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Introduction: Medical imaging's critical role in diagnosis requires prompt and precise image interpretation. Numerous radiology departments, especially in low‐resourced settings, encounter challenges such as a shortage of radiologists in their operational setup. This study explored the perceptions of radiographers and radiologists from low‐resourced departments in a single country regarding operational challenges and potential solutions in image interpretation. Methods: A qualitative approach was utilised, involving heads of departments, senior radiographers, and radiologists with a minimum of 5 years of experience, from three major state referral hospitals. Face‐to‐face, semi‐structured interviews were conducted in November 2022, using an interview guide that included questions on the challenges encountered during image interpretation and the proposed solutions. Data analysis was conducted using Atlas.ti version 9.0, following the four‐step content analysis method. All participants willingly provided consent to participate in the study. Results: Ten participants, comprising two radiologists and eight radiographers participated in the study. The research identified three main themes: image interpretation pathways, image interpretation operational challenges and proposed solutions for image interpretation. In addition, a total of 10 subthemes were generated from the three main themes. Conclusion: The study revealed critical challenges and the need to explore the formal inclusion of radiographers in image interpretation, as a way to improve efficiency. However, a comprehensive assessment of the image interpretation system, encompassing radiographers' knowledge and competence, is recommended for context‐specific, empirical‐based modifications to enhance service provision. [ABSTRACT FROM AUTHOR]

Introduction: breast cancer stands as one of the deadliest forms of cancer among women globally, breast cancer has become a significant global health issue. Knowledge of the risk factors and the various early detection methods is pivotal in ensuring timely treatment initiation. This study aimed at assessing the awareness of the breast cancer (BC) screening methods and risk factors among women attending two health facilities in Windhoek, Namibia. Methods: a quantitative correlational design was used to determine the knowledge of breast cancer screening methods and risk factors; This study sampled a total of 260 purposively recruited women aged 20 years and older who attended the two hospitals' outpatient departments. Results: findings suggest that participants had an average knowledge of BC risk factors, screening methods, and signs and symptoms. Kruskal-Wallis H test with post hoc analysis revealed that several demographic variables were significantly associated with knowledge of screening methods (participants' occupations, p=0.04; educational level, p=0.01; gravidity, p=0.04), knowledge of risk factors (presenting with breast problem, p=0.05) and knowledge of signs and symptoms (age, p=0.008; presenting with breast problem, p=0.03). Conclusion: this study found that participants have an average understanding of breast cancer risk factors, symptoms, and screening methods, with significant associations found between these knowledge areas and factors such as occupation, presence of a breast problem, educational qualifications, and history of pregnancy. There's a need for expanded education and awareness initiatives in Namibia. Utilising social media for these campaigns could improve their reach and impact. [ABSTRACT FROM AUTHOR]

This commentary critiques the study "Route patterns of the collateral venous pathway in patients with tumors invading the superior sagittal sinus" by Pawit Jirawisan et al., highlighting its limitations in discussing parafalcine venous collaterals, reliance on invasive imaging modalities, and lack of structured assessments. It suggests improvements by incorporating alternative imaging techniques, acknowledging crucial venous structures, and providing grading systems for surgical decision-making. [ABSTRACT FROM AUTHOR]

Abnormal-glucose tolerance (Abnl-GT) is due to an imbalance between β-cell function and insulin resistance (IR) and is a major risk factor in cardiovascular disease (CVD). In sub-Saharan Africa, β-cell failure is emerging as an important cause of Abnl-GT (Abnl-GT-β-cell-failure). Visceral adipose tissue (VAT) volume and hyperlipidemia are major contributors to CVD risk when Abnl-GT is due to IR (Abnl-GT-IR). Yet, the CVD profile associated with Abnl-GT-β-cell failure is unknown. Therefore, our goals in 450 African-born Blacks (Male: 65%; Age: 39 ± 10 years; BMI 28 ± 5 kg/m2), living in America were to: (1) determine Abnl-GT prevalence and etiology; (2) assess by Abnl-GT etiology, associations between four understudied subclinical CVD risk factors in Africans: (a) subclinical myocardial damage (high-sensitivity troponin T (hs-cTnT)); (b) neurohormonal regulation (N-terminal pro-Brain-natriuretic peptide (NT-proBNP)); (c) coagulability (fibrinogen); (d) inflammation (high-sensitivity C-reactive protein (hsCRP)), as well as HbA1c, Cholesterol/HDL ratio and VAT. Glucose tolerance status was determined by the OGTT. IR was defined by the threshold at the lowest quartile for the Matsuda Index (≤ 2.97). Abnl-GT-IR required both Abnl-GT and IR. Abnl-GT-β-cell-failure was defined as Abnl-GT without IR. VAT was assessed by CT-scan. For both the Abnl-GT-β-cell-failure and Abnl-GT-IR groups, four multiple regression models were performed for hs-cTnT; NT-proBNP; fibrinogen and hsCRP, as dependent variables, with the remaining three biomarkers and HbA1c, Cholesterol/HDL and VAT as independent variables. Abnl-GT occurred in 38% (170/450). In the Abnl-GT group, β-cell failure occurred in 58% (98/170) and IR in 42% (72/170). VAT and Cholesterol/HDL were significantly lower in Abnl-GT-β-cell-failure group vs the Abnl-GT-IR group (both P < 0.001). In the Abnl-GT-β-cell-failure group: significant associations existed between hscTnT, fibrinogen, hs-CRP, and HbA1c (all P < 0.05), and none with Cholesterol/HDL or VAT. In Abnl-GT-IR: hs-cTnT, fibrinogen and hsCRP significantly associated with Cholesterol/HDL (all P < 0.05) and NT-proBNP inversely related to fibrinogen, hsCRP, HbA1c, Cholesterol/HDL, and VAT (all P < 0.05). The subclinical CVD risk profile differed between Abnl-GT-β-cell failure and Abnl-GT-IR. In Abnl-GT-β-cell failure subclinical CVD risk involved subclinical-myocardial damage, hypercoagulability and increased inflammation, but not hyperlipidemia or visceral adiposity. For Abnl-GT-IR, subclinical CVD risk related to subclinical myocardial damage, neurohormonal dysregulation, inflammation associated with hyperlipidemia and visceral adiposity. ClinicalTrials.gov Identifier: NCT00001853. [ABSTRACT FROM AUTHOR]

Spectral data cubes of the interacting pair of galaxies NGC 2535 and NGC 2536 (the Arp 82 system) targeting bright emission lines in the visible band, obtained with the imaging Fourier transform spectrometer (iFTS) SITELLE attached to the Canada–France–Hawaii Telescope (CFHT), are presented. Analysis of H |$\alpha $| velocity maps reveals a bar in |$\rm NGC\, 2536$|⁠. In |$\rm NGC\, 2535$|⁠ , we find strong non-circular motions outside the ocular ring, in the elliptical arc and tidal tails of |$\rm NGC\, 2535$|⁠ , and a misalignment between the kinematic and photometric position angles. We detect 155 H  ii region complexes in the interacting pair of galaxies and determine oxygen abundances for 66 of them using different calibrators. We find, regardless of the indicator used, that the oxygen abundance distribution in |$\rm NGC\, 2536$| is shallow, whereas in |$\rm NGC\, 2535$|⁠ , it is best fitted by two slopes, the break occurring beyond the ocular ring. The inner slope is comparable to the one observed in isolated normal star-forming galaxies, but the outer slope is shallow. We present a numerical simulation of the interaction that reproduces the observed tidal features, kinematics, and metallicity distribution, to investigate the effect of the interaction on the galaxies. The model indicates that the galaxies have undergone a close encounter, strongly prograde for the primary, and are halfway in their course to a second close encounter. [ABSTRACT FROM AUTHOR]

Introduction: job satisfaction is an integral component of professional relationships, affecting human resource retention and organisational productivity. The study evaluated the job satisfaction levels and their contributing factors as well as turnover intention among radiographers working at three state hospitals. Methods: a quantitative, correlational and cross-sectional design was used to determine job satisfaction and turnover intention as well as their relationship using inferential statistics on a total of 36 out of 40 radiographers working at three public hospitals. A self-administered questionnaire was used to measure job satisfaction and turnover intention. Statistical Package for Social Science (SPSS) (version 25), was used to analyse job satisfaction levels, associated factors and turnover intention. Results: eighty percent of radiographers indicated moderate levels of job satisfaction. Job satisfaction was significantly associated with employee rank (p=0.04), and age (p=0.05). The turnover intention was found to be at 44.4%. Factors significantly associated with turnover intention were tenure in rank (p=0.04), the number of years worked as a radiographer (p=0.05) and the hospital of employment (p=0.005). In this study, there is a moderate, positive, linear relationship between the predictor, job satisfaction, and the outcome, turnover intention (r=0.44; p=0.008). Conclusion: most of the radiographers were satisfied with their jobs, with nearly half of them showing turnover intention. Age and rank, as well as tenure in rank, experience and the hospital of employment, were significantly associated with job satisfaction and turnover intention, respectively. Employee engagement is key to improving job satisfaction and minimising turnover intention. [ABSTRACT FROM AUTHOR]

Patient care has been the major focus of most healthcare discussions, as a way to reinforce strategies that ensure care is of benefit to patients. Understanding the interactions between the patient and radiographer unlocks various opportunities to deliver improved patient care. The purpose of this study was to assess the quality of care received by patients and determine its contributing factors as perceived by patients during the general X-ray examinations. The study used a quantitative, descriptive and cross-sectional survey design. Data were collected from 66 purposefully sampled participants, using a questionnaire. The quality of care for different phases of the radiographic procedures was analysed and the relationships between dependent and independent variables, as well as identified contributing factors, were measured using SPSS version 25. The quality of care rendered to patients in the radiography department before the commencement of the procedure, during the procedure and after the procedure was rated as good, by 77.3%, 81.8% and 68.2%, of the patients respectively. The overall quality of care received by the patients was rated as high, by 89.4% of the patients. Poor communication, overcrowded rooms, radiographers and receptionists' attitudes were factors highlighted by patients as affecting the quality of care they received. Most patients rated highly the quality of care rendered during radiographic procedures, with a few areas reported as negatively affecting this care. Continuous professional development on communication and patient-centred care for radiographers is recommended to improve and maintain the quality of care rendered to patients. [ABSTRACT FROM AUTHOR]

Introduction Methods Results Conclusions Clinical training is crucial for diagnostic radiography students, bridging theoretical knowledge with practical skills. In resource‐constrained settings, this training may face unique challenges that might significantly impact learning outcomes and future practice. Despite its importance, the experiences of diagnostic radiography students during clinical placements remain understudied, particularly in Sub‐Saharan Africa. This study aimed to explore and describe the experiences of diagnostic radiography students during clinical training at two resource‐constrained Sub‐Saharan public hospitals.A qualitative phenomenological study was conducted using face‐to‐face, semi‐structured interviews with 18 diagnostic radiography students (six each from years 2 to 4) from one participating university. Interviews were audio‐recorded, transcribed and analysed using thematic analysis. Trustworthiness was ensured through prolonged engagement, member checking, and researchers' reflexivity. Ethical approval was obtained before data collection commenced.Three main themes were generated: (1) Clinical Environment Challenges, including equipment shortages and understaffing; (2) Independent Learning and Development, highlighting students' resilience and self‐directed learning; and (3) Patient Care Impact, demonstrating students' commitment to quality care despite constraints. Students reported increased confidence and adaptability but also noted negative interactions with healthcare workers and supervision inconsistencies.Despite significant challenges, diagnostic radiography students demonstrated remarkable resilience and commitment to patient care. However, resource limitations and interprofessional issues pose substantial barriers to optimal learning experiences. These findings highlighted the need for targeted interventions in diagnostic radiography education within resource‐constrained settings, including increased investment in equipment and staffing, enhanced interprofessional education, improved supervision models and curriculum enhancements fostering self‐directed learning and resilience. [ABSTRACT FROM AUTHOR]

Introduction: Recently qualified health workers including radiographers struggle with workplace integration. Similarly, in our local context, undocumented complaints were received from the various heads of departments and radiologists regarding recently qualified radiographers' ability to fully assume their professional roles. In light of the complaints, this study sought to explore and describe the lived experiences of recently qualified radiographers from one local University on their readiness to assume their professional roles. Methods: A qualitative, descriptive research design with a phenomenological approach was used to conduct the study. Ten (10) diagnostic radiographers who graduated between 2018 and 2020 from the local university were sampled using the snowball sampling technique. Telephonic interviews were conducted using a semi‐structured interview guide. Data were analysed using Tesch's open coding method. Results: The findings of this study have shown a combination of positive and negative experiences by recently qualified radiographers. The positive experiences (satisfactory work engagement) emanate from increased confidence and creativity, responsibility consciousness and teamwork. Negative experiences (reality shock and professional role conflict) emanated from excessive workload, patient care impediments, the burden of student supervision and lack of professional trust. Conclusion: Though the recently qualified radiographers from our local University experienced some contextual challenges upon assuming their professional roles, they appeared well‐prepared for their clinical roles. Standardised induction and mentorship programmes should be implemented to facilitate the transition process from student to qualified radiographer. [ABSTRACT FROM AUTHOR]

The article by Luis Padevit et al. provides a thorough analysis of multiple craniotomies for brain metastases using propensity score matching and statistical analysis. Their findings suggest that multiple craniotomies do not increase adverse events or morbidity. However, the study lacks detailed analysis of specific surgical factors and minimally invasive techniques, which are crucial for patient selection, surgical planning, and outcomes. Including detailed preoperative tumor sizes, extent of resection, and long-term outcomes would enhance understanding and improve surgical techniques, ultimately benefiting patient care. [ABSTRACT FROM AUTHOR]

Background. Radiographers' role as healthcare workers places them at constant risk for hospital-acquired infections. Practical, evidence-based methods are necessary to reduce the transmission of pathogens to and from patients and healthcare workers. Objective. The main objectives of this study were to determine knowledge, attitude, and practice levels regarding infection prevention and control (IPC) strategies among radiographers in Windhoek and Oshakati, and measure their relationships with other variables. Method. A quantitative descriptive design was employed. To assess the knowledge, attitude, and practice levels among radiographers, a self-administered questionnaire was used. Twenty-seven radiographers took part in the study, producing a 68% response rate. Results. The study revealed that the majority of the radiographers showed an appropriate level of overall knowledge and attitude toward infection prevention and control. However, the majority of their practice levels were poor. Pearson rank correlation test revealed that the radiographers' knowledge was significantly associated with attitudes (P= 0.004; r=0.53) and practices (P=0.03; r=-0.41) with a moderate positive and negative correlation, respectively. Conclusions. In conclusion, the study revealed that radiographers are knowledgeable about IPC strategies, and have good attitudes toward them. However, their practice was poor and inconsistent with the level of knowledge demonstrated. Therefore, it is recommended that healthcare service managers establish efficient and rigorous means of monitoring adherence to IPC strategies and improving practices to reduce incidences of health-acquired infections among radiographers, especially in the age of a pandemic. [ABSTRACT FROM AUTHOR]

Background. An x-ray request form (XRF) is a legal document that aims to communicate a physician's (medical practitioner's) request for radiological procedures to radiographers. Due to the need to conform to radiation protection regulations, the requestor has a responsibility to justify their requests and comply with the legal framework. This study aimed to assess the completeness of cervical spine and pelvis x-ray request forms (XRFs). Materials and method. A review of all plain film x-ray request forms for pelvis and cervical spine during the calendar month of September 2021 was performed to assess for completeness (adequacy) at two radiology departments in Windhoek by means of a retrospective cross-sectional design. A 15-item checklist was used to collect data, employing purposive sampling. The Statistical Software Package for Social Sciences (SPSS) version 27 was used to analyse and present data using descriptive statistics. Results. A total of 172 (110 pelvis and 62 cervical spines) XRFs were assessed. The majority were not adequately completed. Only 4.8% of C-spine and 1.8% of pelvis XRFs were adequately completed. Conclusion. The omissions of certain components on the XRFs are suggestive of ineffective communication between referring medical practitioners, radiologists, and radiographers, affecting the justification of procedures warranting a need for improvement in current referral practices. We recommend in-service training to sensitise medical practitioners and radiographers on the need for adequate completion of XRFs. [ABSTRACT FROM AUTHOR]

Background: Accurate measurement is indispensable for effectively managing hypertension (HTN); any error in technique or instrumentation can lead to misdiagnosis and improper management. Thus, the present study aimed to assess the knowledge and skills of blood pressure (BP) measurement among nurses at a tertiary care cardiac center in Karachi. Materials and methods: Nursing staff responsible for BP assessment at various stations were identified, observed, and interviewed to evaluate their skill and knowledge levels regarding BP measurement techniques. Nurses' skill levels were assessed using a checklist based on the American Heart Association (AHA) guidelines for BP assessment. Results: Seventy-five nurses participated in the study, with 49 (65.3%) being male and a mean age of 32.1 ± 6.2 years. Only 25 (33.3%) nurses reported reading the AHA guidelines for BP measurement. None of the nurses demonstrated excellent skills; 19 (25.3%) showed good skills, while 56 (74.7%) showed poor skills in BP measurement. A poor compliance was observed on a total of 14/31 steps with compliance rate of less than 50%. Similarly, none of the nurses exhibited excellent knowledge; only 3 (4%) had good knowledge, while 72 (96%) had poor knowledge about BP measurement. A poor knowledge was observed on a total of 18/36 items with correct response rate of less than 50%. Conclusion: Nurses working at various stations of a tertiary cardiac center exhibited inadequate skills and knowledge regarding BP measurement. This underscores the necessity for comprehensive training and education to enhance the accurate assessment of BP. [ABSTRACT FROM AUTHOR]

Introduction. Effective communication during radiographic procedures has significant benefits such as enhancing patient understanding and adherence to treatment plans. At the University of Namibia (UNAM), radiography students receive didactic lectures and are exposed to the principles of effective communication during clinical placements. Students are expected to apply verbal and nonverbal communication methods to enhance a patient's experience in radiology departments. The use of ineffective communication methods may hinder patient outcomes and adherence to procedural instruction. Purpose. To assess the effectiveness of communication between student radiographers and patients before, during, and after radiographic procedures. Methods. A quantitative, cross-sectional and descriptive research design was utilised. A convenience sampling strategy was used to select first, second, third and fourth-year radiography students. Data were collected in three phases. Self-developed questionnaires and checklists were used to collect data. Results. A total of 50 students (n=50) and 50 patients (n=50) participated in the study. Patients reported good communication skills: 1st years (84.2%), 2nd years (70%), 3rd years (85.7%), and 4th years (75%). There was no statistically significant association between communication skills and year of study (p=0.883), gender (p=0.495) and spoken language (p=0.357). Effective communication was noted during most interactions with patients. However, weaknesses were found in the communications methods used by the student participants before and after the radiographic procedures. Recommendations. The study recommends that didactic lectures on effective communication should be complemented by using role play and simulation so as to further reinforce students' communication abilities. Proper clinical supervision and mentoring are also recommended to improve clinical training and monitoring with regard to effective communication. [ABSTRACT FROM AUTHOR]

Introduction. Radiographers, like other health professionals, are mandated by their scope of practice to behave in a professional and ethical manner. Technological advances in the profession have led to the modernisation of the radiography profession. However, concerns have been raised in the health sciences' professions regarding unprofessional, unethical and unlawful behaviour of professionals. To gain public trust, radiographers should commit themselves to the standards of the profession. Aim. The aim of this study was to assess the level of professionalism of student radiographers enrolled for the Bachelor of Radiography (Diagnostic) (BRad: D) degree programme at the University of Namibia (UNAM). Methodology. A quantitative design with a cross-sectional approach was used. Data were collected from a conveniently selected sample of students enrolled for the BRad: D degree programme at the UNAM (n=55) who completed a self-administered questionnaire. Data were analysed using the statistical software programme (SPSS) (version 24). Results. Participants reported varied levels of professionalism. Results indicated that the majority of the participants showed good accountability (n=47; 87%), compassion (n=46; 83.6%), excellence (n=39; 70.9%) and integrity (n=44; 80%). No significant association was found between the level of professionalism and the different years of study, how the participants perceived clinical practice and the workload, and how satisfied the participants were with the clinical setting and clinical supervision they received. Overall, it was found that the participants displayed average to good levels of professionalism. Conclusion. Student radiographers work under supervision of radiographers; therefore, it is essential that their professional behaviour is aligned with the professional standards prescribed by the regulatory bodies. Educators should continually reinforce professional values, especially altruism and professional duty, among students during theoretical and clinical training. This will ensure that upon graduation, student radiographers can smoothly transition into professional radiographers who should demonstrate the level of professionalism consistent with the profession. [ABSTRACT FROM AUTHOR]

Background. Student progress in the acquisition of clinical competences during clinical placements is checked using a variety of assessments. Evaluating students in a clinical setting is an indispensable portion of the overall learning progression. Such evaluations provide students with objective updates on their progression. When multiple evaluators assess students, it raises the issue of interrater reliability where different personalities interpret evaluation criteria differently, and have different expectations of students' clinical performance. Radiography students at the University of Namibia (UNAM) are assessed by different assessors. This could create irregularities and inconsistency in grading and could lead to failure. Objective. To explore the experiences of UNAM radiography students regarding practical evaluations. Methods. A qualitative, exploratory, descriptive research design was utilised. The sample consisted of first, second, and third year radiography students at UNAM. Three focused group discussions were conducted for data collection. Findings. Three themes and 10 sub-themes were identified. The three themes were: participants experienced operational challenges during practical evaluations; participants experienced unprofessionalism among clinical instructors; and participants experienced positive experience during practical evaluations. Conclusion. The participants experienced a number of challenges, which affected their performance, during their practical evaluations. Unprofessional behaviour by evaluators was one of the common experiences of the participants resulting in reduced objectivity of their evaluations. Nevertheless, the results show that there were some positive experiences from the evaluation exercise as participants could learn and improved their skills in line with their performance. Based on the findings it is recommended that proper planning and standardisation of practical evaluations should be implemented to improve their objectivity. [ABSTRACT FROM AUTHOR]

Background. An objective structured clinical examination (OSCE) is a comprehensive assessment tool that is used to quantify the clinical competence of health professionals including student radiographers. Students raised concerns about the objectivity of the OSCE in view of a high failure rate at the University of Namibia (UNAM) over the past three years. In accordance with UNAM guidelines, a reassessment is prescribed when > 50% of students fail an assessment. This prompted the researchers to explore the experiences of student radiographers regarding an OSCE. Objective. To explore and describe the experiences of UNAM radiography students regarding an OSCE as a clinical assessment tool. Methods. A qualitative, exploratory, descriptive, retrospective and contextual research design with an ethnographic approach was utilised. A purposively selected sample of second, third and fourth year radiography students (n=20) participated in the study. Four focused group discussions were conducted during data collection. Findings. Four themes emerged from the data: management and administration of an OSCE, psychological factors, validity and reliability of an OSCE, and teaching and learning. These were considered important elements shaping students' experiences regarding their OSCE. Conclusion. Student experienced poor management and administration of an OSCE and psychological factors such as stress and anxiety affected their performance. The findings also indicated low validity and reliability of an OSCE, and positive teaching and learning as student experiences. The recommendations are: effective orientation with clear aims and objectives of an OSCE must be provided to students; OSCE stations should be well aligned to objectives and real life practice with clear instructions and questions; time per each station should be aligned to the content at that particular station rather than having a standard time for all stations and the integration of simulation within an OSCE to enhance and maximise the validity and reliability of the assessment. [ABSTRACT FROM AUTHOR]

The purpose of this study was to explore and describe the experiences of health care professionals regarding the management of Fetal Alcohol Syndrome (FAS) in the Khomas Region of Namibia. The study was qualitative, explorative, descriptive, and contextual in nature and was conducted at two state hospitals in Windhoek. The researcher used in-depth unstructured interviews and focus group discussions. Data was analyzed by using Tesch's method of qualitative data analysis. Ethical principles were employed to avoid acts that diminish self-respect and violate self-determination of research participants. The Findings of the study revealed four main themes on experiences of healthcare workers regarding management of FAS: Lack of knowledge about management of FAS; inadequate resources to facilitate the management of FAS; unconducive environment for mother and family; and lack of inter-professional collaboration. A total of ten sub-themes emerged from these four themes all of which indicated negative experiences that presented barriers to proper management of FAS. It is recommended that guidelines for health professionals should be developed to facilitate the management of children with FAS. In addition, healthcare workers knowledge and the clinical environment should be enhanced to enable effective management of this condition. [ABSTRACT FROM AUTHOR]

Background. All newborn infants are required to undergo the Apgar score/assessment immediately after birth and again at five minutes. This vital examination is performed to determine how well the infant is adjusting to the birthing process and the outside environment. Some newborns may have a normal Apgar score, while others may have a low score. The purpose of this study was to identify factors associated with low Apgar scores among newborns at an intermediate hospital in Northern Namibia. Objective. To identify maternal factors associated with an immediate low Apgar score in newborns at an intermediate hospital in Northern Namibia and to examine the association between maternal factors and an immediate low Apgar score. Quantitative, retrospective, descriptive research methodology was employed. A document review checklist was utilized to collect data at Onandjokwe Intermediate Hospital between August 2020 and October 2020. Results. Gravidity (p0.021), parity (p0.029), haemoglobin after the first ante-natal care visit (p0.011), ante-partum haemorrhage (APH) (p0.004), membrane status (p0.000), duration of labour (p0.000), type of delivery (p0.000), and caesarean section type and indication (p0.000) were found to be associated with an immediate low Apgar score. Conclusions: The study identified maternal factors that influence an infant's initial low Apgar score. Strengthen maternal health education regarding gravidity and parity, diet, and recognizing danger signs during pregnancy. In addition, strict monitoring of patients with a partograph, cardiotocography, accurate record keeping, and prompt referral of patients with risk factors is strongly advised. [ABSTRACT FROM AUTHOR]

The first case of COVID-19 in Nigeria was recorded on February 27, 2020, being an imported case by an Italian expatriate, to the country. Since then, there has been steady increase in the number of cases. However, the number of cases in Nigeria is low in comparison to cases reported by other countries with similar large populations, despite the poor health system prevailing in the country. This has been mainly attributed to the low testing capacity in Nigeria among other factors. Therefore, there is a need for innovative ways to increase the number of persons testing for COVID-19. The aim of the study was to pilot a nasopharyngeal swab self-sample collection model that would help increase COVID-19 testing while ensuring minimal person-to-person contact being experienced at the testing center. 216 participants took part in this study which was carried out at the Nigerian Institute of Medical Research between June and July 2020. Amongst the 216 participants, 174 tested negatives for both self-collected samples and samples collected by Professionals, 30 tested positive for both arms, with discrepancies occurring in 6 samples where the self-collected samples were positive while the ones collected by the professionals were negative. The same occurred in another set of 6 samples with the self-collected samples being negative and the professional—collected sample coming out positive, with a sensitivity of 83.3% and a specificity of 96.7%. The results of the interrater analysis are Kappa = 0.800 (95% CI, 0.690 to 0.910) which implies an outstanding agreement between the two COVID-19 sampling methods. Furthermore, since p< 0.001 Kappa (k) coefficient is statistically different from zero, our findings have shown that self-collected samples can be reliable in the diagnosis of COVID-19. [ABSTRACT FROM AUTHOR]

Background: A number of countries have adopted sugar-sweetened beverage taxes to prevent non-communicable diseases but there is variance in the structures and rates of the taxes. As interventions, sugar-sweetened beverage taxes could be cost-effective but must be compliant with existing legal and taxation systems. Objectives: To assess the legal feasibility of introducing or strengthening taxation laws related to sugar-sweetened beverages, for prevention of non-communicable diseases in seven countries: Botswana, Kenya, Namibia, Rwanda, Tanzania, Uganda and Zambia. Methods: We assessed the legal feasibility of adopting four types of sugar-sweetened beverage tax formulations in each of the seven countries, using the novel FELIP framework. We conducted a desk-based review of the legal system related to sugar-sweetened beverage taxation and assessed the barriers to, and facilitators and legal feasibility of, introducing each of the selected formulations by considering the existing laws, laws related to impacted sectors, legal infrastructure, and processes involved in adopting laws. Results: Six countries had legal mandates to prevent non-communicable diseases and protect the health of citizens. As of 2019, all countries had excise tax legislation. Five countries levied excise taxes on all soft drinks, but most did not exclusively target sugar-sweetened beverages, and taxation rates were well below the World Health Organization's recommended 20%. In Uganda and Kenya, agricultural or HIV-related levies offered alternative mechanisms to disincentivise consumption of sugar-sweetened beverages without the introduction of new taxes. Nutrition-labelling laws in all countries made it feasible to adopt taxes linked to the sugar content of beverages, but there were lacunas in existing infrastructure for more sophisticated taxation structures. Conclusion: Sugar-sweetened beverage taxes are legally feasible in all seven countries Existing laws provide a means to implement taxes as a public health intervention. [ABSTRACT FROM AUTHOR]

Background: Nutrition-related non-communicable diseases contribute to approximately half of the premature deaths in Namibia. Westernisation and urbanisation of communities have resulted in changing dietary patterns that see people eating more refined and high sugar content foods that are a risk for nutrition-related non-communicable diseases. Sugar-sweetened beverage taxation has been found to influence consumer purchasing behaviour and to raise revenue for health-promoting activity in other low- and middle-income countries. Objectives: To analyse Namibia's non-communicable diseases prevention policy landscape and assess the readiness of the Government to adopt sugar-sweetened beverage taxation policies for public health. Methods: Government policy documents relating to nutrition-related non-communicable diseases were analysed, utilising predetermined variables based on policy theory. Thirteen key informant interviews were conducted with stakeholders from Government, nongovernmental organisations and academic institutions. Data sets were analysed utilising Kingdon's analytical theory for agenda setting. Results: Nutrition-related non-communicable diseases are an increasing problem that requires immediate action. Diet and lifestyle are recognised as major contributors to non-communicable diseases. The Government has adopted a multisectoral approach to the control and prevention of non-communicable diseases in Namibia. A sugar-sweetened beverage tax is envisaged in policy, but there is no progress towards its enactment. At the highest level of Government, the Ministry of Finance has ruled out immediate action towards sugar-sweetened beverage taxation. There is little publicly available information about the Namibian beverages industry, but it is closely tied to the South African drinking industry and is influenced by policy action in that country. Conclusion: The Government of Namibia has taken positive steps and the policy environment is friendly towards an SSB tax. The proximity of trade and the competitive nature of the Namibian drinks industry with South Africa suggest that a regional perspective to advocacy would be of value. [ABSTRACT FROM AUTHOR]

Background: Nutrition-related non-communicable diseases contribute to approximately half of the premature deaths in Namibia. Westernisation and urbanisation of communities have resulted in changing dietary patterns that see people eating more refined and high sugar content foods that are a risk for nutrition-related non-communicable diseases. Sugar- sweetened beverage taxation has been found to influence consumer purchasing behaviour and to raise revenue for health-promoting activity in other low- and middle-income countries. Objectives: To analyse Namibia's non-communicable diseases prevention policy landscape and assess the readiness of the Government to adopt sugar-sweetened beverage taxation policies for public health. Methods: Government policy documents relating to nutrition-related non-communicable diseases were analysed, utilising predetermined variables based on policy theory. Thirteen key informant interviews were conducted with stakeholders from Government, non- governmental organisations and academic institutions. Data sets were analysed utilising Kingdon's analytical theory for agenda setting. Results: Nutrition-related non-communicable diseases are an increasing problem that requires immediate action. Diet and lifestyle are recognised as major contributors to non- communicable diseases. The Government has adopted a multisectoral approach to the control and prevention of non-communicable diseases in Namibia. A sugar-sweetened beverage tax is envisaged in policy, but there is no progress towards its enactment. At the highest level of Government, the Ministry of Finance has ruled out immediate action towards sugar-sweetened beverage taxation. There is little publicly available information about the Namibian beverages industry, but it is closely tied to the South African drinking industry and is influenced by policy action in that country. Conclusion: The Government of Namibia has taken positive steps and the policy environment is friendly towards an SSB tax. The proximity of trade and the competitive nature of the Namibian drinks industry with South Africa suggest that a regional perspective to advocacy would be of value. [ABSTRACT FROM AUTHOR]

Background: A number of countries have adopted sugar-sweetened beverage taxes to prevent non-communicable diseases but there is variance in the structures and rates of the taxes. As interventions, sugar-sweetened beverage taxes could be cost-effective but must be compliant with existing legal and taxation systems. Objectives: To assess the legal feasibility of introducing or strengthening taxation laws related to sugar-sweetened beverages, for prevention of non-communicable diseases in seven countries: Botswana, Kenya, Namibia, Rwanda, Tanzania, Uganda and Zambia. Methods: We assessed the legal feasibility of adopting four types of sugar-sweetened beverage tax formulations in each of the seven countries, using the novel FELIP framework. We conducted a desk-based review of the legal system related to sugar-sweetened beverage taxation and assessed the barriers to, and facilitators and legal feasibility of, introducing each of the selected formulations by considering the existing laws, laws related to impacted sectors, legal infrastructure, and processes involved in adopting laws. Results: Six countries had legal mandates to prevent non-communicable diseases and protect the health of citizens. As of 2019, all countries had excise tax legislation. Five countries levied excise taxes on all soft drinks, but most did not exclusively target sugar-sweetened beverages, and taxation rates were well below the World Health Organization's recommended 20%. In Uganda and Kenya, agricultural or HIV-related levies offered alternative mechanisms to disincentivise consumption of sugar-sweetened beverages without the introduction of new taxes. Nutrition-labelling laws in all countries made it feasible to adopt taxes linked to the sugar content of beverages, but there were lacunas in existing infrastructure for more sophisticated taxation structures. Conclusion: Sugar-sweetened beverage taxes are legally feasible in all seven countries Existing laws provide a means to implement taxes as a public health intervention. [ABSTRACT FROM AUTHOR]

Background: Nutrition-related non-communicable diseases contribute to approximately half of the premature deaths in Namibia. Westernisation and urbanisation of communities have resulted in changing dietary patterns that see people eating more refined and high sugar content foods that are a risk for nutrition-related non-communicable diseases. Sugar-sweetened beverage taxation has been found to influence consumer purchasing behaviour and to raise revenue for health-promoting activity in other low- and middle-income countries. Objectives: To analyse Namibia's non-communicable diseases prevention policy landscape and assess the readiness of the Government to adopt sugar-sweetened beverage taxation policies for public health. Methods: Government policy documents relating to nutrition-related non-communicable diseases were analysed, utilising predetermined variables based on policy theory. Thirteen key informant interviews were conducted with stakeholders from Government, non-governmental organisations and academic institutions. Data sets were analysed utilising Kingdon's analytical theory for agenda setting. Results: Nutrition-related non-communicable diseases are an increasing problem that requires immediate action. Diet and lifestyle are recognised as major contributors to non-communicable diseases. The Government has adopted a multisectoral approach to the control and prevention of non-communicable diseases in Namibia. A sugar-sweetened beverage tax is envisaged in policy, but there is no progress towards its enactment. At the highest level of Government, the Ministry of Finance has ruled out immediate action towards sugar-sweetened beverage taxation. There is little publicly available information about the Namibian beverages industry, but it is closely tied to the South African drinking industry and is influenced by policy action in that country. Conclusion: The Government of Namibia has taken positive steps and the policy environment is friendly towards an SSB tax. The proximity of trade and the competitive nature of the Namibian drinks industry with South Africa suggest that a regional perspective to advocacy would be of value. [ABSTRACT FROM AUTHOR]

Background: A number of countries have adopted sugar-sweetened beverage taxes to prevent non-communicable diseases but there is variance in the structures and rates of the taxes. As interventions, sugar-sweetened beverage taxes could be cost-effective but must be compliant with existing legal and taxation systems. Objectives: To assess the legal feasibility of introducing or strengthening taxation laws related to sugar-sweetened beverages, for prevention of non-communicable diseases in seven countries: Botswana, Kenya, Namibia, Rwanda, Tanzania, Uganda and Zambia. Methods: We assessed the legal feasibility of adopting four types of sugar-sweetened beverage tax formulations in each of the seven countries, using the novel FELIP framework. We conducted a desk-based review of the legal system related to sugar-sweetened beverage taxation and assessed the barriers to, and facilitators and legal feasibility of, introducing each of the selected formulations by considering the existing laws, laws related to impacted sectors, legal infrastructure, and processes involved in adopting laws. Results: Six countries had legal mandates to prevent non-communicable diseases and protect the health of citizens. As of 2019, all countries had excise tax legislation. Five countries levied excise taxes on all soft drinks, but most did not exclusively target sugar-sweetened beverages, and taxation rates were well below the World Health Organization's recommended 20%. In Uganda and Kenya, agricultural or HIV-related levies offered alternative mechanisms to disincentivise consumption of sugar-sweetened beverages without the introduction of new taxes. Nutrition-labelling laws in all countries made it feasible to adopt taxes linked to the sugar content of beverages, but there were lacunas in existing infrastructure for more sophisticated taxation structures. Conclusion: Sugar-sweetened beverage taxes are legally feasible in all seven countries Existing laws provide a means to implement taxes as a public health intervention. [ABSTRACT FROM AUTHOR]

The international prevalence of workplace violence (WPV) in the healthcare sector, and isolated cases involving radiographers in a state radiology department in Windhoek, Namibia instigated this research. This study aimed to explore the prevalence of WPV, identify its perpetrators, and determine the emotional state and coping mechanisms of radiographers after WPV incidents. A standardised questionnaire that assessed WPV was distributed to the fifteen radiographers with experience of working night duty. Thirteen questionnaires were returned (response rate = 86.7%). All the respondents had experienced WPV that predominately occurred during night duty. All had experienced verbal abuse (100%) followed by verbal threats (84.6%), sexual harassment (84.6%), and physical assault (46.2%). Causes of WPV included intoxicated patients (100%), long waiting times (61.5%), overcrowding (30.8%), and failure to meet the expectations of patients and their family members (23.1%). WPV perpetrators were mostly patients followed by their family members. The majority of the respondents did not report their respective WPV incidents to the authorities. They were however anxious, disappointed, disgusted and sad after the incidents. They coped by ignoring the incidents or talking to a colleague or family member. The high prevalence of WPV, and its negative implications, requires employers to devise measures to prevent its re-occurrence. [ABSTRACT FROM AUTHOR]

Purpose. Results of a study to determine demographic and clinical characteristics predictive of oversedation and potential opioid-induced respiratory depression (OIRD) in hospitalized patients are reported. Methods. In a retrospective case-controlled study, an incident reporting database was searched to identify cases of in-hospital oversedation; to form the control group, patients who did not experience an oversedation event while hospitalized were sampled in reverse chronological order until the desired total sample size (n = 225) was obtained. An allocation ratio of 2:1 was specified to adjust for case variability. Binary logistic regression was employed to identify factors predictive of oversedation. Results. Female sex (odds ratio [OR], 2.41; 95% confidence interval [CI], 1.05-5.50), comorbid renal disease (OR, 4.22; 95% CI, 1.66-10.70), untreated sleep apnea (OR, 32.32; 95% CI, 2.72-384.72), receipt of longacting oxycodone (OR, 4.76; 95% CI, 1.70-13.33), and as-needed use of hydromorphone (OR, 2.73; 95% CI, 1.19-6.27) were significant predictors of oversedation; as-needed analgesia administered by the oral route (OR, 0.16; 95% CI, 0.07-0.36) or i.v. route (OR, 0.33; 95% CI, 0.14-0.80) had a significant protective effect. The final prediction model explained 47.8% of variance in oversedation risk and was found to have strong discriminatory performance. Conclusion. The identified risk factors for oversedation and potential OIRD in hospitalized patients can form the basis of quality-improvement initiatives to prevent oversedation through improved prescribing and patient monitoring. [ABSTRACT FROM AUTHOR]

Background: Severe malaria is a medical emergency associated with high mortality. Adequate treatment requires initial parenteral therapy for fast parasite clearance followed by longer acting oral antimalarial drugs for cure and prevention of recrudescence.Methods: In a randomized controlled clinical trial, we evaluated the 42-day parasitological outcomes of severe malaria treatment with intravenous artesunate (AS) or intravenous quinine (QNN) followed by oral artemisinin based combination therapy (ACT) in children living in a high malaria transmission setting in Eastern Uganda.Results: We enrolled 300 participants and all were included in the intention to treat analysis. Baseline characteristics were similar across treatment arms. The median and interquartile range for number of days from baseline to parasite clearance was significantly lower among participants who received intravenous AS (2 (1-2) vs 3 (2-3), P < 0.001). Overall, 63.3% (178/281) of the participants had unadjusted parasitological treatment failure over the 42-day follow-up period. Molecular genotyping to distinguish re-infection from recrudescence was performed in a sample of 127 of the 178 participants, of whom majority 93 (73.2%) had re-infection and 34 (26.8%) had recrudescence. The 42 day risk of recrudescence did not differ with ACT administered. Adverse events were of mild to moderate severity and consistent with malaria symptoms.Conclusion: In this high transmission setting, we observed adequate initial treatment outcomes followed by very high rates of malaria re-infection post severe malaria treatment. The impact of recurrent antimalarial treatment on the long term efficacy of antimalarial regimens needs to be investigated and surveillance mechanisms for resistance markers established since recurrent malaria infections are likely to be exposed to sub-therapeutic drug concentrations. More strategies for prevention of recurrent malaria infections in the most at risk populations are needed.Trial Registration: The study was registered with the Pan African Clinical Trial Registry ( PACTR201110000321348 ). [ABSTRACT FROM AUTHOR]