Malaria vaccine efficacy, safety, and community perception in Africa: a scoping review of recent empirical studies.

AIM: The review summarizes the recent empirical evidence on the efficacy, safety, and community perception of malaria vaccines in Africa. METHODS: Academic Search Complete, African Journals Online, CINAHL, Medline, PsychInfo, and two gray literature sources were searched in January 2023, and updated in June 2023. Relevant studies published from 2012 were included. Studies were screened, appraised, and synthesized in line with the review aim. Statistical results are presented as 95% Confidence Intervals and proportions/percentages. RESULTS: Sixty-six (N = 66) studies met the inclusion criteria. Of the vaccines identified, overall efficacy at 12 months was highest for the R21 vaccine (N = 3) at 77.0%, compared to the RTS,S vaccine (N = 15) at 55%. The efficacy of other vaccines was BK-SE36 (11.0-50.0%, N = 1), ChAd63/MVA ME-TRAP (- 4.7-19.4%, N = 2), FMP2.1/AS02A (7.6-9.9%, N = 1), GMZ2 (0.6-60.0%, N = 5), PfPZ (20.0-100.0%, N = 5), and PfSPZ-CVac (24.8-33.6%, N = 1). Injection site pain and fever were the most common adverse events (N = 26), while febrile convulsion (N = 8) was the most reported, vaccine-related Serious Adverse Event. Mixed perceptions of malaria vaccines were found in African communities (N = 17); awareness was generally low, ranging from 11% in Tanzania to 60% in Nigeria (N = 9), compared to willingness to accept the vaccines, which varied from 32.3% in Ethiopia to 96% in Sierra Leone (N = 15). Other issues include availability, logistics, and misconceptions. CONCLUSION: Malaria vaccines protect against malaria infection in varying degrees, with severe side effects rarely occurring. Further research is required to improve vaccine efficacy and community involvement is needed to ensure successful widespread use in African communities.

Comparison of short-term outcomes between people with and without a pre-morbid mental health diagnosis following surgery for traumatic hand injury: a prospective longitudinal study of a multicultural cohort.

BACKGROUND: Following traumatic hand injury, few studies have compared outcomes between people with and without a pre-morbid mental health diagnosis. This study aimed to compare sub-acute outcomes in a multicultural patient cohort with surgically managed traumatic hand injury with and without a pre-morbid mental health diagnosis. METHODS: A prospective, observational cohort study of people with traumatic hand injury presenting pre- surgically to a high-volume hand injury centre in a region of cultural and language diversity was conducted. Participants were assessed face-to-face (baseline) then via telephone (3-months post-surgery) and categorized according to a pre-morbid medically diagnosed mental health diagnosis. Baseline and follow-up assessments included global mental health, and the EuroQol (EQ) 'Health Today' analogue scale (0-100) and health domains. Return-to-work status, complications/symptomatic complaints, and hand function (QuickDASH) were also collected at follow-up. Adjusted analyses-accounting for covariates including cultural identity-were conducted to determine whether 3-month outcomes were associated with a pre-morbid mental health diagnosis. RESULTS: From 405 eligible patients, 386 were enrolled (76% male, mean age 38.9 (standard deviation 15.6)); 57% self-identified as Australian and 22% had a pre-morbid mental health diagnosis. Common injuries regardless of pre-morbid mental health diagnosis were skin (40%), tendon (17%) and bone (17%) injuries. None were complex mutilating injuries. Seventy-eight per cent of the cohort was followed-up. In adjusted analyses, a pre-morbid mental health diagnosis was associated with lower odds for reporting 'good or better' global mental health (Odds Ratio (OR) 0.23 (95% Confidence Interval (CI) 0.18, 0.47), p < 0.001), 'no' anxiety or depression (OR 0.21 (0.11, 0.40), p < 0.001) and no pain (OR 0.56 (0.31, 0.98), p = 0.04)(EQ domains), and worse EQ 'Health Today' (10 points on average (95%CI -14.9, -5.1, p < 0.001). QuickDASH scores, rates of complications/symptomatic complaints and return-to-work profiles were similar. CONCLUSIONS: Despite reporting worse mental and health-related quality-of-life outcomes post-surgery, people with a pre-morbid mental health diagnosis regardless of cultural identity experienced similar clinical and return-to-work outcomes. Future research assessing the value of screening for pre-morbid mental health conditions on post-surgical outcomes is required and should include people with more complex hand injuries.

Experience of the waiting area as perceived by haemodialysis patients and family carers.

AIM: To identify the meaning of the waiting area based on the experiences of haemodialysis patients and their carers and to develop an optimal social environment for meaningful nursing care. BACKGROUND: Haemodialysis patients require treatment three times a week and they and their carers spend much of their time in waiting areas, where they experience a unique culture. Limited qualitative research has focused on the culture of the waiting area among haemodialysis patients in South Korea. DESIGN: A qualitative study using an ethnographic approach. METHODS: Eighteen participants were recruited in a hospital waiting area. The data were collected via participant observations and interviews from 24 November 2015-21 April 2016. Spradley's research sequence was employed to analyse the data. RESULTS: Three themes were identified that describe the unique characteristics of the waiting area: sharing information and consoling, inhabiting a separate area of ease and discomfort and experiencing vigilance and unsure stillness. The overarching theme was a boundary space that presented antithetical and dynamic patterns. CONCLUSIONS: This study contributes to a better understanding of the distinct culture experienced by haemodialysis patients in the waiting area and the findings can help nurses deliver more meaningful care. Nursing interventions germane to psychological and emotional support and applicable nursing education should be seriously considered for haemodialysis waiting rooms.

Self-Care Behaviors of Nepalese Adults With Type 2 Diabetes: A Mixed Methods Analysis.

BACKGROUND: Most previously reported literature on diabetes self-care is either solely quantitative or qualitative research conducted in developed countries; findings may not be generalizable to developing countries with different sociodemographic and cultural factors. PURPOSE: The study aims to develop an explanatory mediation model for self-care and enhance model interpretation through qualitative input. METHODS: A quantitatively driven, sequential, mixed method design was used. Structured questionnaires were used to collect data for the quantitative component from 230 participants. Participants for the qualitative interview were selected using maximum variation sampling (n = 13), and interviewing was guided by semistructured questions. RESULTS: Diabetes management self-efficacy had the strongest influence on diabetes self-care (standardized path coefficient = .42, p < .001), followed by perceived social support (standardized path coefficient = .26, p < .001), and educational status (standardized path coefficient = -.22, p < .001). Diabetes management self-efficacy significantly and partially mediated the relationship between diabetes duration and diabetes self-care (Sobel's z = 2.65, p < .001) and between expectation regarding aging and diabetes self-care (Sobel's z = 3.03, p < .001). Perceived social support significantly and partially mediated the relation between educational status and diabetes self-care (Sobel's z = -2.81, p < .001). The qualitative component elucidated nine themes interwoven in Nepalese culture, social structure, and religious belief. Responsibilities toward family and belief in God acted as boosters for self-care in the case of Nepalese adults, which differed by age, gender, and literacy status. DISCUSSION: The results from this study suggest that tailored psychosocial interventions to promote diabetes management self-efficacy may be beneficial in promoting self-care among Nepalese adults with diabetes mellitus.

Prevalence of cardiovascular risk factors among Asian migrant workers in South Korea.

BACKGROUND: The burden of non-communicable diseases is rapidly increasing among young adults in middle- and low-income countries. Asian migrant workers continue to be a significant contributor to South Korea's economy; however, their cardiovascular health is neglected. We explored the prevalence of cardiovascular risk factors among Asian migrant workers in South Korea. METHODS: Cross-sectional survey, anthropometric measurements, blood pressure measurements, and biochemical tests including triglyceride, high-density lipoprotein, low-density lipoprotein, total cholesterol, fasting blood sugar, HbA1c, and C-reactive protein levels were conducted in 141 Asian migrant workers in South Korea. RESULTS: The mean age of the participants was 31.3 (5.6) years. Of the participants, 14.8% were current smokers, and 47.5% consumed alcohol. The prevalence of overweight/obesity was 32.4%. The prevalence of hypertension and dyslipidemia were 51.2% and 64.6%, respectively. Of the participants, 98.5% had an increased waist circumference; elevated HbA1C and C-reactive protein was seen in 20.9% and 4.3%, respectively. The prevalence of metabolic syndrome was 5.5%. Clustering of two or more risk factors was seen in 45% of the participants. Factors associated with a high risk of cardiovascular diseases (clustering of two or more risk factors) were age (odds ratio 1.16, p < 0.01) and smoking (4.98, p < 0.05). CONCLUSION: The prevalence of cardiovascular risk factors was alarmingly high among Asian migrant workers employed in South Korea. Efforts to mitigate and eliminate those risk factors are urgently required.

Factors Related to Clinical Competence among Graduating Nursing Students during the COVID-19 Pandemic: A Cross-Sectional Study.

PURPOSE: This study investigated clinical competency, COVID-19-related anxiety, coping strategies, self-efficacy, and perceived stress among graduating nursing students during the COVID-19 pandemic. METHODS: We conducted a cross-sectional survey. Participants were recruited from universities located in four major cities in South Korea. General demographic information, clinical competency, self-efficacy, perceived stress, COVID-19-related anxiety, and coping strategies were assessed using reliable questionnaires. Descriptive statistics, correlations, and multiple regression tests were used to analyze the data. RESULTS: The mean clinical competency, self-efficacy, perceived stress, adaptive coping, and maladaptive coping were 138.16 ± 18.34, 83.85 ±14.02, 21.37 ± 5.79, 53.15 ± 4.64, and 30.98 ± 6.73, respectively. COVID-19-related anxiety was reported by 4.3% of participants. Clinical competency was significantly positively correlated with self-efficacy (r = .44, p < .001) and adaptive coping (r = .20, p = .035) and was significantly negatively correlated with maladaptive coping (r = .20, p = .035). The predictors of clinical competency were self-efficacy (ß = .434, p < .001) and adaptive coping (ß = .173, p < .039), which explained 23% of the variance in clinical competency. CONCLUSION: Self-efficacy and adaptive coping strategies are significant predictors of clinical competence during the pandemic. Planning and implementing various curricular and non-curricular activities to increase senior students' self-efficacy and adaptive coping strategies will help prepare competent nursing graduates for the pandemic when they enter the nursing workforce.

Stress and health related quality of life of Nepalese students studying in South Korea: a cross sectional study.

BACKGROUND: In recent years there has been a growing trend among students to travel for educational purposes to other countries where there is the possibility of experiencing considerable amounts of stress affecting their physical and mental functioning. The aims of the current study were to investigate the health related quality of life (HRQOL) of Nepalese students studying in South Korea to explore the relationship between HRQOL and perceived and acculturative stress, and to identify the determinants of HRQOL. METHODS: One hundred and thirty students were enrolled in this study. HRQOL was assessed using the Medical Outcomes Study Short Forms (SF-12) questionnaire. Perceived stress and acculturative stress was measured using the Perceived Stress Scale and Acculturative Stress Scale for international students, respectively. Pearson's correlation test and multiple regression analysis were performed. RESULTS: Perceived stress and acculturative stress were negatively correlated with HRQOL. The highest value in the HRQOL was reported for the vitality subscale and the lowest value was reported for the role-emotional. In the regression model, perceived stress, acculturative stress, relationship with advisor, and marital status accounted for a significant (p < .001) portion of the variance (49%) in the mental component summary of the HRQOL. CONCLUSIONS: The findings of this study indicate that Nepalese students studying in South Korea experience a considerable amount of perceived and acculturative stress, which is negatively related with their HRQOL. Provision of culture specific counseling and orientation programs may benefit the students. The determinants of HRQOL identified in this study were perceived stress, acculturative stress, relationship with advisor, and marital status.

Assessment of Socio-Demographic Factors, Mother and Child Health Status, Water, Sanitation, and Hygienic Conditions Existing in a Hilly Rural Village of Nepal.

In many low income developing countries, socioeconomic, environmental and demographic factors have been linked to around half of the disease related deaths that occur each year. The aim of this study is to investigate the sociodemographic factors, mother and child health status, water, sanitation, and hygienic conditions of a Nepalese community residing in a hilly rural village, and to identify factors associated with mother and child health status and the occurrence of diarrheal and febrile disease. A community-based cross-sectional survey was carried out and 315 households from the village of Narjamandap were included in this study. Factors associated with diarrhea, febrile disease, and full maternal and under-five immunizations were assessed using logistic regression. Results showed that higher education level (middle school versus primary education; Odds Ratio (OR): 0.55, p = 0.04; high school versus primary education; OR 0.21, p = 0.001) and having a toilet facility at home were significantly associated with a lower risk of developing diarrhea and febrile disease (OR 0.49, p = 0.01), while, interestingly, the use of improved water supply was associated with higher risk (OR 3.07, p = 0.005). In terms of maternal immunization, the odds of receiving a tetanus toxoid vaccination were higher in women who had regular antenatal checkups (OR 12.9, p < 0.001), and in those who developed complications during pregnancy (OR 4.54, p = 0.04); for under-five immunization, the odds of receiving full vaccination were higher among children from households that reported diarrhea (OR 2.76, p < 0.001). The findings of this study indicated that gaps still exist in the mother and child healthcare being provided, in terms of receiving antenatal checkups and basic immunizations, as evidenced by irregular antenatal checkups, incomplete and zero vaccination cases, and higher under-five deaths. Specific public health interventions to promote maternal health and the health of under-five children are suggested.

Predictors of the Health-Promoting Behaviors of Nepalese Migrant Workers.

BACKGROUND: Health-promoting behaviors assist individuals to prevent disease, promote health, increase longevity, and enjoy a better quality of life. A number of interpersonal, social, and environmental factors have been shown to influence health-promoting behaviors. Little empirical evidence exists about the predictors of health-promoting behaviors among migrant workers. PURPOSE: This study uses Pender's health promotion model to describe and identify the predictors of health-promoting behaviors in Nepalese migrant workers in Korea. METHODS: A cross-sectional research design was used. Nepalese migrants who had been working in South Korea (n = 169) for over 6 months were surveyed between July and December 2012. Self-efficacy was measured using the Perceived Health Competence Scale, the Health-Promoting Lifestyle Profile II was used to measure health-promoting lifestyle behaviors, and perceived health status was measured using a single-item question. Descriptive statistics, correlation analysis, and multiple regression analysis were used to analyze data. RESULTS: Spiritual activity was the highest reported health-promoting behavior, whereas physical activity was the least practiced behavior. Self-efficacy was the only significant predictor of health-promoting behavior. CONCLUSIONS: The results of this study suggest that future health-promoting interventions should enhance the self-efficacy of target populations for individual health behaviors. Factors such as working conditions, culture, and economic background that may affect the health-promoting behaviors of migrant workers must be considered when planning nursing interventions. Multicultural nursing structures and policies are needed to reach out proactively to all adult migrant groups.

Zero-Inflated Poisson Modeling of Fall Risk Factors in Community-Dwelling Older Adults.

The aim of this study was to identify risk factors for falls among community-dwelling older adults. The study used a cross-sectional descriptive design. Self-report questionnaires were used to collect data from 658 community-dwelling older adults and were analyzed using logistic and zero-inflated Poisson (ZIP) regression. Perceived health status was a significant factor in the count model, and fall efficacy emerged as a significant predictor in the logistic models. The findings suggest that fall efficacy is important for predicting not only faller and nonfaller status but also fall counts in older adults who may or may not have experienced a previous fall. The fall predictors identified in this study--perceived health status and fall efficacy--indicate the need for fall-prevention programs tailored to address both the physical and psychological issues unique to older adults.