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Helen Lamesgin Endalew,1 Bikis Liyew,2 Tilahun Kassew,3 Gebrekidan Ewnetu Tarekegn,4 Ambaye Dejen Tilahun,2 Tesfa Sewunet Alamneh4 1Department of Surgical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 2Department of Emergency and Critical Care Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 3Department of Psychiatry, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 4Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaCorrespondence: Bikis LiyewDepartment of Emergency and Critical Care Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, P.O.Box 196, Gondar, EthiopiaTel +251932731964Email biksliyew16@gmail.comBackground: Myocardial infarction is the fifth leading causes of disability-adjusted life years in low-income countries including Ethiopia. The aim of this study was to construct a hypothetical model to determine the factors affecting the health-related quality of life of myocardial infarction survivors at the cardiac center Ethiopia.Methods: A cross-sectional study design was employed, and 421 myocardial infarction patients were enrolled through consecutive sampling technique from the outpatient clinic at the cardiac center of Ethiopia. The World Health Organization Quality of Life-BREF-26 tool was used to assess the problem. It consists of four domains such as physical, psychological, social relationships, and environmental health domains. The structural equation modeling (SEM) analysis was employed using STATA-14 software to examine the relationship between various exogenous and endogenous or mediating variables with overall quality of life.Results: Psychological, physical, environmental health domains and sex had significant association with health-related quality of life (β=0.708, p< 0.001, β= 0.237, p=0.046, β=0.242, p=0.020, and β=0.189, p=0.017, respectively), whereas age had direct, negative association with health-related quality of life (β=− 0.007, p=0.026). Residence and level of education were not directly associated with health-related quality of life. Residence indirectly, negatively influenced health-related quality of life (β= − 0.379, p< 0.001). On the other hand, level of education indirectly, positively affects health-related quality of life (β=i0.133, p< 0.001).Conclusion: Psychological health factors had the most substantial causal effect on health-related quality of life, which was larger than the causal effects of physical and environmental health-related factors. Developing and providing comprehensive interventions are necessary to assess and manage psychological, physical, and environmental health factors and to improve the quality of life in myocardial infarction patients.Keywords: health-related quality of life, myocardial infarction, structural equation model, Ethiopia

Abstract Background Dry evergreen montane forests of Ethiopia provide economic and ecological services for the community but it is under several threats of natural and anthropogenic disturbances. The study aimed to investigate the floristic composition, species diversity, and plant community distribution of Guard forest along environmental gradients. Methods A systematic sampling technique was used to collect vegetation and environmental data. Fifty eight plots each with 400 m2 (20 m X 20 m) were established for trees and shrubs and 2 m x2m (4 m2) for herbs along eleven transect lines. Shannon Weiner diversity index and evenness were used to assess the species diversity and richness. The similarities among plant communities were computed using Sorenson’s similarity index. The plant community types and vegetation-environment relationships were analyzed using hierarchical cluster analysis and Canonical correspondence analysis (CCA) in R software, respectively. Results A total of 137 plant species belonging to 111 genera and 55 families were identified. The most dominant families in the study area were Fabaceae and Asteraceae. Among the total plant species documented in the forest, 42(30.65%) were trees, 36 (26.28%) were shrubs, 48(35.04%) were herbs, and 11 (8.03%) were climbers. Of the total species, 14(10.22%) species are endemic to Ethiopia and Eritrea. Three plant community types were identified by cluster analysis. The Shannon-Weiner Diversity Index was 3.39 and evenness was 0.87 for the forest. The pattern of plant species distribution was significantly influenced by altitude, pH, BD, slope, and charcoal (P

The species composition in the aboveground vegetation and soil seed bank (SSB) were described for the dry Afromontane forest patches of Northwestern Ethiopia. Plots (30 × 30 m) were established to collect the vegetation and environmental data. Soil samples were collected for the soil bank study from the small plots measuring 10 cm × 10 cm from four soil layers. Shannon Weiner index and evenness were used to assess the species diversity and richness of the forest. Density, DBH, basal area, frequency, and importance value indices (IVI) of woody species were computed to characterize the vegetation structure of the forest. Results indicate the presence of 176 plant species belonging to 80 families. The Shannon diversity index and evenness values of the study area were 2.79 and 0.95, respectively were medium, compared to other dry Afromontane forests of Ethiopia. The total basal area and density of woody species were 51.42 m2 ha−1 and 2679.33 individual ha−1, respectively. The most dominant species as and indicated by their important value index (lVI) was Prunus africana (17.97). A total of 2133 seedlings belonging to 44 species and 27 families were identified from the soil seed bank, with a viable seed density of 4636.95seeds/m2. The species composition of the seed bank was dominated by 29 herb species (65.9%) compared to 2 tree species, which accounted for only 4.54% of the total number of species. The highest number of species density was recorded in the litter and the upper 3 cm layer of the soil and gradually decreased with increasing depth. The Similarity between soil seed bank species composition and aboveground vegetation was low and conclude that the regeneration potential of the forest from seed bank is limited. Redundancy analysis (RDA) showed that emerged seedlings from the soil seed bank were significantly influenced by elevation and soil cation exchange capacity. The natural regeneration process of soil seed bank should be assisted through transplanting indigenous tree species in to the forests to accelerate the restoration of the vegetation and conservation and sustainable utilization of the reaming of forest patches is a necessity.

Kahitassa forest is one of the State Forests of Ethiopia with great floral diversity. However, the forest is under threat due to selective cutting of important indigenous tree species and encroachment of the forest area for agricultural purpose. Therefore, the study was intended to explore the floristic composition, structure, and regeneration status of Kahitassa forest. Vegetation data were collected from June to November 2020 using systematic sampling technique from 6 parallel transect lines laid out 500 m apart each other. A total of 101 plots (20 × 20 m) were laid with 100 m apart along transect lines. Vegetation description parameters including Shannon–Weiner Index, evenness, density, DBH, basal area, frequency, and importance value indices (IVI) were computed to characterize both species diversity and vegetation structure. Hierarchical cluster analysis was used to identify plant communities using R (Version 3.1.2) software. A total of 46 woody plant species belonging to 45 genera and 36 families were identified in the forest. Fabaceae and Rosaceae were the dominant families both constituting 34.78% of the total species. The Shannon diversity index (H’) and evenness (E) values of the study area were 2.92 and 0.72, respectively, showing the healthy status of the forest. Five plant community types, namely, Croton macrostachyus–Embelia schemperi, Maytenus undata–Olea europaea subsp. cuspidata, Pavetta abyssinica–Bersama abyssinica, Peucadanum mattiroli, Albizia schimperiana, and Rubus apetalus–Phytolacca dodecandra were identified. The most dominant species as indicated by their important value index (lVI) were Pavetta abyssinica (34.08), Vachellia abyssinica (IVI = 25.13), and Albizia schimperiana (IVI = 21.45). Analyses of DBH revealed that the forest exhibits an inverted J-shape which is typical for selective cutting of multipurpose trees from the forest. Conservation approaches such as enrichment of selected species as well as in situ and ex situ conservation are needed for some plant species under threat.

Plant community types are influenced by topographic factors, the physical and chemical properties of soil. Therefore, the study was carried out to investigate the relationships of soil and topographic factors on the distribution of species and plant community formation of the Dega Damot district in Northwestern Ethiopia. Vegetation and environmental data were collected from 86 plots (900 m2). Agglomerative hierarchical cluster analysis and redundancy analysis (RDA) with R software were used to identify plant communities and analyze the relationship between plant community types and environmental variables. Five plant community types were identified: Erica arborea-Osyris quadripartita, Discopodium penninervium-Echinops pappii, Olea europaea -Scolopia theifolia, Euphorbia abyssinica-Prunus africana, Dodonaea anguistifolia-Acokanthera schimperi. The RDA result showed that the variation of species distribution and plant community formation were significantly related to altitude, organic matter, moisture content, slope, sand, pH, EC, total nitrogen and phosphorus. Our results suggest that the variation of plant communities (Community 1, 2, 3, and 4) were closely related to environmental factors, including altitude, moisture content, OM, slope, sand, pH, EC, soil nitrogen, and phosphorus, among which altitude was the most important one. However, all the measured environmental variables are not correlated to Dodonaea anguistifolia-Acokanthera schimperi community type. Therefore, it can be concluded that some other environmental variables may influence the species composition, which is needed to be further investigated.

Background: More than 90% of babies acquire HIV/AIDS through vertical transmission, primarily due to low maternal comprehensive knowledge about Mother-To-Child Transmission (MTCT) of HIV/AIDS and its prevention, which is a cornerstone for eliminating MTCT of HIV/AIDS. However, there are limitations in terms of population data and literature evidence based on recent Demographic and Health Surveys (DHS) reports in East Africa. Therefore, this study aims to assess the comprehensive knowledge and PMTCT of HIV/AIDS among women, as well as the associated factors in East Africa., Methods: Our data was obtained from the most recent DHS conducted in East African countries between 2011 and 2022. For our research, we included DHS data from ten nations, resulting in a total weighted sample of 133,724 women for our investigation. A generalized linear model (GLM) with a log link and binomial family to directly estimate prevalence ratios (PR) and 95% confidence intervals (CI) for the association between the independent variables, and the outcome variable. Finally, we reported the adjusted prevalence ratios along with their corresponding 95% CIs. Factors with p-values ≤ 0.2 for univariate logistic regression and < 0.05 were considered statistically significant factors of HIV/AIDS knowledge and prevention in the final model., Results: In this study, 59.41% (95% CI: 59.15-59.67) of respondents had a comprehensive knowledge about MTCT of HIV/AIDS and its prevention among reproductive-age women in East Africa. Being in the older age group, better education level, being from a rich household, employment status, having ANC follow up, institutional delivery, and modern contraception usage were associated with higher prevalence ratios of comprehensive knowledge about MTCT of HIV/AIDS and its prevention. However, being single in marital status, rural women, and traditional contraception utilization were associated with lower ratios of comprehensive knowledge about MTCT of HIV/AIDS and its prevention., Conclusion: Our findings indicate a significant deficiency in comprehensive knowledge and prevention of HIV/AIDS MTCT among women in East Africa. These results emphasize the need for significant improvements in maternal-related health services. It is crucial to effectively target high-risk populations during interventions, raise awareness about this critical public health issue, and address the catastrophic consequences associated with MTCT. By implementing these measures, we can make substantial progress in reducing the transmission of HIV/AIDS from mother to child and ensuring better health outcomes for both mothers and their children., (© 2024. The Author(s).)

Introduction: Acute coronary syndrome (ACS) is the most common cause of morbidity and mortality in patients with coronary heart disease. Furthermore, the recurrence of this problem has significant adverse outcomes. However, there is insufficient information pertaining to this problem in Ethiopia; hence, this study aims to assess the incidence rate and identify the predictors of ACS recurrence in the West Amhara region., Methods: A retrospective follow-up study was conducted among 469 patients diagnosed with primary ACS. Data from the patient chart were collected using a pre-tested structured data extraction tool. The study employed the Weibull regression analysis model, and the effect size was measured using an adjusted hazard ratio (HR) with a 95% confidence interval (CI). The statistical significance of the findings was established based on a p -value <0.05., Result: A total of 429 patients were included in the final analysis [average age, 60 ± 13.9 years; and 245 (57.1%) men]. A total of 53 patients (12.35%; 95% CI: 9.55%-15.83%) experienced recurrent ACS. The overall risk time was found to be 93,914 days (3,130.47 months), and the recurrence rate was 17/1,000 patients/month. The identified predictors were the typical symptoms of ACS such as syncope (HR: 3.54, p  = 0.013), fatigue (HR: 5.23, p  < 0.001), history of chronic kidney disease (HR: 8.22, p  < 0.001), left ventricular ejection fraction of <40% (HR: 2.34, p  = 0.009), not taking in-hospital treatments [aspirin (HR: 9.22, p  < 0.001), clopidogrel (HR: 4.11, p  = 0.001), statins (HR: 2.74, p  = 0.012)], and medication at discharge [statins (HR: 4.56, p  < 0.001)]., Conclusion: This study found a higher incidence rate of recurrent ACS. Hence, the implementation of guideline-recommended anti-ischemic treatment should be strengthened., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2023 Alamaw, Asefa, Abebe, Zemariam and Liyew.)

Background: Globally, traumatic brain injury is the leading cause of death and disability which affects more than 69 million individuals a year., Objective: This study aimed to assess the outcome and associated factors of traumatic brain injury among adult patients treated in Amhara regional state comprehensive specialized hospitals., Method: Institutional-based cross-sectional study design was conducted from January 1, 2018, to December 30, 2020. A simple random sampling technique was used and a checklist was used to extract data between March 15 and April 15, 2021. The data were entered into Epi-data version 4.2 and exported to SPSS version 25 for analysis after being checked for consistency. Associated variables with outcomes of traumatic brain injury were determined by a binary logistic regression model. The degree of association was interpreted by using AOR and a 95% confidence interval with a p-value less than or equal to 0.05 at 95% CI was considered statistically significant., Result: In this study road traffic injury was the most frequent cause of traumatic brain injuries among adult patients, accounting for 181 (37.5%), followed by assault, accounting for 117 (24.2%) which affects adult age groups. One-third of the participant had a moderate Glasgow coma scale of 174(36%). Only 128(26.8%) patients arrived within one hour. One hundred sixty, 160 (33.1%) of patients had a mild traumatic brain injury, whereas, 149(36%) of patients had a severe traumatic brain injury. Regarding computerized tomography scans findings, the hematoma was the most common (n = 163, 33.7%). Ninety-one, 91(18.8%) of participants had cerebrospinal fluid otorrhea, and, 92(19%) were diagnosed with a positive battle sign. The overall prevalence of unfavorable outcomes after traumatic brain injury was found to be 35.2% (95%CI (30.8-39.1). Having additional Injury, hypoxia, time to hospital presentation after 24 h, severe Glasgow Coma Scale, moderate Glasgow Coma Scale, tachypnea, bradypnea, and cerebrospinal fluid Othorrhea, were factors associated with unfavorable outcomes., Conclusion and Recommendation: In this study, the overall unfavorable outcome was experienced by about four out of every 10 victims of traumatic brain injury. Time of arrival > 24 h, low Glasgow coma scale, additional injury, Cerebrospinal fluid otorrhea, abnormal respiration, and hypoxia were significant predictors of unfavorable outcomes. To reduce the adverse effects of traumatic brain injury in adults, it is therefore desirable to guarantee safe road traffic flow and improve health care services., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Background: In Ethiopia, the youth are more exposed to substances such as alcohol, Khat, and tobacco than other populations. Despite the seriousness of the situation, low- and middle-income nations, particularly Ethiopia, have intervention gaps. Service providers must be made more aware of relevant evidence to combat these problems. This research focused on finding out how common substance abuse is among teenagers and the factors that influence it., Methods: The 2016 Ethiopian Demographic and Health Survey data were used for secondary data analysis. This survey includes all young people aged 15 to 24 years. The total sample size was 10,594 people. Due to the hierarchical nature of the survey data, a multilevel logistic regression model was employed to uncover the individual- and community-level characteristics related to substances., Results: In Ethiopia, the overall current prevalence of occasional or daily substance use 30 days prior to the survey was 46.74%. Of the participants, 36.34, 12.56, and 0.95% were drinking alcohol, chewing Khat, and smoking cigarettes/any tobacco products, respectively. Male sex, 20-24 years of age, exposure to media, having a job, and living in large central and metropolitan regions were the factors associated with the problem., Conclusion: According to the 2016 EDHS, substance use among young people is widespread in Ethiopia. To lower the prevalence of substance use among youth, policymakers must increase the implementation of official rules, such as restricting alcohol, Khat, and tobacco product marketing to minors, prohibiting smoking in public places, and banning mass-media alcohol advertising. Specific interventions targeting at-risk populations, such as youth, are mainly required in prominent central and metropolitan locations., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Kassew, Tarekegn, Alamneh, Kassa, Liyew and Terefe.)

Background: Alcohol consumption during pregnancy is a known contributor to teratogen and causes a range of effects on pregnancy and birth outcomes. This study aimed to investigate the spatial variation and determinants of alcohol consumption among pregnant women in Ethiopia., Methods: A secondary data analysis was conducted using the 2016 Ethiopian Demographic and Health Survey data. A total of 1,135 pregnant women were included in the analysis. ArcGIS version 10.7 software was used to explore the spatial distribution of alcohol consumption, and SaTScan version 9.6 was employed to identify the significant spatial clusters of alcohol consumption. A mixed multi-level logistic regression analysis was employed to identify the determinant factors of alcohol consumption during pregnancy., Results: The result showed that the prevalence of alcohol consumption during pregnancy was 22.49% (with a 95% CI: 18.18 to 26.17). The spatial analysis showed that the spatial distribution of alcohol consumption significantly varied across the country [Global Moran's I value = 0.30 (P<0.001)]. The SaTScan analysis identified two most likely clusters with high rates of alcohol consumption such as northwest Ethiopia (Log-Likelihood Ratio (LLR) = 155.56, p<0.001) and central Ethiopia (LLR = 19.27, p<0.01). Never in union, divorced and/ widowed [Adjusted odds ratio (AOR) = 2.56; 95% CI: 1.07, 10.14], attended primary school [AOR = 0.45; 95% CI: 0.27, 0.95], having two or more lifetime sexual partners [AOR = 2.59; 95% CI: 1.11, 6.18], living in rural [AOR = 1.52; 95% CI: 1.12, 2.93] and higher community media exposure [AOR = 0.54; 95% CI: 0.28, 0.97] were the factors associated with alcohol consumption., Conclusion: Alcohol consumption during pregnancy in Ethiopia was high. The spatial distribution of alcohol consumption was significantly varied across the country. Therefore, public health interventions targeting areas with high alcohol consumption are needed for drinking cessation and to prevent poor pregnancy outcomes related to alcohol use., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2022 Kassew et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Burn is one of the critical health problems worldwide. Developing countries with sub-Saharan and Asian populations are affected more. Its mortality and non-fatal complications depend on several factors including age, sex, residency, cause, the extent of the burn, and time and level of care given., Objective: The purpose of this study was to assess the outcome of burn injury and its associated factor among patients who visited Addis Ababa burn emergency and trauma hospital., Methods: The institutional-based, retrospective cross-sectional study design was conducted from April 1, 2019, to March 30, 2021. After checking the data for its consistency the data were entered and analyzed by using SPSS version 25. A total of 241 patients who had visited Addis Ababa burn, emergency and trauma Hospitals after sustained burn injury were recruited through convenience sampling method for final analysis. Model goodness-of-fit was checked by Hosmer and Lemeshow test (0.272). After checking multi-collinearity both the bi-variable and multivariable logistic regression model was fitted and variables having a p-value less than or equal to 0.05 at 95% CI in the multivariable analysis were considered statistically significant., Result: Adults (age 15 to 60 years) are the most affected groups accounting for 55.2% followed by pediatric age groups (age <15 years) (43.6%) and the elderly (age > 60 years) (1.2%). Scald burn was the major cause accounting for 39 % followed by Flame burn (33.6%), Electrical burn (26.6%), and chemical burn (0.8%). The mean TBSA% was 15.49%, ranging from1% to 64%. Adult males are more affected by electrical burns while adult females and the elderly encounter flame burn. 78.4% of patients were discharged without complications, 14.9% were discharged with complications and 6.6% died. The commonest long-term complication is the amputation of the extremity (19, 7.9%). Age greater than 60 years and TBSA% greater than 30% is a strong predictors of mortality with odds of 2.2 at 95% CI of [1.32, 3.69] and 8.7 at 95% CI of [1.33, 57.32] respectively., Conclusion and Recommendation: The mortality rate show decrement from previous studies. Overall scald burn is common in all age groups but electrical burns and flame burns affected more adult and elderly age groups. Extremities were by far, the commonest affected body parts. The extent of burn injury and the age of the patient independently predict mortality. Early intervention will reduce mortality and complications., (© 2022. The Author(s).)

Background: Abortion is one of the top five causes of maternal mortality in low and middle-income countries. It is associated with a complication related to pregnancy and childbirth. Despite this, there was limited evidence on the prevalence and associated factors of abortion in East African countries. Therefore, this study aimed to investigate the prevalence and associated factors of abortion among reproductive-aged women in East African countries., Methods: The Demographic and Health Surveys (DHS) data of 12 East African countries was used. A total weighted sample of 431,518 reproductive-age women was included in the analysis. Due to the hierarchical nature of the DHS data, a multilevel binary logistic regression model was applied. Both crude and Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) was calculated for potential associated factors of abortion in East Africa. In the final model, variables with a p value < 0.05 were declared as statistically significant factors of abortion., Results: Around 5.96% (95%CI: 4.69, 7.22) of reproductive-aged women in East Africa had a history of abortion. Alcohol use, tobacco or cigarette smoking, being single, poorer wealth index, currently working, traditional family planning methods, and media exposure were associated with a higher risk of abortion. However, higher parity, having optimum birth intervals, and modern contraceptive uses were associated with lower odds of abortion., Conclusions: The prevalence of abortion among reproductive-aged women in East Africa was high. Abortion was affected by various socio-economic and obstetrical factors. Therefore, it is better to consider the high-risk groups during the intervention to prevent the burdens associated with abortion., (© 2022. The Author(s).)

Background: Early diagnosis and treatment of childhood fever are essential for controlling disease progression and death. However, the Treatment-seeking behaviour of caregivers is still a significant challenge in rural parts of the African region. This study aimed to assess individual and community-level factors associated with treatment-seeking behaviours among caregivers of febrile under-five age children in Ethiopia., Method: The recent Ethiopian Demographic and Health Survey data (EDHS 2016) was used for the study. The survey collected information among 1,354 under-five children who had a fever within two weeks before the survey. The data were extracted, cleaned, and recoded using STATA version 14. Multilevel logistic regressions were used to determine the magnitude and associated factors of treatment-seeking behaviour among caregivers with febrile children in Ethiopia. Four models were built to estimate both fixed and random effects of individual and community-level factors between cluster variations on treatment-seeking behaviour. The Adjusted Odds Ratios with 95% Confidence Intervals (CI) of the best-fitted model were reported at p<0.05., Result: This study revealed that 491 (36.26%) caregivers seek treatment for their febrile children. Living in metropolitan and small peripheral regions, delivery at health institutions, being poorer, middle and richer wealth quintiles, having a child with diarrhoea, cough, short rapid breathing, and wasting were positively associated with treatment-seeking behaviour of caregivers., Conclusion: The caregivers had poor treatment-seeking behaviour for their febrile children in Ethiopia. Health education programmers should emphasise the importance of seeking early treatment, taking action on childhood febrile illness signs., Competing Interests: The authors have declared that no competing interests exist.

Background: In the intensive care units, patients need special consideration and monitor frequently with appropriate physical assessment skills. Nurses working in the intensive care units play a fundamental role in detecting patients at risk of deterioration through ongoing assessment and action in response to changing health status. Most of the nursing activities were poorly assessed in low-income countries including Ethiopia. Therefore, this study was aimed to assess the nurses' practice and barriers to physical assessment among critically ill patients in Northwest Ethiopia., Methods: An institution-based multicenter cross-sectional study was conducted at Amhara regional state referral hospitals from March to September 2019. A total of 299 nurses working in the intensive care units were recruited through the convenience sampling method. A 30-item physical assessment practice and 36-item barriers to nurses' use of the physical assessment scale inventory were used. The linear regression analysis model was fitted, and the adjusted unstandardized beta ( β ) coefficient with a 95% confidence interval was used. A p value < 0.05 was considered statistically significant., Results: The mean score of the nurses' practice towards physical assessment among critically ill patients was 101.26 ± 24.99. Greater perceived reliance on others and technology ( β = -0.78, 95% CI (-1.07, -0.48)), ward culture ( β = -0.48, 95% CI (-0.85, -0.11)), specialty area ( β = -1.46, 95% CI (-2.01, -0.90)), lack of nursing role model ( β = -0.54, 95% CI (-1.06, -0.02)), being unmarried ( β = -6.10, 95% CI (1.75, 10.46)), taken training ( β = 11.53, 95% CI (6.34, 16.72)), and knowledge score ( β = 2.81, 95% CI (2.00, 3.63)) were the factors significantly associated with the nurses' practice score towards physical assessment. Reliance on others and technology towards physical assessment practice was the most important barrier followed by ward culture and specialty area., Conclusion: Nurses working in the intensive care units had a good practice towards physical assessment among critically ill patients. Hence, to increase the practice towards physical assessment in intensive care settings, especially for married nurses, experienced critical care nurses, and specialist professionals, practice support training, modifying ward environment, and educational support care are recommended., Competing Interests: The authors declare no competing of interest., (Copyright © 2021 Bikis Liyew et al.)

Background: Preoperative fasting is important to reduce the risk of pulmonary aspiration during anesthesia. The influence of prolonged fasting time on glucose levels during anesthesia in children remains uncertain. Therefore, this study is aimed at assessing preoperative fasting time and its association with hypoglycemia during anesthesia in pediatric patients undergoing elective procedures at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. The research hypothesis of the study is as follows: there is a prolonged preoperative fasting time, and it influences the glucose levels during anesthesia among pediatric patients undergoing elective procedures at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia., Methods: Institutional based cross-sectional study was conducted among 258 pediatric patients who had undergone elective procedures in a tertiary care center. A systematic sampling method was used to select study participants. The data were collected through face-to-face interviews and medical record reviews. Binary logistic regression was used to identify associated factors of hypoglycemia during anesthesia among pediatric patients undergoing elective procedures. All explanatory variables with a p value of ≤0.25 from the bivariable logistic regression model were fitted into the multivariable logistic regression model to control the possible effect of confounders, and finally, the variables which had an independent association with hypoglycemia were identified based on adjusted odds ratio with 95% confidence interval, and a p value less than 0.05 was significant., Results: The mean (standard deviation) fasting hours from breast milk, solid foods, and clear fluids were 7.75 (2.89), 13.25 (3.14), and 12.31 (3.22), respectively. The majority (89.9%, 57.9%, and 100%) of participants had fasted from solid, breast milk, and clear fluids for more than 8, 6, and 4 hours, respectively. More than one-fourth (26.2%) of participants were hypoglycemic immediately after induction. Residence, order of nothing per mouth, source of patient, and duration of fasting from solid foods had a significant association with hypoglycemia during anesthesia in children., Conclusion: Children undergoing elective procedures were exposed to unnecessarily long fasting times which were associated with hypoglycemia during anesthesia., Competing Interests: The authors declared that they have no competing interests., (Copyright © 2021 Hussien Endris Assen et al.)

Background: Patients with mental disorders have high rates of co-existing alcohol use disorder and vice versa. Alcohol use disorder has emerged as a major challenge to intervene patients with severe mental disorders. It is under-recognized and has not been investigated well in low-income countries like Ethiopia. The aim of this study was to assess the prevalence and associate factors of alcohol use disorder among patients with severe mental disorders attending psychiatric follow-ups at the University of Gondar comprehensive specialized hospital, northwest Ethiopia., Methods: A total of 384 patients with severe mental disorders selected by a systematic random sampling technique took part in the interviews for this cross-sectional study. The alcohol use disorder identification test was used to assess the problem. Univariate and multivariate binary logistic regressions were computed to examine the associated factors. An adjusted odds ratio with a 95% confidence interval (CI) was used for reporting the result., Results: The prevalence of alcohol use disorder among patients with severe mental disorders was 36.2%. Of the participants, 23.5%, 8.6%, and 4.1% had hazardous, harmful alcohol drinking and alcohol dependency, respectively. In the multivariate analysis, male sex, younger age, psychotic and bipolar disorder diagnoses, having poor social support, moderate and high perceived stress, and current tobacco smoking were factors significantly associated with alcohol use disorder., Conclusion: The prevalence of alcohol use disorder among patients with severe mental disorders was found to be high. Early intervention and integrating treatment services for co-existing mental disorders and alcohol use disorder is important. The special treatment, where it is offered for young male patients and those with the diagnosis of psychotic and bipolar disorders, is recommended to promote the uptake of alcohol and mental health treatment services., Competing Interests: The authors declare that they have no conflict of interest., (© 2021 Kassew et al.)

Background: Needlestick and sharp injuries are a big risk to the health of nurses. Every day, nurses face the likelihood that they will injure themselves. Although many injuries will have no adverse effect, the possibility of acquiring infections like hepatitis C virus, hepatitis B virus, and human immunodeficiency virus can cause untold psychological harm. Nurses are in danger of injuries caused by needlestick and sharp instruments in hospitals., Objective: The objective of this study was to assess the magnitude and determinants of needlestick and/or sharp injuries among nurses working at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia, 2018., Methods: An institution-based cross-sectional study was conducted among 268 nurses working at Tikur Anbessa Specialized Hospital from February to March 2018. A stratified random sampling technique was used to select the study participants. Data were collected using a self-administered questionnaire. A bivariate and multivariate logistic regression model was fitted to spot factors associated with needlestick and/or sharp injury. An adjusted odds ratio with a 95% confidence interval was computed to determine the level of significance., Result: The prevalence of needlestick and/or sharp injuries among nurses was 36.2% (95% CI 30.2%, 42.3%). Presence of contaminated needles and/or sharp materials in the working area (AOR = 2.052 (95% CI 1.110, 3.791)), needle recapping after use (AOR = 1.780 (95% CI 1.025, 3.091)), working in the pediatric ward (AOR = 0.323 (95% CI 0.112, 0.930)), and being female (AOR = 0.461 (95% CI 0.252, 0.845)) were significantly associated with needlestick and/or sharp injury at p value of ≤0.05. Conclusion and Recommendation . The proportion of needlestick and/or sharp injury was high among nurses. The safety of nurses depends directly on the degree to which nurses can identify and control the numerous occupational hazards specific to jobs. Thus, working unit specific safety precautions, a safe working environment, and appropriate needle and sharp disposal improve nurses' safety practices and thereby decrease the injuries., Competing Interests: The authors declare no competing interest., (Copyright © 2020 Bikis Liyew et al.)

Introduction: Nurses working in the intensive care unit play an essential role in detecting patients at risk of deterioration through ongoing assessment and action in response to changing health status., Objectives: To assess knowledge, attitude, and associated factors towards physical assessment on critically ill patients among nurses working in the intensive care unit at Amhara regional state referral hospitals, Northwest Ethiopia, 2019. The research hypothesis: there is poor physical assessment knowledge, poor physical assessment attitude, and there are factors that are likely to affect nurses' knowledge and attitude towards physical assessment providing this care to critically ill patients at Amhara regional state referral hospitals, Northwest Ethiopia, 2019., Methods: Institution-based cross-sectional study was conducted among 299 nurses from March to September 2019. A convenience sampling method was used. Data were entered by using Epi Info 7.2.2 and analyzed by using STATA 14. The result was computed by descriptive statistics and to explore predictors of knowledge, and attitude linear regression analysis models were fitted, and the adjusted unstandardized beta ( β ) coefficient at 95% CI was used. A p -value <0.05 was considered significant. Result and conclusion: the knowledge mean scores were 9.93 ± 2.99 [95% CI (9.59, 10.31)]. The proportion of nurse's knowledge who score above the mean was 167 (55.9%) [95% CI (50.2, 61.5)] and below the mean 132 (44.1%) [95% CI (38.5, 49.8)]. Attitude means scores were 36.85 ± 6.21 [(36.16, 37.51)]. The proportions of nurse's attitudes who score above the mean were 158 (52.8%) [95% CI (47.5, 58.5)] and below the mean 141 (47.2) [95% CI (41.5, 52.5)]. Regarding predictor variables, being male [ β  = 0.84, 95% CI (0.16, 1.52)] and taken training [ β  = 1.85, 95% CI (1.14, 2.56)] were factors positively associated with knowledge, whereas has taken training [ β  = 4.13, 95% CI (2.82, 5.44)], total years of experience [ β  = 0.59, 95% CI (0.25, 0.93)], and knowledge [ β  = 0.92, 95% CI (0.0.72, 1.12)] were factors positively associated with attitude towards physical assessment., Conclusion: Based on the result of this study, the knowledge and attitude towards physical assessment regarding critically ill patients among nurses working in intensive care units were good. Hence, training, educational support services, and awareness are recommended to encourage nurse's knowledge and attitude towards physical assessment., Competing Interests: The authors declare that they have no conflicts interest regarding the publication of this paper., (Copyright © 2020 Bikis Liyew et al.)

Background: Physical restraint is a common practice in the intensive care units which often result in frequent skin laceration at restraint site, limb edema, restricted circulation, and worsening of agitation that may even end in death. Despite the sensitivity of the problem, however, it is felt that there are nurses' evidence-based practice gaps in Ethiopia. To emphasize the importance of this subject, relevant evidence is required to develop protocols and to raise evidence-based practices of health professionals. So, this study aimed to assess the knowledge, attitude, and influencing factors of nurses regarding physical restraint use in the intensive care units in northwest Ethiopia., Methods: An institution-based cross-sectional study was maintained from March to September 2019 at Amhara regional state referral hospitals, northwest Ethiopia. A total of 260 nurses in the intensive care units were invited to take part in the study by a convenience sampling technique. The Level of Knowledge, Attitudes, and Practices of Staff regarding Physical Restraints Questionnaire was used to assess the nurses' knowledge and attitude. Linear regression analysis was employed to examine the influencing factors of knowledge and attitude. Adjusted unstandardized beta ( β ) coefficient with a 95% confidence interval was used to report the result of association with a p value < 0.05 statistical significance level., Result: The mean scores of nurses' knowledge and attitude regarding physical restraint use among critically ill patients were 7.81 ± 1.89 and 33.75 ± 6.50, respectively. These mean scores are above the scale midpoint nearer to the higher ranges which imply a moderate level of knowledge and a good attitude regarding physical restraint. Lower academic qualification and short (<2 years) work experience were associated with lower-level of knowledge, and reading about restraint from any source and taken training regarding restraints were factors associated with a higher knowledge. Diploma and bachelor's in academic qualification were significantly associated with a negative attitude regarding restraint. Besides, there was a more positive attitude among nurses with a higher level of knowledge and who received training regarding physical restraint use., Conclusion: The nurses working in the intensive care unit had a moderate level of knowledge and a good attitude regarding physical restraint use. So, developing and providing educational and in-service training to the nurses regarding physical restraint are necessary to strengthen the quality of care for critically ill patients., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2020 Tilahun Kassew et al.)

Introduction . Pain is unpleasant sensory and emotional experience associated with actual and potential tissue damage. Inadequate pain management has been shown to affect patient outcomes by potentially increasing hospital stay and delaying recovery; thus, the management of pain has major implications for nursing. The study was aimed to identify gaps in knowledge and attitude of nurse's level of pain management., Objective: This study aimed to assess knowledge and attitude towards pain management among nurses working at University of Gondar comprehensive specialized referral hospital, Northwest Ethiopia, 2019., Methods: Institution-based cross-sectional study was carried out during May 20-30, 2019. A stratified random sampling technique was used to select 422 nurses. Hospital departments were classified into 5 main strata having nearly the same working conditions: (1) Internal Medicine, (2) Pediatrics, (3) Surgical, (4) Outpatient Clinics, and (5) Emergency and Intensive Care Departments. The proportional allocation was taken from each stratum, and then a simple random technique was applied. Descriptive statistics like frequency, mean, median, standard deviation, and percentage were used to describe the distribution of data. Independent samples t -test was used in comparing the gender knowledge and attitude mean score of the nurses towards pain management. One-way ANOVA was also used in determining the differences between knowledge and attitude towards pain management with sociodemographic characteristics at the p =0.05 level of significance., Result: A total of 411 study participants were involved in this study. More than half of the nurses, 225 (58.1%), were males; 308 (79.5%) of them were in the age category of 19-29 years. The magnitude of good knowledge towards pain management among nurses was 66.9% with a mean score of 7.14 (1.74 SD). The magnitude of favorable attitude towards pain management among nurses was 51.7% with a mean score of 49.33 (7.13 SD). Conclusion and Recommendation . This study revealed that nurses working at University of Gondar hospital had good knowledge and a lower level of attitude towards pain management than those reported in previous studies. Thus, the situation demands various educational and quality improvement initiatives that could enhance the nurse's knowledge and attitude in the area of pain management., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2020 Bikis Liyew et al.)

Background: Poor attitude towards antipsychotic drugs is high, and it is a factor for non-adherence to treatment. This increases the risk of relapse, associated healthcare utilization, and costs. This study aimed to assess attitude towards antipsychotic medication among patients with schizophrenia., Objectives: The aim of this institution based cross-sectional study was to assess attitude towards antipsychotic medications and associated factors among patients with schizophrenia who attend the outpatient clinics at Amanuel Mental Specialized Hospital, 2018., Methods: In a cross-sectional study, 393 schizophrenic patients from Amanuel Mental Specialized Hospital were recruited by a systematic random sampling technique. Drug Attitude Inventory (DAI-10) was used to assess attitude, experience, and belief about antipsychotics. Glasgow antipsychotic side effect scale modified version, positive and negative syndrome scale, and Birch wood's insight scale for psychosis were the instruments used to assess the associated factors. Simple and multiple linear regression analysis models were fitted, and the adjusted unstandardized beta ( β ) coefficient at 95% confidence interval was used., Results: The mean score of attitude towards antipsychotic medications was 6.51 with standard deviation (SD) of 2.22. In multiple linear regression, positive symptoms ( β = -0.07, 95% CI: (-0.09, -0.05)), negative symptoms ( β = -0.04, 95% CI: (-0.06,-0.02)), shorter (≤5 years) duration of illness ( β = -0.39, 95% CI: (-0.63, -0.15)), first generation antipsychotics ( β = -0.35, 95% CI: (-0.55,-0.14)), having sedation ( β = -0.28, 95% CI: (-0.52, -0.02)), and extra-pyramidal side effects ( β = -0.34, 95% CI: (-0.59,-0.09)) were factors negatively associated with attitude towards antipsychotic medication treatment. Insight to illness ( β = 0.24, 95% CI: (0.20, 0.27) was a factor positively associated with attitude towards antipsychotic medications., Conclusion: The result suggests that the mean score of participants' attitude towards antipsychotic medications was good. Prevention of side effects particularly due to first generation antipsychotics is necessary.