Quality of care for patients with hypertension in selected Health Centres in Rwamagana District, Rwanda

Background Hypertension is the main risk factor for cardiovascular diseases and its prevalence is high in Rwanda. Rwanda has integrated the management of hypertension in health centres (HCs). However, little is known about the quality of hypertension care in HCs in Rwanda. Study objective To examine the quality of care for patients with hypertension and associated outcome of hypertension control in Health Centres. Methods A cross-sectional study design was used, and data were collected from a convenience sample of 202 patients. A self-reported questionnaire and blood pressure measurement were taken. Data were analysed using descriptive, bivariate, and hierarchical logistic regression analyses. Results A total of 166 (82.2%) patients participated in the study. Of these, 130 (78.3%) were females. Mean age was 57.8 (SD =14.0). The quality of hypertension care process was high with mean score of 5.86 over 7 (SD = 1.4). However, only 30.1% (n = 50/166) had well-controlled hypertension. Comorbidity (OR = 2.3; 95% CI:1.0- 5.1, p =.039) and the quality of care (OR = 1.6; 95% CI: 1.1- 2.4, p = .024) were associated with higher odds of having hypertension control. Conclusion Tailored patient-centred primary care interventions that consider comorbidity could contribute to hypertension control in primary HCs in Rwanda.

Building Nursing and Midwifery Capacity Through Rwanda's Human Resources for Health Program.

Global disparities in the quantity, distribution, and skills of health workers worldwide pose a threat to attainment of the Sustainable Development Goals by 2030 and deepens already existing global health inequities. Rwanda and other low-resource countries face a critical shortage of health professionals, particularly nurses and midwives. This article describes the Human Resources for Health (HRH) Program in Rwanda, a collaboration between the Ministry of Health of Rwanda and a U.S. consortium of academic institutions. The ultimate goal of the HRH Program is to strengthen health service delivery and to achieve health equity for the poor. The aim of this article is to highlight the HRH nursing and midwifery contributions to capacity building in academic and clinical educational programs throughout Rwanda. International academic partnerships need to align with the priorities of the host country, integrate the strengths of available resources, and encourage a collaborative environment of cultural humility and self-awareness for all participants.

Hearing, listening, action: Enhancing nursing practice through aural awareness education.

Abstract Noise overload within the clinical environment has been found to interfere with the healing process for patients, as well as nurses' ability to assess patients effectively. Awareness and responsibility for noise production begins during initial nursing training and consequently a program to enhance aural awareness skills was designed for graduate entry nursing students in an Australian university. The program utilized an innovative combination of music education activities to develop the students' ability to distinguishing individual sounds (hearing), appreciate patients' experience of sounds (listening) and improve their auscultation skills and reduce the negative effects of noise on patients (action). Using a mixed methods approach, students reported heightened auscultation skills and greater recognition of both patients' and clinicians' aural overload. Results of this pilot suggest that music education activities can assist nursing students to develop their aural awareness and to action changes within the clinical environment to improve the patient's experience of noise.

Hearing, Listening, Action: Enhancing nursing practice through aural awareness education.

Abstract Noise overload within the clinical environment has been found to interfere with the healing process for patients, as well as nurses ability to effectively assess patients. Awareness and responsibility for noise production begins during initial nursing training and consequently a program to enhance aural awareness skills was designed for graduate entry nursing students in an Australian university. The program utilised an innovative combination of music education activities to develop the students' ability to distinguishing individual sounds (hearing), appreciate patient's experience of sounds (listening) and improve their auscultation skills and reduce the negative effects of noise on patients (action). Using a mixed methods approach, students' reported heightened auscultation skills and greater recognition of both patients' and clinicians' aural overload. Results of this pilot suggest that music education activities can assist nursing students to develop their aural awareness and to action changes within the clinical environment to improve the patient's experience of noise.

Effect of continuing nursing education on nurses' attitude toward and accuracy of nursing diagnosis.

PURPOSE: To test the effectiveness of a 12-hr educational course on nursing diagnosis, critical thinking, and clinical reasoning. METHOD: This two-group, quasi-experimental study was conducted with 100 practicing nurses, 50 in each group. Attitude was measured by the Positions on Nursing Diagnosis scale. Accuracy of nursing diagnosis was measured with three valid and reliable case studies, and the Lunney scoring method. FINDINGS: After completion, there was a significant difference in the mean attitude between control and experimental groups, and in the accuracy of nursing diagnosis. CONCLUSIONS: Continuing education can improve clinical reasoning, as shown by improved attitudes toward and accuracy of nursing diagnosis. PRACTICE IMPLICATIONS: Nurse educators should create educational strategies for practicing nurses to improve clinical reasoning skills.

Variation and heritability in immune gene expression by diseased honeybees.

Social insects are frequent targets for pathogens and have consequently evolved diverse ways to minimize disease impacts, one of which is the innate immune response. Here, a 4-generation mating scheme was carried out to assess heritability and variation in a honeybee (Apis mellifera) immune trait, the production of the key antimicrobial peptide abaecin. Larval offspring from controlled crosses (n = 576 offspring from 36 singly inseminated queens) as well as offspring of field colonies (896 individuals in 53 colonies) were challenged individually with a widespread bee pathogen, the gram-positive bacterium Paenibacillus larvae. After bacterial challenge, transcript levels for the gene encoding abaecin were quantified and then compared using known pedigrees and colony environments. Considerable variation among highly related siblings (r = 0.75) indicates that subtle allelic differences in immune pathway genes can have large effects on transcriptional profiles. Abaecin levels were moderately heritable (h(2) = approximately 0.3-0.4), reflecting high amounts of standing genetic variation, and suggesting that this and other immune traits are amenable to selective programs aimed at improving honeybee health. The results help efforts to determine the relative effectiveness of social versus individual defenses by social insects toward their pathogens.

Chill sensitivity of honey bee, Apis mellifera, embryos.

Improved methods for preservation of honey bee, Apis mellifera L., germplasm would be very welcome to beekeeping industry queen breeders. The introduction of two parasites and the emergence of an antibiotic resistant disease have increased demands for resistant stock. Techniques for artificial insemination of queens are available, and semen has been cryopreserved with limited success. However, cryopreservation of embryos for rearing queens would mesh well with current practices and also provide drones (haploid males). Eggs at five ages between twenty-four hours and sixty-two hours were exposed to 0, -6.6, and/or -15 degrees C for various times, and successful hatch measured. Honey bee embryos show chill sensitivity as do other insect embryos, and the rate of chill injury increases dramatically with decrease in holding temperature. The 48 h embryos in both groups showed the greatest tolerance to chilling, although 44 h embryos were only slightly less so.