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ABSTRACTMany individuals are now reflecting on spirituality and religiosity being essential parts of their life that helped them cope and overcome the fears associated with COVID-19 during the quarantine period. Although medical interventions remained vital in managing the COVID-19 outbreak, little attention was given to the contributions of spirituality as a personal coping mechanism in South Asian culture. Through a qualitative descriptive exploratory approach, we explored the roles which spirituality and faith played in lives of COVID-19 patients and their families during the quarantine period in Karachi, Pakistan. Twenty-two dyads of COVID-19 patients and their family members were purposively selected and interviewed via telephone or Zoom. Quarantine was a reflective opportunity to focus on one’s inner-self and make spiritual connection or re-connection with God. Participants felt the pandemic reminded them that humanity must come closer, act as one household, and extend help to each other. However, there were conflicting views regarding the impacts of spirituality and religiosity during the restrictions and quarantine period.

Introduction: Body mass index (BMI) is a simple and cost-effective tool for monitoring the clinical responses of patients living with human immunodeficiency virus (HIV) after antiretroviral therapy (ART) initiation, especially in resource-limited settings where access to laboratory tests are limited. Current evidence on the association between longitudinal BMI variation and clinical outcomes among adults living with HIV receiving ART is essential to inform clinical guidelines. Therefore, this study examines the association between BMI variation and premature mortality in adults living with HIV on ART. Methods: An institution-based retrospective cohort study was conducted among 834 adults living with HIV receiving ART from June 2014 to June 2020 at Debre Markos Comprehensive Specialized Hospital in Northwest Ethiopia. We first identified predictors of mortality and BMI variation using proportional hazards regression and linear mixed models, respectively. Then, the two models were combined to form an advanced joint model to examine the effect of longitudinal BMI variation on mortality. Results: Of the 834 participants, 49 (5.9%) died, with a mortality rate of 4.1 (95% CI 3.1, 5.4) per 100 person-years. A unit increase in BMI after ART initiation corresponded to an 18% reduction in mortality risk. Patients taking tuberculosis preventive therapy (TPT), mild clinical disease stage, and changing ART regimens were at lower risk of death. However, patients with ambulatory/bedridden functional status were at higher risk of death. Regarding BMI variation over time, patients presenting with opportunistic infections (OIs), underweight patients, patients who started a Dolutegravir (DGT)-based ART regimen, and those with severe immunodeficiency had a higher BMI increase over time. However, patients from rural areas and overweight/obese patients experienced a lower BMI increase over time. Conclusion: BMI improvement after ART initiation was strongly associated with a lower mortality risk, regardless of BMI category. This finding implies that BMI may be used as a better predictor tool for death risk in adults living with HIV in Ethiopia. Additionally, patients who took a DGT-based ART regimen had a higher BMI increase rate over time, which aligns with possible positive effects, such as weight gain, of the DGT-based ART regimen in developing countries.

Purpose: The purpose of this research is to focus on work-based problems catalysed by the COVID-19 global pandemic, based on a case study of a multi-continental, multi-campus university distributed across Kenya, Tanzania, Uganda and Pakistan. Higher education institutions (HEIs) in developing countries lacked pre-existing infrastructure to support online education and/or policy and regulatory frameworks during the pandemic. The university's programmes in Pakistan and East Africa provide lessons to other developing countries' HEIs. The university's focus on teaching and learning and staff development has had a transformational organisational effect. Design/methodology/approach: Case study with participatory approaches aimed at co-production of responsive systems and co-creation of effective curriculum and faculty training is used. Findings: Systems and processes developed across the university in the effort to ensure educational continuity. From the disruption to all educational programmes and the disarray of regulatory bodies' responses, collaboration emerged as a key driver of positive change. The findings reiterate the value of trust and provision of opportunities for those with the requisite competencies to lead in a participatory and distributive manner whilst addressing limited human and financial resources. The findings reflect on previous work respecting organisational change recast in the digital age. Originality/value: This paper reflects the authors' work in real-time as they led and managed changes encountered during the COVID-19 pandemic. The paper will be of value to management and leadership cadres, particularly in developing contexts, responsible for recovery and sustainability of the higher education sector.

Introduction: Tropical diseases are public health problems affecting hundreds of millions of people globally. However, the development of adequate, affordable, and accessible treatments is mostly neglected, resulting in significant morbidity and mortality that could otherwise be averted. Leishmaniasis is one of the neglected tropical diseases caused by the obligate intracellular protozoan Leishmania parasite and transmitted by the bite of infected phlebotomine sandflies. No systematic review and meta-analysis has been done to identify the prevalence and risk factors of leishmaniasis to the authors’ knowledge. Therefore, the objective was to determine the prevalence and risk factors of human leishmaniasis in Ethiopia. Methods: Eleven studies conducted in all regions of Ethiopia, which were fully accessible, written in any language, and original articles done on prevalence and risk factors of leishmaniasis, were included. STATA™ version 11.1 was used for statistical analysis. Chi-square, I2, and pvalues were assessed to check heterogeneity. A random effects model with heterogeneity taken from an inverse-variance model was employed to estimate the pooled effect. Subgroup meta-analysis was computed to reduce random variations among each article’s point prevalence, and Egger and funnel plots were used to check for publication bias. Results: The highest proportion of human leishmaniasis was reported from a study done in Amhara region (39.1%), and the lowest was reported from a survey done in Tigray (2.3%). The overall pooled prevalence of leishmaniasis was 9.13% (95% CI 5–13.27). Subgroup analysis by region revealed moderate heterogeneity (I2= 51.8%) in studies conducted in the Southern Nations Nationalities and Peoples Region (SNNPR). The presence of hyraxes and being male were associated with an increased risk of human leishmaniasis. Conclusion: The prevalence of leishmaniasis in Ethiopia remains high (9.13%), with significant risk factors being male and the presence of hyraxes within a 300-m radius of the sleeping area.

This paper reports the gathered information from an international environmental scan of university-baseline information for the creation of a Nursing Knowledge Network. An online environment scan of organizational context (February to October 2021) explored the identification of research areas, existing resources, expected benefits, innovations in teaching research, barriers to knowledge dissemination, and prospective contributions of the Network. Target informants were 200 nursing faculty affiliated to 63 universities located in 13 countries, as well as nursing networks in the Ibero-American context. One informant per university was asked to respond to the questionnaire. The participation rate was nearly 70% (42/63). The informants’ universities per country included Brazil (n = 21); Canada (n = 4); Portugal and Spain (n = 3 each); Colombia, Mexico, Peru, and USA (n = 2 each); Chile, Italy, and Paraguay (n = 1 each). Nursing faculty provided rich information and shared knowledge confirming a strong commitment to global co-creation of innovations and research partnership capacities through collaboration, cooperation, and knowledge exchange among nursing higher education institutions. Seldom researched areas are a potential focus for the Network to generate appropriate evidence to inform local scientific practices. The gathered information will inform further review of nursing and governmental policies and programs related to the application and dissemination of nursing evidence across local, regional, and global levels.

Background Health-care environments influence service delivery; approaches need to be more wholistic and culturally competent requiring effective interagency collaboration to bridge traditional Indigenous and mainstream health services. Despite considerable research on collaboration, the concept remains misunderstood, at worst, and formative, at best. Within the nexus of these two diverse health services, there is limited information on how collaborations could be created and sustained effectively.Purpose To explore the perspectives/experiences of collaboration of select Saskatchewan health professionals practicing across these diverse services to understand the concept from their perspectives.Methods This qualitative study explored collaboration through observation and interviews to elicit perspectives (two-eyed seeing) of health professionals working within the context of a traditional–mainstream health services partnership.Results Individual- and system-level factors and accountabilities are needed for successful cross-cultural collaboration and can be enabled by embedding the virtues of Indigenous and values of mainstream health services along with building and maintaining relationships, valuing difference, creating supportive environments and wholistic approaches, having the right people at the table, and making a change for impactful outcomes.Conclusion Findings support the need for implementing contextually relevant collaborative practice models for productive, wholistic health services. Two-eyed seeing provides the ability to capture and catalyze the tremendous value and strengths of both worlds, potentiating complementary aspects to meet the needs of clients and communities.

Despite substantial antiretroviral therapy (ART) coverage in other groups with the human immunodeficiency virus (HIV) in Tanzania, there is a progressive decline in ART enrollment among HIV-infected children. This study aimed to determine the factors affecting the enrollment of children with HIV in ART and to identify an effective, sustainable intervention to address children’s ART care enrollment. To achieve this, we conducted a cross-sectional study using a mixed-method sequential explanatory design, including children with HIV aged 2 to 14 years in the Simiyu region. Stata™ and NVIVO™ software were used to perform quantitative and qualitative data analyses, respectively. In the quantitative analyses, we considered 427 children, with a mean age of 8.54 ± 3.54 years and a median age of 3 years (interquartile range: 1–6 years). The mean length of ART initiation delay was 3.71 ± 3.21 years. Additionally, independent child enrollment predictors included distance to the facility (adjusted odds ratio [AOR]: 3.31; 95% confidence interval [CI]:1.14–9.58), caregivers’ income (AOR: 0.17; 95% CI: 0.07–0.43), and fear of stigma (AOR: 3.43; 95% CI: 1.14–10.35). In qualitative analyses, 36 respondents reported that stigma, distance, and lack of HIV-positive status disclosure to their fathers were causes for low enrollment in ART. Overall, this study demonstrated that a caregiver’s income, distance to obtain HIV care services, HIV-positive status non-disclosure to the father, and fear of stigma played a significant role in children’s enrollment in HIV care. As such, HIV/acquired immunodeficiency syndrome programs would benefit from having intensive interventions to address distance, such as scaling up care and treatment centers, as well as techniques to reduce stigma in the population.

According to Greene (2005), “history is written by the victor – meaning that the voices of the defeated are often muted in the historical record, overwritten by the perspectives of the more powerful” (p. 1). However, winter counts (waniyetu wówapi), traditional pictographic calendars on animal hide, challenge this historical recount through their simple symbolic representation that captures history from the perspective of Indigenous communities. This paper proposes the re-visioning of winter counts in achieving their traditional roles of facilitating Elder and community discussions, preserving and passing on history (Burke, 2007a), assisting the “People” to know and understand their history (Scott, 2006), and acting as a “medium of moral and social instruction” (Risch, 2000). Our contention is that re-visioning of winter counts as a sound Indigenous methodology is decolonizing.

An unusual synthesis of isoxazoles from α,β-unsaturated ketoximes is reported. Using very inexpensive reagents, isoxazoles are isolated in good yields. Notably, a mixture of E and Z oxime isomers is employed. Initial studies indicate the oxidative cyclization reaction does not proceed via radical route; a copper insertion/elimation route is proposed.

Continuing competence programs (CCPs) are becoming required in many nursing jurisdictions across Canada. CCPs have the common goal of ensuring nurses remain up-to-date and competent in their professional practice. They often incorporate reflective practice as a tool for nurses to critically explore their practice and professionalism on an ongoing basis. Feedback is one of the strategies within reflective practice which enables nurses to increase reflective capabilities and enhance professional performance through collegial exchange. Locus of control, a personality variable, is considered as a potential indicator of how receptive nurses may be toward CCPs. For CCPs to be optimally embraced by nurses, it is imperative that professional nursing bodies address nurses’ loci of control in developing, supporting, and strategizing for reflective practice, generally, and feedback, specifically.

AbstractThe Southern Saskatchewan/Urban Aboriginal Health Coalition is an interdisciplinary, intersectoral team of researchers and communities dedicated to exploring what ‘culturally respectful’ care means in Aboriginal communities. Although the purpose of the research project was to examine this concept in an effort to improve health care service delivery and education for health professions, the members of the Coalition realized early in the process that one of the primary factors related to the success of the project would be the building and sustaining of relationships. This paper describes a relational process that was used to initiate, facilitate, and support a research partnership with the Aboriginal communities. Through a community-based process, two communities and the Coalition used sharing circles and workshops as a method to create relationships and begin a discussion about what constitutes key elements of culturally respectful health care and education. These elements have not yet been determined as the Coalition and community members have focused on fostering relationships which have been critical to building the partnership with the Aboriginal communities.

Background: Loss to follow-up (LTFU) is a major public health problem to antiretroviral therapy (ART) programs in sub-Saharan Africa. Failure to account for patients’ LTFU outcomes (self-transfers and restarts) can result in inaccurate reporting of retention in care. In Ethiopia, specifically in the Benishangule Gumuz region, high LTFU reported patients, who were not assessed for their outcomes, are identified as a gap. Therefore, our objective was to determine the outcomes (alive or dead) of patients lost to follow-up (LTFU) from ART and identify factors associated with successful tracing and mortality of these patients. Results: The proportion of successful tracing was 75.5% (249 of 330). Among the traced patients (n?=?249), 22.9% were deceased, 47.8% were on ART, and 29.3% had discontinued treatment. However, the remaining untraceable patients were not locatable due to wrong addresses (53.1%), change of residence (29.6%), and/or lack of functional phone contact (17.3%). Some (32.9%) of the patients discontinued because of negative test results, others (21.9%) for spiritual reasons or side effects (28.8%), and the remaining (16.4%) for other reasons. Tracing using phone numbers (AOR?=?2.97, 95% CI 1.57–5.59) and existing long-term follow-up period for ART (AOR?=?2.13, 95% CI 1.17–3.88) were strong predictors of successful tracing while not receiving cotrimoxazole preventive therapy (CPT) (AOR?=?2.59, 95% CI 1.22–5.39) is a predictor for mortality of patients post-LTFU. Conclusion: ART programs need to retain current contact information of patients or guardians/friends for tracing. Having phone contact numbers and prolonged lengths of compliance with ART are predictors of successful tracing, while lack of cotrimoxazole preventive therapy is a predictor of mortality. Early tracing of beginners (newly admitted recipients) and updating their detailed information at each follow-up visit is essential.

An unusual synthesis of isoxazoles from α,β‐unsaturated ketoximes (E/Z mixture) is reported.