Design

Research shows that conversations and daily interaction among teachers and children is crucial for their development. Observing children and interpreting their thinking processes is a significant factor in intentionally planning curriculum that emerges from children’s thinking, assists them in making connections, and extends their learning. This article presents findings of a single case design study investigating the effects of the observation and interpretation processes in a Cycle of Inquiry System (COI) (Broderick and Hong in Early Childh Res Pract 13:1–14, 2011) intervention on preschool teachers’ productive conversations with children. The intervention for each teacher consisted of pre and post interviews, a 1-day COI training, use of COI observation and interpretation forms, and coaching meetings with the researcher. The participants were 4 preschool teachers in Northeast Tennessee. Teachers were videotaped in their classrooms working with children during the free play time and coded for productive and non-productive conversation strategies for determining the baseline and changes during the intervention. All the teachers show an increase in productive conversation strategies to differing degrees. The non-overlapping pairs analysis for all participants is represented by a large value. The findings indicate the benefit of training teachers to observe and interpret the meaning of children’s conversations to intentionally plan for productive conversations that impact learning

Street foods in Accra, Ghana: how safe are they?

OBJECTIVE: To investigate the microbial quality of foods sold on streets of Accra and factors predisposing to their contamination. METHODS: Structured questionnaires were used to collect data from 117 street vendors on their vital statistics, personal hygiene, food hygiene and knowledge of foodborne illness. Standard methods were used for the enumeration, isolation, and identification of bacteria. FINDINGS: Most vendors were educated and exhibited good hygiene behaviour. Diarrhoea was defined as the passage of > or =3 stools per day) by 110 vendors (94.0%), but none associated diarrhoea with bloody stools; only 21 (17.9%) associated diarrhoea with germs. The surroundings of the vending sites were clean, but four sites (3.4%) were classified as very dirty. The cooking of food well in advance of consumption, exposure of food to flies, and working with food at ground level and by hand were likely risk factors for contamination. Examinations were made of 511 menu items, classified as breakfast/snack foods, main dishes, soups and sauces, and cold dishes. Mesophilic bacteria were detected in 356 foods (69.7%): 28 contained Bacillus cereus (5.5%), 163 contained Staphylococcus aureus (31.9%) and 172 contained Enterobacteriaceae (33.7%). The microbial quality of most of the foods was within the acceptable limits but samples of salads, macaroni, fufu, omo tuo and red pepper had unacceptable levels of contamination. Shigella sonnei and enteroaggregative Escherichia coli were isolated from macaroni, rice, and tomato stew, and Salmonella arizonae from light soup. CONCLUSION: Street foods can be sources of enteropathogens. Vendors should therefore receive education in food hygiene. Special attention should be given to the causes of diarrhoea, the transmission of diarrhoeal pathogens, the handling of equipment and cooked food, hand-washing practices and environmental hygiene

Street foods in Accra, Ghana: how safe are they?

OBJECTIVE: To investigate the microbial quality of foods sold on streets of Accra and factors predisposing to their contamination. METHODS: Structured questionnaires were used to collect data from 117 street vendors on their vital statistics, personal hygiene, food hygiene and knowledge of foodborne illness. Standard methods were used for the enumeration, isolation, and identification of bacteria. FINDINGS: Most vendors were educated and exhibited good hygiene behaviour. Diarrhoea was defined as the passage of > or = 3 stools per day) by 110 vendors (94.0%), but none associated diarrhoea with bloody stools; only 21 (17.9%) associated diarrhoea with germs. The surroundings of the vending sites were clean, but four sites (3.4%) were classified as very dirty. The cooking of food well in advance of consumption, exposure of food to flies, and working with food at ground level and by hand were likely risk factors for contamination. Examinations were made of 511 menu items, classified as breakfast/snack foods, main dishes, soups and sauces, and cold dishes. Mesophilic bacteria were detected in 356 foods (69.7%): 28 contained Bacillus cereus (5.5%), 163 contained Staphylococcus aureus (31.9%) and 172 contained Enterobacteriaceae (33.7%). The microbial quality of most of the foods was within the acceptable limits but samples of salads, macaroni, fufu, omo tuo and red pepper had unacceptable levels of contamination. Shigella sonnei and enteroaggregative Escherichia coli were isolated from macaroni, rice, and tomato stew, and Salmonella arizonae from light soup. CONCLUSION: Street foods can be sources of enteropathogens. Vendors should therefore receive education in food hygiene. Special attention should be given to the causes of diarrhoea, the transmission of diarrhoeal pathogens, the handling of equipment and cooked food, hand-washing practices and environmental hygiene