A comparative study to explore the challenges faced by newly qualified nurses in their first year of practice : A cultural perspective of Norway and Zambia.

The purpose of this study was to explore challenges facing newly qualified nurses in the first year of practice, a cultural perspective on Norway and Zambia. This was a qualitative type of study with a purposeful convenience sampling of newly qualified nurses in their first year of practice. However, the inclusion criteria extended to nurses who had more years in service and their responses proved to be relevant to the study. Data were gathered using a semi-structured interview guide, which was electronically sent for data collection and analyzed with a colour coding process through which four categories of intra-personal, inter-personal, organizational and structural levels emerged. The intra-personal level mainly presented similarities for the two countries, showing that the newly qualified nurses had the will and drive to work as nurses in the first year of practice, while the inter-personal level showed differences in caring for patients and/or their relatives between Norway and Zambia and this was linked to differences in the type of culture. The organizational level showed differences between the two set-ups associated with hierarchy and finally the structural level brought out more challenges from the Zambian respondents because of the country's Lower Middle Income status. Ethical considerations were ensured by means of privacy, anonymity and confidentiality. The authors recommend that more research should be done on how potential gender differences may have an impact on the challenges facing newly qualified nurses in their first year of practice

Digital CXR with computer aided diagnosis versus symptom screen to define presumptive tuberculosis among household contacts and impact on tuberculosis diagnosis.

BACKGROUND: Household (HH) contact tracing is a strategy that targets high risk groups for TB. Symptom based screening is the standard used to identify HH contacts at risk for TB during HH contact tracing for TB. However, this strategy may be limited due to poor performance in predicting TB. The objective of this study was to compare CXR with Computer Aided Diagnosis (CAD) against symptom screen for defining presumptive TB and how TB detection changes with each method. METHODS: Household contacts of consecutive index bacteriologically confirmed TB cases were visited by study teams and given TB/HIV education to raise awareness of the risk of TB following close contact with a TB patient. Contacts were encouraged to visit the health facility for screening; where symptoms history was obtained and opt out HIV testing was provided as part of the screening process. CXR was offered to all regardless of symptoms, followed by definitive sputum test with either Xpert MTB RIF or smear microscopy. RESULTS: Among 919 HH contacts that presented for screening, 865 were screened with CXR and 464 (53.6%) had an abnormal CXR and the rest had a normal CXR. Among 444 HH contacts with valid sputum results, 274 (61.7%) were symptom screen positive and 255 (57.4%) had an abnormal CXR. Overall, TB was diagnosed in 32/444 (7.2%); 13 bacteriologically unconfirmed and 19 bacteriologically confirmed. Of 19 bacteriologically confirmed TB 8 (42.1%) were symptom screen negative contacts with an abnormal CXR and these 6/8 (75.0%) were HIV positive. Among the 13 bacteriologically unconfirmed TB cases, 7 (53.8%) were HIV positive and all had an abnormal CXR. CONCLUSION: Symptom screen if used alone with follow on definitive TB testing only for symptom screen positive individuals would have missed eight of the 19 confirmed TB cases detected in this study. There is need to consider use of other screening strategies apart from symptom screen alone for optimal rule out of TB especially in HIV positive individuals that are at greatest risk of TB and present atypically

Can nurse call systems be used to improve nursing care for post stroke patients at Livingstone general hospital?

SK108 Medical and Surgical Nursin

A comparative study to explore the challenges faced by newly qualified nurses in their first year of practice : A cultural perspective of Norway and Zambia.

Global Knowledge GK 302 Mai 2013The purpose of this study was to explore challenges facing newly qualified nurses in the first year of practice, a cultural perspective on Norway and Zambia. This was a qualitative type of study with a purposeful convenience sampling of newly qualified nurses in their first year of practice. However, the inclusion criteria extended to nurses who had more years in service and their responses proved to be relevant to the study. Data were gathered using a semi-structured interview guide, which was electronically sent for data collection and analyzed with a colour coding process through which four categories of intra-personal, inter-personal, organizational and structural levels emerged. The intra-personal level mainly presented similarities for the two countries, showing that the newly qualified nurses had the will and drive to work as nurses in the first year of practice, while the inter-personal level showed differences in caring for patients and/or their relatives between Norway and Zambia and this was linked to differences in the type of culture. The organizational level showed differences between the two set-ups associated with hierarchy and finally the structural level brought out more challenges from the Zambian respondents because of the country's Lower Middle Income status. Ethical considerations were ensured by means of privacy, anonymity and confidentiality. The authors recommend that more research should be done on how potential gender differences may have an impact on the challenges facing newly qualified nurses in their first year of practice

Implementation Research to Inform the Use of Xpert MTB/RIF in Primary Health Care Facilities in High TB and HIV Settings in Resource Constrained Settings.

BACKGROUND: The current cost of Xpert MTB RIF (Xpert) consumables is such that algorithms are needed to select which patients to prioritise for testing with Xpert. OBJECTIVE: To evaluate two algorithms for prioritisation of Xpert in primary health care settings in a high TB and HIV burden setting. METHOD: Consecutive, presumptive TB patients with a cough of any duration were offered either Xpert or Fluorescence microscopy (FM) test depending on their CXR score or HIV status. In one facility, sputa from patients with an abnormal CXR were tested with Xpert and those with a normal CXR were tested with FM ("CXR algorithm"). CXR was scored automatically using a Computer Aided Diagnosis (CAD) program. In the other facility, patients who were HIV positive were tested using Xpert and those who were HIV negative were tested with FM ("HIV algorithm"). RESULTS: Of 9482 individuals pre-screened with CXR, Xpert detected TB in 2090/6568 (31.8%) with an abnormal CXR, and FM was AFB positive in 8/2455 (0.3%) with a normal CXR. Of 4444 pre-screened with HIV, Xpert detected TB in 508/2265 (22.4%) HIV positive and FM was AFB positive in 212/1920 (11.0%) in HIV negative individuals. The notification rate of new bacteriologically confirmed TB increased; from 366 to 620/ 100,000/yr and from 145 to 261/100,000/yr at the CXR and HIV algorithm sites respectively. The median time to starting TB treatment at the CXR site compared to the HIV algorithm site was; 1(IQR 1-3 days) and 3 (2-5 days) (p<0.0001) respectively. CONCLUSION: Use of Xpert in a resource-limited setting at primary care level in conjunction with pre-screening tests reduced the number of Xpert tests performed. The routine use of Xpert resulted in additional cases of confirmed TB patients starting treatment. However, there was no increase in absolute numbers of patients starting TB treatment. Same day diagnosis and treatment commencement was achieved for both bacteriologically confirmed and empirically diagnosed patients where Xpert was used in conjunction with CXR

The People v Ronald Kaoma Chitotela SSPD/034/2022

In a recent decision, Magistrate Jennipher Bwalya sitting in Zambia\u27s Economic and Financial Crimes Court (EFCC) discharged former tourism minister Ronald Chitotela in a case he was arrested for, on two counts of possessing property reasonably suspected to be proceeds of crime. Chitotela\u27s arrest had been at the hands of the Anti-Corruption Commission (ACC). In 2019, the ACC had signed a consent settlement with Chitotela which, apparently, gave the EFCC a basis for discharging Chitotela. Chitotela raised a preliminary issue before the EFCC, asking Lusaka magistrate Jennipher Bwalya to dismiss the matter he was recently arrested for, arguing that, under Article 18 of the Constitution, he cannot be tried for the same offence twice. He also alluded to the principle of ‘double jeopardy’. The magistrate agreed. It is our opinion that her decision was wrong in law. It is especially important to point out that Chitotela’s request was made at a preliminary stage and, therefore, as the magistrate herself pointed out, ‘the view I have taken does not in any way amount to an acquittal but a discharge of the accused.’ Since she did not elaborate on the distinction she was making in this context between ‘acquittal and discharge’, it is not clear what she intended the effect of her judgment to be

Interdisciplinary Care Compliance with Antenatal Physical Activity and Exercises Guidelines for Management of Excessive Gestational Weight Gain for Prevention of Overweight and Obesity, Busia County, Kenya

Gestational overweight and obesity remains one of the leading causes of adverse health consequences for women and their offspring. Despite recommended antenatal guidelines on gestational weight gain monitoring and management of excessive weight gain as a risk factor for poor pregnancy outcomes, trends continue to increase. The study determined interdisciplinary compliance to antenatal guidelines by antenatal care providers to stipulated strategies for management of excessive gestational weight gain for prevention of overweight and obesity during pregnancy in primary healthcare settings, in Busia County, Kenya. Socio-Ecological Theory guided the study. A prospective descriptive study design was adopted. The study population were antenatal care workers from level four primary healthcare settings in the antenatal clinics. Stratified sampling was used to select urban and rural health facilities while purposive sampling was used to select key informants. A sample size of 43 was selected. A structured questionnaire was administered face-to face by investigators. The data collected was entered and analysed with SPSS version 20. The study revealed majority (67.4%) antenatal care providers in the interdisciplinary team were females with 32.4% males with a ratio of 1:2. Majority (37.2%) were aged between 26 to 33 years with (46.5%) midwives nurses. Majority (58.1%) qualified with a diploma and 39.5% had worked for more than 2-5 years. Majority (76.7%) revealed screening of gestational weight gain were practiced and implemented in line with National maternal policy for early detection of gestational overweight and obesity in ANC. There was a significant relationship on age and number of years worked with a (P-Value 0.000); one’s qualification level (p-value 0.001); number of years of practice (P-value (P-value 0.003) that influenced weight gain screening that determined frequency of gestational overweight and obesity among pregnant women in antenatal clinics. Majority (46.5%) acknowledged gestational overweight and obesity were highest recorded in the second and third trimesters respectively. Majority (65.2%) recommended light aerobics. While 70% did not recommend high-intensity exercises or daily activities participation. A few (46.5%) recommended strengthening while 69.8% vigorous exercises. Majority (90.7%) were awareness of gestational overweight and obesity trends occurred between 18 to 30 years in their 2nd and 3rd trimesters. Despite screening of gestational weight gain, more than (75.2%) in the four hospitals had never and less often diagnosed pregnant women with gestational hypertension, diabetes mellitus, obstructed labour, prolonged labour and urinary incontinence. There is need for more proactive implementation of antenatal physical activity and exercises guidelines for management of&nbsp;&nbsp; excessive weight gain for management of overweight and obesity among pregnant women aged between 18-30 years in their 2nd and 3rd trimesters. More so, there is need to screen and document pregnancy-related risks to excessive weight gain in the 2nd and 3rd trimesters. The study recommends further exploration interdisciplinary care compliance to prescription of supervised structured antenatal physical activity and exercises guidelines to maintain recommended weight gain for management of gestational overweight and obesity

The low participation of girls in football in selected primary and secondary schools of Kaunda square zone in Lusaka district, Zambia.

Thesis of Master of Education in Physical Education and Sport.This research aimed to assess girls' involvement in football within selected primary and secondary schools situated in the Kaunda Square zone of Lusaka District, Zambia. Employing a qualitative approach with a descriptive research design, fifty participants were engaged, including school administrators, guidance counselors, heads of Physical Education and Sports departments, sports teachers, and pupils. Focus group discussions and interview schedules were utilized as primary research instruments. The findings revealed remarkably low participation levels of girls in football within primary and secondary schools in the Kaunda Square zone, attributed to factors such as inadequate funding, limited infrastructure, restricted access to sports facilities, negative attitudes towards girls' football, biological challenges, and entrenched gender roles. Based on these findings, the study recommended enhancements in sports infrastructure, fostering greater female participation in football, ensuring improved access to sports facilities, and launching community-wide campaigns on gender and leadership to challenge prevailing cultural norms and stereotypes related to sports and gender. It also suggested exploring successful international models for promoting girls' football participation and adapting them to the Zambian context. Aligned with Liberal Feminism theory, the study underscores the structural and ingrained iscriminatory practices perpetuating gender disparities in sports participation. It emphasized the need for targeted interventions that challenge and reshape cultural attitudes, addressing both practical constraints and ingrained perceptions. The study highlighted the critical role of parental influence, absence of female role models, and limited facility access in shaping girls' football participation, advocating for a holistic approach involving schools, parents, communities, and sports organizations. The study contributed to a comprehensive understanding of barriers faced by girls in football, offering actionable steps for improvement and implications for policy changes and educational practices to promote gender equality in sports and narrow the gap in understanding the challenges faced by girls in football. Keywords: Girl’s football, Girls participation, Challenges, Girls player

The role of social cash transfer in influencing educational and sexual decision making among girls in Mazabuka, Monze and Pemba districts, Zambia

ThesisThe importance of ensuring that girls are educated at the secondary level has been recognized as critical to the national development of any country. Worldwide 62 million adolescents are estimated to have dropped out of school due to poverty. Many unmarried adolescent girls in low income countries engage in sexual relationships for cash and gifts, this has led to an increase in early pregnancy, early marriages and school drop-outs. Social Cash Transfers (SCTs) are the main social assistance intervention used in developing countries to mitigate effects of poverty and are viewed as key to social solidarity and development. Social Cash Transfers have shown effectiveness in improving girls’ school participation and help postpone pregnancy and marriage. The purpose of this study was to explore the role of social cash transfers in influencing education and sexual decision making among girls. The study utilized qualitative case study design. Data was collected from 18 IDIs and 4 FGDs among 48 school-going girls aged 14 to 17 years and in grade 8 receiving SCTs from the Research Initiative to Support Girls’ Education (RISE). The participants and schools were selected using purposive sampling and 6 schools participated in the study. Scripts from the field were transcribed manually, thematic method was used to analyse data by identifying major themes and sub-themes. SCTs impacted on girls’ sexual decision making and also led to economic empowerment.The girls had experience in the following five areas; benefits of girls’ education; SCTs led to concentration on education and hope for a bright future. On experience with family and community; SCTs increased support for girls from parents and resistance to bad advice. On Sexual decision making; SCTs led to assertiveness, enhanced self-esteem and independent decision making. On economic empowerment; SCTs saved as a source of pocket money, led to reduced chances of early pregnancy and early marriages, improved school attendance and reduced burden of school fees. Experience with community, siblings and friends; SCTs led to supportive and unsupportive atmospheres. The support given to girls by RISE helped to reduce the desire for sexual relationships with boys for cash and gifts hence also contributed to a decrease in early pregnancy, early marriages and school drop outs. Girls were now more focused on their education. SCTs led to the following benefits for girls; concentration on education and gave hope for a bright future for both the girls and their parents; Increased support for girls from parents, siblings and community; Increased girls’ resistance to bad advice; Led to girls’ assertiveness, enhanced self-esteem and independent decision making; Source of pocket money for the girls and reduced chances of early pregnancy and early marriages; Improved school attendance and reduced burden of school fees; Created both supportive and unsupportive atmospheres in the community. The Government, RISE and stakeholders should roll out SCTs to other schools within the country experiencing an increase in the number of early pregnancy; early marriages and school dropout. Keywords: Early pregnancy, marriage, social cash transfer, sexuality, school drop-outs

Treatment of Carcinogenic Volatile Organic Contaminants Using Uv and Uv/hydrogen Peroxide Advanced Oxidation Process

Volatile organic compounds (VOCs) are chemicals that are potentially hazardous to human health and the environment. Some VOCs have been shown to cause cancer in animals and are classified as potential human carcinogens. The United States Environmental Protection Agency (USEPA) is considering regulating as many as 16 VOCs as a group instead of individually. This approach of regulating chemicals implies that these grouped chemicals could be remediated by a single technology or perhaps a group of technologies. Advanced oxidation processes (AOPs) such as ultra-violet (UV) light in combination with hydrogen peroxide (UV/H2O2) are potential treatment processes for VOC removal. Given the applicability of AOP as a VOC treatment technology, there are fundamental gaps to understand and predict the transformation of VOCs. There is a need to understand the removal efficiencies of individual VOCs with AOP and how the treatment process is affected by changes in the water matrix. Eleven VOCs were studied for their reactivity with UV and OH radicals using a low pressure mercury vapor UV radiation source emitting principally at 253.7nm. These VOCs include one aromatic organic, benzene; two chlorinated alkenes, trichloroethylene and tetrachloroethylene; four chlorinated ethanes, 1,1,2,2- tetrachloroethane, 1,1,1,2-tetrachloroethane, 1,1-dichloroethane, 1,2-dichloroethane;two chlorinated methanes, dichloromethane and carbon tetrachloride and two chlorinated propanes, 1,2-dichloropropane and 1,2,3-trichloropropane. The aromatic organic and chlorinated alkenes showed the highest reactivity during both direct photolysis and UV induced OH radical oxidation. There was little or no removal of the chlorinated alkanes when exposed to UV only. Degradation using UV/H2O2&nbsp;AOP was evident among all 11 VOCs. Experimentally, 1,1, 2,2-terachloroethane showed the lowest reactivity along with carbon tetrachloride. A common feature among the two chemicals is that they have the highest number of chlorine atoms in the group which fundamentally affect their reaction with OH radicals. To ensure the effective degradation of all VOCs in a single UV AOP system, optimization and design of UV-based hydroxyl radical oxidation systems should be based on the most chlorinated VOCs if the new regulation is enforced. UV-based AOP should be used for those compounds most amenable to oxidation while other technologies fill in for the slower reacting compounds.</p