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This study was aimed to recognize the reproductive performance and herd composition of sheep and goat in six studied area located in east and west river Nile at Assiut governorate. A set of semi-structured questionnaire was used to collect information from 300 sheep owners based on single-visit-interviews. The study revealed that farmers keep mixed livestock species. Sheep and goat production are the major livestock activity in located study area. The average farm size of households surveyed in Assiut Governorate was 8.2 feddan. The farmers cultivated 50.74% and 50.86 % of their lands for green fodder and field crops in winter and summer, respectively. About 50.89 % of the total farm size area cultivated with animal fodder around the year. In summer 25.37%. Of the area was cultivated with field crops. The reproductive and productive performance of sheep and goats were discussed and data showed that, no significant differences were observed in lambing interval and age at first lambing between sheep and goats, while goats were significantly higher in litter size (P<0.01), lambing mortality (p<0.05) weaning weight (p<0.01) and age at marketing (p<0.05) than sheep. Generally, Sheep and goat production in the studied areas was constrained by different problems; where the major ones are availability and cost of feeds, limitation of land for the expansion of production and poor extension services. Sheep and goats are very important smallholder producers due to their biological factors such as short generation interval, twinning, short growth periods, do not require much space and low food requirements. In this domain, reasons of high lamb mortality rates should be identified and reduced in order to make sheep and goat production profitable and sustainable. [ABSTRACT FROM AUTHOR]

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The present study aimed to elucidate the effect of partial replacing of Guar plant (Cyamopsis tetragonoloba) either as green forage (GGF) or green forage silage (GGS) to concentrate feed mixture (CFM)) on some blood metabolites and thyroxine hormones (T3 and T4) in Farafra male sheep. For this reason, twenty-four growing male lambs, aged 5 months and weighed 16.69±0.69 kg were divided into three comparable groups (8 each) according to their live body weights. Three rations were tested in the experiment. G1 (70% CFM + 30% rice straw) and considered as a control group, G2 fed40% CFM + 40% GGF + 20% rice straw) and G3 fed 40% CFM + 40% GGFS + 20% rice straw. The CFM and rice straw were fed to G1, G2 and G3 groups at rates3% and 1% of live body weight, respectively. While GGF and GGFS were offered to replace part of CFM protein. The trial extended 120 days. Blood samples collected from all experimental animals before morning feeding (fasting) and blood serum was separated until chemical analysis of total protein, albumin, urea N, total cholesterol, AST and ALT enzymes and thyroxine hormones (T3 and T4). Results showed that levels of total protein, albumin, globulins and T3 hormone increased (P<0.05) in G3 compared to G2 and control group. The concentration of urea-N for GGF and the control diet increased significantly (P<0.05) compared to GGFS diet. The activity of AST and ALT enzymes decreased (P<0.05) in G3 compared to other groups. Regardless the treatments, concentrations of total protein and its fractions increased significantly (P<0.05), while levels of urea-N, total cholesterol, AST and ALT enzymes and T3 and T4 hormones decreased significantly (P<0.05) at the end of the trial compared to other periods. The interaction between the experimental diets and periods of the trial was significant for the levels of urea-N (p<0.01), AST and ALT activities (P<0.05) and T3 and T4 hormones (P<0.05). While no significant differences detected for total protein and its fractions and for total cholesterol. The results obtained revealed that feeding lambs on rations containing GGF or GGFS as non-traditional rations partially replaced protein of CFM, up to 40%, appeared to have no harmful effect on animal health and this is evident through the normal range of all tested blood metabolites and the activity of thyroid hormones among experimental groups. [ABSTRACT FROM AUTHOR]

Background Childbirth is a significant life event that is accompanied by fear, particularly among primigravida mothers. However, little is known about the expectations and fears of childbirth of primigravida women in Saudi Arabia. Aim This study aimed to explore expectations and fears of childbirth among primigravidas. Methods An exploratory, descriptive, cross-sectional study involving 369 primigravidas was conducted at antenatal outpatient clinics at the Maternity and Children's Hospital in Tabuk, Saudi Arabia. Results In the current study, most participants were aged 25-34 years 204 (55.3%), married 355 (96.2%), and had secondary or higher education 279 (75.6%). A majority of participants 265 (71.8%) reported financial difficulties and 244 unplanned pregnancies (66.1%), while most were pregnant beyond 30 weeks 254 (66.4%). The results showed that the mean total score on the Wijma Delivery Expectancy Questionnaire (W-DEQ) fear of childbirth scale was 57.56, indicating moderate levels of fear on average among primigravida women, with the highest subscale score for the moment of birth. The mean total score on the Childbirth Expectations Questionnaire (CEQ) childbirth expectations scale was 108.15, also indicating moderate expectations on average, with other significant expectations having the highest subscale score. A significant negative correlation was found between the fear and expectations scales (r=-0.775, p<0.001). Sociodemographic factors such as older age, higher education, income, employment, and planned pregnancy were associated with higher expectations and lower fear, whereas younger age, lower education, income, employment, unplanned pregnancy, and medical issues were associated with higher fear. Conclusions The findings of this study provide valuable insights into the expectations and fears of childbirth of primigravida women in Saudi Arabia. The results could inform healthcare providers and policymakers about the predictors of fear and effective interventions to reduce fear and improve birth experience in primiparous women., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Albalawi et al.)

Background and Objectives: A care pathway is a structured care plan based on best clinical practice for a particular patient group. It reorganizes a complex process by providing structured, standardized care and supportive multidisciplinary teamwork. Although care pathways are used worldwide, the impact and benefit of a care pathway for coronary care practices have been minimally debated. This preliminary study aimed to examine the effect of a care pathway on the autonomy, teamwork, and burnout levels among coronary care nurses in a tertiary hospital., Methods: A preliminary study was conducted using a pre/posttest one-group quasi-experimental design. A self-administered questionnaire was provided to 37 registered nurses from the cardiac ward of a tertiary hospital. The care pathway was developed on the basis of the current literature, local guidelines, and expert panel advice. The autonomy, teamwork, and burnout levels at the beginning and 4 months after disseminating the care pathway were measured. Implementing the care pathway included educational sessions, training in using the care pathway, and site visits to monitor nursing practices., Results: Most of the respondents were female (94.6%; n = 35), the median age of the respondents was 26.5 years (interquartile range [IQR] = 23-31), and the median length of the clinical experience was 4 years (IQR = 2-8). A statistically significant reduction in the mean burnout score was observed (mean of 58.12 vs 52.69, P < .05). A slight improvement in autonomy level was found, although it was not statistically significant. No statistically significant improvement was found in the teamwork levels., Conclusion: The care pathway was associated with reduced nurse burnout. The results showed a slight improvement in autonomy level among coronary care nurses after implementing the care pathway. From a practical viewpoint, the current study can help policy makers and managers reduce burnout. This study highlights the importance of using care pathways as a tool to reorganize the care process and improve the working environment. Managers must support nursing decisions and provide continuous education to enhance nurses' autonomy, which may increase understanding of respective roles, leading to higher levels of teamwork. However, with a small sample size, caution must be applied, as the findings might not be generalizable., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)

Background Accountability pressure is rising in healthcare, and this demonstrates that the quality of care provided within a residential care setting is of utmost importance. Hostmanship is a quality improvement program focusing on person-centered care in residential care settings. Objectives This study aimed to explore the influencing factors for job satisfaction and intention to leave among healthcare workers and the difference in job satisfaction and intention to leave the employer between residential care centers with and without Hostmanship. Methods A quantitative, cross-sectional study was conducted in sixteen Flemish residential care settings in Belgium. A total of 293 participants completed the questionnaire, divided into two groups: the group with Hostmanship (n = 139), at least one year into a change process implementing Hostmanship, and the group without the Hostmanship program (n = 154). Hierarchical logistic regression analysis estimated effects between demographic characteristics (block one), facility management, staffing and Hostmanship (block two), work characteristics (block three), and work engagement or burnout dimensions (block four) as explanatory variables of job satisfaction and turnover intention as outcome variables. Results This study confirmed the positive impact of social capital and decision latitude on staff member job satisfaction, as shown in previous findings. Age and workload were associated with turnover intentions. A hierarchical logistic regression model explained 68.7 % of the variance in workers' job satisfaction, and a hierarchical logistic regression explained 49.2% of the variance in their intent to leave. Also, no effects were found for Hostmanship on staff job satisfaction and intention to leave. Conclusions This study shows how a quality improvement project such as Hostmanship could produce counterintuitive results for organizations in elderly residential centers. However, results inconsistent with literature were found. It is unclear whether Hostmanship warrants job satisfaction or retaining personnel. Future research must take into consideration success factors when implementing new quality initiatives. A general framework for successful implementation in the healthcare sector should be provided., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Daghash et al.)

Background: Vaccine hesitancy in Saudi Arabia continues even after reaching 17 million doses. This study was conducted to comprehensively assess coronavirus disease 2019 (COVID-19) vaccine hesitancy in adult people who ignore the COVID-19 vaccine in the Saudi Arabian population and explore community awareness of public health after 17 million doses of COVID-19 vaccination., Methods: A cross-sectional survey was used in this study. The questionnaire included three domains: demographic information, vaccine hesitancy by the health belief model related to the COVID-19 vaccine, and hesitancy by attitude and conspiracy towards the COVID-19 vaccine. A total of 401 adults participated in this study., Results: The respondents' perceptions of COVID-19 susceptibility and severity showed that the participants did not feel at risk nor believe that COVID-19 was serious. Connivance beliefs were found to be associated with reliance on social media as a major source of information about COVID-19 vaccines, and lack of trust in vaccine manufacturers (pharmaceutical companies). The majority of the respondents were concerned about the efficacy and safety of the COVID-19 vaccine, which can be reported as a major barrier to vaccination., Recommendations: To increase vaccination rates, health authorities need to communicate both the benefits and risks of vaccination. In addition, we recommend using a qualitative study to understand and evaluate the participants' concepts in depth., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2021, Alrajeh et al.)

Background: Health care institutions need to construct management strategies for patients diagnosed with acute coronary syndrome (ACS) that focus on evidence-based treatments, adherence to treatment guidelines, and organized care. These help to reduce variations as well as the mortality and morbidity rates, which indicates the critical need for standardized care and adherence to evidence-based practices for patients hospitalized with ACS. The care pathways translate research and guidelines into clinical practice to close the gap between the guidelines and the clinical practices., Objectives: This review focuses on identifying the indicators used to evaluate ACS care pathways and their effect on the care process and clinical outcomes., Methods: This review follows the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. The systematic research was conducted using five research databases. Two groups were created by dividing the studies according to their year of publication. The first group included those studies published from 1997 to 2007 ("Group 1"), while the second included those published from 2008 to 2018 ("Group 2"). Selected studies were screened using the Effective Public Health Practice Project (EPHPP) quality assessment tool., Results: Seventeen studies were included in this review. One study was a randomized controlled trial, 14 were predesigns and postdesigns, and two were longitudinal observational designs. The Group 1 studies demonstrated that ACS care pathways had a positive effect on reducing the length of the hospital stay and the door-to-balloon times. Similar effects were observed for the Group 2 studies., Conclusion: Implementing ACS care pathway helps to organize care processes and decrease treatment delays as well as improve the patient outcomes without adverse consequences for patients or additional resources and costs. While the current level of evidence is inadequate to warrant a formal recommendation, there is a need for more studies with an emphasis on well-designed randomization to measure patient outcomes., (© 2019 John Wiley & Sons, Ltd.)