Medicine and Health Sciences Commons^™

Food Choices And Practices During Pregnancy Of Immigrant Women With High-Risk Pregnancies In Canada: A Pilot Study, Gina M A. Higginbottom, Helen Vallianatos, Joan Forgeron, Donna Gibbons, Fabiana Mamede, Rubina Barolia

School of Nursing & Midwifery

Background: Immigrant women may be regarded as a vulnerable population with respect to access and navigation of maternity care services. They may encounter difficulties when accessing culturally safe and appropriate maternity care, which may be further exacerbated by language difficulties and discriminatory practices or attitudes. The project aimed to understand ethnocultural food and health practices and how these intersect in a particular social context of cultural adaptation and adjustment in order to improve the care-giving capacities of health practitioners working in multicultural perinatal clinics.
Methods: This four-phase study employed a case study design allowing for multiple means of data collection …

A Review Related To Midwifery Led Model Of Care, Shahnaz Shahid, Rafat Jan, Rahat Najam Qureshi, Salma Rattani

School of Nursing & Midwifery

Background: Midwifery led care (MLC) is a model of care in which perinatal care is provided to women throughout different phases of childbirth by a midwife.
Objective: This paper aims to provide a literature review on MLC.
Methods: A variety of databases and reports were considered to do the literature review on MLC. The search was limited from 1991 to 2011 by using keywords. A total of 50 articles were critically appraised for this review.
Findings: The main theme that emerged was women ^’s satisfaction with MLC. Satisfaction was integrated with midwife ^’s presence throughout childbirth, experience to …

Teachers’ Accounts Of Their Perceptions And Practices Of Providing Written Feedback To Nursing Students On Their Assignments, Sajid Iqbal, Raisa Gul, Arusa Lakhani, Nusrat Fatima Rizvi

School of Nursing & Midwifery

Written feedback can facilitates students’ learning in several ways. However, the teachers’ practice of written feedback may be affected by various factors. This study aimed to explore the nurse teachers’ accounts of their perceptions and practices of providing written feedback.

A descriptive exploratory design was employed in the study. A purposive sample of 12 teachers from nursing institutions in Karachi, Pakistan, participated in the study. Using a semi-structured guide, in-depth interviews were conducted with the participants, between January-September, 2013. The interviews were tape recorded and transcribed verbatim and were manually content analyzed.

The analysis of findings led to three sections: …

Factors That Act As Facilitators And Barriers To Nurse Leaders' Participation In Health Policy Development, Nilufa Jivraj Shariff

School of Nursing & Midwifery, East Africa

Background: Health policies impact on nursing profession and health care. Nurses' involvement in health policy development ensures that health care is safe, of a high quality, accessible and affordable. Numerous factors influence nurse leaders' ability to be politically active in influencing health policy development. These factors can be facilitators or barriers to their participation. There is scant research evidence from Eastern African region that draws attention to this topic. This paper reports part of the larger study. The objectives reported in this paper were those aimed to: build consensus on factors that act as facilitators and barriers to nurse leaders' …

Unmet Need For Contraception And Unintended Pregnancies Among Women Of Reproductive Age Group: A Situation Analysis, Sumera Aziz Ali, Savera Aziz Ali

School of Nursing & Midwifery

Each year approximately 210 million pregnancies occur worldwide and more than one-third (75 to 80 million) of these are unintended, more than half of these (46 million) unintended pregnancies undergo unsafe abortions. In Pakistan 16% of the births are reported to be unwanted and if the unwanted fertility is eliminated, total fertility in Pakistan would be 3.1 births per woman. Total demand for family planning in Pakistan is 55%, while the contraceptive prevalence rate is 35% and unmet need for family planning is 20%. Reasons for unmet need and unintended pregnancy include lack of permission, fear of side effects, poor …

Mycobacterium Tuberculosis Central Asian Strain (Cas) Lineage Strains In Pakistan Reveal Lower Diversity Of Miru Loci Than Other Strains, Asho Ali, Zahra Hasan, Sana Jafri, Raunaq Inayat, Rumina Hasan

Department of Pathology and Laboratory Medicine

Mycobacterium tuberculosis (MTB) Central Asian Strain (CAS) lineage strains are predominant in South Asia. Mycobacterial interspersed repetitive units-variable number of tandem repeats (MIRU-VNTR) typing is an effective way of determining genetic diversity of strains. A maximum of 24 loci-based MIRU-VNTR typing can be used, however, it is important to investigate the relevance of specific MIRU loci for regional strains for more cost-effective MIRU typing. MIRU-VNTR typing was performed on MTB strains from Pakistan. Strains were comprised of CAS (n=113) and non-CAS lineages (n=87) - both multi-drug resistant (MDR) and drug susceptible. Hunter Gaston Discriminatory Index (HGDI) for each MIRU loci …

Perinatal Distress In Women In Low- And Middle-Income Countries: Allostatic Load As A Framework To Examine The Effect Of Perinatal Distress On Preterm Birth And Infant Health, Shahirose Sadrudin Premji

School of Nursing & Midwifery

In low- and middle-income countries (LMIC), determinants of women's and children's health are complex and differential vulnerability may exist to risk factors of perinatal distress and preterm birth. We examined the contribution of maternal perinatal distress on preterm birth and infant health in terms of infant survival and mother-infant interaction. A critical narrative and interpretive literature review was conducted. Peer-reviewed electronic databases (MEDLINE, Embase, Global Health, CINHAL), grey literature, and reference lists were searched, followed by a consultation exercise. The literature was predominantly from high-income countries. We identify determinants of perinatal distress and explicate changes in the hypothalamic-pituitary-adrenal axis, sympathetic, …

Lifetime Prevalence Of Emotional/Psychological Abuse Among Qualified Female Healthcare Providers., Azmat Jehan Khan, Rozina Karmaliani Professor, Tazeen Saeed Ali, Nargis Asad, Farhana Madhani

School of Nursing & Midwifery

The purpose of this study was to determine the lifetime prevalence of emotional/psychological abuse among married female healthcare providers in tertiary care hospitals in Karachi, Pakistan. A descriptive cross-sectional study was conducted in a sample of 350 married female nurses and doctors, recruited from three tertiary healthcare hospitals (one public and two private). This study used the self-administered modified truncated WHO multi-country questionnaire. Descriptive and univariate analysis was performed. Of the total sample of 350 female married healthcare providers, 97.7% (n = 342) were reported with one or more forms of domestic violence at some point in their married life, …

Practice Of Written Feedback In Nursing Degree Programmes In Karachi: The Students' Perspective, Amina Aijaz Khowaja, Raisa B. Gul, Arusa Lakhani, Nusrat Fatima Rizvi, Faiza Saleem

School of Nursing & Midwifery

Objective: To identify students' perceptions about the practices of provision and utilization of written feedback in the nursing degree programmes in Karachi.

Study Design: Cross-sectional descriptive study.

Place and Duration of Study: Nine Nursing Institutions in Karachi, Pakistan were selected for the study, from February to October 2011.

Methodology: The sample consisted of 379 second year nursing students from nine institutions in Karachi. The data was collected through a modified Assessment Experience Questionnaire (AEQ) developed by Gibbs and Simpson. The data obtained through AEQ was analyzed in the SPPS.

Results: Students reported wide variations in the practices related to written …

Harassment: A Challenge At Workplace, Muhammad Younas, Salma Rattani

School of Nursing & Midwifery

Health care professionals are deeply involved in caring for the human life and during this process, they come in a close contact with the care recipients. This, at times, positions the health care professionals in a vulnerable situation including workplace harassment which is an offensive verbal or physical act and comprises of an unwanted behavior or advancement or demand for sexual and other favors. This conduct creates an intimidating, unfriendly, and offensive work environment (Sigal, 2006). Consequently, it impacts on care providers' performance, quality care and their retention in the system. Hence, it is important that the health care personnel …

Responding To Health Care Complexity: Suggestions For Integrated And Interprofessional Workplace Learning, Pim Kuipers, Carolyn Ehrlich, Sharon Brownie

School of Nursing & Midwifery, East Africa

This report highlights complexity in health care and the relevance of integrated and interprofessional care and learning. It is proposed that appropriate workforce training in response to complexity should be contextually relevant and workplace integrated, and should focus on building interprofessional capability for reflective practice and critical thinking. This training should be interprofessional and foster systems thinking. It is suggested that the World Health Organization's International Classification of Functioning, Disability and Health (ICF) is a useful integrating framework.

Verbal Violence At Workplace: A Reality From Pakistani Context., Laila Akber Cassum

School of Nursing & Midwifery

Work place violence is the most distressing subject globally, and has been a concern for many decades affecting home and work environment.This cancer has even invaded health care sector worldwide. Nursing professionals whether they are at hospital or at academics institutions are subjected to violence. Although, it has been a burning issue, among nursing health care workers it has often gone unchecked, and people tend to accept it as the part of the system.

In this paper I would be discussing and deliberating that work place violence particularly verbal abuse is a serious matter and it can have negative consequences …

Complementary And Alternative Medicine In Oncology Nursing, Salima Somani, Fauziya Ali, Tazeen S. Ali, Nasreen Sulaiman Lalani

School of Nursing & Midwifery

Use of complementary and alternative medicine (CAM) has increased globally, particularly among oncology patients. This study investigated the knowledge, experience and attitudes of oncology nurses towards CAM. A quantitative study was conducted in tertiary care hospitals in Karachi, Pakistan, where 132 oncology nurses were surveyed. The survey revealed that more than 50% of nurses had never heard about many of the CAM therapies used in Pakistan. Approximately 65% of the nurses had knowledge about prayer and less than 30% had experience of CAM education or training. In addition, the majority of nurses had seen patients using CAM and felt that …

Associations Of Controlling Behavior, Physical And Sexual Violence With Health Symptoms, Tazeen S. Ali, Aamir Abbas, Fazal Ather

School of Nursing & Midwifery

Controlling behavior is often manifested as monitoring, coercing or threatening the partner. Globally, it has been experienced by the women (in range of 5.2% to 56.6%) and often results in their physical and mental ill health. To the best of our knowledge there is no published research on controlling behaviors. Therefore, a cross sectional study was conducted to measure the magnitude of the controlling behaviors and its association to some physical stress symptoms of women. The study was conducted in urban settings of Karachi, Pakistan, using simple random sampling technique. The data was collected by trained midwifes from the 759 …

Women’S Perception And Attitude Towards Male Dominancy And Controlling Behaviors, Tazeen S. Ali, Noureen Karamali, Omer Malik

School of Nursing & Midwifery

Introduction/Background: The study was conducted in urban Karachi, Pakistan to investigate women’s perceptions and attitudes towards male dominancy, female autonomy, and controlling behavior of husbands.
Method: This was investigated in a population based study with a cross-sectional design, involving married women aged 25 to 60 years. A Structured questionnaire developed by World Health Organisation (WHO) on violence was used. Community midwives interviewed these married women living in pre-selected low, middle and upper socio-economic areas of urban Karachi, Pakistan.
Findings: This study revealed women’s overall perception regarding male dominancy and controlling behavior and highlighted this attitude, as being …

The Feasibility Of An Internet-Based Intervention For Chinese People With Mental Illness: A Survey Of Willingness And Attitude, Xiu-Y Yao, Zheng Li, David Arthur, Lili Hu, Gen Cheng

School of Nursing & Midwifery

Background: The easy accessibility, increasing usage, and low cost of internet make it a desirable way of providing health information and delivering interventions for health consumers. Studies in other countries have verified and confirmed the effectiveness of internet-based interventions among people with mental health problems. Similar programs have yet to commence in China. Purpose: This study investigated the willingness for, and attitude toward internet-based intervention in Chinese mental health service users and explored the feasibility of such an intervention.
Methods: A cross-sectional survey utilizing a self-developed questionnaire was administered to 186 mental health service users in Beijing, …

Interprofessional Curriculum On Environmental And Social Determinants Of Health In Rural Kenya: Aga Khan University East Africa University Of California San Francisco Integrated Primary Health Care Program, M. R. Mahoney, K. Baltzell, Esther Nderitu, R. Dhanani, S. Macfarlane

School of Nursing & Midwifery, East Africa

The Aga Khan University East Africa (AKU)-University of California San Francisco (UCSF) Integrated Primary Health Care Program (IPHC) is a public–private partnership with community and government to strengthen the primary health care (PHC) system in Kenya. IPHC provides opportunities for health professions students to work and learn together in the rural and underserved district of Kaloleni.

Childhood Obesity In Asia: The Value Of Accurate Body Composition Methodology, Andrew P. Hills, Najat Mokhtar, Sharon Brownie, Nuala M. Byrne

School of Nursing & Midwifery, East Africa

Childhood obesity, a significant global public health problem, affects an increasing number of low- and middle-income countries, including in Asia. The obesity epidemic has been fuelled by the rapid nutrition and physical activity transition with the availability of more energy-dense nutrient-poor foods and lifestyles of many children dominated by physical inactivity. During the growing years the pace and quality of grow this best quantified by a combination of anthropometric and body composition measures. However, where normative data are available, this has typically been collected on Caucasian children. To better define and characterise overweight and obesity in Asian children, and to …

A Single Competency-Based Education And Training And Competency-Based Career Framework For The Australian Health Workforce: Discussing The Potential Value Add, Sharon Brownie, Janelle Thomas

School of Nursing & Midwifery, East Africa

This brief discusses the policy implications of a research study commissioned by Health Workforce Australia (HWA) within its health workforce innovation and reform work program. The project explored conceptually complex and operationally problematic concepts related to developing a whole-of-workforce competency-based education and training and competency-based career framework for the Australian health workforce and culminated with the production of three reports published by HWA. The project raised important queries as to whether such a concept is desirable, feasible or implementable – in short what is the potential value add and is it achievable? In setting the scene for discussion, the foundation …

The “Secret” Impact Of Population Statistics On The Metrics Of Diabetes, Lyndal H. Hunter, Sharon Brownie, Walter F. Robb

School of Nursing & Midwifery, East Africa

The accuracy of disease metrics is dependent on the quality of population-based data. Many diseases, including diabetes, are age and sex dependant. Accurate age- and sexspecific population survey data, population estimates and projections are required to assess the scale and trends in the burden of these diseases. No assessment of the quality of population data being used in the UAE diabetes metrics has been published. We provide insight into the availability and quality of published population data, which is currently being used to inform diabetes research and health services planning in the UAE. We show the absence of credible population-based …

Exercise Physiologists: Essential Players In Interdisciplinary Teams For Noncommunicable Chronic Disease Management, E Sme J. Soan, Steven J. Street, Sharon Brownie, Andrew P. Hills

School of Nursing & Midwifery, East Africa

Noncommunicable diseases (NCDs), such as obesity and type 2 diabetes mellitus, are a growing public health challenge in Australia, accounting for a significant and increasing cost to the health care system. Management of these chronic conditions is aided by interprofessional practice, but models of care require updating to incorporate the latest evidence-based practice. Increasing research evidence reports the benefits of physical activity and exercise on health status and the risk of inactivity to chronic disease development, yet physical activity advice is often the least comprehensive component of care. An essential but as yet underutilized player in NCD prevention and management …

Qualitative Research: A Pathway To Gain An Understanding Of Uae Mothers’ Experiences And Perceptions Of Managing A Child Newly Diagnosed With Type 1 Diabetes, Jennifer Louise Cooper, Suhad Marjei, Rachel Rossiter, Sharon Brownie

School of Nursing & Midwifery, East Africa

A childhood diagnosis of Type 1 diabetes is a life changing event for both the child and his/her family. The impact is experienced strongly by mothers who most frequently fulfil the primary caregiver role for children12 yrs old and younger. Studies which have sought to understand mothers’ experiences and perceptions of managing a child newly diagnosed with Type 1 diabetes are mostly questionnaire-based and few, if any, explore the issues within the uniqueness of a Middle-Eastern context. The qualitative research methods described in this discussion have been designed to gain a better understanding of UAE mothers’ experience in managing a …

Post Exposure Prophylaxis Among Ugandan Nurses Accidents Do Happen, J. Mill, Esther Nderitu, S. Richter

School of Nursing & Midwifery, East Africa

Purpose: In 2009 we conducted a study to explore Ugandan nurses’ practice of universal precautions while caring for persons living with HIV. During our interviews about universal precautions, nurses’ also shared their experience with post-exposure prophylaxis (PEP) following needle-stick injuries. We present findings related to nurses’ understanding of PEP and their experience with, and reporting of, needle stick injuries.

Background: Nurses have high rates of exposure to blood-borne pathogens. Although there is minimal risk of the transmission of blood-borne pathogens from health care workers (HCWs) to patients and vice versa, post-exposure prophylaxis, has become routine following the occupational exposure of …

Exploring The Potential For Advanced Nursing Practice Role Development In Kenya: A Qualitative Study, Linda Anne East, John Arudo, Martha Loefler, Catrin Mai Evans

School of Nursing & Midwifery, East Africa

Background: Definitions of advanced nursing practice abound, yet little has been published concerning the context for advanced nursing in sub-Saharan Africa. This study set out to explore the existence of, and potential for, advanced nursing practice in Kenya.

Methods: Ten nurses were invited to participate in semi-structured qualitative interviews. Participants were purposively selected to provide insight into the practice of experienced nurses in urban, rural, community, hospital, public and private health care settings. Interview narratives were recorded, transcribed and subsequently analysed using a thematic approach.

Results: All participants reported that they were engaged in the delivery of expert, evidence-based care. …

Rising To The Challenge: Nursing Leadership Via Nurse-Led Service Provision For Chronic Disease Management And Prevention, Gary E. Day, Sharon Brownie

School of Nursing & Midwifery, East Africa

All nations are currently challenged by the increasing prevalence of non-communicable and chronic disease [1]. In Australia, by 2051, over 50% of the population over 50 will have a chronic disease [2]. In addition to increased levels of chronic disease, services will be stretched through workforce shortages, and government policies to provide greater access to services. Within the United States of America demand for primary care services will further increased by the passage and progressive implementation of the Affordable Care Act (ACA), which expands Medicaid coverage to millions of low-income Americans [3]. Given the increasing levels of disease burden, all …

Teaching Basic Life Support To The Digital Generation: Randomized Trial Comparing Videoassisted Versus Practical Simulation, Antonio Bonacaro, Ged Williams, Sharon Brownie

School of Nursing & Midwifery, East Africa

• Simulation is a teaching method used to facilitate learning of Basic life support and Defibrillation (BlsD) techniques. This study explored the potential of two ways of teaching BlsD techniques in order to understand which one could be the best between Low- Fidelity Simulation and Moderate-Fidelity Simulation.

• A sample (n = 127) of nursing students was selected for this two group pre- post- test conveniently randomized design with 4-month follow up to compare two methods of simulation teaching.

• Students were allocated to Low-Fidelity (LF) (n = 64) and Moderate-Fidelity (MF) (n = 63) simulation teaching. Early evaluation immediate …

Health Care For All: Building A Public Health Workforce To Achieve The Uae 2021 Vision For Health, Sharon Brownie, Nelson Lebogo, Mohammed Hag-Ali

School of Nursing & Midwifery, East Africa

Much has been written regarding the public health challenges facing the UAE, particularly the high levels of preventable non-communicable diseases such as cardiovascular disease, diabetes, renal disease, and traffic related injuries. Committed to reversing this trend, the Government of the UAE have identified ‘Health for All’ as an important strategic priority in the ongoing development of the nation. The availability of an appropriately skilled workforce is a key consideration in the achievement of this aim. This is highlighted by the WHO report ‘A universal truth: No health without a workforce’, which was presented to inform the Third Global Forum in …

Active Ageing In Pakistan: Challenges And Opportunities, Samina Vertejee, Noureen Nasruddin Karamali

Department of Surgery

Abstract

The increasing number of ageing population is a signpost for re-directing the resources to ensure quality of life for elderly thus promoting active ageing. However, the challenges to achieve the goal outweigh the opportunities due to scarcity of resources. Several factors including, brain drain, poverty, lack of knowledge of elderly to protect their rights in association with poor state laws determines the poor quality of life for elderly in Pakistan. Although, the apparent scenario is quite unpleasant yet there are several opportunities such as improved crude birth and death rates, increased awareness about gerontology as a specialty care area …