Experiences of professional autonomy among critical care nurses in Kenya: a qualitative study

Exercising autonomy allows nurses to demonstrate their knowledge and skills. However, more information is needed about the critical care nurses' perceptions of their professional autonomy in rural areas. Objective: To explore the perceptions, facilitators and barriers to professional autonomy among critical care nurses in rural Kenya. Methods: The hermeneutic phenomenological study design was used in this study. Data were collected in a critical care unit using a semi-structured interview guide. A sample of 10 participants were recruited. The study was conducted in Nyeri County Referral Hospital. Results: Three themes emerged from the study on the nurses' experiences of professional autonomy, perceptions of autonomy, facilitators of autonomy, and barriers to autonomy. Conclusion: Autonomy undeniably plays a pivotal role in defining the professional status of the nursing profession. Perceptions, facilitators and barriers to professional autonomy form the background of the current professional status. Nurses, therefore, exercise autonomy effectively when it aligns with patient care needs and when a conducive environment supports it.

The pituitary reserve for gonadotrophins and prolactin in women under long-term use of depo-medroxyprogesterone acetate (DMPA) as a contraceptive.

PIP: Pituitary reserve was assessed in women who had used depo-medroxyprogesterone acetate (DMPA) for 1, 5 and 10 years, and their responses were compared to 2 control groups--IUD users and noncontraceptive users. 100 ug GnRH and 200ug TRH were injected as a bolus and the Follicle Stimulating Hormone (FSH), Luteinizing Hormone (LH) and Prolaction (PRL) responses noted. The basal PRL levels were similar in all groups. The PRL response to stimulation was significantly greater among 5 and 10 year DMPA users and also IUD users. The mean basal levels of LH were within the normal follicular phase range in all groups. However, the response to stimulation was significantly higher among 1 and 5 year DMPA users when compared with noncontraceptive users. The basal serum FSH levels in both the study and control groups were comparable to those of normally cycling women in the follicular phase. The response to stimulation was greater in the 10 year DMPA users when compared to both the noncontraceptive users and IUD users. The study shows that basal levels of FSH, LH and PRL were similar in the study and control groups. The observed amplified response to stimulation among longterm DMPA users could be the result of failure of gonadotropin cyclic release, possibly resulting in increased pituitary reserves.^ieng

Baseline studies on semen and hormonal parameters in fertile Black males in Kenya.

PIP: Masturbatory semen specimen from 49 fertile Black African males in Kenya whose wives were pregnant was obtained after at least 3 days of abstinence for the analysis of parameters which included volume motility, vitality, sperm concentration, pH, fructose and acid phosphatase levels. About 1/2 the spermatozoa was actively progressive in motility, while 40% was nonmotile. Vitality in the 1st hour revealed that 81.4% of the sperm was alive. About 90% of the semen specimens had more than 40% idea forms of spermatozoa. Spermatozoal abnormalities were a frequent feature. There was no correlation between age and the testicular volume, but seminal fluid volume and sperm density tended to decrease with age. Serum levels of Follicle Stimulating Hormone, Luteinizing Hormone, Prolactin and Testosterone were determined in the subjects' sera, enabling the establishment of reference values for these parameters in African Kenyan males.^ieng