Background: Brucellosis is a zoonotic bacterial infection caused by ingestion of unpasteurized milk or undercooked meat from infected livestock, or close contact with their secretions. Knowledge and practices regarding brucellosis are essential for the implementation of control measures and consequently prevention of brucellosis. The study was designed to estimate knowledge and determine practices regarding this disease among the high-risk population. Objectives: The study aimed to identify the level of knowledge regarding brucellosis and misconceptions and malpractices associated with brucellosis in the Southern region of Jordan. Methods: This cross-sectional study was carried out to assess knowledge and practices of the population towards brucellosis in Southern Jordan. Data were collected using a well-defined pretested questionnaire, and the SPSS statistical package was used for data analysis. Results: Out of the 1,593 participants, 1,325 (83.2%) were aware of the disease. Among participants who were aware of the disease, their knowledge of brucellosis was assessed. The majority of these respondents demonstrated appropriate knowledge (72.0%, n=954n=954). The majority of participants demonstrated good practices while handling domesticated animals and their secretions. Conclusion: The study demonstrated appropriate knowledge and practice towards brucellosis among the population in the Southern region of Jordan.
In the article titled “The Risk Factors of Premature Myocardial Infarction: A Case Control Study in Iran” by Mehdi Ehtesham in Global Journal of Health Science, volume 8, issue number 11, pages 69-76, the name of the first author was presented incorrectly. The author’s name originally appeared as “Mehdi Ehtesham" but should have been written as “Medy Ehtesham". The corrected author list is shown above. The authors apologize for this error.
Moral distress is a significant psychological challenge among intensive care unit (ICU) nurses, often arising when they are unable to act according to their ethical values due to organizational or external constraints. This distress can negatively influence job satisfaction, which is a critical factor affecting nurse retention, performance, and quality of patient care. Self-awareness has been proposed as a key psychological factor that may mitigate the adverse effects of moral distress. Therefore, this literature review aimed to examine the mediating role of self-awareness in the relationship between moral distress and job satisfaction among ICU nurses. A comprehensive search was conducted across PubMed, CINAHL, PsycINFO, and Google Scholar databases for studies published between 2019 and 2024. A total of 1,042 articles were initially identified, with 10 studies meeting the inclusion criteria after screening and full-text review. The findings indicate that moral distress is highly prevalent among ICU nurses and is associated with burnout, emotional exhaustion, and decreased job satisfaction. Job satisfaction, influenced by both intrinsic and extrinsic factors, plays a vital role in improving nurses’ well-being and reducing turnover intentions. Importantly, self-awareness emerged as a significant mediating factor that helps nurses cope with ethically challenging situations by enhancing emotional regulation, resilience, and alignment between personal and professional values. Nurses with higher levels of self-awareness demonstrated lower levels of moral distress and higher job satisfaction. Interventions such as reflective practices and debriefing sessions were found to strengthen self-awareness and improve coping mechanisms. In conclusion, self-awareness plays a crucial role in buffering the negative effects of moral distress on job satisfaction among ICU nurses. Promoting self-awareness through targeted interventions may enhance nurse well-being, improve job satisfaction, and ultimately contribute to better patient care outcomes and healthcare system sustainability.
Background: Hair loss is a frequent and distressing manifestation among patients with hypothyroidism. In addition to thyroid hormone imbalance, deficiencies in vitamins and minerals may contribute to impaired hair follicle function. Objective: This study aimed to assess serum vitamin and mineral profiles in patients with hypothyroidism-associated hair loss and to explore their relationship with thyroid hormone status. Methods: the study was conducted on a total of 90 participants, including 65 patients diagnosed with hypothyroidism-associated hair loss, 25 control - and sex-matched apparently healthy control subjects, groups aged 30 and over. Serum levels of vitamin D3, vitamin B12, zinc, iron, ferritin, calcium, magnesium, thyroid-stimulating hormone (TSH), triiodothyronine (T3), and thyroxine (T4) were measured using standard laboratory techniques. Venous blood samples were collected for analysis of hematological, hormonal and biochemical parameters. Comparative and correlation analyses were performed to evaluate differences between patients and controls and to assess associations between biochemical parameters and hair loss. Results: Reduced serum levels of vitamin D3, vitamin B12 and calcium (P≤0.05), Iron (p < 0.01), ferritin (p < 0.01), Magnesium (p < 0.01) and zinc (p < 0.01) were commonly observed among patients with hair loss. Elevated TSH levels showed an inverse association with selected micronutrients, particularly iron stores and vitamin D3. No consistent association was found between calcium or magnesium levels and hair loss. Conclusion: Micronutrient deficiencies are common among patients with hair loss associated with hypothyroidism. Periodic assessment of vitamin and mineral levels can support overall clinical management and help improve hair health.
Breast cancer remains the most frequently diagnosed cancer among women globally and continues to pose major public-health challenges because screening uptake and early help-seeking behaviour remain uneven across and within countries. This revised systematic literature review examines communication and behaviour-change interventions relevant to breast cancer prevention, screening, and early detection, with particular attention to the applicability of Communication for Behavioural Impact (COMBI) as a conceptual framework. A literature search was conducted in January 2025 using PubMed and Google Scholar. The source manuscript reports that 45 records were screened and 28 studies met the inclusion criteria. The available evidence indicates that most interventions were broader communication or behaviour-change strategies rather than explicitly labelled COMBI programmes. Across the accessible literature, the most promising approaches were multi-component interventions combining reminders, culturally tailored communication, interpersonal support, navigation, community outreach, and where relevant, reduction of structural barriers. Similar studies in the wider literature also suggest that educational interventions may improve screening uptake, knowledge, and beliefs, but the magnitude and consistency of effect vary substantially according to population, intervention intensity, and context. Overall, the evidence supports the relevance of COMBI-aligned approaches while also indicating that COMBI-specific effectiveness in breast cancer prevention has not yet been conclusively established. The review therefore recommends cautious positioning of COMBI as a useful organising framework for designing effective communication strategies rather than as a directly validated intervention package in this field.
BACKGROUND: The Boko Haram insurgency in North-Eastern Nigeria has caused widespread displacement and severe psychological distress, particularly among internally displaced women. OBJECTIVE: This study examined the prevalence, severity, and sociodemographic correlates of depression and post-traumatic stress disorder (PTSD) among internally displaced women in Maiduguri, Nigeria. METHODS: A descriptive cross-sectional design was adopted. A total of 2,046 women aged 18 years and above were selected through multistage sampling from internally displaced persons (IDP) camps. Data were collected using a sociodemographic questionnaire, the Hopkins Symptom Checklist-25 (HSCL-25), and the Harvard Trauma Questionnaire (HTQ). Data were analyzed using descriptive statistics, correlation, and multiple regression analyses at p < .05. RESULTS: The prevalence of depression and PTSD was 94.4% and 79.6%, respectively, with 72.6% of participants experiencing comorbidity. Most respondents reported moderate to severe psychological distress. Depression and PTSD were significantly associated with age, marital status, education, employment, and duration of displacement (p < .01). Regression analysis showed that all sociodemographic variables significantly predicted PTSD, with duration of displacement as the strongest predictor (R² = .181, p < .001). The depression model was also significant (R² = .075, p < .001). CONCLUSION: Internally displaced women in Maiduguri experience a high burden of mental health problems. Integrated, gender-sensitive, and trauma-informed interventions are urgently required.
BACKGROUND: Cancer education has been a core element of Japan’s National Basic Plan for Promoting Cancer Control since 2012. As school-based programs expand, it becomes increasingly important to understand how such education is perceived by families affected by parental cancer. While cancer education is expected to promote accurate knowledge and reduce stigma, it may also pose unique challenges for children whose parents have cancer. This study explores the perceptions and experiences of cancer education among parents diagnosed with cancer and their children, and it identifies key educational considerations from the perspective of those directly affected. METHODS: A cross-sectional questionnaire survey was conducted between February and September 2020 among elementary- to high-school-aged children (grades 4–12) with a parent diagnosed with cancer and their parents. Participants were recruited through a nonprofit organization that provided support to families whose parents had cancer. Data were collected by mail and analyzed using descriptive statistics and thematic categorization of free-text responses. RESULTS: Valid responses were obtained from 55 children and 65 parents. Among them, 30.9% of parents and 32.3% of children reported having received cancer education at school. Although more than 80% of parents and 93% of children perceived cancer education as necessary, the reasons differed. Parents emphasized the importance of fostering communication within the family and preparing children for the future. In contrast, children valued the role of education in promoting social understanding, reducing prejudice, and ensuring fair access to information. Parents expressed concerns about the emotional impact of cancer education on their children, requesting notice and emotional support before and after the lessons. However, the children expressed relatively few requests for special considerations, and some appreciated the opportunity to engage in conversations with their parents about cancer. CONCLUSIONS: Both parents and children acknowledge the importance of school-based cancer education. Parents focused on emotional protection and family dynamics, while children emphasized social understanding and educational equity. These findings demonstrate the value of integrating both perspectives when designing inclusive, sensitive, and flexible cancer education programs in collaboration with families, schools, and healthcare professionals.
PURPOSE: To compare communication-training components at Fukushima Medical University (FMU) and the National University of Singapore (NUS) and identify practices that could strengthen communication education at FMU. METHODS: During a four-week FMU–NUS exchange (two weeks at NUS’s Centre for Medical Education and two weeks in a clinical rotation), the first author observed curricula, teaching methods, small-group tutorials, simulation and role-play sessions, formative feedback processes, and bedside coaching. Comparative analysis focused on curriculum design, instructional methods, opportunities for practice, and mechanisms for reflection and feedback. RESULTS: NUS implements a longitudinal, integrated model in which communication skills are introduced early, reinforced across preclinical and clinical years, and taught through interactive, student-centered methods (small-group cases, simulation, role-play, early clinical exposure, and structured reflection). Faculty deliberately link classroom learning with in situ clinical coaching and routine formative feedback. FMU operates a spiral curriculum that revisits domains over six years but remains largely lecture-based; practical opportunities for guided practice and reflection are limited, and connections between theory and clinical application are often implicit. CONCLUSIONS: Embedding experiential learning, early clinical exposure, structured feedback, and student–faculty partnerships into FMU’s communication curriculum could accelerate development of competence and confidence and better align education with international standards. Practical, feedback-rich strategies are recommended to translate theoretical content into consistent clinical performance.
The purpose of this article is to analyze the determinants of demand for street medicines in the Republic of Congo. Based on a statistical analysis of survey data, the following variables—the occupation of the purchasers of these medicines, their income, their level of education, and their assessment of the effectiveness of medicines imported from Democratic Republic of Congo (DRC)—represent the determinants of demand for street medicines. Eradicating the sale of these illegal medicines requires the implementation of a better public policy on medicine prices, their availability, and the accessibility of healthcare for the entire population. Coordination of sub- regional health policies between Congo and its neighboring countries also appears necessary.
Burnout is classified as an occupational phenomenon rather than a medical condition. It is manifested by a triad that includes emotional exhaustion (EE), depersonalization (DP), and diminished feelings of personal accomplishment (PA). The study aimed to determine the prevalence and associated factors of burnout among nurses at the Cardiac Center in Madinah. This cross-sectional study was held at the Cardiac Center, Al-Madinah, in May 2024. For burnout evaluation, the validated Maslach Burnout Inventory-Human Services Survey was used. Independent-samples t-tests and analysis of variance (ANOVA) were conducted to test for associations between burnout dimensions and independent variables. Multiple linear regression analysis was used to develop the predictor model for burnout. Out of 320 nurses invited, only 222 responded and completed the survey. Sixty percent of participants scored high on EE, 25 (11.3%) scored high on DP, while 72 (32.4%) scored low on PA. Participants who worked more than 8 hours per day, were Filipino, and had no children showed significantly higher mean EE scores. The mean DP scores were significantly different among the groups of participants who worked more than 8 hours per day. Those who worked 1-8 overtime hours per week had significantly lower mean PA scores. The study found that the majority of the nurses had a high score on at least one of the burnout subscales. Some sociodemographic and work-related factors associated with burnout such as working hours and the number of children.
Background: Hemophilia is a rare X-linked bleeding disorder that commonly presents with hemarthrosis. Although the joints bleed easily, exercise is encouraged to support joint function. Unfortunately, some patients avoid exercise due to perceived barriers and a lack of motivation. Objective: This quality improvement study was conducted over 6 months to promote exercise among hemophiliacs through education, coaching, and monitoring. The primary outcome was improvement in physical fitness, including parameters: maximum oxygen uptake (VO2 max), 6-minute walk test (6MWT), and wall squat (WS). The secondary outcomes were improvements in perceptions and quality of life (QoL). Study design: A prospective observational study was conducted among hemophiliacs nationwide from April to October 2021, during the pandemic peak in Thailand. Methods: 35 participants were included, with hemophilia A and B comprising 32 and 3, respectively. The severity of hemophilia was moderate (31.4%) and severe (68.6%). Smart watches were distributed for monitoring and assessment. The primary outcome was measured 3 times and analyzed using repeated-measures ANOVA. The secondary outcomes were collected from an electronic questionnaire pre- and post-monitoring and analyzed using the Wilcoxon signed-rank test. Results: A total of 34 male participants were enrolled. The mean age was 25.8±9.3 (12-44). VO2 max means were 60.9±10.3, 46.5±6.5, and 46.5±6.3 ml/kg/min, which declined significantly after 3 months, but did not differ significantly between the 3rd and 6th months. Means of 6MWT were 407.9±164.4, 470.8±136.50, 507.5±115.63 meters and increased statistically significantly (p<0.001). The means of WS were 62.6±57.7, 93.2±67.3, 113.9±69.6 seconds, and increased statistically significantly (p<0.001). Exercise perception scores increased statistically significant (3[0-3] vs. 6[6-6], p<0.001) and exercise anxiety scores decreased statistically significant (7[6-8] vs. 4[2-6], p<0.001). QoL scores increased statistically significant (7[5-8] vs 9[7-9], p<0.001). Conclusions: Exercise monitored via smartwatch showed improvements in 6MWT, reflecting aerobic exercise, and WS, reflecting muscle strengthening. Meanwhile, VO2 max did not show concurrently, which might be from various factors. Furthermore, participants showed a significant increase in perception and QoL scores after completing the study.
Obstetric Fistula is widely debated in the literature, but little is known about pregnant women's perceptions of the condition. This paper was aimed at identifying the level of enlightenment of pregnant women in a medical institution in Ilesha, Nigeria, regarding the risk factors and causes of obstetric fistula This was a facility-based cross-sectional study conducted among 570 pregnant women attending antenatal clinics at the Wesley Guild Hospital, Ilesha, between January 2023 and February 2025. Statistical Software Package (STATA) version 18 was used for analysis. Tables were used to present descriptive data as percentages. Chi-square and parallel multivariate logistic regression were used to identify the factors associated with obstetric fistula knowledge. The level of significance was p<0.05, with a 95% CI. The majority of research participants (65.2%) were between the ages of 18 and 23, and 37.4% had no formal education. The study found that 16.7% of respondents had good knowledge of obstetric fistula. Poor knowledge of obstetric fistula showed a significant association with younger age (p < 0.001) and lower educational status [aOR = 8.55; p < 0.001; 95% CI (2.83-25.81)]. The participants in the study had limited knowledge regarding obstetric fistulas. The study found significant associations between age and education with knowledge of obstetric fistula. Thus, there must be a broad campaign to raise awareness of obstetric fistulas and encourage girls' education.
Church leaders have used scripture to encourage congregants to reflect on their health choices. Still, this study focuses on Black pastors who used other approaches to prompt awareness about COVID-19 and vaccination. The purpose of the study is to explore how Black posters use medical information and scripture to discuss COVID-19 vaccination within the communities they serve. This study uses a phenomenological design; ten Black pastors in South Carolina were recruited through snowball sampling to learn about their information dissemination practices during the COVID-19 pandemic. The study describes their rhetoric, foregrounding medical facts and supporting them with biblical passages. The pastors who participated in semi-structured interviews presented scientific information to the church community and encouraged members to "follow the science." Two central themes emerged from the study: 1) Stand by the science to educate the Black community about COVID-19 vaccines, and 2) Balancing science and scripture to reinforce positive COVID-19 vaccine messaging. The study's implication demonstrates how Black pastors are instrumental in providing a narrative of factual health information in a spiritual setting.
BACKGROUND: Infertility affects an estimated 186 million people globally, with about 12% of couples of reproductive age being affected. In sub-Saharan Africa, the prevalence of infertility ranges between 9% and 30%, and individuals often experience stigma, gendered blame, and psychosocial distress. The role of nurses in infertility care support is paramount to improve patients’ experiences during treatment. In Namibia, research is limited, particularly on nurses’ perceptions of infertility care and patient experiences. METHODS: A qualitative exploratory and descriptive study was conducted between March and August 2024 at four referral hospitals: Intermediate Hospital Katutura, Windhoek Central Hospital, Intermediate Hospital Rundu, and Intermediate Hospital Oshakati. Eleven nurses were purposively sampled from the gynaecology departments. A semi-structured interview guide was used for the interviews. Data were analysed thematically using Braun and Clarke’s six-step framework, guided by the health belief model. Trustworthiness was ensured through Lincoln and Guba’s criteria. RESULTS: Five themes and twelve subthemes emerged: inadequate fertility care in the public sector, characterised by limited diagnostic and treatment options and financial barriers. Limited nursing roles and insufficient knowledge in psychosocial support. Patient experiences are marked by sadness, denial, and stigma, with women disproportionately blamed while men are often denied responsibility. Cultural and gender expectations that reinforced stigma and discouraged psychological support. Desired infertility care improvements, including the introduction of In Vitro fertilisation in the state facilities, community education, adoption options, training for nurses, and dedicated infertility clinics. CONCLUSION: Infertility care in Namibia remains inadequate, with important gaps in service provision and psychosocial support. Nurses emphasised the need for comprehensive infertility care in the public sector, strengthening nursing roles through training and the integration of patient-centred approaches to address stigma, gendered blame and emotional distress.
This study aimed to understand the research hotspots, current status, and development trends of qualitative research in perinatal nursing from the establishment of the database to December 31, 2023. Using the Web of Science core database as the data source, English language articles of perinatal nursing qualitative research published during this period were retrieved. And we analyzed the annual number of papers, national and institutional co-authorship network, journal distribution and citation, co-authorship and co citation of authors, keyword co-occurrence network and clustering. A total of 751 articles were finally included. The number of papers on qualitative research of perinatal nursing s has shown a continuous upward trend. The number of articles published in the United States ranks first, and exhibited the highest total link strength. The University of California, San Francisco was the institution with the largest number of publications. Research hotspots in this field include the evolving concept of maternal "care," the intersection of mental health and psychological support, childbirth decision-making, and maternal experiences. Emerging research frontiers involve personalized health management for pregnant women and prenatal healthcare services. In recent years, qualitative research in perinatal nursing has continued to develop. Future studies should perform ongoing bibliometric analyses across multiple databases to capture real-time research hotspots and accurately track trends in this field.
The phenomenon of the multiple burden of malnutrition, which includes undernutrition, overweight, obesity, and micronutrient deficiencies, presents a significant public health challenge in middle-income countries (MICs). However, there is scanty literature that examines the MICs as a separate group, with most combining the MICS with the low-income countries. Most of the studies explore the malnutrition issue in the LMICs (Low and middle-income countries). Given their importance in the global landscape, the MICs deserve a separate examination. This study presents the status, trends and burden of malnutrition in the MICs and uses color mapping schemes to identify malnutrition hotspots. The analysis points to the existence of multiple burdens of malnutrition in these countries. The study reviews the drivers of malnutrition. The results suggest that effective strategies must integrate multi-sectoral approaches that address the shared drivers of malnutrition, including food insecurity and dietary patterns.
This study investigates the primary risk factors for hypertension in Malawi using predictive analytics and the CARROT-BUS (Capacity Building, Accountability, Resources, Results, Ownership, Transparency – Bottom-Up Strategy) model as a guiding framework. Drawing on baseline data from a population-level control cohort study, multiple machine learning models—Logistic Regression, Random Forests, Support Vector Machines (SVMs), Neural Networks, and XGBoost—were applied to assess predictive performance. Among them, XGBoost achieved the highest accuracy (88%) and AUC-ROC (0.92), followed by Random Forest and Logistic Regression. Key predictors included age, body mass index (BMI), systolic blood pressure, physical inactivity, and high sodium intake. In parallel, qualitative data from focus group discussions (FGDs) provided contextual insights into community knowledge, attitudes, and barriers regarding hypertension prevention and care. Participants revealed widespread misconceptions about hypertension symptoms and causes, reliance on traditional medicine, inadequate infrastructure, and medication shortages. The CARROT-BUS model served as a lens to assess systemic enablers and constraints, emphasizing the importance of community ownership, transparent resource allocation, and sustainable intervention planning. This mixed-methods approach demonstrates the value of integrating machine learning with participatory community engagement to guide data-informed, culturally relevant public health strategies. While the cross-sectional nature of the baseline data limits causal inference, and some self-reported variables may reflect social desirability bias, the study offers actionable insights for improving hypertension control in low-resource settings. Future phases, including midline and endline assessments, will further evaluate the effectiveness and sustainability of the interventions. These assessments are critical for enabling causal inference and determining the longitudinal impact of the intervention on hypertension control.
Cushing syndrome (CS) is a rare endocrine disorder characterized by continuous exposure to abnormally high cortisol levels, most often from endogenous hypercortisolism. The standard treatment for ACTH‑independent CS is unilateral adrenalectomy (UA), which carries a risk of postoperative adrenal insufficiency due to hypothalamic‑pituitary‑adrenal (HPA) axis suppression. This review examines glucocorticoid replacement therapy (GRT) after UA. Recent evidence supports tailoring GRT duration to each patient’s adrenal recovery. Under moderate stress, the adrenal cortex normally produces the equivalent of 10 mg hydrocortisone or 2.5 mg prednisolone daily, and glucocorticoids must be tapered gradually, sometimes over several months to more than a year, to prevent insufficiency. Not all patients recover by six months. Some with overt CS require 11–12 months or longer. Unrecognized subclinical hypercortisolism or pheochromocytoma can increase perioperative risk, so close monitoring of hormone levels and clinical symptoms is essential. In conclusion, personalized GRT, step‑wise dose reduction, and vigilant endocrine follow‑up are important to safe recovery and improved long‑term outcomes after UA.
BACKGROUND: Gender differences in anxiety disorders and personality have been reported, but few studies have evaluated gender differences in the relationship between anxiety and personality in a normative sample. AIM: The goal of the present study was to evaluate gender differences anxiety and personality in a normative sample. METHOD: In the present study, 124 (94 female, 30 male) undergraduate students were evaluated with the State Trait Anxiety Inventory and the NEO Five Factor Inventory of personality. RESULTS: The female participants showed greater Trait Anxiety and Neuroticism than male participants, with trends for the female participants to show greater State Anxiety and Agreeableness than the male participants. Both male and female participants showed strong relationships between State and Trait Anxiety and increased Neuroticism. Additionally, both male and female participants showed a relationship between decreased Extraversion and increased Anxiety. Neither gender showed any relationship between anxiety and Openness, consistent with other studies. The female participants, but not the male participants, showed strong relationships between higher State and Trait Anxiety and lower Agreeableness and lower Conscientiousness. CONCLUSION: The different relationship of anxiety and personality in the male and female participants may suggest that this relationship may have a different underlying structure in each gender.
Reviewer Acknowledgements for Global Journal of Health Science, Vol. 17, No. 5, 2025.
