Midwifery Students’ Confidence in New-Born Care at Completion of Training in Selected Midwifery Schools in Zambia. A Multicentric Study: A Case of Zambia

Background: Quality education is one of the important factors in empowering midwives to provide quality health care services to mothers and newborns irrespective of their practice settings. Due to lack of standardization of the duration, content, and structure of midwifery education and different pathways to midwifery across the world, midwives may lack the confidence to deliver quality health care services in the main domain of the ICM competences. Aim: To assess the confidence of final year midwifery students in the domain of new-born care based on the ICM midwifery competencies. Methods: The first phase consisted of a quick situation analysis of midwifery education and regulation in Zambia, followed by a cross-sectional survey through a self-administered questionnaire to assess the confidence of final year midwifery students. Results: Most (51.9%) of the respondents were aged between 18 and 28 years, and majority of them were placed in Levels 1, 2 and 3 Hospitals and also clinics for their clinical practice, with between one hundred to ten thousand annual births, followed by 16.9% who were placed in Level 3 hospitals only. Most students (38.3%) reported receiving classroom instruction by both Lecture and Demonstration. Few students (22.7%) responded that they were not satisfied with their clinical supervision, while 77.3% were satisfied. There was significant association between confidence to perform skills independently and having enough time to practice on models in the labs (p value = 0.024), confidence when practiced for the first time on mothers (p value = 0.007) and satisfaction with supervision during clinical practice (p value = 0.000). Binary logistic regression of characteristics associated with confidence to perform new-born skills independently revealed significant association between satisfaction with clinical supervision and confidence to perform skills independently, 95% CI [1.83, 15.37]. Conclusion: Midwifery students need quality training both theoretically and practically in order for them to gain confidence in newborn care upon completion of their training. They need adequate time to practice on models in the skills laboratory, and need adequate clinical supervision for them to gain confidence in performing new born skills independently.

Screening of New Born and Infants for Hearing by OAE

The present study was carried out in the department of the otorhinolaryngology at a Secondary health care institute, with the aim of screening of new born (especially high risk) for hearing with OAE (Oto Acoustic Emission test). Loss of impairment of auditory sense is the most prevalent deficit of all sensory organs. Hearing impairment causes a huge impact on one’s social, educational, and economic wellbeing. There are about 5 - 6 infants who have hard of hearing out of 1000 neonates. It was carried out over a period of 15 months (April 21 to July 22) in association with department of Paediatrics. 645 new born and infants were screened by DPOAE (Distortion Product Oto Acoustic Emission) test for congenital hearing impairment. 54 new born infants out of 645 neonates screened showed “refer” in our study. To decrease the burden of morbidity of hearing loss in the society, universal new born hearing screening (UNBHS) policy is the concept to diagnose and treat at the earliest age of affected child, because early detection remains the primary element to decrease the associated morbidity.

Pattern of Development in Foals from Four Different Breeds between Birth and Weaning

Several studies have shown a major development in height and cannon bone circumference in foals from birth to weaning and from different breeds. However, in Brazil, there is little information about foal development. For this reason, this study has used data on foals from seven different farms in Pernambuco, Northeast Brazil, where horses have a major economic importance. The aim of this study was to compare foal’s development from four breeds and to develop a regression formula in order to estimate such development. It was used data from 210 suckling foals (Arabians n = 18, Campolina n = 86, Mangalarga Marchador n = 42 and Quarter Horses n = 64), raised in similar management practices. Their height at withers, heart girth, and cannon bone girth were measured monthly from birth to weaning. Data we reanalyzed by ANOVA and Tukey Test, with P established in 5%. The highest mean of height at withers was observed in the Arabian foals, and it was similar to Campolina and Mangalarga Marchador foals. The last breed presented a higher percentage of gain in height (~36%) and higher heart girth. On the other hand, Campolina foals had the highest mean of cannon bone girth. There was a significant interaction between breed and development phase in heart and cannon bone girths. All regression for mulas obtained from this data was very significant, and it was showed that they can predict height at withers in the four breeds studied. Heart and cannon bone girths showed medium value of R2 and large significance. It is important to highlight that fetal programing produces significant impact on foal development, even after weaning. So, this study would have observed some more changes if its scope had been extended beyond this phase.

Application of the sodium hyaluronate-CNTF scaffolds in repairing adult rat spinal cord injury and facilitating neural network formation

The present study aimed to explore the potential of the sodium hyaluronate-CNTF (ciliary neurotrophic factor) scaffold in activating endogenous neurogenesis and facilitating neural network re-formation after the adult rat spinal cord injury (SCI). After completely cutting and removing a 5-mm adult rat T8 segment, a sodium hyaluronate-CNTF scaffold was implanted into the lesion area. Dil tracing and immunofluorescence staining were used to observe the proliferation, differentiation and integration of neural stem cells (NSCs) after SCI. A planar multielectrode dish system (MED64) was used to test the electrophysiological characteristics of the regenerated neural network in the lesioned area. Electrophysiology and behavior evaluation were used to evaluate functional recovery of paraplegic rat hindlimbs. The Dil tracing and immunofluorescence results suggest that the sodium hyaluronate-CNTF scaffold could activate the NSCs originating from the spinal cord ependymal, and facilitate their migration to the lesion area and differentiation into mature neurons, which were capable of forming synaptic contact and receiving glutamatergic excitatory synaptic input. The MED64 results suggest that functional synapsis could be established among regenerated neurons as well as between regenerated neurons and the host tissue, which has been evidenced to be glutamatergic excitatory synapsis. The electrophysiology and behavior evaluation results indicate that the paraplegic rats’ sensory and motor functions were recovered in some degree. Collectively, this study may shed light on paraplegia treatment in clinics.