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The purpose of this study was to assess the relative effectiveness of cooperative learning (CL) strategies on learners' peer relatedness, academic support (AS), and learning gains in Biology. A quasi-experimental non-equivalent group pre-test post-test design was employed, involving a sample of 81 students. Both quantitative and qualitative data were collected, and analyses were conducted using t-tests, one-way MANOVA, bivariate correlation, and regression analysis. As anticipated, the t-test and MANOVA results revealed that participation in CL strategies had a moderate to substantial effect on the measured variables, with Partial [eta-squared] values ranging from 0.471 to 0.722. In addition, regression analysis indicated that peer relationships and AS together accounted for 43.2% of the variance in overall learning gains. Qualitative findings highlighted significant challenges to the effective implementation of CL, including students' unfamiliarity with the method, resource constraints, and teacher resistance. The findings provide preliminary evidence that shifting classroom instruction from a content-centric approach to a learner-centered approach can enhance not only the quality of teaching but also the quality of learning and key indicators of student success.

In the past four decades, it is interesting to note that the issue of gender diversity management (GDM) in education has attracted scholarly and policy attention. However, there has been little or no study on the perceptions and policy practices of GDM in Ethiopian public higher education institutions (HEIs). Therefore, the purpose of this article was to explore the perceptions and policy practices of the GDM in the selected five Ethiopian public HEIs. It was also aimed to provide insights that might guide practical and successful interventions as well as ideas for improvements. Employing mixed methods, a total of 395 regular undergraduate students (N=395) were recruited to take part in the quantitative phase of the study, while an additional group of 34 individuals (N=34) was sought to participate in the qualitative part. In total, (N=429) respondents participated in the study. A survey questionnaire comprising fourteen items was developed and subsequently analyzed using SPSS version 25. A narrative inquiry approach was also used for semi-structured interview analysis that allowed participants to present their tales. To substantiate data generated through questionnaires & interviews, further document analysis was also conducted. The results show that inadequate GDM policy is being implemented on top of a lower perception of it, even in an environment where policy is generally positive. Additionally, this survey offered a substantial amount of new insight into perceptions and policy practices regarding GDM. Ethiopian public HEIs need to identify areas for improvement and revise and implement policies that are aligned with the needs and expectations of twenty first century's GDM issues.

According to the Ethiopia Ministry of Education (2015), school feeding initiatives, such as feeding children in food insecure conditions, providing educational resources, and school meals are essential for supporting access to general education. The purpose of this study was to assess the impact of school feeding program on the academic performance and class participation of Grade 8 students in the primary public schools in Gulele sub city, Ethiopia. A quantitative research method with a quasi-experimental design was used in conducting the study. From Grade 8, two hundred students were selected by using purposive sampling technique. From five out of ten Woredas, the sample primary schools with Grade 8 were selected. Standardized Attentions Check List and the roster cards were used to solicit the primary and secondary sources of data. Difference in Difference linear regression and Independent Sample t- test were applied for analyzing academic achievement, attendance and attention data respectively. Result of data analysis indicated the positive effect of school feeding program on academic achievement and attendance of Grade 8 students. The school feeding also has an effect on the students' attention span. Providing for greater financing and more coverage for the school-feeding program at country level is recommended.

The objective of this study was to examine the effectiveness of blended physics laboratory experimentation on pre-service physics teachers' (PSPTs') understanding of the nature of science (NOS) during an electricity and magnetism laboratory course. The study used a non-equivalent comparison group using a pre-test-post-test quasi-experimental design that contrasted blended, virtual, and real mode of physics experimentations. A total of 63 PSPTs, 16 in blended experimental group, 26 in virtual experimental group, and 21 in real experimental group, participated in the study. Except for the type of manipulatives, the experiments in all the three cases were the same. Quantitative Likert-type questions were administered before and after the intervention and open-ended questions were administered after the intervention. The quantitative data were analyzed using one-way ANOVA and ANCOVA, while the qualitative data were categorized under naïve, mixed, and informed views. The results revealed that experimenting with blended, virtual, and real manipulatives were found to be ineffective in enhancing understanding of NOS on the PSPTs'. Apart from the type of experiment used, it was suggested that adequate consideration be paid to NOS issues in the laboratory courses in order to obtain well-educated and trained physics teachers.

Educational leaders at all levels may achieve Disability Diversity Management (DDM) commitment and satisfaction by actively enhancing their institutions' performance through the intentional inclusion of Persons with Disabilities (PWDs). The goal of this study was, therefore, to investigate the commitment and satisfaction of DDM in Ethiopian public Higher Education Institutions (HEIs) so as to make recommendations for its improvement. The study was conducted in the selected five Ethiopian public HEIs, namely, Addis Ababa University, Addis Ababa Science and Technology University, Debre Berhan University, Selale University and Kotebe University of Education. convergent parallel mixed research (Quantitative and Qualitative) procedures that adhered to the pragmatic research paradigm was used. To that end, the study engaged the quantitative involvement of (N=247) regular students with disabilities (physical, visual, and hearing disability). Survey questionnaires containing 16 items were created in line with Hurtado et al., (2012)'s Diversified Learning Environment (DLE) model. Mean, standard deviation, correlation, t-test and statistical significance (P-value) were calculated using both descriptive and inferential statistics with the help of Statistical Package for Social Science (SPSS) Version 25. A narrative inquiry technique was also employed by conducting semi-structured interviews with thirty-two respondents to relate to their lived experiences. The commitment of the top management at the selected five Ethiopian public HEIs towards DDM was found to be not enough. On top of it, undergraduate students with disabilities were not satisfied with the DDM of their campuses. The study also gave vital insight on DDM commitment as well as satisfaction. For DDM to be satisfactory, the initiatives must contain a solid mix of commitment at Ethiopian public HEIs. The leadership must be vigorously committed to DDM satisfaction with its equality ideals and societal norms. Providing resources for the committedly implementation of the DDM plan were also recommended.

Human diversity in education, particularly in higher education, has several positive effects on students' intellectual and social experiences as well as it has quite a number of challenges. Globally, numerous empirical studies have been conducted on the opportunities and challenges of human diversity in higher education institutions (HEIs). However, there is a lack of qualitative contextual discourse analysis. The goal of this brief contextual discourse analysis was therefore to figure out essential reasons as to why human diversity in HEIs is beneficial and at the same time challenging. The study was realized using a qualitative contextual discourse analysis method. To this end, a review and reflection of various published books and peer reviewed articles were used to explore the current worldwide condition of the human diversity at HEIs, the opportunities to teach and employ human diversity in HEIs, and the challenges of doing so. The reviewed literature showed that, despite certain fundamental challenges, human diversity in HEIs is extremely useful since it supports knowledge growth and transmission. The educational planners at HEIs should have a framework for human diversity to maximize resource allocation and develop a community of HEIs that is actively engaged across cultures, fostering productivity and outstanding institutional performance. Therefore, to effectively implement their planning in the context of current globalization, educational leaders in the twenty-first century need to seriously consider the findings of this study on opportunities and challenges of human diversity. Policymakers must also create an inclusive human diversity policy that accurately reflects heterogeneous individuals in order to make the HEIs a sector that values human diversity.

PURPOSE: We hypothesized that eribulin combined with cyclophosphamide (EC) would be an effective combination with tolerable toxicity for the treatment of advanced breast cancer (ABC). METHODS: Patients with histologically confirmed metastatic or unresectable ABC with any number of prior lines of therapy were eligible to enroll. In the dose escalation cohort, dose level 0 was defined as eribulin 1.1 mg/m2 and cyclophosphamide 600 mg/m2, and dose level 1 was defined as eribulin 1.4 mg/m2 and cyclophosphamide 600 mg/m2. Eribulin was given on days 1 and 8 and cyclophosphamide on day 1 of a 21-day cycle. In the dose expansion cohort, enrollment was expanded at dose level 1. The primary objective was clinical benefit rate (CBR), and secondary objectives were response rate (RR), duration of response (DOR), progression-free survival (PFS), and safety. RESULTS: No dose-limiting toxicities were identified in the dose escalation cohort (n = 6). In the dose expansion cohort, an additional 38 patients were enrolled for a total of 44 patients, including 31 patients (70.4%) with hormone receptor-positive (HR +)/HER2- disease, 12 patients (27.3%) with triple-negative breast cancer (TNBC), and 1 patient (2.3%) with HR + /HER2 + disease. Patients had a median age of 56 years (range 33-82 years), 1 prior line of hormone therapy (range 0-6), and 2 prior lines of chemotherapy (range 0-7). CBR was 79.5% (35/44; 7 partial response, 28 stable disease) and the median DOR was 16.4 weeks (range 13.8-21.1 weeks). Median PFS was 16.4 weeks (95% CI: 13.8-21.1 weeks). The most common grade 3/4 adverse event was neutropenia (47.7%, n = 21). Fourteen of 26 patients (53.8%) with circulating tumor cell (CTC) data were CTC-positive ([Formula: see text] 5 CTC/7.5 mL) at baseline. Median PFS was shorter in patients who were CTC-positive vs. negative (13.1 vs 30.6 weeks, p = 0.011). CONCLUSION: In heavily pretreated patients with ABC, treatment with EC resulted in an encouraging CBR of 79.5% and PFS of 16.4 weeks, which compares favorably to single-agent eribulin. Dose reduction and delays were primarily due to neutropenia. The contribution of cyclophosphamide to eribulin remains unclear but warrants further evaluation. NCT01554371.

Abstract Children and their families living in leprosarium areas may have a lower quality of life than the general population. However, there is limited evidence on health-related quality of life and its associated factors among children living in previous leprosarium settlement areas. Hence, this study aimed to compare the health-related quality of life among children living in previous leprosarium and non-leprosarium settlement areas in eastern Ethiopia. A community-based comparative cross-sectional study was conducted among 515 randomly selected children aged 8 to 18 years living in the Amir Nur and Babile districts from January to February 30, 2024. Data were collected through interviews with children and parents using the Pediatric Quality of Life Inventory Version 4. The data were analyzed using STATA version 14. Simple and multiple linear regression was employed to identify associations between independent and outcome variables. The overall mean health-related quality of life scores were 73.98 ± 18.47 and 77.67 ± 14.72 in the child self-reports (P = 0.01) and 55.78 ± 12.03 and 55.61 ± 8.50 (P = 0.85) in the parent proxy reports in the previous leprosarium and nonleprosarium settlement areas, respectively. In multiple linear regression, child education (β = 14.69; 95% CI: 8.69, 20.69), the absence of neglected and tropical diseases (β = 4.02; 95% CI: 0.66, 7.37), and child face washing habits (β = 5.54, 95% CI: 2.14, 8.95) increase health-related quality of life. However, a previous history of neglected and tropical diseases (β = -8.54; 95% CI: -12.93, -4.15) and the absence of hand washing facilities (β = -8.57; 95% CI, -15.22, -1.92) decrease the mean health-related quality of life. Based on child self-reports, one in four children from previous leprosarium areas had poor health-related quality of life compared to children living in none leprosarium areas. Children’s educational status, their daily habits of washing their face, not having neglected, and tropical diseases had improved health-related quality of life. To improve health-related quality of life, stakeholders should pay attention to and work on the early detection and treatment of neglected and tropical diseases, child education, and proper sanitation practices in the leprosarium community.

Abstract Background Community health programs (CHPs) are integral components of primary health care (PHC) systems and support the delivery of primary care and allied health and nursing care services. CHPs are necessary platforms for delivering health services toward universal health coverage (UHC). There are limited prior studies on comprehensive evidence synthesis on how CHPs strengthen community health systems for the demand and supply of PHC services. Therefore, this scoping review synthesized existing evidence on the interlinkage between CHPs and the community health system and beyond for delivering and utilising PHC services toward UHC. Methods We conducted a scoping review of research articles on CHPs. We identified research articles in six databases (PubMed/Medline, CINAHL, Scopus, Cochrane, Web of Science, and Embase) and Google Scholar using search terms under three concepts: CHPs, PHC, and UHC. Of the 3836 records identified, 1407 duplicates were removed, and 2346 were removed based on titles and abstracts. A total of 83 articles were eligible for the full-text review; of them, 18 articles were removed with reasons, and the other 16 were included through hand search. Themes were identified and explained using Sacks and colleagues’ “Beyond the Building Block” framework. Results A total of 81 studies were included in the final review. Studies described CHPs as foundations for community health system readiness for PHC services, including decentralization in the health sector, community-controlled governance, resource mobilization, ensuring health commodities (e.g., through community pharmacies), and information evidence. These foundational inputs mediate the actions of CHPs by partnership with community organizations and health workforces (e.g., community health workers). CHPs contributed to improved access to health services by providing health services in public health emergencies, affordable and comprehensive care, and modifying social determinants of health. Conclusions CHPs are platforms for implementing and delivering PHC services close to communities. They help to modify social determinants of health, promote health and wellbeing, reduce care costs, prevent disease progression, and reduce hospitalisation rates. CHPs are integral parts of community health systems and require investment to improve access to PHC services. Gaps and challenges of CHPs include inadequate funding, limited engagement of the private sector, poor quality of health services, and limited focus on non-communicable diseases (NCDs). Further implementation research is needed to mitigate the burden of NCDs. Health systems efforts focus on increasing resources (e.g., financial and human) required in CHPs to ensure the quality of PHC services provided through CHPs toward better service access, and reaching the unreached and achieve equity and universality of PHC services.

Abstract Background Female Genital Mutilation/Cutting (FGM/C) is a form of gender-based violence that has negative health consequences. The decision to perform FGM/C is often made collectively and a variety of actors influence the decision. There is inconsistent and inconclusive evidence that health education interventions lead behavioural changes related to FGM/C among key decision-makers. Therefore, the aim of this systematic review and meta-analysis was to examine the effectiveness of health education interventions on decision-makers intentions not to perform FGM/C in the future. Methods A systematic review and meta-analysis were performed according to the Preferred Item for Systematic Review and Meta-analysis (PRISRMA) guideline. Studies were obtained from databases such as PubMed, Google Scholar, EMBASE, CINAHL, Cochrane, African Journals Online and relevant lists of identified studies (interventional studies related to FGM/C among key decision-makers). Unpublished sources and organizational websites were also searched for relevant articles. The quality of studies was assessed using the Quality Assessment Tool for Quantitative Studies developed by the Effective Public Health Practice Project’s. The meta-analysis was carried out using STATA.17 and Review Manager 5.3 software. Heterogeneity and publication bias were assessed using the I2 statistic and funnel plot, respectively. The pooled effect size with a 95% confidence interval was presented using a forest plot and random effect model. Results This meta-analysis included nineteen studies with a total of 13,326 study participants. The overall pooled relative risk of intention not to perform FGM/C in the future was 1.55 (95% CI;1.24, 1.94). In the subgroup analysis, the effect of health education on intention not to perform in the future was higher in studies that used both health education and other interventions (RR = 3.75, 95% CI; 2.04, 6.88) compared to those using only health education (RR = 1.35, 95% CI; 0.95, 1.92). Studies with longer intervention duration (above 12 months) had a greater effect on intention not to perform (RR = 1.34, 95% CI; 0.86, 2.09) compared to studies with a short intervention period (6–12 months) (RR = 1.14, 95% CI; 0.61, 2.15). Conclusion This review examined the impact of health education on key decisions-makers’ intention not to perform FGM/C in the future. Although the pooled effect size estimate may have been influenced by heterogeneity, the results suggest that education about FGM/C has a positive influence on the intentions of key decision-makers. It is recommended that health education interventions target local decision-makers such as religious and clan leaders and include them in initiatives aimed at preventing and eliminating FGM/C. PROSPERO registration number CRD42024542541.

Abstract Background The spread of multidrug-resistant tuberculosis (MDR-TB) poses a significant challenge to TB control efforts. This study evaluated the treatment outcomes and associated factors among patients receiving treatment for MDR-TB in southern Ethiopia. Methods A retrospective follow-up study covering ten years, from 2014 to 2023, analyzed the records of confirmed cases of pulmonary TB admitted to Yirgalem General Hospital, an MDR-TB treatment initiation center in the Sidama Region. To compare the successful treatment outcomes across the years, a chi-square test of independence was conducted. Bivariate and multivariable logistic regression models were used to identify factors associated with treatment outcomes for MDR-TB. Results Out of 276 confirmed MDR-TB cases, 4(1.4%) were diagnosed with resistance to second-line drugs (SLDs). Overall, 138 patients achieved favourable treatment outcomes, resulting in a treatment success rate of 50.0% [95% CI 44.1–55.9%]. Among these 138 patients, 105(76.1%, 95 CI 68.7–83.5%) were cured, while 33(23.9%, 95 CI 16.5–31.3%) completed their treatment. The successful treatment outcomes varied significantly across the years, ranging from 3.6% in 2020 to 90% in 2021. The analysis indicated a statistically significant difference in treatment outcomes when considering data from 2014 to 2023 (χ2 = 44.539, p = 0.001). The proportion of patients with deaths, lost-to-follow-up (LTFU), treatment failures and not evaluated were 7.9% [95% CI 4.8–11.2%], 10.9% [95% CI 7.2–14.6%), 2.2% [95% CI 1.1–3.3%), and 28.9% [95% CI 23.7–34.2%] respectively. Individuals with a positive HIV status had significantly lower odds of a favorable treatment outcome [AOR = 0.628, 95% CI (0.479–0.824), p = 0.018]. Similarly, patients with a BMI of less than 18 are more likely to have unfavorable treatment outcomes compared to those with a BMI of 18 or higher [AOR = 2.353, 95% CI 1.404–3.942, p

Abstract Background The World Health Organization (WHO) cautions against unnecessary prolongation of postoperative antibiotics to prevent surgical site infections (SSI), however this practice is still common in many countries. This study aims to describe drivers of prolonged postoperative antibiotic prescribing and clinicians’ perspectives on antibiotics resistance and stewardship in Ethiopia. Methods We conducted semi-structured interviews of 16 surgeons and nine surgical ward nurses at three academic referral hospitals in Addis Ababa. Audio recordings were transcribed verbatim and coded. Codes were inductively and iteratively derived between two researchers, tested for inter-rater reliability (IRR), and the codebook was consistently applied to all transcripts. Thematic analysis was performed to understand drivers of prolonged prophylactic antibiotic use in surgical patients. Results Interviews revealed factors contributing to postoperative prophylactic antibiotics overprescribing, including inadequate infection prevention and control (IPC) practices, wide variability in local prescribing practices, and distrust in the applicability of WHO guidelines. Antimicrobial resistance was also identified as a major concern by staff. Barriers to improving stewardship included a lack of multidisciplinary teamwork to inform prescribing decisions, while solutions included constructing appropriate context-specific guidelines and improving evidence-based practices through input from local stakeholders, including surgeons, clinical pharmacists, and nurses. Conclusions Study participants perceived that existing evidence and guidelines did not apply in their settings due to high rates of surgical site infections and gaps in perioperative IPC practices (e.g., availability of water for handwashing, sterility breaches). These gaps were a key contributor to prophylactic antibiotic overprescribing, reinforcing the need to strengthen upstream and perioperative surgical antisepsis processes. The findings of this study underscore the importance of engaging multidisciplinary teams in strengthening antimicrobial stewardship efforts, aligning processes to achieve compliance with best practices, and the need for rigorous, contextually appropriate studies from these settings to inform policy.

Abstract Background Scabies is one of public health concerns among communicable disease in Ethiopia, especially among disadvantaged and the poor. This current study aims to detect the spatiotemporal patterns of scabies in Tigray from 2018 to 2023 using scabies data aggregated at the zonal level. The study also examined the persistent patterns in the spatial variation of scabies incidence across the administrative regions during the study period. Method We collected scabies data using a weekly disease surveillance reporting format of the country from 2018 to 2023 across all accessible district health facilities in Tigray region, Ethiopia. We conducted retrospective analyses using both purely spatial and spatiotemporal scan statistic approaches, employing a discrete Poisson probability model to identify statistically significant clusters of high scabies rates throughout the Tigray regional zones in Ethiopia. Our methodology involved the use of Kulldorff’s spatial scan statistic software (SaTScan v10.1.3), R programming software version 4.3.1, and ArcGIS Pro for all analyses. Results A total of 101,116 cases of scabies were reported from 2018 to 2023. Our study indicated a spatial heterogeneity in the pattern of scabies across Tigray region as well as its localization among geographically contiguous zones across space, except for the Western zone of Tigray where no data was collected. The detected statistically significant spatial clusters $$\:p-value

Abstract Introduction Work-related musculoskeletal disorders represent a major public health problem, contributing significantly to the global burden of disability-adjusted life years and affecting the quality of life of all population groups. The main problem in most musculoskeletal disorders is low back pain. Therefore, our study aims to identify the overall prevalence of work-related low back pain among the working population in sub-Saharan Africa. Methods Research published between 2010 and 2023 in English, conducted in Sub-Saharan Africa was included in this systematic review and meta-analysis. Using Boolean logic operators and targeted keywords, we searched for publications on a number of electronic databases (Web of Science, PubMed, Google Scholar, African Journals Online (AJOL), and Science Direct). The Joanna Briggs Institute Critical Appraisal techniques were utilized to conduct a quality assessment of the papers and ascertain their relevance to the study. The degree of heterogeneity among the included studies, the 95% confidence interval, and the pooled prevalence were estimated using a random effects model. Sensitivity studies were carried out to determine the causes of heterogeneity and the impact of outliers. Results In this study, a total of 970 articles were retrieved, and 35 studies were included in the systematic review and meta-analysis. The overall estimated pooled prevalence of low back pain among the working population in sub-Saharan Africa was (55.05% [95% CI: 49.34, 60.76]). Based on a sub-group analysis by countries, the higher pooled prevalence of low back pain was found in Uganda at (61.48% [95% CI: 40.39, 82.57]), while the lower pooled prevalence of low back pain was in Ghana at (34.48% [95% CI: 17.96, 51.01]). Conclusions This systematic review and meta-analysis found that 55.05% of the included study participants experienced low back pain in the previous years. Therefore, it is recommended that policymakers incorporate and enhance strategies for the prevention and management of low back pain within the health system management guidelines of each country.