School of Nursing

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    Latent Class Analysis Of The Capacity Of Countries To Manage Diabetes And Its Relationship With Diabetes-Related Deaths And Healthcare Costs.
    (BMC Health Services Research, 2025-01-15) Akyirem et al.
    Abstract Background The prevalence of diabetes is escalating globally, underscoring the need for comprehensive evidence to inform health systems in efectively addressing this epidemic. The purpose of this study was to examine the pat terns of countries’ capacity to manage diabetes using latent class analysis (LCA) and to determine whether the pat terns are associated with diabetes-related deaths and healthcare costs. Methods Eight indicators of country-level capacity were drawn from the World Health Organization Global Health Observatory dataset: the widespread availability of hemoglobin A1C (HbA1c) testing, existence of diabetes registry, national diabetes management guidelines, national strategy for diabetes care, blood glucose testing, diabetic retin opathy screening, sulfonylureas, and metformin in the public health sector. We performed LCA of these indicators, testing 1–5 class solutions, and selecting the best model based on Bayesian Information Criteria (BIC), entropy, cor rected Akaike Information Criteria (cAIC), as well as theoretical interpretability. Multivariable linear regression was used to assess the association between capacity to manage diabetes (based on the latent class a country belongs) and dia betes-related deaths and healthcare costs. Results We included 194 countries in this secondary analysis. Countries were classifed into“high capacity” (88.7%) and“limited capacity” (11.3%) countries based on the two-class solution of the LCA (entropy=0.91, cAIC=1895.93, BIC=1862.93). Limited capacity countries were mostly in Africa. Limited capacity countries had signifcantly higher percentage of their deaths attributable to diabetes (adjusted beta=1.34; 95% CI: 0.15, 2.53; p=0.027) compared to high capacity countries even after adjusting for income status and diabetes prevalence. Conclusions Our fndings support the report by the Lancet commission on diabetes, which suggests that difer ences in diabetes outcomes among countries may be explained by variations in the capacity of and investments made in their health systems. Future studies should evaluate initiatives such as the WHO Global Diabetes Compact that are currently underway to improve the capacity of resource-limited countries.
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    Quality Of Life of Adolescents Living with Sickle Cell Disease in the Accra Metropolis
    (University of Ghana, 2021-08) Ajusiyine, M.J.
    Sickle Cell Disease (SCD) is an inherited genetic disorder characterized by chronic haemolytic anaemia, painful ischaemic episode of vaso-occlussion and progressive organ failure. SCD is endemic worldwide affecting millions of particularly children and has been declared by the World Health Organization and the United Nations as a disease of public health importance. Despite this, very little attention is given to the disease in Ghana. This study explored the quality of life of adolescents living with SCD in the Accra Metropolis. This qualitative research adopted the exploratory descriptive design. Purposive sampling was used to sample 11 adolescents receiving care at the 37 Military Hospital. All participants were interviewed face-to-face after ethical approval was sought. Thematic analysis was used to analyze data, which went on concurrently with verbatim transcription of audio recorded interviews. Four main themes and twenty-nine subthemes were derived. The four main themes include physical, psychological, social and spiritual well-being. The findings revealed that majority of the adolescents experienced fatigue, sleep disturbances, pain, and limitation in roles. All reported absenting themselves from school at some point. Again, majority reported receiving adequate family, social, financial, and emotional support. Few however, reported being stigmatized, feeling depressed, and feeling anxious. Few associated SCD with curse, and witchcraft. All the adolescents said their sources of inner strengths were their parents and God and that they had great hope they would get well. It is expected that the findings would improve care. These findings have implications for nursing practice, education, administration and research.