bluuebunny/crossref_metadata_2025 huggingface dataset:
Dampak Keteladanan Hidup Keluarga Gembala Terhadap Keharmonisan Jemaat di GBI Serambi Salomo Makassar
Authors: Prihanto Agus , Sapan Andy Mulyadi , Saturi Saturi
Published: July 2024

Abstract: Pastors and their families are important figures in church life. The exemplary life of the pastor's family is an attitude that the congregation often pays attention to. Pastoral families that do not set an example can have a negative impact on the life of the congregation. This can affect the life of the congregation including the harmony of the church family. The focus of the problem in this writing is how the pastoral family can be a good role model so that it can have an impact on the harmony of the congregational family. The research method used is the descriptive qualitative research method, with primary data sources from interviews and secondary data sources from journal articles on the internet. The harmony of the shepherd's family is a form of example for the congregation and this is a form of their ministry. The scope of exemplary family pastors includes integrity, being actively involved in service, paying attention to the congregation, not discriminating in service, being ready to serve, communicating, and being spiritual parents. Family harmony has the following characteristics: solving problems well, complementing each other, loving each other, openness, helping each other, togetherness, and honesty.Keywords: exemplary; shepherd family; The harmony of the church family Abstrak: Gembala dan keluarganya merupakan figur yang penting dalam kehidupan bergereja. Keteladanan hidup keluarga gembala merupakan sikap yang sering diperhatikan oleh jemaat. Keluarga gembala yang tidak memberi teladan dapat memberikan dampak yang buruk bagi kehidupan jemaat. Hal ini dapat mempengaruhi kehidupan jemaat termasuk keharmonisan keluarga jemaat. Fokus permasalahan dalam penulisann ini adalah bagaimana keluarga gembala dapat menjadi teladan yang baik, sehingga dapat memberi dampak pada keharmonisan keluarga jemaat. Metode penelitian yang digunakan yaitu metode penelitian kualitatif diskriptif, dengan sumber data primer dari hasil wawan cara dan sumber data skunder dari artikel-artikel jurnal dari internet. Keharmonisan keluarga gembala menjadi bentuk keteladanan bagi jemaat dan hal ini merupakan bentuk pelayanan mereka. Ruang lingkup keteladanan keluarga gembala antara lain berintegritas, terlibat aktif dalampelayanan, memberikan perhatian kepada jemaat, tidak membeda-bedakan dalampelayanan, siap sedia untuk melayani, komunikasi, dan menjadi orang tua rohani. Keharmonisan keluarga memiliki ciri-ciri :Menyelesaikan persoalan dengan baik, saling memperlengkapi, saling mengasihi, keterbukaan, tolong menolong, kebersamaan, dan kejujuran.Kata kunci : Keteladanan; Keluarga gembala; Keharmonisan keluarga jemaat
Kajian Teologis Terhadap Kepemimpinan Perempuan Menurut Kitab Ester di Jemaat GBI Visi Pemulihan Nanggala Toraja
Authors: Matta Ruth Ester Maevi , Toisuta Jakson Sespa
Published: July 2024

Abstrak: Kepemimpinan merupakan suatu hal yang tidak bisa dipisahkan dari kehidupan manusia, khususnya dalam suatu organisasi atau kelompok masyarakat maupun dalam kehidupan kekristenan, dan sangat dipengaruhi oleh kaum laki-laki. Kepemimpinan merupakan satu komponen yang mengatur kelompok atau organisai untuk mencapai tujuan. Namun saat ini perempuan juga memiliki andil yang besar dalam tugas kepemimpinan dan semakin meningkat dalam semua segi kehidupan, serta memiliki status dan kedudukan yang sama dengan laki-laki dalam hal kepemimpinan. Tujuan dari penelitian ini yaitu agar dapat mengetahui gaya kepemimpinan perempuan lewat kajian teologis menurut kitab Ester dalam membangun jemaat di GBI Visi Pemulihan Nanggala Toraja. Metode penelitian yang digunakan yaitu kualitatif deskriptif, dilakukan wawancara untuk memperoleh data dengan responden sebanyak 5 orang Jemaat, kemudian data wawancara di transkip secara verbatim lalu dianalisa dan disimpulkan. Hasil penelitian didapatkan dari kajian teologis kitab Ester terhadap gaya kepemimpinan peremuan di jemaat GBI Visi Pemulihan Nanggala, yaitu : pertama ; memiliki sikap Spiritual untuk membangun iman jemaat. Kedua ; memiliki visi pembaharuan dalam jemaat. Ketiga ; memiliki karakter, berani, tegas dan memiliki kepedulian. Kata Kunci : Kepemimpinan; Kedudukan Perempuan; Pertumbuhan Jemaat
Challenges and Strategies for Implementing Education Management in the Digital Age: A Review of Curriculum Innovation and Development
Authors: Sari Desi Ratna
Published: July 2024

The digital age not only transforms the way we learn but also undergoes changes in educational system management. In an environment influenced by globalization and technological advancements, educational institutions must adapt to more adaptive and innovative models. Educational managers must continually update their strategies and practices to remain relevant and effective in delivering quality education. The importance of educational inclusion in the digital era takes center stage. Despite technology opening access to educational resources for many individuals, challenges remain in ensuring equal access for all, including those in remote areas or with special needs. Therefore, educational management in the digital age must consider the need for justice and inclusion in providing educational services. In the context of higher education, universities are also faced with the demand to prepare graduates with skills relevant to the ever-changing job market. The development of relevant curricula, project-based learning, and partnerships with industries become primary focuses. Cybersecurity challenges also take top priority, given the vulnerability of educational institutions to cyberattacks. It is important to acknowledge that implementing educational management in the digital age also involves cultural and mindset changes within educational institutions. Educational leaders must become progressive change agents and be open to innovation. By fostering a culture of collaboration, experimentation, and continuous learning, the educational environment can become dynamic and responsive to present and future challenges.
REGULATION OF DIGITAL HEALTHCARE SERVICES – (NOT) COVERED UNDER THE DIGITAL SERVICES ACT?
Authors: Sopúchová Soňa
Published: July 2024

The regulation of digital services is currently experiencing significant growth, primarily due to the adoption of new legal regulation at the European Union level, specifically the Digital Services Act. Digital services play a pivotal role in a country's economy by facilitating cross-border trade and enabling entrepreneurs to reach a vast user base, often comprising consumers. Despite their advantages, these services also entail substantial risks, particularly in relation to their widespread and more challenging-to-regulate usage. Alongside their positive impact, they also contribute significantly to the dissemination of illegal and harmful information. In recent years, there has been a notable development and utilization of new electronic information systems within the healthcare sector, accompanied by electronic healthcare services. This connection is not limited to the Covid-19 pandemic but is also a result of the dynamic evolution of information and communication technologies and their potential in healthcare provision. In this paper, the author analyzes the research question regarding which digital healthcare services in the Slovak Republic fall within the scope of the new European legislation. The author examined European regulations, focusing on the types of electronic healthcare services existing in Slovakia. By synthesizing and applying available information and rules to selected electronic healthcare services, the study concludes that the Digital Services Act has only a limited impact on the functioning of these selected digital healthcare services.
PROCESNÉ ASPEKTY PREKÁŽKY LITISPENDENCIE V KONTEXTE SLOVENSKEJ A MEDZINÁRODNEJ PRÁVNEJ ÚPRAVY
Authors: Üvegesová Vivienn
Published: July 2024

Príspevok sa zameriava na jednu z tzv. procesných podmienok, ktorá musí byť daná, aby sa o veci mohlo konať a rozhodnúť. Prekážka litispendencie má svoje významné postavenie v rámci procesných podmienok a jej vznik je podmienený uplatnením „toho istého“ predmetu sporu, či mimosporovej veci na viacerých súdoch, resp. súde a inom orgáne súčasne. Zákonodarca práve v snahe eliminovať množenie sporov v tých istých veciach a v zmysle zásady ne bis in idem ju vníma jednoznačne ako dôvod na zastavenie konania v tých prípadoch, ak je daný predpoklad konania v tej istej veci. V súvislosti s touto prekážkou sú v doktríne civilného procesu zásadné otázky vzájomného vzťahu žaloby na plnenie a tzv. určovacej žaloby. Okrem uvedeného sa autorka v príspevku čiastočne zameriava aj na jej vyhodnotenie v kontexte právnych vzťahov s cudzím prvkom v medzinárodnom právnom priestore a pokúsi sa objasniť, či existujú v tomto zmysle spoločné kritériá pre jej existenciu a to aj s ohľadom na právne následky s ňou spojené.
Control Interno y su incidencia en la Utilidad caso: Almacén Electrorepuestos García, La Maná
Authors: Casa Guerra Victoria Katherine , Saltos Anchundia Mayra Tamara , Díaz Córdova Pedro Enrique
Published: July 2024

En el entorno económico actual, la gestión eficaz del control interno se ha establecido como un pilar fundamental para el éxito de las pequeñas y medianas empresas (PyMEs). Este estudio se centra en el almacén Electrorepuestos García, ubicado en el cantón La Maná, Ecuador, con el objetivo de examinar cómo el control interno influye en su utilidad. A través de un enfoque metodológico mixto que combina análisis cuantitativos y cualitativos, se identificaron mejoras significativas en la utilidad, eficiencia operativa y reducción de pérdidas. Los resultados muestran un crecimiento anual de ventas del 10% al 15% y un aumento en el margen de utilidad neta del 15% al 20% entre 2021 y 2023. Asimismo, se observó una reducción en la pérdida de inventario del 5% al 3% y una disminución de incidencias de control interno del 10% al 20%. Las encuestas cualitativas revelaron una alta familiaridad y compromiso del personal con los controles internos. Este estudio subraya la importancia de la capacitación continua, el monitoreo constante y el compromiso de la dirección para maximizar los beneficios del control interno.
Traditional and GenAI Text Analysis of COVID-19 Pandemic Trends in Hospital Community Benefits IRS Documentation
Authors: Hadley Emily , Marcial Laura , Quattrone Wes , Bobashev Georgiy
Published: July 2024

The coronavirus disease 2019 (COVID-19) pandemic presented unique challenges to the U.S. healthcare system, particularly for nonprofit U.S. hospitals that are obligated to provide community benefits in exchange for federal tax exemptions. We sought to examine how hospitals initiated, modified, or disbanded community benefits programming in response to the COVID-19 pandemic. We used the free-response text in Part IV of Internal Revenue Service (IRS) Form 990 Schedule H (F990H) to assess health equity and disparities. We combined traditional key term frequency and Hierarchical Density-Based Spatial Clustering of Applications with Noise (HDBSCAN) clustering approaches with a novel Generative Pre-trained Transformer (GPT) 3.5 summarization approach. Our research reveals shifts in community benefits programming. We observed an increase in COVID-related terms starting in the 2019 tax year, indicating a pivot in community focus and efforts toward pandemic-related activities such as telehealth services and COVID-19 testing and prevention. The clustering analysis identified themes related to COVID-19 and community benefits. Generative Artificial Intelligence (GenAI) summarization with GPT3.5 contextualized these changes, revealing examples of healthcare system adaptations and program cancellations. However, GPT3.5 also encountered some accuracy and validation challenges. This multifaceted text analysis underscores the adaptability of hospitals in maintaining community health support during crises and suggests the potential of advanced AI tools in evaluating large-scale qualitative data for policy and public health research.
Gender Difference in Risky Sexual Behaviour and Associated Factors among Undergraduate Students in Dambi Dollo University, Ethiopia:
Authors: Gutu Birhanu
Published: July 2024

Background: Youths, whether or not they are sexually active, have increased exposure to sexually transmitted infections including Human Immunodeficiency Virus.
Methods: I used Institution based comparative cross-sectional study design. The data was collected using pretested structured self administered questionnaire. Five hundred seventy nine students received, properly filled and returned the questionnaire.
Results: Life time risky sexual behaviour was higher in male compared to female, 181(54.8.0%) and 54(21.7%) respectively. Respondents with age less than 20 years old were less likely to have life time risky sexual behaviour. Male students were 3.5 times more likely to practice life time risky sexual behaviour compared to female. The likelihood of students ever visited night clubs to practice life time risky sexual behaviour compared to non visitors was high. The odds of the students who ever drunk and ever chewed Kchat to commit life time risky sexual behaviour were more than those who never did for chewing and for alcohol. Ever watching romantic films increased the odds of lifetime risky sexual behaviour by compared to those who did not. Students ever attended sexual and reproductive health education tends to have more odds of lifetime risky sexual behaviour.
Conclusion: Life time risky sexual behaviour was common in this study. Significant gender difference was observed with higher risk in male respondents compared to female. Specific Strategies that address and promote safe sexual and reproductive health should be identified and implemented. The finding from this study provided insight to gender differences in risky sexual behaviours and associated factors that lead to the development of gender based strategies to combat the development of HIV/IDS, STIs and other reproductive health related problems among adolescents and youths.
Factors Associated with Non-Utilization of Long Acting and Permanent Contraceptive Methods among Married Women of Reproductive Age in Chencha District, Southern Ethiopia
Authors: Alamdo Andamlak Gizaw
Published: July 2024

Abstract
Background: In many developing countries like Ethiopia, access and the utilization of LAPCMs is very low and it also difficult to find them from many reproductive health programs.  The aim of this study was to assess factors associated with non-utilization of long-acting and permanent contraceptive methods among married women in the reproductive age (15-49 years).
Methods: A community based unmatched case-control study was conducted in Chencha District, Southern Ethiopia from November 2015 to December 2015.  Cases were those women who used contraceptive methods other than LAPCMs and women who were not using contraceptive methods. Controls were women who used LAPCMs in their lifetime. Study participants were selected by simple random sampling with proportional allocation to the population size. Records were reviewed and then by tracing their address, the selected samples were interviewed. We analyzed data using SPSS version 20.0 and logistic regression models to identify associated factors.
Results: We enrolled 328 women: factors associated with non-utilization of LAPCMs were identified:  Partner’s lower level of education (p=0.003),  less number of live children (p= 0.04 ,  preference to have children in the future (p=0.042), husband’s approval to LAPCMs ( p=0.002), not informed to use contraception (p= 0.006), started using contraceptives during campaign  ( p= 0.021)  and discussion with health professionals (p= 0.039) were predictors of non-utilization of LAPCMs.
Conclusion: Quality of health service, knowledge are among factors associated to Non-utilization of LAPCMs in the district.  Interventions to improve utilization of LAPCMs in the area should focus on couple’s knowledge, approval and use of family planning and training of service providers in quality care, especially about counseling about family planning, the rights of clients, informed the choice of contraceptive methods
Urinary Incontinence Prevalence during Pregnancy: the Ethiopian perspective
Authors: Kebede Eskinder , Kassaye Getu
Published: July 2024

ABSTRACT
Urinary incontinence (UI) is a common but under-reported problem among women globally. Information on the prevalence and health burden of UI in Ethiopia is unknown. Measuring the prevalence of these symptoms has been difficult because of lack of uniform nomenclature and standardized tool. This study aimed to establish the prevalence of urinary incontinence and its determinants among pregnant women in Addis Ababa, Ethiopia.
This was a cross-sectional study in which the International Consultation on Incontinence criteria qualified Questionnaire was administered in July 2015, to 333 consenting pregnant women aged 15 to 42 years who were attending Antenatal care at, tertiary Hospitals, in Addis Ababa, Ethiopia.
Of the three hundred thirty three pregnant women 82(24.6%) reported Urinary Incontinence. Thirty eight (11.4%) reported stress urinary incontinence only, 15(4.5%) reported urge incontinence only and 29(8.7%) reported mixed incontinence during the preceding month (8% had moderate or severe symptoms). Sixty nine percent of these had not consulted a health care professional. The determining factor for prevalence of UI was the mode of delivery. Of the pregnant women who practiced C/S the prevalence of UI was lower than those women whose mode of delivery was vaginal (AOR: 0.46:95%CI (0.22, 0.98).
This study showed that many pregnant women in Ethiopia suffer in silence from a variety of lower urinary tract symptoms. There is need to create awareness among women with symptoms as nearly two third (64%) of those with daily episodes of urinary incontinence do not seek help. Health care providers must build their capacity to recognize, investigate and manage lower urinary tract morbidities in pregnancy
Keywords: Lower urinary tract symptoms, Pregnancy, ICI, the Leister Urinary Symptom Questionnaire, Addis Ababa, Ethiopia
GUIDELINES AND BEST PRACTICE RECOMMENDATIONS ON CONTRACEPTION AND SAFE ABORTION CARE SERVICE PROVISION AMID COVID-19 PANDEMIC: SCOPING REVIEW
Authors: Asfaw Mariamawit , Tolu Lemi Belay , Urgie Tadesse , Nigatu Balkachew , Bekele Delayehu , Asrat Shiferaw Matiyas
Published: July 2024

Abstract
Introduction: Policy makers and health professionals prefer to use summarized evidence of practice recommendations. The aim of this scoping review is therefore to identify available practice recommendations on contraception and safe abortion care service provision during the COVID-19 pandemics.
Methods: We searched guideline databases and websites of professional associations and international organizations working on sexual and reproductive health. Additionally, we searched: PubMed, EMBASE Google Scholar MedRxiv and Research Square. We included English records labelled guideline, or recommendation, or consensus, or practice parameter, or position papers on contraception and safe abortion care service practice during the COVID-19 pandemics. Data extraction was done by two independent reviewers using a customized tool that was developed to record the key information of the source that is relevant to the review question. The difference between the two authors on data extraction was resolved by discussion.
Results: Fourteen records on safe abortion care and thirteen records on contraception service were identified. Identified recommendations were categorized into thematic areas. The records addressed approaches to the safe medication and surgical abortion, self-serving family planning and long term and reversible contraception.
Conclusions: Consensus statements and recommendations consistently stated that there should be access to contraception service and safe abortion care during the COVID-19 pandemics. The practice recommendations focus on innovative ways of service provision to minimize patient and staff exposure to COVID-19 as well as alleviate the burden on the health care system. These include utilizing telemedicine or digital health and community/home-based care or self-care 
Keywords: COVID-19, Pandemic, Reproductive health, Abortion, Contraception.
Disrespect and abusive maternity care and associated factors in the labor and delivery wards of public health facilities in Assosa Zone, Ethiopia
Authors: Abamila Nahom , Agago Tesfamichael , Garedew Muluneh
Published: July 2024

Background: Disrespect & abuse during maternity care significantly affects a woman's decision to look for service and the quality of care she receives. Yet, its burden is not well identified in the developing regions of Ethiopia, specifically in the study area.
Methods: Facility-based cross-sectional study design was employed. A total of 437 sampled mothers who attended labor and delivery wards of public health facilities of the Assosa zone were recruited using a systematic random sampling method. Data were collected using a semi-structured interviewer-administered questionnaire.
Results: The overall prevalence of D&A was 350 (82.4%). The most reported types of D&A were non?consented care (68.0%), non-confidentiality (35.5%), and physical harm (33.6%).
Conclusions: The prevalence of D&A was high. Hence, health facility managers, professionals, and other development partners should aim to make healthcare facilities more client-centered and attuned to the community's needs for safe maternity care.
Keywords: Disrespect; Abusive care; Mistreatment; Childbirth; Maternity care.
The prevalence of post-term pregnancy and its associated factors at Adama Hospital Medical College, Adama, Ethiopia
Authors: Tegene Dereje , Mohammed Kedir , Amana Kebed
Published: July 2024

Background: Pregnancy that extend to or beyond 42 completed weeks of gestation  is defined as a post-term pregnancy. Post-term pregnancies are associated with increased risk of fetal, neonatal and maternal mortality and morbidity. This study aimed to assess the prevalence of post-term pregnancy and its associated factors.
Methods: Institutional based cross sectional study was conducted on 328 laboring women at Adama Hospital Medical College, Southeast Ethiopia. The study partcipants were selected by systematic random sampling technique. Data entry was made by Epi- info 7 and SPSS version 20 was used for analysis. Descriptive & analytical statistics were performed. Logistic regression analysis was used to identify factors associated with post-term pregnancy (P < 0.05).
Results: The prevalence of post-term pregnancy was 13.7% (95% confidence interval (CI) 10.1 – 18.2%). Previous history of post-term pregnancy (AOR = 7.94; 95% CI: 1.70 - 37.10), family history of post-term pregnancy (AOR = 5.51; 95% CI: 1.08 - 28.02), and having a male fetus (AOR = 2,62; 95% CI: 1.07 - 6.39) were significantly increased the risk of post-term pregnancy. Induction of labor (AOR = 7.35; 95% CI: 3.15 - 17.16), operative vaginal delivery (AOR = 7.06; 95% CI: 1.72 - 29.00), low 5th minute APGAR score (AOR = 4.24; 95% CI: 1.06 - 12.84), and Neonatal intensive care unit (NICU) admission rate (AOR = 3.59; 95% CI: 1.01 - 12.84) were significantly associated with post-term pregnancy.
Conclusions: The prevalence of post-term pregnancy was higher in the study area. Previous history of post-term pregnancy, family history of post-term pregnancy, having a male fetus, induction of labor, operative vaginal delivery, low 5th minute APGAR score, and NICU admission rate were significantly associated with post-term pregnancy.   
Key words: Adama, Ethiopia, Post-term pregnancy, Gestational age.
DETERMINANTS OF PELVIC ORGAN PROLAPSE AMONG WOMEN VISITING ARBA MINCH, SAWLA AND JINKA GENERAL HOSPITALS, SOUTHERN ETHIOPIA
Authors: Abdulkadir Hanan , Menur Berhanu Nida  , Sultan Hussen Hebo  , Teshale Fikadu  , Zeleke Gebru  , Bitew Mekonnen chekole
Published: July 2024

Background: Pelvic organ prolapse is one of the most common gynecological health problems; it can severely limit a woman's psychological, social, physical, and sexual function. The factors causing pelvic organ prolapse have been poorly understood. Therefore this study aimed to investigate the determinants of pelvic organ prolapse among women visiting Arba Minch, Sawla, and Jinka General Hospitals, Southern Ethiopia.
Method: Institution-based case-control study was conducted from July 10 to August 31, 2020, in Arba Minch, Sawla, and Jinka general hospital. A total of 348 participants were included in the study.  Cases and controls were identified by health professionals using the pelvic organ prolapse symptom score (POP-SS). Data was collected by using a pre-tested interviewer-administered questionnaire. Bivariate logistic regression was done to identify variables candidate for Multivariable logistic regression at p-value <0.25. Multivariable logistic regression analysis was done and p-value <0.05 and 95%CI of AOR were used to declare the level significance.
Result: Age of the mother at first delivery (AOR=4, 95% CI: 1.48-11.53), carrying heavy object (AOR=2.8, 95% CI: 1.9-7.62), place of previous delivery (AOR=3.6, 95% CI: 1.37-9.47), mode of previous delivery (AOR=3, 95% CI: 1.73-8.44), family history of pelvic organ prolapse. (AOR=4, 95% CI: 1.63-11.2), body mass index (AOR=4, 95% CI: 1.82-12.9) and household food insecurity (AOR=3, 95% CI: 1.51-7.75) were identified as the determinants of pelvic organ prolapse.
Conclusion: In this study age of the mother at first delivery, carrying a heavy object, place of previous delivery, mode of previous delivery, body mass index, family history of pelvic organ prolapse, and household food insecurity were factors found to be significantly associated with pelvic organ prolapse. Therefore, to prevent pelvic organ prolapse health care providers should counsel mothers for maintaining normal weight and skilled delivery. Also, women in the community should be screened for food insecurity and linked with the agriculture sector.
A case of Uterine didelphis with cervical atresia: A Case Report
Authors: Fantahun Yitbarek , Kebede Eskinder , Abate Hamelmal
Published: July 2024

Congenital uterine malformations are deviations from normal anatomy resulting due to defective fusion of Mullerian ducts or the paramesonephric ducts in the developing embryo.
 The prevalence of female genital tract anomalies is 4%-7% in general population and up to 8%-10% in women who have recurrent pregnancy loss.(1)  The type and degree of anatomical distortion has associated health implications that may include, cyclical abdominal pain, reproductive failure, obstructed menses and inability to engage in sexual intercourse.(2)   
Uterus didelphys (double uterus) is a developmental abnormality that results from the failure of fusion of the Mullerian ducts leading to separate uterine cavities and 2 cervices 1. It is a rare anomaly accounting for 5% of all uterine anomalies. (3)  Cervical agenesis is a rare Mullerian anomaly with an incidence of 1 in 80,000 females. (4)  It represents 3% of all uterine anomalies. It is rarely associated with a functioning uterus (4.8%). Cervical agenesis is often associated with vaginal atresia (less than 50%). It is important to classify these anomalies for easy diagnosis and plan appropriate preoperative treatment.
An Observational Study of Treatment Outcomes of Uterine Myoma among Clients who had Undergone Invitro Fertilization at a Public Center in Addis Ababa, Ethiopia
Authors: Teshome Abel , Dr. Mustefa Negash  , Dr.Feiruz Surur  , Dr.Feiruz Surur
Published: July 2024

Background: - For clients undergoing invitro-fertilization(IVF) there is no consensus regarding the management of non-cavity distorting Intramural myoma 
Objective: To assess the prevalence and treatment outcomes of IVF clients with uterine myoma.
Methods: A 2-year (April 1 2019-April 1,2021) chart review was conducted for 1300 infertile women who had undergone IVF. Categorical data were summarized in proportion, and continuous data were summarized using mean, median, and standard deviation where appropriate. Bivariate logistic regression was conducted to assess the association between predictor variables and the outcome variable (clinical pregnancy). P-Value < 0.05 was taken to be significant
Results: Of the total 1,300 IVF clients, 282 (21.7%) cases were diagnosed to have myoma. Among the 13 cases of cavity distorting intramural myoma who underwent IVF without myomectomy, all were negative for clinical pregnancy, whereas among the 60 cases of cavity distorting myoma who had pre-IVF myomectomy followed by IVF, 16 (26.7%) were positive for clinical pregnancy. This difference was not statistically significant (P=0.160).
Among 138 cases of non-cavity distorting Intramural Myoma who had undergone IVF without pre-IVF myomectomy, 38 (27.5%) had clinical pregnancy. In contrast, among 19 cases who had undergone pre-IVF myomectomy followed by IVF, only 2 (10.5%) had a clinical pregnancy. This difference was not statistically significant (P=0.160).
Conclusion: While not statistically significant, conducting pre-IVF myomectomy for cavity distorting myomas improves clinical pregnancy, while pre-IVF Myomectomy does not improve clinical pregnancy for women with non-cavity distorting myoma. we recommend further research with a larger sample size
Prevalence and Associated Factors of Postpartum Modern Contraceptive Uptake among Mothers Delivered at Mekelle Public Hospitals, Northern Ethiopia
Authors: Teka Hale , James Tesloach , Tesfay Frewoini , Amare Birhane , Yemane Awol
Published: July 2024

Background
Postpartum family planning has the potential to reduce maternal and child morbidity and mortality. A short birth interval of less than two years is associated with adverse health effects for the mother and baby and the society as a whole. Postpartum contraceptive uptake is one of the lowest in Ethiopia.
Objectives
The aim of this study was to determine the magnitude and associated factors of postpartum family planning acceptance in Mekelle public hospitals from 1 April to 31 July 2022.
Methodology           
The cross-sectional study design was employed. Data were collected prospectively using an interviewer-administrated structured questionnaire. In both hospitals (i.e. Mekelle General Hospital and Ayder Comprehensive Specialised Hospital), 399 mothers were interviewed in their immediate postpartum period. Data were analysed using the Statistical Package for Social Sciences (SPSS) version 22. In addition to descriptive statistics, Pearson’s chi-square test was used for bivariate analysis of sociodemographic and reproductive health factors and postpartum family planning. Multiple logistic regression was used to explore factors associated with postpartum contraceptive use.
Results
The prevalence rate of family planning uptake in the immediate postpartum period was 17.8% (n=71). More than a third (n=152, 38.1%) of mothers in this study did not receive appropriate family planning. Slightly more than half (52.8%) intend to use contraceptives at 6 weeks postpartum. Compared to those who did not counseled, those who were counseled were ten times more likely to receive postpartum family planning (AOR=10.1, 95% CI: (3.911-26.375). Women who gave birth by cesarean delivery used family planning twice more than those who gave vaginally (AOR = 1.954, 95% CI: (1.072-2773).
Conclusion
Despite the high-risk obstetric population in teaching hospitals, a small proportion of women used family planning. Furthermore, many women did not receive appropriate counseling on postpartum family planning. Counseling was the most significant factor influencing postpartum modern contraception uptake. Because referral and teaching hospitals host a large number of high-risk mothers, immediate postpartum family planning uptake should be considered a very important element of care. Previous studies have reported that most women who planned to come for contraceptive uptake 6 weeks postpartum do not actually come. Therefore, timely (ie, periconceptional and antepartum) and appropriate counseling should be advocated to increase the immediate adoption of postpartum family planning.
Key words: Postpartum family planning, counseling, contraception,
Prevalence of Episiotomy and Factors Associated with Its Practice in Three Teaching Hospitals, Addis Ababa, Ethiopia
Authors: Kebede Eskinder , Fantahun Yitbarek , Hassen Sofia
Published: July 2024

Background: Episiotomy is a surgical incision into the perineum and posterior vaginal wall during the second stage of labor to increase the diameter of the soft tissue pelvic outlet to facilitate delivery. Episiotomy rates vary from population to population. Limited information exists related to the practice of episiotomy in Ethiopia.
 
Objective:  To assess the prevalence of episiotomy practice and associated factors at three teaching hospitals (Tikur Anbessa Hospital, Gandhi Memorial Hospital, and Zewditu Memorial Hospital) in Addis Ababa Ethiopia.
Method and Materials: Hospital-based cross-sectional study was conducted from January 2022 to March 2022 on 386 mothers who had a vaginal delivery in the three hospitals. A structured questionnaire was used to collect data.  The data was entered, coded, and analyzed using Statistical Package for Social Science (SPSS) version 25. Binary and multivariable logistic regression analyses were performed. P value ? 0.05 was used to determine the level of statistically significant variables.
Results: The prevalence of episiotomy was 49%. Age ?24 years (AOR=0.17, 95%CI=0.055, 0.52), operative vagainal delivery (vacuum AOR=3.1, 95%CI=1.50,18.67 and forceps AOR=3.5, 95%CI=1.87, 11.06), duration of second stage of labor ?2HR (AOR=3.5, 95%CI=1.87, 11.06), birth weight of newborn ?4000 grams (AOR=5.3, 95%CI=95%CI, 1.28, 22.02) and FGM (AOR=2.8, 95%CI=1.64, 4.94) were factors significantly associated with episiotomy practice.
Conclusion:  The prevalence of episiotomy in this study (49%) is higher than the WHO’s recommendation (10%).  Variables that remained associated significantly with episiotomy were maternal age, instrument delivery, duration of the second stage of labor ?2HR, newborn weighing ?4000 grams, and FGM. An effort should be made to reduce the prevalence of episiotomy by adhering to the correct indications and preparing periodic on-job training regarding the indication of episiotomy to all obstetric care providers.
Relationship between Endometrial Thickness and Pregnancy Outcomes in Assisted Reproductive Technology Cycles
Authors: Abdulahi Ahmed Mutasim
Published: July 2024

ABSTRACT
Objective:  To explore the relations of different ultrasonic endometrial thickness (EMT)values on hCG trigger day and the pregnancy rate (PR) after fresh embryo transfer (ET) in controlled ovarian stimulation (COS) cycles.
Background: Successful implantation and delivery require both the functional embryo and receptive endometrium in assisted reproductive technology (ART) cycles which is an expensive procedure with low implantation and pregnancy rate (PR). It is estimated that embryos account for one-third, and suboptimal endometrial receptivity for the remaining two-thirds of implantation failures. There is still an ongoing debate regarding the predictive ability of ultrasonic endometrial evaluation on the day of human chorionic gonadotrophin (hCG) trigger during controlled ovarian stimulation (COS) on the outcomes of pregnancies after in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI).
Method: A retrospective review of data from medical records of all patients who underwent COS, oocyte retrieval, IVF/ICSI, and fresh ET between March 2021and July 2022 at Centre for Fertility and Reproductive Medicine (CFRM), St Paul Millennium medical College (SPHMMC) Addis Ababa, Ethiopia. Patients were categorized based on their ET outcome (as pregnant or non-pregnant) and EMT values on the day hCG trigger (groups A <8mm, B 8-12mm, and C>12 in mm) to study and analyze if any relation between endometrial thickness and pregnancy rate existed.
Results: A total of 548 records were analyzed. PR was 40.9%. The odds of pregnancy were higher among patients with EMT group B (82.8% vs 74.6%, p=0.05) and was shown to be significant after controlling for the effects of multiple confounding factors. Although receiver operator curve (ROC) analysis indicated that EMT has a limited value to be used as an indicator of the pregnancy rate as evidenced by the area under the curve (AUC) of 0.59 (95% CI= 0.53, 0.63), it was not possible to determine a cutoff of the endometrial thickness value with an acceptable trade-off between sensitivity and specificity
Conclusion: There is a positive relationship between the EMT measured on the day of hCG injection and PR and that EMT is an independent factor. Further prospective study is needed to explore the issue in more detail in our setup.
TIMELY INITIATION OF POSTPARTUM MODERN CONTRACEPTIVE UTILIZATION AND ASSOCIATED FACTORS AMONG WOMEN OF CHILD BEARING AGE IN ARBA MINCH TOWN PUBLIC HEALTH FACILITIES, GAMO ZONE, ETHIOPIA
Authors: Mancho Mayaye
Published: July 2024

ABSTRACT
 
Background: Most the women average time to first postpartum ovulation is 45 days and can occur as early as 25 postpartum days (1). But, many women do not recognize that they are at risk of pregnancy during this period. Most postnatal women are exposed to pregnancy, by seven to nine months after delivery up till now have not obtained contraceptives (2).
 
Objectives: - To assess the timely initiation of postpartum modern contraceptive utilization and associated factors among women of childbearing age in Arba Minch Town health facilities.
 
The method:-An institutional-based cross-sectional study was employed using pretested interviewer-administered questions among 574 interviewees. The systematic random sampling method was done from April 15 to May 15, 2020. Bivariate and multivariate logistic regression analysis was done. P-value < 0.05 was used to consider as statically significant variables.
 
Results: The magnitude of timely initiation of postpartum contraceptive utilization was found to be 260 (45.3%) 95% [CI: 40.1-49.0]. The educational level of respondents, (AOR=0.46; 95% [CI: 0.31-0.71], No of ANC visit [AOR=2.913,95% [CI:1.39-6.07], counseling of postpartum family planning after the last delivery (AOR=2.29,95% [CI:1.46-3.58], couple discussed (AOR=4.94,95%[CI:3.01-8.09], resumption of sexual intercourse (AOR=1.74, 95% [CI: 1.36-2.77] and return of menses (AOR=(6.6, 95% [CI:1.91-22.78) were significantly associated variables with timely initiation of postpartum contraceptive utilization.
 
Conclusion: less than half of the study participants have timely initiated modern contraceptives in Arba Minch Town. Family planning programs should be established incorporated at antenatal and postnatal follow-up actively. 
 
Keywords:  Timely initiation, modern contraceptive,
Sexual and Reproductive Health Services Utilization among Adolescents in South Ethiopia: Examining the Role of Stigma, Social Support, and Self-Efficacy
Authors: Boti Negussie , Abebe Kerbo Amene , Daka Gidebo Kassa , Dibaba Wado Yohannes
Published: July 2024

Abstract
Introduction: Despite the high burden of Sexual and Reproductive Health (SRH) during adolescence and it associated negative consequences. Yet, relatively little attention has been given to the role of stigma, social support, and self-efficacy in adolescents’ SRH services utilization. Therefore, this study aimed to examine the role of stigma, social support, and self-efficacy in adolescents’ SRH services utilization in South Ethiopia.
Methods: A total of 1172 adolescents were selected using a multistage stratified random sampling method.  Correlation analysis was performed to identify relationships between the variables. A structural equation model was used to examine the chain and single mediating roles of self-efficacy and perceived social support.
Results: This study found that the direct, indirect, and overall effects of SRH-related stigma on the utilization of SRH services were significant. A single mediation effect via perceived social support was -0.0017 [bootstrap 95% CI: -0.0026, -0.0007] and self-efficacy was -0.00123 [bootstrap 95% CI: (-0.0023, -0.0002)] in the association between SRH service utilization and SRH-related stigma. The chain mediation effect test showed that perceived social support and self-efficacy mediated the effect of SRH-related stigma on SRH service utilization, with a mediation effect score of -0.0025 [bootstrap 95% CI: (-0 .0034, -0.0015)].
Conclusion: The association between SRH-related stigma and SRH service utilization was partially mediated by self-efficacy and perceived social support. The chain mediation effect test also confirmed that perceived social support and self-efficacy sequentially mediated the effect of SRH-related stigma on SRH service utilization. Therefore, designing comprehensive interventions that target “3S” stigma, social support, and self-efficacy may be effective in improving service utilization.
Keywords: Adolescents; Sexual and Reproductive Health Service; Stigma; Self-efficacy, Perceived social support; South Ethiopia.
INVESTIGATING THE EFFECTS OF PAUSINYSTALIA YOHIMBE AQUEOUS LEAVES EXTRACT ON PARAMETERS FOR REPRODUCTIVE PERFORMANCE IN EXPERIMENTAL RATS
Authors: Ojatula Adekunle
Published: July 2024

ABSTRACT
BACKGROUND: Herbal plants and herbal preparations are widely used as immunomodulatory medicines that helps in improving reproductive health in humankind, and they are globally used and have rapidly grown in economic developmental importance.
OBJECTIVE: The study was conducted to investigate the effects of the aqueous extract of P. yohimbe leaves on sexual reproductive performance in Wistar rats. The primary outcome of the study is the reproductive performance sexual rate.
METHODS: The experimental study was carried out on albino rats of the Wistar strain, weighing between 150 and 200g sexually naive. The animals were raised in polyethylene cages and divided into four groups, which received a saline solution (control group), 2, 5, and 10 mL/kg of the aqueous extract of P. yohimbe leaves for fourteen days orally. The sexual behavior test was performed according to three types of crossing.
RESULTS: The results of the treated groups showed a significant increase in mating frequency compared to the control group. Overall, the results showed that P. yohimbe significantly affects sexual behavior. The aqueous extract of P. yohimbe leaves increased sexual behaviour and orientation activity performance recorded in the treated rats.
CONCLUSION AND RECOMMENDATION: The enhanced reproductive performance appetitive detected in the study, justify the indigenous use of the herbal plant in reproductive medicine and could be a precursor in the synthesis of useful drugs. However, based on the current findings, we recommend that careful administration be considered as a better option justifying human circumstances for patient with advanced mankind age in low dosage resource settings, as it achieves a better reproductive performance rate at a lower dose dependent increase.
Obstetric HDU: A Supply-Based Alternative for ICU Care in a Low-Income Setting: A Descriptive Study
Authors: Fessehaye Abraham , Bekele Delayehu , Belay Lemi , Birara Malede , G.Medhin Genet , Abdulkadir Abdulfetah , Gudu Wondimu , Fessehaye Abraham
Published: July 2024

Abstract
 
Background: The demand of ICU care for obstetric patients is rising in low-income settings, where there is low ICU-bed capacity. Introduction of obstetric High-dependency unit (HDU) has been described as an effective strategy to bridge this gap in resource-restricted settings.
 
Objective: To describe the clinical characteristic and maternal outcomes of obstetric patients admitted to the first obstetric HDU in Ethiopia.
Study Design:  This was a descriptive study on clinical characteristics and maternal outcomes of obstetric patients admitted to obstetric HDU over one year (October 2021 to September 2022) at St. Paul’s Hospital Millennium Medical College (Ethiopia). Data were collected retrospectively through reviewing patients’ medical records using a data extraction format with KOBO collect tool. Data were analyzed using SPSS version 23 and simple descriptive statistics were employed. Proportions and percentages were used to present the results.
Results:  After excluding 18 patients who did not meet the inclusion criteria, a total of 355 obstetric patients who were admitted to an obstetric HDU were included in the final analysis.  Among these all-obstetric patients admitted to obstetric HDU, pre-eclampsia/ eclampsia (82/355, 23.1%) and postpartum hemorrhage (66/355, 18.6%) were the most frequent reasons for admission to the HDU whereas cardiac disease constituted 14.1% (50/355) of the indication for admissions to the unit.
Majority (318/355, 89.6%) from the study participants were transferred to other wards with improvement, while 37(7.9%) deteriorated with 9(2.53%) of them died. Septic shock (6/9, 66.6%) and DIC (2/9, 22.2%) were the leading causes of death in the HDU.
Conclusion:  Findings of our study demonstrate that opening HDU in a low-income setting is feasible and results in favorable maternal outcomes. Introduction of obstetric HDU in low-income settings is an effective intervention to reduce severe maternal morbidity and mortality associated with low ICU-bed capacity in those settings.
Adapting through technology: enhancing resilience in environmental planning against climate challenges with IT solutions
Authors: Tano Isagani
Published: July 2024

This study delves into the realm of environmental planning and resilience-building against climate change challenges, focusing on the pivotal role of IT solutions in enhancing adaptive capacity. Through a mixed-method research design, the findings underscore the critical importance of integrating IT solutions into environmental planning processes to bolster resilience. By enhancing data accessibility, stakeholder engagement, risk assessment, and adaptive management, organizations can better prepare for and respond to environmental uncertainties. However, addressing barriers such as limited infrastructure access, technological literacy gaps, and financial constraints is crucial for promoting widespread adoption. Collaboration between public and private sector stakeholders is essential to overcome these obstacles and capitalize on facilitators for successful implementation. The study highlights the transformative potential of data-driven IT solutions in decision-making and strategic planning, particularly in the face of climate variability and extreme weather events. Moreover, IT innovations facilitate cross-sectoral collaboration by fostering information exchange, expertise sharing, and resource collaboration among stakeholders, with public administration's support being integral for promoting integration and overcoming barriers to collaboration. Ultimately, this study emphasizes the urgent need to leverage IT solutions for enhancing resilience in environmental planning against climate challenges.
Climate change in the digital era: the role of IT in enhancing environmental planning for climate mitigation
Authors: Tano Isagani
Published: July 2024

This study delves into the role of Information Technology (IT) in enhancing environmental planning for climate mitigation in the Philippines, uncovering disparities in digital tool availability, utilization, challenges, and perceived benefits. Employing a mixed-method approach, the findings reveal significant discrepancies in digital tool availability across regions, suggesting notable disparities in access that can impact planning effectiveness. Moreover, while digital tools are highly utilized across various environmental planning sectors, challenges such as limited access to technology infrastructure, insufficient digital skills, and resistance to change pose barriers to adoption. However, perceived benefits include enhanced stakeholder engagement, improved decision-making, and increased transparency. Addressing disparities in digital access, fostering digital literacy, and targeted interventions to overcome barriers are crucial for leveraging digital solutions effectively. Ultimately, this study underscores the transformative potential of digital tools in promoting inclusive and participatory environmental planning processes for climate resilience.