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Background: In 2020, Malawi had 6.9 million malaria cases and 2551 deaths, mainly in children under five years of age. The 2017–2022 Malawi malaria control strategic plan promoted the consistent use of insecticide-treated nets through free distribution and mass campaigns. Despite widespread availability of the control strategy plan, Chikwawa District continues to suffer from high malaria burden especially among under five children, due to inconsistent insecticide-treated (ITN) net usage. For this reason, this study aimed at exploring caregivers' perceptions on insecticide-treated net utilisation and also find out about its effectiveness among those who consistently use them. Methods: This study used a sequential exploratory mixed methods design. The data used for quantitative analysis was drawn from the population of under-five children's caregivers within the catchment area of Chikwawa district hospital. The sample size was 96 participants, as determined by Cochran's formula. The data collection lasted from December 2023 to April 2024 and included four in-depth interviews and three focus group discussions to address the objectives qualitatively. Results: The study revealed that 91.67% of households used ITNs, with 87.50% using them daily. The significant factors influencing ITN utilisation included the number of nets, user satisfaction, perceived impact, user habits, acquisition method, and usage frequency (all p values < 0.001). Under-five malaria cases were also significant (p = 0.025). The odds of the perceived net impact influencing utilisation were 4.956 times greater. Non-usage was due to heat, quality concerns, limited access, breathing difficulties, health conditions such as asthma, and misconceptions about net treatment. Conclusion: The study revealed a strong belief in insecticide-treated net efficacy. However, some challenges such as access, durability, and misinformation of insecticide-treated nets were discovered. These challenges affected utilisation of insecticide-treated nets in agreement with some literature reviewed. The insights found in this study will help policymakers in addressing health interventions for the reduction of malaria cases in Malawi. [ABSTRACT FROM AUTHOR]

Background Maternal mortality ratio (MMR) in Madagascar is 392 deaths per 100 000 live births, and this is a major public health concern. One of the strategies for reducing MMR and achieving target 3.1 of the Sustainable Development Goals (i.e. reducing the global MMR below 70 per 100 000 live births) is the utilisation of skilled birth attendants (SBAs). This analysis examined the prevalence and social determinants of SBA utilisation among married and cohabiting women of Madagascar. Methods Data from the 2021 Madagascar Demographic and Health Surveys was analysed on a weighted sample of 6997 married and cohabiting women. A multilevel regression was carried out to determine the social determinants of utilising SBAs. The results are presented as odds ratios (ORs) associated with 95% confidence intervals (CIs) and a p-value <0.05 to determine the significant associations. Results The prevalence of SBAs among married and cohabiting women of Madagascar was 64.4% (95% CI 0.62 to 0.68). In model 3 of the multilevel regression, women 35–39 y of age (adjusted OR [aOR] 1.86 [95% CI 1.30 to 2.60]), women with secondary/higher education (aOR 1.67 [95% CI 1.32 to 2.10]), women whose partners had secondary/higher education (aOR 1.58 [95% CI 1.25 to 1.99]), cohabiting women (aOR 1.33 [95% CI 1.07 to 1.65]), women who had four or more antenatal care visits (aOR  2.05 [95% CI 1.79 to 2.35]), female household head (aOR 1.44 [95% CI 1.06 to 1.95]), Muslims (aOR 1.58 [95% CI 0.71 to 3.53]), those of the richest wealth index (aOR 4.32 [95% CI 2.93 to 6.36]) and women who lived in communities with high literacy levels (aOR 2.17 [95% CI 1.57 to 3.00]) had higher odds of utilisation of SBA. Conclusion This current analysis revealed low SBA utilisation among married and cohabiting women in Madagascar. The analysis points to the fact that understaffing and inaccessibility of health facilities remain major contributors to the low utilisation of SBAs. The findings call on the government and stakeholders in Madagascar to consider implementing programs that will empower women and focus on disadvantaged groups. These programs could include providing free maternal healthcare services to all pregnant women and intensifying health education programs that target women and their partners with no formal education. [ABSTRACT FROM AUTHOR]

Summary: The correct application of by‐products produced in the food and dairy industries is essential for attaining sustainability goals and minimising waste. By‐products, which used to be viewed as throwaway materials, have lately been recognised as valuable sources. By‐products can have significant nutritional, physiological and economic value. This paper addresses the novel techniques and technologies that have been employed to successfully transform these by‐products into products with value‐added hybrid products; there are also some instances of success mentioned, as well as the trends that will likely have an impact on the sector in the coming years. Through case studies and scientific insights, the reader may discover how businesses and society as a whole can benefit from using by‐products. Overall, the goal of this endeavour is to demonstrate the transformative potential of using food and dairy by‐products and to serve as an avenue of encouragement and knowledge for researchers, business executives and policymakers interested in increasing the value of by‐products in the food and dairy sectors. Despite the fact that there are a few articles on the utilisation of food and dairy by‐products, none of them have employed bibliometric analysis to reach insights. The present study is an exemplary instance of looking into the evolution of publication patterns over time, suggesting the need for additional research in this area. [ABSTRACT FROM AUTHOR]

This study aims to discover the factors that influence the acceptance of electronic learning media and its effect on the effectiveness of digital instruction. The study involved a learning management system and online tutorials using management system (MS) teams from various faculties at the Universitas Terbuka. These include the Faculty of Economics and Business, the Faculty of Teacher Training and Education, the Faculty of Science and Technology, and the Faculty of Law, Social Sciences, and Political Sciences. also conducted in three regional offices in Ambon, Gorontalo and Makassar, which were selected through purposive sampling. Primary data sources include participant questionnaires and interviews. Analytical methods include correlation and multiple regression analysis, with descriptive statistics used to summarize the dataset. Variable selection involves reliability and validity tests and classical assumption tests like multicollinearity. The F-test demonstrates a statistically significant and beneficial influence of utilizing e-learning media and individual ability, training, and intention to use it for digital learning success. The results of ttests and regression models provide empirical evidence supporting the significant effect of e-learning media and intention to use on the effectiveness of digital learning. However, variables related to training and ability do not show any significant influence. [ABSTRACT FROM AUTHOR]

Objective: Parkinson's disease (PD) is one of the most prevalent neurodegenerative disorders, globally affecting approximately 120 per 100,000 people by age 70. Deep brain stimulation (DBS) is a US Federal Drug Administration (FDA)-approved and highly effective treatment for late-stage PD. However, country-specific reimbursement regulations and health policies may affect access to PD-DBS. We aimed to evaluate the uptake rate and 'treatment gap' for DBS across high-income countries. Methods: We reviewed previous literature to investigate the cost and utilisation of PD-DBS in high-income countries across Asia, Europe, Oceania, and North America (Australia, Canada, France, Germany, Hong Kong, Japan, Korea, the Netherlands, New Zealand, Norway, Spain, Switzerland, UK, and USA). Using previous estimates of DBS candidate eligibility rates, we calculated theoretical DBS uptake rates and treatment gaps nationally. Results: PD-DBS utilisation was highest in Australia and the USA and lowest in Korea and New Zealand. The total cost of PD-DBS in the first 12 months was highest in the USA and France and lowest in the UK and Germany. The utilisation rate (i.e. uptake rate) of PD-DBS (% DBS surgeries per PD case) was highest in Australia and the USA, and lowest in New Zealand and the UK, where the treatment gap reflected these trends. Conclusions: Our results highlight differences in access to DBS for PD patients among high-income countries, which we discuss in the context of health systems. Better access to effective PD treatments such as DBS is critical given the increasing prevalence of PD in an ageing world and the associated, avoidable morbidity. What is known about the topic? Deep brain stimulation (DBS) is a US Federal Drug Administration (FDA)-approved and highly effective treatment for late-stage PD; however, inequities in access to DBS for PD exist across high-income countries, likely stemming from differences in DBS cost and utilisation. What does this paper add? Our study is the first to use cost and utilisation data to calculate a PD-DBS treatment gap informing accessibility barriers. What are the implications for practitioners? The results of this study can be utilised to guide future national policy decisions and advocacy efforts by patient organisations and specialist societies. [ABSTRACT FROM AUTHOR]

Abstract Background In 2020, Malawi had 6.9 million malaria cases and 2551 deaths, mainly in children under five years of age. The 2017–2022 Malawi malaria control strategic plan promoted the consistent use of insecticide-treated nets through free distribution and mass campaigns. Despite widespread availability of the control strategy plan, Chikwawa District continues to suffer from high malaria burden especially among under five children, due to inconsistent insecticide-treated (ITN) net usage. For this reason, this study aimed at exploring caregivers’ perceptions on insecticide-treated net utilisation and also find out about its effectiveness among those who consistently use them. Methods This study used a sequential exploratory mixed methods design. The data used for quantitative analysis was drawn from the population of under-five children’s caregivers within the catchment area of Chikwawa district hospital. The sample size was 96 participants, as determined by Cochran’s formula. The data collection lasted from December 2023 to April 2024 and included four in-depth interviews and three focus group discussions to address the objectives qualitatively. Results The study revealed that 91.67% of households used ITNs, with 87.50% using them daily. The significant factors influencing ITN utilisation included the number of nets, user satisfaction, perceived impact, user habits, acquisition method, and usage frequency (all p values

Background: This article examines discrepancies in the frequency of diagnoses of attention-deficit/hyperactivity disorder (ADHD) in children and adolescents in Germany using information on health care utilisation from both administrative and parent-reported survey data linked at person level. Methods: 5,461 parents of 0- to 17-year-olds insured with DAK-Gesundheit in 2020 and being registered with a confirmed administrative ADHD diagnosis (ICD-10 F90.0-9) in at least one quarter in 2020 (M1Q criterion) were surveyed online on their child’s ADHD diagnosis, utilisation of specialist care and therapeutic service providers. With regard to the presence of a parental report of the child’s documented ADHD diagnosis, administrative data and survey data were bi- and multivariately analysed. Results: The response rate was 21.5 %. ADHD diagnoses were given more frequently in the context of paediatric care, but in the multivariable model with the administrative data only the diagnosis made by mental health professionals (OR = 2.78), in the model with the survey data only utilisation of mental health professionals (OR = 2.99) positively predicted the parental diagnostic report. With regard to the utilisation of therapeutic service providers, only the utilisation of occupational therapy was associated with the parental report of the diagnosis in both data sources. Conclusions: Parental non-reporting of a child’s administrative ADHD diagnosis in survey studies can be in part be explained by utilisation characteristics.

Abstract Background Insecticide-treated nets (ITNs) are pivotal tools for malaria prevention in endemic regions like Ghana. Understanding the protective factors and barriers influencing ITN ownership and usage is crucial for designing effective interventions. A scoping review was conducted to identify studies exploring protective factors and barriers related to ITN ownership and usage. Methods This review followed the guidelines by Askey and O’Malley. Search was done in four major databases including PubMed, Science Direct, PubMed CENTRAL, and JSTOR. Additional searches were done in Google Scholar and Google. Peer-reviewed and grey literature were included. Results A total of 24 papers met the eligibility criteria and were included in the review. Included studies found regional disparities in ITN ownership and usage. Furthermore, included studies reported ownership rates between 97.8 and 28% and usage rates between 94 and 20%. Protective factors facilitating ITN ownership were marital status, higher educational attainment, higher income levels, and being aged 25 years or older. In contrast, the factors for its use included community-level campaigns advocating for ITN use and awareness, individuals with secondary education or higher and those residing in urban areas. Missed opportunities in free distribution exercises and the unavailability of subsidized ITNs at health facilities were barriers to ownership. Conclusion Understanding and addressing protective factors and barriers influencing ITN ownership and usage are crucial for enhancing malaria prevention strategies and achieving sustainable progress in combating malaria in endemic areas. Collaborative and evidence-based interventions are essential for addressing these challenges effectively.

Background: Ultrasonography (USG) is used extensively across countries to diagnose and manage diseases. However, the existing USG services must be utilised rationally and effectively. Aim: Understanding the pattern of USG prescriptions and findings is important for improving the quality of healthcare services delivered by any healthcare system. Patients and Methods: A mixed methods study was conducted at a rural sub-district hospital in northern India to assess the pattern and completeness of prescriptions and USG findings and explore the patient and doctor-related factors influencing the USG prescription practices. Results: Of the 505 patients studied, 324 (64.2%) were females. The median age was 32 years (interquartile range: 24–45 years). The availability of complete medical history and clinical examination recording was 471 (85.7%) and 145 (28.7%), respectively. The indication for USG was mentioned in 436 (86.3%) prescriptions. Of the total, 251 (49.7%) had abnormal ultrasound findings. The abnormal finding was significantly high amongst patients (a) aged 45–59 years (P = 0.015) and (b) referred from surgery, paediatrics and other outpatient departments (P = 0.001) after adjustment to other factors. Patient-related factors such as non-harmfulness, free availability, reassurance of normality and health system/provider-level factors such as absence or low awareness of guidelines and changed clinical practice were the reasons for the current pattern of USG prescriptions. Conclusion: Although the medical history is better recorded, the incomplete recording of clinical examination needs improvement. Placing a guideline for prescribing USG, imposing nominal user fees and patient education and counselling can be tested for effectively utilising the USG services. Further, tracking the change in clinical management following the USG in Indian setting is the need of the hour.

Abstract Background One of the most effective ways to reduce maternal and neonatal mortality is to improve mother and newborn health via the provision of appropriate postnatal care services by qualified healthcare providers. However, there is limited information on the use of postnatal care services in Yemen. This study aimed to determine the utilisation of postnatal care services among mothers in Yemen. Methodology A descriptive cross-sectional study was conducted in the Maeen District of Sana’a City, Yemen from December 2022 to January 2023. Convenience sampling was employed to recruit 321 participants. Semi-structured questionnaires were applied as the study tool in the face-to-face survey. Result Less than half (45.2%) of the study participants utilised postnatal care services in this study. The mode of delivery, place of delivery, and receiving information about postnatal care during antenatal visits were significantly associated with postnatal care service utilisation. Conclusion Less than half of the study participants were informed about postnatal care services, contributing to their low utilisation. Thus, it is vital to strengthen the provision of information, education, and communication with regard to postnatal care services among pregnant mothers visiting antenatal clinics.

Introduction: Nurses, as gatekeepers of health, are expected to seek formal healthcare services, reflecting the advice they give patients. However, squalid working conditions, long hours, and heavy workloads expose them to occupational health hazards, limiting their ability to care for themselves. Properly implemented employee clinic services can help nurses address health problems, promote well-being, and reintegrate them into the workforce. Objective: This study sought to determine factors associated with the utilization of staff clinic services by nurses at Parirenyatwa Group of Hospitals. Materials and Methods: The study used an analytical cross-sectional design conducted in May 2023. A consecutive sampling method selected 50 participants. Data were collected via a structured questionnaire and presented as numbers and percentages. The questionnaire was divided into sections as follows: Participant demographic information (Age, gender, marital status, religion etc.); uptake of staff clinic services (Screening, treatment, awareness services etc), and factors associated with uptake of staff clinic services among nurses. Chi-square test or Fisher’s exact test to evaluate significant differences for unpaired data. Statistical analysis was performed using STATA 16. Results: Among the 50 participants, 66% were female. The study results show that the uptake of staff clinic services was low, with only 54% of the participants visiting the clinic on rare occasions. The most common barriers to utilizing the staff clinic were lack of time to go for screening (16%), fear of stigma (14%), and uncertainty about confidentiality (14%). Most participants utilized the acute illness treatment service (62%). Age was a significant factor associated with the utilization of the staff clinic (p = 0.021), with younger nurses using the clinic more often. Perceived benefits were also significantly associated with utilization (p < 0.05). Discussion: The utilization of staff clinic services by nurses remains suboptimal despite high knowledge and awareness of these services. Utilization was mainly associated with age, perceived benefits of accessing the staff clinic services, and reasons for not utilizing some of the services. There is need to strengthen promotional activities for the utilization of staff clinic health services as this has been proven to increase productivity and health outcomes of clinical staff.

Background: India launched a national health insurance scheme named Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) in 2018 as a key policy for universal health coverage. The ambitious scheme covers 100 million poor households. None of the studies have examined its impact on the quality of care. The existing studies on the impact of AB-PMJAY on financial protection have been limited to early experiences of its implementation. Since then, the government has improved the scheme's design. The current study was aimed at evaluating the impact of AB-PMJAY on improving utilisation, quality, and financial protection for inpatient care after four years of its implementation. Methods: Two annual waves of household surveys were conducted for years 2021 and 2022 in Chhattisgarh state. The surveys had a sample representative of the state's population, covering around 15,000 individuals. Quality was measured in terms of patient satisfaction and length of stay. Financial protection was measured through indicators of catastrophic health expenditure at different thresholds. Multivariate adjusted models and propensity score matching were applied to examine the impacts of AB-PMJAY. In addition, the instrumental variable method was used to address the selection problem. Results: Enrollment under AB-PMJAY was not associated with increased utilisation of inpatient care. Among individuals enrolled under AB-PMJAY who utilised private hospitals, the proportion incurring catastrophic health expenditure at the threshold of 10% of annual consumption expenditure was 78.1% and 70.9% in 2021 and 2022, respectively. The utilisation of private hospitals was associated with greater catastrophic expenditure irrespective of AB-PMJAY coverage. Enrollment under AB-PMJAY was not associated with reduced out-of-pocket expenditure or catastrophic health expenditure. Conclusions: AB-PMJAY has achieved a large coverage of the population but after four years of implementation and an evidence-based increase in reimbursement prices for hospitals, it has not made an impact on improving utilisation, quality, or financial protection. The private hospitals contracted under the scheme continued to overcharge patients, and purchasing was ineffective in regulating provider behaviour. Further research is recommended to assess the impact of publicly funded health insurance schemes on financial protection in other low- and middle-income countries. [ABSTRACT FROM AUTHOR]

Background: Insecticide-treated nets (ITNs) are pivotal tools for malaria prevention in endemic regions like Ghana. Understanding the protective factors and barriers influencing ITN ownership and usage is crucial for designing effective interventions. A scoping review was conducted to identify studies exploring protective factors and barriers related to ITN ownership and usage. Methods: This review followed the guidelines by Askey and O'Malley. Search was done in four major databases including PubMed, Science Direct, PubMed CENTRAL, and JSTOR. Additional searches were done in Google Scholar and Google. Peer-reviewed and grey literature were included. Results: A total of 24 papers met the eligibility criteria and were included in the review. Included studies found regional disparities in ITN ownership and usage. Furthermore, included studies reported ownership rates between 97.8 and 28% and usage rates between 94 and 20%. Protective factors facilitating ITN ownership were marital status, higher educational attainment, higher income levels, and being aged 25 years or older. In contrast, the factors for its use included community-level campaigns advocating for ITN use and awareness, individuals with secondary education or higher and those residing in urban areas. Missed opportunities in free distribution exercises and the unavailability of subsidized ITNs at health facilities were barriers to ownership. Conclusion: Understanding and addressing protective factors and barriers influencing ITN ownership and usage are crucial for enhancing malaria prevention strategies and achieving sustainable progress in combating malaria in endemic areas. Collaborative and evidence-based interventions are essential for addressing these challenges effectively. [ABSTRACT FROM AUTHOR]

Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Adolescent pregnancy poses a significant global challenge, with Ghana experiencing high rates contributing to annual maternal deaths. Effective contraception utilisation can prevent both pregnancy and sexually transmitted infections among adolescents. This study examines attitudes and social norms influencing adolescents' contraception utilisation in Bongo District, Ghana, employing a quantitative self-report cross-sectional design. Convenience sampling was used to recruit 379 adolescents, with data collected using a standardized questionnaire. Analysis conducted using SPSS Version 21 revealed a 100 % response rate, predominantly comprising females (66.8 %, n=253), with a mean age of 17.4. Approximately half of the respondents (53.3 %, n=202) reported using contraception, and adolescents' attitudes towards contraception use were mainly positive (n=229, 60.4 %). Furthermore, subjective norms positively affected contraception use. A majority of participants (n=233, 61.5 %) reported experiencing social pressure or support to use contraception, with the highest level of support coming from healthcare providers (n=237, 62.5 %). The study underscores the critical role of midwives, public health nurses, and healthcare providers in educating and promoting contraception use among adolescents. [ABSTRACT FROM AUTHOR]

Introduction Methods Results Conclusions Increases in computed tomography (CT) use may not always reflect clinical need or improve outcomes. This study aimed to demonstrate how population level data can be used to identify variations in care between patient groups, by analysing system‐level changes in CT use around the diagnosis of new conditions.Retrospective repeated cross‐sectional observational study using West Australian linked administrative records, including 504,723 adults diagnosed with different conditions in 2006, 2012 and 2015. For 90 days pre/post diagnosis, CT use (any and 2+ scans), effective dose (mSv), lifetime attributable risk (LAR) of cancer incidence and mortality from CT, and costs were assessed.CT use increased from 209.4 per 1000 new diagnoses in 2006 to 258.0 in 2015; increases were observed for all conditions except neoplasms. Healthcare system costs increased for all conditions but neoplasms and mental disorders. Effective dose increased substantially for respiratory (+2.5 mSv, +23.1%, P < 0.001) and circulatory conditions (+2.1 mSv, +15.4%, P < 0.001). The LAR of cancer incidence and mortality from CT increased for endocrine (incidence +23.4%, mortality +18.0%) and respiratory disorders (+21.7%, +23.3%). Mortality LAR increased for circulatory (+12.1%) and nervous system (+11.0%) disorders. The LAR of cancer incidence and mortality reduced for musculoskeletal system disorders, despite an increase in repeated CT in this group.Use and costs increased for most conditions except neoplasms and mental and behavioural disorders. More strategic CT use may have occurred in musculoskeletal conditions, while use and radiation burden increased for respiratory, circulatory and nervous system conditions. Using this high‐level approach we flag areas requiring deeper investigation into appropriateness and value of care. [ABSTRACT FROM AUTHOR]

Nigeria is often described as a land flowing with milk and honey in reflection of the rich endowment of natural and mineral resources embedded in the country. Sadly, few of its people have benefited from these abundant resources as a large percentage of its population remains poor, particularly in rural areas. Hence, this present study assessed the awareness and utilisation of the natural and mineral resources in 24 selected southwest rural communities. The study adopts the mixed method to elicit responses from rural and urban respondents in four of Nigeria's southwest states. Findings from the study revealed a high level of awareness of available resources in rural communities but gross underutilisation of the resources. The study concludes that the available resources in the southwest rural communities if tapped into, could transform the rural economy and ameliorate the level of underdevelopment in those areas. The study recommends that the government at all levels needs to recognise the rural areas as the fulcrum of national economic development and should be given utmost priority regarding infrastructural provisions and adequate funding. Plain language summary: The purpose of the study is to examine the level of awareness and utilisation of natural and mineral resources for the development of rural economy. The study adopts the mixed method to elicit responses from rural and urban respondents in four of Nigeria's southwest states. Using in-depth interview guide and questionnaire as research instruments. The study concludes that the available resources in the southwest rural communities if tapped into, could transform the rural economy and ameliorate the level of underdevelopment in those areas. The study has implication for policy by encouraging government and relevant stakeholders to focus more on the rural economy rather than the current urban bias toward them. The study is limited in its coverage as it those not cover the entire communities in Southwest Nigeria. This could affect the generalisability of its findings. [ABSTRACT FROM AUTHOR]

The use of assisted reproductive technologies to improve productivity in livestock industry is becoming popular. The study aimed to determine the utilisation of artificial insemination (AI) and to find out the factors associated with adoption of AI by beef farmers in selected areas of Southern and Ghanzi districts. The data were collected through a survey where a questionnaire was administered to beef farmers. Random sampling was used to interview 54 beef farmers in Southern district and 40 beef farmers in Ghanzi district. The data were analysed using Frequency procedure in Statistical Package for Social Sciences (SPSS). The association between the nominal variables was tested using Pearson Chi-square in SPSS. There is significant (P < 0.05) association between AI utilization by beef farmers and these socio-economic factors; district where farming is done, age of the farmer, education level, occupation of the farmer, purpose of rearing cattle (commercial or subsistence) and land (communal or ranches). Gender of the farmer is not associated with AI utilization. [ABSTRACT FROM AUTHOR]

Background: One of the most effective ways to reduce maternal and neonatal mortality is to improve mother and newborn health via the provision of appropriate postnatal care services by qualified healthcare providers. However, there is limited information on the use of postnatal care services in Yemen. This study aimed to determine the utilisation of postnatal care services among mothers in Yemen. Methodology: A descriptive cross-sectional study was conducted in the Maeen District of Sana'a City, Yemen from December 2022 to January 2023. Convenience sampling was employed to recruit 321 participants. Semi-structured questionnaires were applied as the study tool in the face-to-face survey. Result: Less than half (45.2%) of the study participants utilised postnatal care services in this study. The mode of delivery, place of delivery, and receiving information about postnatal care during antenatal visits were significantly associated with postnatal care service utilisation. Conclusion: Less than half of the study participants were informed about postnatal care services, contributing to their low utilisation. Thus, it is vital to strengthen the provision of information, education, and communication with regard to postnatal care services among pregnant mothers visiting antenatal clinics. [ABSTRACT FROM AUTHOR]

Background: Ethiopian maternal mortality remains high, despite the implementation of extensive health programmes. This indicates that the full potential of maternal health services is not being effectively utilised. Aim: This study aimed to evaluate the utilisation and factors influencing maternal healthcare services in public health facilities in Addis Ababa. Setting: This study was conducted in five public hospitals and 10 public health centres of Addis Ababa city administration from 31st August 2023 to 13th October 2023. Methods: The study’s design utilised a cross-sectional quantitative technique, which involved interviewing 354 women from each group who received visits throughout their pregnancy, delivery and postpartum period. The data were analysed using SPSS version 26. Results: This study analysed maternal health service utilisation indicators, revealing a 70.8% overall utilisation of services, with antenatal care (ANC) at 85.5%, delivery at 71.58% and family planning services (PNC) at 55.4%. The study found that the length of time spent travelling to public health facilities significantly impacts the use of maternal health services. Pregnant women who travelled less than 30 min used services 2.29 times more than those over 2 h. The average client wait time also influenced service usage. Pregnant women with four or more prenatal care visits were more likely to use services. Conclusion: The study conducted in Addis Ababa’s capital city revealed that the utilisation of maternity health care services is not optimal, despite the concentrated resources. Contribution: The findings of the study could be beneficial for the Addis Ababa Health Bureau, Ministry of Health, legislators, and other stakeholders. It can help in the development of affordable intervention programmes, filling knowledge gaps and updating scientific understanding.

Background: The radiology report is the primary means of conveying imaging findings between radiologists and clinicians. As a result, clinician satisfaction with the radiology report is an indicator of its quality and clinical relevance. It is crucial to identify factors that can enhance the radiology report in order to improve service delivery. Objectives: This study evaluates clinician and radiologist opinions, preferences and clinician utilisation of the radiology report. Method: Mixed quantitative and qualitative survey questionnaires were distributed in-person and online from December 2022 to February 2023 to a total of 287 clinicians and 43 independent medical practitioners specialising in radiology. Results: A total of 73.0% of radiologists and 56.5% of clinicians expressed satisfaction with the radiology reports. Additionally, 72.0% of radiologists expressed dissatisfaction with the history provided on the referral forms. It was found that 87.6% of clinicians read the radiology report, while 26.2% reviewed the radiological imaging without referring to it. Interestingly, 77.8% of clinicians preferred itemised listed reports, whereas 53.8% of radiologists preferred reports in paragraph format. It was discovered that 69.6% of radiologists and 65.4% of clinicians preferred a standardised reporting format. Conclusion: More than half of the clinicians and most of the radiologists expressed satisfaction with the radiology report. Both clinicians and radiologists showed a preference for a structured reporting format. A crucial element in constructing a good radiology report was having a relevant clinical history. The radiologist continued to be the preferred professional for interpreting radiological imaging. Contribution: This survey was a good starting point for improving communication between clinicians and radiologists. This will ultimately result in reports that are more useful to clinicians and radiologists who have a better understanding of what should be included in reports and how they should be structured.

BackgroundDonor liver transaminases (ALT and AST) have been used to decline livers for transplant, despite evidence that they do not influence transplant outcomes. This study assesses the effect that raised donor transaminases have on the unnecessary decline of livers.MethodsThis retrospective cohort study used the National Health Service registry on adult liver transplantation (2016–2019). Logistic regression models were built to assess the impact of donor transaminases on the utilisation of organs donated following brain stem death (DBD) and circulatory death (DCD). A further model was used to simulate the impact on liver decline if raised donor ALT was not used to make utilisation decisions.Results5,424 adult livers were offered for transplant, of which 3,605 were utilised (2,841 DBD, 764 DCD). In multivariable analysis, adjusted for key factors, increasing peak donor ALT independently increased the odds of liver decline (DBD aOR = 1.396, 1.305–1.494, p 40 U/L (n = 1,683) were declined for transplantation. In this group, our model predicted a 48% (38%–58%) decrease in decline if raised donor ALT was excluded from these decisions. This represents an additional 37 (30–45) liver transplants every year in the UK.ConclusionsRaised donor ALT increased the likelihood of liver decline. As it does not influence transplant outcome, avoiding donor ALT-based organ decline is an immediate and effective way to expand the donor pool.

Abstract Objective Long waiting times for elective hospital treatments are common in many countries. This study seeks to address a deficit in the literature concerning the effect of long waits on the wider consumption of healthcare resources. Methods We carried out a retrospective treatment-control study in a healthcare system in South West England from 15 June 2021 to 15 December 2021. We compared weekly contacts with health services of patients waiting over 18 weeks for treatment (‘Treatments’) and people not on a waiting list (‘Controls’). Controls were matched to Treatments based on age, sex, deprivation and multimorbidity. Treatments were stratified by the clinical specialty of the awaited hospital treatment, with healthcare usage assessed over various healthcare settings. Wilcoxon signed-rank tests assessed whether there was an increase in healthcare utilisation and bootstrap resampling was used to estimate the magnitude of any differences. Results A total of 44,616 patients were waiting over 18 weeks (the constitutional target in England) for treatment during the study period. There was an increase (p

The publication of research activities and results as well as the various participants pose major challenges for data exchange, exploration and visualization. The German Centre for Higher Education Research and Science Studies (DZHW) has developed an open data portal for the National Academics Panel Study (Nacaps), funded by the Federal Ministry of Education and Research (BMBF). With interactive graphics on topics such as doctoral conditions, career intentions, mobility and financing, the portal offers an overview of the life and work reality of doctoral students in Germany. Survey data is prepared in the data portal so that it can be used at a low threshold. Since the data is made available free of charge in open and reusable formats without restrictions, it can be used by researchers and the public alike. At the same time, the portal offers cooperating partner universities university-specific reporting on the data of doctoral students at their institution in a protected space. The possible further development and effective use of the Nacaps data portal for the management of open survey data will be discussed. In particular, the quality of open survey data as well as the potential and special features of the Nacaps data portal when visualizing survey data are discussed. [ABSTRACT FROM AUTHOR]

Objective: Long waiting times for elective hospital treatments are common in many countries. This study seeks to address a deficit in the literature concerning the effect of long waits on the wider consumption of healthcare resources. Methods: We carried out a retrospective treatment-control study in a healthcare system in South West England from 15 June 2021 to 15 December 2021. We compared weekly contacts with health services of patients waiting over 18 weeks for treatment ('Treatments') and people not on a waiting list ('Controls'). Controls were matched to Treatments based on age, sex, deprivation and multimorbidity. Treatments were stratified by the clinical specialty of the awaited hospital treatment, with healthcare usage assessed over various healthcare settings. Wilcoxon signed-rank tests assessed whether there was an increase in healthcare utilisation and bootstrap resampling was used to estimate the magnitude of any differences. Results: A total of 44,616 patients were waiting over 18 weeks (the constitutional target in England) for treatment during the study period. There was an increase (p < 0.0004) in healthcare utilisation for all specialties. Patients in the Cardiothoracic Surgery specialty had the largest increase, with 17.9 [interquartile-range: 4.3, 33.8] additional contacts with secondary care and 17.3 [-1.1, 34.1] additional prescriptions per year. Conclusion: People waiting for treatment consume higher levels of healthcare than comparable individuals not on a waiting list. These findings are relevant for clinicians and managers in better understanding patient need and reducing harm. Results also highlight the possible 'false economy' in failing to promptly resolve long elective waits. [ABSTRACT FROM AUTHOR]

Background: Cognitive impairment (CI) raises risks for unplanned healthcare utilisation and expenditures and for premature mortality. It may also reduce risks for planned expenditures. Therefore, the net cost implications for those with CI remain unknown. Method: We examined differences in healthcare utilisation and cost between those with and without CI. Using administrative healthcare utilisation and cost data linked to the Singapore Chinese Health Study cohort, we estimated regression-adjusted differences in annual healthcare utilisation and costs by CI status determined by modified Mini-Mental State Exam. Estimates were stratified by ex ante mortality risk constructed from out-of-sample Cox model predictions applied to the full sample, with a separate analysis restricted to decedents. These estimates were used to project differential healthcare costs by CI status over 5 years. Results: Patients with CI had 17% higher annual cost compared to those without CI (SGD4870 versus SGD4177, P<0.01). Accounting for the greater mortality risk, individuals with CI cost 9% to 17% more over 5 years, or SGD2500 (95% confidence interval 1000-4200) to SGD3600 (95% confidence interval 1300-6000) more, depending on their age. Higher cost was mainly due to more emergency department visits and subsequent admissions (i.e. unplanned). Differences attenuated in the last year of life when costs increased dramatically for both groups. Conclusion: Ageing populations and higher rates of CI will further strain healthcare resources primarily through greater use of emergency department visits and unplanned admissions. Efforts should be made to identify at risk patients with CI and take appropriate remediation strategies. [ABSTRACT FROM AUTHOR]

Small Private Online Courses (SPOCs) platform enables individuals to carry out their online and offline learning activities. In order to understand individuals’ utilisation of SPOCs, this study develops a research model to examine the joint influences of four dimensions of perceived fit manifested in perceived technology-task fit (TTF), perceived individual-technology fit (ITF), perceived online-offline task fit (OTF), and perceived online-offline interactivity fit (OIF). A survey is conducted at a famous university in China, and 371 data are collected from students who select courses on the SPOC platform. Structural equation modelling method is used to examine the research model. The empirical results suggest that ITF is the most significant antecedent of individual performance expectancy, followed by OTF, TTF, and OIF. Furthermore, individual performance expectancy positively influences satisfaction and continuance intention in the SPOC platform. Moreover, this study incorporates self-regulation as a moderator to explore behavioural differences between individuals with high and low self-regulation. This study extends the traditional perceived fit framework by introducing OTF and OIF and uncovers the antecedents and boundary conditions of individuals’ utilisation of SPOCs in the emerging research context. [ABSTRACT FROM AUTHOR]

Background: In Nigeria, there is a disparity among physiotherapists regarding therapeutic exercise as a core treatment for patients with knee osteoarthritis (OA). The attitudes and beliefs of physiotherapists could influence this. Objective: To investigate Nigerian physiotherapists’ knowledge, attitude, and utilisation of evidence-based therapeutic exercises Design: A mixed-method of cross-sectional survey and focus group discussion. Setting: Secondary and tertiary health institutions in Nigeria Participants: Physiotherapists consecutively sampled from the selected institutions. Main outcome measures: Participants’ knowledge, attitude and utilisation of evidence-based therapeutic exercises for the management of knee OA Results: This study revealed that 81% of physiotherapists in Nigeria had a fair knowledge of evidence-based practice and the efficacy of therapeutic exercises in managing knee OA. Despite this fair knowledge, 95.3% had a poor attitude. The important emerging categories/themes are treatment preference, clinical experience, and strength of evidence. Conclusion: Physiotherapists in Nigeria have a fair knowledge of evidence-based therapeutic exercises in managing patients with knee OA, although there is a poor attitude and disparity between the use and current recommendations. [ABSTRACT FROM AUTHOR]

This article presents the results of the study of the morphological composition of municipal solid waste (MSW) from the landfill of Atyrau city, and the waste's energy characteristics and presence of microorganisms, including bacteria, fungi and viruses. This study was carried out under a government order to determine the feasibility of recycling accumulated and incoming waste into electricity and its hazard to the environment and the workers involved in handling it. At the moment, there is no MSW recycling in Kazakhstan, which has led to the accumulation of more than 125 million tons of waste with an annual increase of 5 million tons. The research included four major cities (Almaty, Shymkent, Atyrau and Astana), which were selected not only on the basis of population, but also because the cities were located in different climatic zones. Samples were collected at the city landfills: 10 samples with an average distance of 100 m from each other were collected to provide a maximum coverage of both recently received waste and long-time stored waste. The research showed that neither climatic conditions nor the population size had a significant impact on MSW density, the values of which ranged from 120.1 kg/m3 to 145.4 kg/m3, as this indicator directly depends on the quality of life. The mass of the combustible fraction ranged from 39.41% to 54.62% and was mainly represented by plastic, textile and paper waste. The average value for the four cities was 50.30%. The higher calorific value fell in the range of 24.22–30.49 MJ/kg, with an average value of 26.71 MJ/kg. Microbiological studies showed little difference in average composition regardless of climatic conditions. Thus, no sharp differences in MSW composition, its energy characteristics and microbiological composition were found. The results of this study may be useful for optimising MSW recycling and disposal processes, as well as for developing measures to reduce their negative impact on the environment and human health. [ABSTRACT FROM AUTHOR]

Background: In a rapidly evolving educational landscape, blended learning is becoming an increasingly popular transition from traditional forms of learning and teaching to e-learning. It is therefore important that lecturers adapt their practice and transform their teaching in line with the online platform in use, as this has the potential to benefit students, lecturers and the institution alike. However, little research exists regarding the perspectives of nurse educators on the use of blended learning as a teaching method. Aim: The study aimed to explore and describe the perspectives of nurse educators on the use of blended learning as a teaching method at the Faculty of Health Sciences at a university in Namibia. Setting: The study was conducted at a public nurse education institution in Namibia. Methods: A qualitative exploratory, descriptive design that was contextual was applied to collect data from a convenient sample of 15 lecturers using semi-structured interviews. Results: Four themes emerged in this study, namely, understanding of blended learning, benefits of utilising blended learning, challenges of utilising blended learning, and recommendations to ensure effective use of blended learning. Conclusion: The study findings identified potential areas of both strengths and shortcomings in nurse educators’ use of blended learning as a teaching and learning strategy. Contribution: These findings may be used to develop ongoing strategies and targeted interventions that can strengthen nurse educators’ abilities to design learning environments that are conducive to blended learning.

ObjectiveThis study aimed to understand community voices on factors influencing utilisation of MMWHs in Zambia.MethodsThe study employed a mixed method study design in four selected health facilities across Zambia districts between January 2021 and December 2022. Purposeful sampling was used to select study participants using MMWH registers as the sampling frame for mothers who had utilised MMWHs and their spouses. Sampling of participants through face-to-face, in-depth interviews (IDIs) and focus group discussions (FGDs) was conducted to saturation in all targeted health facilities Data was transcribed verbatim and analysed thematically.ResultsResults found that the comfortable state of the MMWHs, long distances to health facilities, fear of maternal complications, availability and positive attitudes of specialized health personnel, and the information on childcare provided were major factors. Spouses supported their partners using MMWHs due to the quality of care and the availability of modern equipment and furniture. However, some spouses indicated that utilisation of MMWHs has a bearing on a household's financial resources.ConclusionMMWHs are a pivotal intervention in improving maternal outcomes. All health facilities had no maternal and newborn complications or deaths over the study period.

Background: In the past decade, Kerala has witnessed an increase in the number of sexually transmitted diseases and unmet family planning needs. This study examines the knowledge of modern contraceptives, their use, and the current use of modern Keralite contraceptives against selected indicators. Methodology: The dataset from the fifth round of the National Family Health Survey was used for this study (N=10969). To analyse the factors associated with and affecting knowledge and use of contraceptives (current use of modern and ever use of any), chi-square test and binary logistic regression were used. Results: Wealth, age, and education level were positively associated with knowledge of modern contraceptives, whereas tribals were less aware than other castes. Wealthier, older, and less educated individuals had higher odds of using any/modern contraceptives than poor, younger, and higher educated individuals (odds

This study assessed the utilization of open databases in accessing agricultural information among agricultural professionals in Rivers State. Two stage sampling procedure was used to select two hundred and forty (240) respondents for the study. A structured questionnaire was used to collect data for the study, while data collected were analysed using mean score, percentages, frequency, Ordinary Least regression analysis and Analysis of Variance (ANOVA). Results further showed that the agriculture professionals were mainly aware of Global Open Data for Agriculture and Nutrition (GODAN), (100%), National Bureau of Statistics (NBS), (96%), World Bank (70%), FAO-FAOSTAT (69%) and Nigeria Metrological Agency (NiMET), (68%) while NBS (95%), World Bank (84%), National Agricultural Extension and Research Liaison (58%) and FAO-FAOSTAT (53%) were the mainly utilised open data bases. The level of education, work experience, household size, age and marital status was found to influence agriculture professional’s utilisation of open data bases for accessing agriculture information. Also, significant difference exists in the utilization of open databases among agricultural professionals in Rivers state (F (2, 237) =2.950, p < .05). The study recommends massive sensitisation and training of agricultural profession to develop skill and capacity for increased use of open data bases.

Abstract Background Wild edible fruits found in Tanzania's miombo woods are an indispensable source of food and medicine. Unfortunately, with the rapid expansion of human activities and urbanisation in the Tabora rural, Uyui and Sikonge districts of Western Tanzania, some wild fruits are disappearing due to the loss of plant diversity. The objectives of this study wereL: to document the knowledge related to wild edible fruits; to quantify the use and cultural significance, and to determine their threats. Methods The ethnobotanical study was conducted from June 2022 to February 2023 involving 244 local informants. The study used field visits, the collection of plant parts, and semi-structured interviews with locals for its data collection. Descriptive statistics and correlation test were used to analyse the knowledge related to wild fruits. Frequency citation (f) and use reports (UR) were computed to understand the diversity and cultural significance (CI). Results The study documented 27 wild edible fruit species used for food and medicine. The life form constituted deciduous shrubs or trees (64%), shrub trees (21%) and evergreen or deciduous trees (15%). About (56%) of wild edible fruits were collected from June to August after the rainy season, (33%) were harvested between December and May during the rainy season, and (11%) were gathered from September and November before the rainy season. Household size and sex of the respondents were significantly correlated to the knowledge of wild edible fruits. Higher utilisation frequency (f) was recorded for Vitex mombassae Vatke (f = 0.84), Strychnos spinosa Lam. (f = 0.82), Vitex payos (Lour.) Merr. (f = 0.56), Phyllogeiton discolor (Klotzsch) Herzog. (f = 0.45), Vangueria infausta Burchell (f = 0.45), Tamarindus indica L. (f = 0.38), Parinari curatellifolia (f = 0.25), Landolphia parvifolia K.Schum. (f = 0.22) and Microcos conocarpa Burret (f = 0.22) fruits species. Additionally, Phyllogeiton discolor (Klotzsch) Herzog. (UR = 56), Vitex mombassae Vatke (UR = 56), Tamarindus indica L. (UR = 37), Strychnos spinosa Lam. (UR = 14) and Friesodielsia obovata (Benth.) Verdc. (UR = 11), have higher use reports (UR) and considered culturally important. Wild fruits were used to cure diabetes, gastrointestinal, reproductive, and respiratory infections ailments. Discussion and conclusion Multiple uses as well as the related knowledge of wild fruits have been documented. Friesodielsia obovata, Grewia flavescens Juss and Thespesia garckeana F.Hoffm. are the medicinal fruit species reported for the first time. Harvesting of wood plants, charcoal activities, crop cultivation, grazing expansion, and environmental change, have had an impact on the diversity of wild edible fruit plants. Over the past three decades, the use of wild fruits has been impacted by the loss of plant diversity due to decline of cultural norms on the forests management. Given the variety of uses for wild fruits, promoting markets for native fruits, sensitising the locals about the cultural importance and innovation on processing techniques are necessary to spur conservation efforts.

This article presents the results of the study of the morphological composition of municipal solid waste (MSW) from the landfill of Atyrau city, and the waste’s energy characteristics and presence of microorganisms, including bacteria, fungi and viruses. This study was carried out under a government order to determine the feasibility of recycling accumulated and incoming waste into electricity and its hazard to the environment and the workers involved in handling it. At the moment, there is no MSW recycling in Kazakhstan, which has led to the accumulation of more than 125 million tons of waste with an annual increase of 5 million tons. The research included four major cities (Almaty, Shymkent, Atyrau and Astana), which were selected not only on the basis of population, but also because the cities were located in different climatic zones. Samples were collected at the city landfills: 10 samples with an average distance of 100 m from each other were collected to provide a maximum coverage of both recently received waste and long-time stored waste. The research showed that neither climatic conditions nor the population size had a significant impact on MSW density, the values of which ranged from 120.1 kg/m3 to 145.4 kg/m3, as this indicator directly depends on the quality of life. The mass of the combustible fraction ranged from 39.41% to 54.62% and was mainly represented by plastic, textile and paper waste. The average value for the four cities was 50.30%. The higher calorific value fell in the range of 24.22–30.49 MJ/kg, with an average value of 26.71 MJ/kg. Microbiological studies showed little difference in average composition regardless of climatic conditions. Thus, no sharp differences in MSW composition, its energy characteristics and microbiological composition were found. The results of this study may be useful for optimising MSW recycling and disposal processes, as well as for developing measures to reduce their negative impact on the environment and human health.

Background: The utilisation of outpatient dental services is an important indicator for monitoring healthcare provision in Germany. In the general population, the 12-month prevalence of dental service utilization is 82.2 %. For refugees, this indicator has hardly been measured, although studies suggest an objectively high need for dental care. Methodology: As part of the population-based cross-sectional RESPOND study (2018), self-reported health and healthcare, including the use of dental services, was assessed in three representative, random samples of refugees residing in reception and shared accommodation centres in Baden-Württemberg and Berlin. Results: The indicator was available for 68.8 % (594) of the 863 surveyed refugees. Overall, 38.2 % of the respondents stated that they had utilised dental services in the previous 12 months, whereas 41.4 % had never used any dental care in Germany. Conclusions: The utilisation of dental services among refugees is very low compared to the level of utilisation in the general population. It reflects a discrepancy between access and needs.

Abstract Background Women living with breast cancer (BC) rely on traditional medicine (TM) in addition to orthodox medicine. There is a need to understand how and why women diagnosed with BC utilise TM. This study explored and described the lived experiences of women living with BC in terms of their utilisation of traditional medicine. Methods A descriptive phenomenology design was used to purposively conduct 20 face-to-face in-depth interviews using a semi-structured interview guide. Data were analysed using NVivo-12 based on Collaizzi’s framework for thematic data analysis. Results Overall, five main themes emerged, namely: sources of knowledge on TM, motivations for using TM, treatment modalities, timing for the initiation of TM, the reasons for discontinuing use of TM, and the decision to seek orthodox medicine. Under the category of motivations for using TM, four themes emerged: financial difficulties and perceived cost effectiveness of TM, influence of social networks, including family and friends, assurance of non-invasive treatment, delays at the healthcare facility, and side effects of orthodox treatment. Non-invasive treatments included herbal concoctions, natural food consumption, and skin application treatments. Regarding the timing of initiation, TM was used in the initial stage of symptom recognition prior to the decision to seek orthodox medicine, and was also used complementarily or as an alternative after seeking orthodox medicine. However, patients eventually stopped using TM due to the persistence of symptoms and the progression of cancer to a more advanced stage, and disapproval by orthodox practitioners. Conclusion Women living with BC in Ghana utilise traditional medicine (TM) for many reasons and report their family, friends and the media as a main source of information. A combination of herbal concoctions and skin application modalities is obtained from TM practitioners to treat their BC. However, they eventually discontinue TM when symptoms persist or when disapproval is expressed by their orthodox healthcare providers. We conclude that there is an opportunity to better integrate TM into the standard of oncological care for BC patients.

Research purpose. Cultural heritage in movable or immovable form contributes with its tools to the creation of a coherent and inclusive society. The cultural direction of the society should be built on the basic principles of inclusion, equality, participation and availability with the help of marketing and marketing communication. The aim of the contribution is, on the basis of the data database of culture, which is implemented by institutions under the authority of the Ministry of Culture of the Slovak Republic, to determine the use and sustainability of non-periodical publications registered in libraries in the Slovak Republic, which should lead to the creation and maintenance of mutual understanding between them and the public with the ultimate goal of supporting knowledge the society's potential.

Background: Wild edible fruits found in Tanzania's miombo woods are an indispensable source of food and medicine. Unfortunately, with the rapid expansion of human activities and urbanisation in the Tabora rural, Uyui and Sikonge districts of Western Tanzania, some wild fruits are disappearing due to the loss of plant diversity. The objectives of this study wereL: to document the knowledge related to wild edible fruits; to quantify the use and cultural significance, and to determine their threats. Methods: The ethnobotanical study was conducted from June 2022 to February 2023 involving 244 local informants. The study used field visits, the collection of plant parts, and semi-structured interviews with locals for its data collection. Descriptive statistics and correlation test were used to analyse the knowledge related to wild fruits. Frequency citation (f) and use reports (UR) were computed to understand the diversity and cultural significance (CI). Results: The study documented 27 wild edible fruit species used for food and medicine. The life form constituted deciduous shrubs or trees (64%), shrub trees (21%) and evergreen or deciduous trees (15%). About (56%) of wild edible fruits were collected from June to August after the rainy season, (33%) were harvested between December and May during the rainy season, and (11%) were gathered from September and November before the rainy season. Household size and sex of the respondents were significantly correlated to the knowledge of wild edible fruits. Higher utilisation frequency (f) was recorded for Vitex mombassae Vatke (f = 0.84), Strychnos spinosa Lam. (f = 0.82), Vitex payos (Lour.) Merr. (f = 0.56), Phyllogeiton discolor (Klotzsch) Herzog. (f = 0.45), Vangueria infausta Burchell (f = 0.45), Tamarindus indica L. (f = 0.38), Parinari curatellifolia (f = 0.25), Landolphia parvifolia K.Schum. (f = 0.22) and Microcos conocarpa Burret (f = 0.22) fruits species. Additionally, Phyllogeiton discolor (Klotzsch) Herzog. (UR = 56), Vitex mombassae Vatke (UR = 56), Tamarindus indica L. (UR = 37), Strychnos spinosa Lam. (UR = 14) and Friesodielsia obovata (Benth.) Verdc. (UR = 11), have higher use reports (UR) and considered culturally important. Wild fruits were used to cure diabetes, gastrointestinal, reproductive, and respiratory infections ailments. Discussion and conclusion: Multiple uses as well as the related knowledge of wild fruits have been documented. Friesodielsia obovata, Grewia flavescens Juss and Thespesia garckeana F.Hoffm. are the medicinal fruit species reported for the first time. Harvesting of wood plants, charcoal activities, crop cultivation, grazing expansion, and environmental change, have had an impact on the diversity of wild edible fruit plants. Over the past three decades, the use of wild fruits has been impacted by the loss of plant diversity due to decline of cultural norms on the forests management. Given the variety of uses for wild fruits, promoting markets for native fruits, sensitising the locals about the cultural importance and innovation on processing techniques are necessary to spur conservation efforts. [ABSTRACT FROM AUTHOR]

Large (>3 m) slender-bodied rat snakes are abundant in agroecosystems of southern Asia and are heavily exploited for their skins and meat. We examined 216 specimens killed at commercial facilities in Cirebon, West Java, to quantify morphological and reproductive traits and evaluate harvest sustainability by comparing this sample to one taken 25 years previously. The snakes we examined were mostly adults, and mostly male. Females were less heavy-bodied than males of the same body length, matured at a larger size than males, but attained smaller maximum sizes. Reproduction and energy (fatbody) storage was seasonal in both sexes, with females containing oviductal eggs primarily during the annual wet season. Clutch size averaged 12.6 eggs and increased with maternal body size. Comparison of the two samples taken 25 years apart revealed strong similarity in sex ratio, the numerical preponderance of adults, body sizes at sexual maturation and mean adult body sizes, sexual dimorphism in body length and mass, reproductive seasonality in females, mean fecundity, and the relationship between fecundity and maternal body size. That consistency suggests that commercial harvesting over the intervening period has not affected the biological traits of rat snake populations, consistent with a sustainable level of offtake. The heavily exploited oriental rat snake is common across much of Asia. Despite its economic and ecological importance, little is known about its biology or the sustainability of the harvest. Dissection of 216 commercially collected snakes from West Java and comparison with a sample taken 25 years previously shows that the harvest is based mainly on adults and is likely sustainable. Sustainability is enhanced by the snake's rapid growth, early maturation, high reproductive output, and ability to exploit available resources. Photograph by Nathan Rusli. [ABSTRACT FROM AUTHOR]

Summary: The manufacturing sector is vital to the blistering economic transformation of developing countries such as Ethiopia. According to Ethiopia's industrial development strategy, one of the priority sub‐sectors of the manufacturing sector is the agricultural processing industry. This study focuses on the utilisation prospects, health, and environmental performance of afro‐food processing industries. The data were collected from 71 industry‐level respondents. The data collectors used Open Data Kit (ODK) packages as a data collection mechanism. The average utilisation of the cereal processors in Ethiopia was calculated to be 50.84%, 57.39%, 72.18%, 58.44%, and 42.81% for biscuits, macaroni, maize flour, spaghetti, and wheat flour, respectively. The average efficiency was determined to be 68.27%, 73.72%, 90.49%, 83.38%, and 64.76% for biscuits, macaroni, maize flour, spaghetti, and wheat flour, respectively. It is also noted that among the edible oil processors, peanut oil has the highest average efficiency (90.49%) and utilisation (72.18%). The lowest average efficiency and utilisation were determined to be 64.76% and 42.81% respectively for sunflower oil. From a health and environmental performance perspective, it is noted that 70.83% of oil processors and 59.57% of cereals processors have quality control laboratories. Moreover, 91.48% of cereal processors and 87.5% of oil processors have solid waste disposal systems. [ABSTRACT FROM AUTHOR]

Background: Women living with breast cancer (BC) rely on traditional medicine (TM) in addition to orthodox medicine. There is a need to understand how and why women diagnosed with BC utilise TM. This study explored and described the lived experiences of women living with BC in terms of their utilisation of traditional medicine. Methods: A descriptive phenomenology design was used to purposively conduct 20 face-to-face in-depth interviews using a semi-structured interview guide. Data were analysed using NVivo-12 based on Collaizzi's framework for thematic data analysis. Results: Overall, five main themes emerged, namely: sources of knowledge on TM, motivations for using TM, treatment modalities, timing for the initiation of TM, the reasons for discontinuing use of TM, and the decision to seek orthodox medicine. Under the category of motivations for using TM, four themes emerged: financial difficulties and perceived cost effectiveness of TM, influence of social networks, including family and friends, assurance of non-invasive treatment, delays at the healthcare facility, and side effects of orthodox treatment. Non-invasive treatments included herbal concoctions, natural food consumption, and skin application treatments. Regarding the timing of initiation, TM was used in the initial stage of symptom recognition prior to the decision to seek orthodox medicine, and was also used complementarily or as an alternative after seeking orthodox medicine. However, patients eventually stopped using TM due to the persistence of symptoms and the progression of cancer to a more advanced stage, and disapproval by orthodox practitioners. Conclusion: Women living with BC in Ghana utilise traditional medicine (TM) for many reasons and report their family, friends and the media as a main source of information. A combination of herbal concoctions and skin application modalities is obtained from TM practitioners to treat their BC. However, they eventually discontinue TM when symptoms persist or when disapproval is expressed by their orthodox healthcare providers. We conclude that there is an opportunity to better integrate TM into the standard of oncological care for BC patients. [ABSTRACT FROM AUTHOR]

Background: The MS disease-modifying therapies (DMTs) prescribing landscape in Australia have changed over time. Objectives: This study evaluated the utilisation and cost trends of MS-related DMTs in Australia over 10 years and investigated differences between States/Territories. Methods: The prescription and costs of 16 DMTs were extracted from the Pharmaceutical Benefits Scheme for 2013–2022. Descriptive approaches analysed the total number of people prescribed DMTs and total DMT costs per 10,000 population, proportions of prescriptions/costs by DMT groups and the number of people prescribed each individual DMT and costs of each DMT over the 10-year period. All estimates were for Australia and each State/Territory individually. Results: The number of people prescribed DMT and costs per 10,000 population had substantial growth between 2013 and 2022: 125%/164% for Australia, and 94%–251%/129%–373% for individual States/Territories. Higher efficacy group accounted for 54% of total people prescribed DMTs in 2013 and 75% in 2022. Fingolimod was the most popular DMT until 2020, then was dominated by ocrelizumab. The trends of individual DMT prescriptions and costs differed between states particularly in Western Australia (WA), Tasmania and Northern Territory (NT). Conclusion: DMT prescriptions and costs continuously increased over the last decade, particularly for higher efficacy DMTs, and their trends differed between States/Territories. [ABSTRACT FROM AUTHOR]

The possible utilisation of the thirteen senile fruit-bearing trees were determined based on their physical and mechanical properties. The trees consisted of manggang kalabaw (Mangifera indica L.), manggang pahutan (Mangifera altissima Blanco), guyabano (Annona muricata L.), atis (Annona squamosa L.), avocado (Persea americana Mill.), lansones (Lansium domesticum Correa), santol (Sandoricum koetjape (Burm.f.) Merr.), nangka (Artocarpus heterophyllus Lam.), marang (Artocarpus odoratissimus Blanco), duhat (Syzygium cumini (L.)), bignai (Antidesma bunius (L.) Skeels), pomelo (Citrus maxima (Burm.)), and chico (Manikara zapota (L.) R. Royen). The tests were done using the ASTM D143-2014 standard and the tree samples were obtained from Laguna and Butuan City. Results showed that lansones (79.54%), duhat (60.77%), and chico (58.74%) had the lowest green moisture content (MC) and the highest relative density (RD) (0.66, 0.73, and 0.79, respectively). On the other hand, duhat and lansones had the highest tangential shrinkage (TS) (10.12% and 10.17%, respectively). Lansones also recorded the highest radial (RS) (7.80%) and volumetric (VS) (17.15%) shrinkage. For longitudinal shrinkage (LS), manggang pahutan (1.26%), and bignai (1.31%) displayed the highest value. For the strength properties, lansones recorded MOR (76.10 MPa), SPL (40.25 MPa), MOE (8.01 GPa), compression parallel-to-grain (32.05 MPa), and shear strength (7.06 MPa). Chico achieved higher compression perpendicular-to-grain (8.36 MPa), hardness: side (7.27 kN), and hardness: end (7.49 kN) than the other species. Based on the properties obtained, the 13 senile fruit-bearing trees are feasible alternatives that the local wood sector may consider to increase the supply of commercial lumber. [ABSTRACT FROM AUTHOR]

Women with cerebral palsy have the same sexual and reproductive healthcare (SRH) needs and rights as non-disabled women across the life course. Multi-level barriers prevent their SRH needs from being met in a timely way. Grouped according to Bronfenbrenner's socio-ecological model, these include physical and psychosocial determinants. The aim of this scoping review was to collate global literature of access to, and utilisation of, SRH for women with cerebral palsy across the life course. We screened five databases for international empirical studies published in English between 2000–2019. Twelve studies met the inclusion criteria. The review highlights that women with cerebral palsy face challenges to receiving good quality healthcare, including limited practitioner knowledge and training on the effects of cerebral palsy in adulthood and how it interacts with women's SRH needs. Much more research is needed to inform the provision of appropriate SRH treatment for women with cerebral palsy across the life course. This article blends together the findings of 12 international studies on healthcare of girls and adult women with cerebral palsy, particularly focusing on sexual and reproductive health and healthcare. The review indicates a significant gap in evidence about the experiences of healthcare transitions for women with cerebral palsy as they move from childhood to adulthood and children's to adult healthcare The review highlights large gaps in the global literature, in relation to sexual and reproductive healthcare across the lifecourse of disabled women in general, but women with cerebral palsy in particular. The studies found that General Practitioners (GPs) (family doctors) did not consider how prescribed contraceptives relate to impairment effects for girls and women with cerebral palsy. Barriers to good quality sexual and reproductive healthcare for women with cerebral palsy include: inaccessible physical environment and procedures (cervical smear and breast scans), and limited practitioner knowledge about the effects of cerebral palsy in adulthood for women and its interaction with sexual and reproductive health needs. [ABSTRACT FROM AUTHOR]

It has been suggested that actions can provide a fruitful conceptual context for sound symbolism phenomena, and that tight interaction between manual and articulatory processes might cause that hand actions, in particular, are sound-symbolically associated with specific speech sounds. Experiment 1 investigated whether novel words, built from speech sounds that have been previously linked to precision or power grasp responses, are implicitly associated with perceived actions that present precision manipulation or whole-hand grasp tool-use or the corresponding utilisation pantomimes. In the two-alternative forced-choice task, the participants were more likely to match novel words to tool-use actions and corresponding pantomimes that were sound-symbolically congruent with the words. Experiment 2 showed that the same or even larger sound–action symbolism effect can be observed when the pantomimes present unfamiliar utilisation actions. Based on this we propose that the sound–action symbolism might originate from the same sensorimotor mechanisms that process the meaning of iconic gestural signs. The study presents a novel sound–action phenomenon and supports the view that hand–mouth interaction might manifest itself by associating specific speech sounds with grasp-related utilisations. [ABSTRACT FROM AUTHOR]