Correlates of Performance of Healthcare Workers in Emergency,Triage, Assessment and Treatment plus Admission Care (ETAT+) Course in Rwanda: Context Matters

Background

The Emergency, Triage, Assessment and Treatment plus Admission care (ETAT+) course, a comprehensive advanced pediatric life support course, was introduced in Rwanda in 2010 to facilitate the achievement of the fourth Millennium Development Goal. The impact of the course on improving healthcare workers (HCWs) knowledge and practical skills related to providing emergency care to severely ill newborns and children in Rwanda has not been studied.

Objective

To evaluate the impact of the ETAT+ course on HCWs knowledge and practical skills, and to identify factors associated with greater improvement in knowledge and skills.

Methods

We used a one group, pre-post test study using data collected during ETAT+ course implementation from 2010 to 2013. The paired t-test was used to assess the effect of ETAT+ course on knowledge improvement in participating HCWs. Mixed effects linear and logistic regression models were fitted to explore factors associated with HCWs performance in ETAT+ course knowledge and practical skills assessments, while accounting for clustering of HCWs in hospitals.

Results

374 HCWs were included in the analysis. On average, knowledge scores improved by 22.8/100 (95% confidence interval (CI) 20.5, 25.1). In adjusted models, bilingual (French & English) participants had a greater improvement in knowledge 7.3 (95% CI 4.3, 10.2) and higher odds of passing the practical skills assessment (adjusted odds ratio (aOR) = 2.60; 95% CI 1.25, 5.40) than those who were solely proficient in French. Participants who attended a course outside of their health facility had higher odds of passing the skills assessment (aOR = 2.11; 95% CI 1.01, 4.44) than those who attended one within their health facility.

Conclusions

The current study shows a positive impact of ETAT+ course on improving participants’ knowledge and skills related to managing emergency pediatric and neonatal care conditions. The findings regarding key factors influencing ETAT+ course outcomes demonstrate the importance of considering key contextual factors (e.g., language barriers) that might affect HCWs performance in this type of continuous medical education.     

Women Are Seen More than Heard in Online Newspapers

Feminist news media researchers have long contended that masculine news values shape journalists’ quotidian decisions about what is newsworthy. As a result, it is argued, topics and issues traditionally regarded as primarily of interest and relevance to women are routinely marginalised in the news, while men’s views and voices are given privileged space. When women do show up in the news, it is often as “eye candy,” thus reinforcing women’s value as sources of visual pleasure rather than residing in the content of their views. To date, evidence to support such claims has tended to be based on small-scale, manual analyses of news content. In this article, we report on findings from our large-scale, data-driven study of gender representation in online English language news media. We analysed both words and images so as to give a broader picture of how gender is represented in online news. The corpus of news content examined consists of 2,353,652 articles collected over a period of six months from more than 950 different news outlets. From this initial dataset, we extracted 2,171,239 references to named persons and 1,376,824 images resolving the gender of names and faces using automated computational methods. We found that males were represented more often than females in both images and text, but in proportions that changed across topics, news outlets and mode. Moreover, the proportion of females was consistently higher in images than in text, for virtually all topics and news outlets; women were more likely to be represented visually than they were mentioned as a news actor or source. Our large-scale, data-driven analysis offers important empirical evidence of macroscopic patterns in news content concerning the way men and women are represented.     

Measuring Microhabitat Temperature in Arboreal Primates: A Comparison of On-Animal and Stationary Approaches

Arboreal primates actively navigate a complex thermal environment that exhibits spatial, daily, and seasonal temperature changes. Thus, temperature measurements from stationary recording devices in or near a forest likely do not reflect the thermal microenvironments that primates actually experience. To better understand the thermal variation primates encounter, we attached automated temperature loggers to anklets worn by free-ranging mantled howling monkeys (Alouatta palliata) to record near-animal ambient temperatures. We compared these measures to conventional, stationary temperature measurements taken from within the forest, in nearby open fields, and at a remote weather station 38.6 km from the field site. We also measured temperatures across vertical forest heights and assessed the effects of wind speed, solar radiation, rain, and vapor pressure on primate subcutaneous temperatures (collected via implanted loggers). Ambient temperatures at measurement sites commonly used by researchers differed from those experienced by animals. Moreover, these differences changed between seasons, indicating dynamic shifts in thermal environment occur through space and time. Temperatures increased with height in the forest, with statistically significant, albeit low magnitude, differences between vertical distances of one meter. Near-animal temperatures showed that monkeys selected relatively warmer microhabitats during nighttime temperature lows and relatively cooler microhabitats during the day. Lastly, the thermal variables wind speed, solar radiation, vapor pressure, and rain were statistically associated with primate subcutaneous temperatures. Our data indicate that the temperatures arboreal primates experience are not well reflected by stationary devices. Attaching automated temperature loggers to animals provides a useful tool for more directly assessing primate microhabitat use.     

Acceptability and suitability of Tuta absoluta eggs from irradiated parents to parasitism by Trichogramma nerudai and Trichogramma pretiosum (Hymenoptera: Trichogrammatidae)

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