Blended teaching and learning methods in nursing and midwifery education: A scoping review of the literature

Background: Blended learning (BL) is defined as the combination of both traditional face-to-face learning and synchronous or asynchronous e-learning approaches. The aim of this scoping review was to explore the literature to obtain a broad understanding of the use of BLin nursing and midwifery education in general, in Sub-Saharan Africa (SSA), and in particular Rwanda.Methods: The literature published between 2010 and 2019 were reviewed from six electronic databases using keywords including blended learning, nursing education, midwifery education, higher education, SSA, and Rwanda. Arksey and O'Malley's framework was used in this review.Results: The initial search identified 1,283 records. Eleven articles were selected for this review after the application of predetermined inclusion criteria. Almost all reviewed articles indicated that the integration of BLmethods improved the quality of nursing and midwifery education in general, and in SSAcountries including Rwanda.Conclusions: Initial research in this area highlights that moving from traditional classroom-delivered programs to the BLapproach is feasible and can promote the quality of nursing and midwifery standards of education. This scoping review highlights a paucity of research on BL in nursing and midwifery education, particularly in SSAcountries. Keywords: Blended learning, nursing and midwifery education, SSA, Rwand

Early routine amniotomy: an unnecessary procedure

Early routine amniotomy, also known as artificial rupture of the amniotic membrane, is one of the procedures used to induce and accelerate labour before cervical dilation reaches four centimeters. Because of its benefits and risks, there are at least two schools of thought about this controversial issue. The purpose of this paper is to argue against early routine amniotomy as an unnecessary procedure that can have drastic and unintended outcomes associated with the labour process, the fetus, and the mother. This commentary paper articulates that early routine amniotomy is a questionable procedure because its risks outweigh its benefits. Therefore, routine early amniotomy should be discouraged among obstetrical procedures. Keywords: Amniotomy, artificial rupture of membrane, routine, labour, proces

Processes and partnerships for effective regional surveillance of banana diseases

Crop diseases do not respect country borders and yet preventive measures to curtail the introduction, establishment and spread of diseases are often coordinated on a country-by-country basis. This is because each country has its own mandate to safeguard food security and trade relations. However, knowledge held by researchers and regulatory officials within each country for any given disease can benefit those in neighbouring countries, and this can be reciprocated for other diseases, depending on aggregated disease distribution and experience of methods for effective diagnosis and management. Based on an appreciation of this common goal, national research and regulatory officials from seven countries networked to prioritize which diseases of banana (Musa spp.) were of critical importance and where to undertake spatially designed surveillance exercises around the Great Lakes region of sub-Saharan Africa. Surveys for banana Xanthomonas wilt and banana bunchy top disease were targeted to zones where outbreaks had been reported but not confirmed, and where invasion risk was high as a consequence of proximity to areas or countries known to contain either disease. To ensure that disease diagnoses were precise, field based visual assessments of symptoms were supported by molecular based diagnostics performed under laboratory conditions. Samples were transferred from plants in the field to the laboratory using pathogen DNA capture kits that could be swiftly and safely moved across country borders for analysis at a centralized laboratory to ensure that results from different surveys could be compared. The accuracy of global positioning system (GPS) coordinates recorded as the origin of samples from surveys was validated by comparing the altitude given by the GPS with altitude data provided by digital elevation models. Geographical information system (GIS) maps could then be generated to clearly show the prevalence of banana Xanthomonas wilt and banana bunchy top disease for the zones surveyed. Furthermore, the GIS maps can be used to interpolate different GPS-linked data sets to highlight factors driving disease establishment and spread, such as conducive environmental conditions, and to determine where to prioritize management strategies based on food insecurity measures. The need to prioritize investments across a region is of particular importance in developing countries where capacities for disease surveillance and diagnostics are limited, resulting in inaccurate pest lists and, as a consequence, limited prospects for sustained agricultural trade. If there is political will for regional communication, harmonized diagnostics and reporting mechanisms, the current scenario of fighting fully blown epidemics with exorbitant funds can be averted by coordinated, pre-emptive and thus cost efficient management interventions