BackgroundPost-intensive Care Syndrome (PICS) is defined as various physical, psycho-logical, and cognitive, impairments that can arise during an ICU stay, continueafter leaving the ICU, or even persist following hospital discharge. It impactsboth patients and their family’s quality of life. Various primary studies worldwidehave reported prevalence of PICS among ICU survivors. However, these studiesexhibit inconsistency and wide variations. Therefore, this systematic review andmeta-analysis aimed to estimate the pooled prevalence of post intensive caresyndrome among intensive care unit survivors along with its association with ICUlength of stay.MethodsWe used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA) 2020 checklist for this review. We searched PubMed/Medline, CINHAL,Embase, and Google scholar to retrieve articles. The Newcastle Ottawa Scale (NOS)was used for quality assessment of articles. The random effects model with I-squaredtest was used to estimate the prevalence of PICS and its association with ICU lengthof stay. To identify the source of heterogeneity within the included studies, meta-regression and subgroup analysis were used. We employed Egger’s regression testand funnel plots for assessing publication bias. STATA version 17.0 software wasused for all statistical analyses. A p-value of < 0.05 with 95% confidence interval wasused declare statistically significant.
ResultsA total of 19 articles with a population of 10179 ICU-survivors were included in thisreview. The pooled prevalence of PICS was found to be 54.35% (95% CI = 45.54,63.15). In sub-group analysis by region, the highest prevalence was observed instudies done in south and north America with overall prevalence of 61.95% (95%CI = 28.33, 95.62). Among the three domains of PICS (physical, cognitive and mentaldomains), the highest prevalence score was observed in the physical domain withoverall prevalence of 45.99% (95% CI = 34.66, 57.31). In this meta-analysis, thosepatients who stayed more than four days in the ICU were 1.207 [95% CI = 1.119,1.295] times more likely to develop at least one among the three domains of PICS inthe post-intensive care period than their counterparts.ConclusionThis systematic review and meta-analysis demonstrate a high prevalence of PICSamong ICU survivors, and highlight the significant association between ICU lengthof stay and the development of PICS. These findings underscore the need for tar-geted interventions to mitigate the long-term effects of critical illness, particularly forpatients with prolonged ICU stays.

Introduction Nurse burnout negatively impacts patient care quality, safety, and outcomes, while harming nurses’mental health, job satisfaction, and retention. It also imposes financial burdens on healthcare organizations throughabsenteeism, reduced productivity, and higher turnover costs, highlighting the need for research to address thesechallenges. The umbrella review methodology was selected to integrate evidence from multiple systematic reviewsand meta-analyses, offering a broad and in-depth summary of existing research to guide practice and policy. Thisapproach equips stakeholders with a holistic understanding of the multifaceted impacts of nurse burnout, facilitatingthe design of effective interventions that support nurses, enhance healthcare delivery, and optimize patientoutcomes. Consequently, this umbrella review aims to evaluate the global prevalence and contributing factors ofnurse burnout.Methods This umbrella review included 14 systematic reviews and meta-analyses identified from various databases.The quality of each study was assessed using the Assessment of Multiple Systematic Reviews (AMSTAR II). Data wereextracted using Microsoft Excel and analyzed with STATA 17.0. Heterogeneity was measured using Higgin’s I2 Statistics,and summary prevalence estimates were calculated with the Der Simonian-Laird random-effects model. Meta-regression and subgroup analyses were conducted to identify the source of high heterogeneity. Publication bias wasassessed using funnel plots and Egger’s regression test, with the former providing a visual assessment of bias and thelatter offering a statistical method to detect asymmetry.Results The global prevalence of nurse burnout was evaluated in three areas: emotional exhaustion (33.45%, 95%CI 27.31–39.59), depersonalization (25.0%, 95% CI 17.17-33.00), and low personal accomplishment (33.49%, 95% CI28.43–38.55). Emotional exhaustion was most common among nurses working during the COVID-19 pandemic(39.23%, 95% CI 16.22–94.68). Oncology nurses experienced the highest rate of depersonalization (42%, 95% CI16.71–77.30), while nurses in intensive care units reported the highest rate of low personal accomplishment (46.02%,95% CI 43.83–48.28).
Conclusions Nurse burnout is prevalent worldwide, often marked by a sense of low personal accomplishment.Several factors contribute to this issue, including role conflict, negative emotions, family problems, moral distress,stress, commuting distance, predictability of work tasks, and workplace advancement.Keywords Nurse, Burnout, Determinant factors, And umbrella review

Introduction
Dyslipidemia is a major risk factor for cardiovascular disease, with its prevalence steadily rising in both developed and developing nations. An unhealthy lifestyle significantly contributes to the development of dyslipidemia, with smoking being a well-known risk factor.
Methods
A comprehensive search was conducted across several databases, including Google Scholar, Web of Science, African Journals Online (AJOL), HINARI, and PubMed/MEDLINE. Articles published up until June 24, 2024, were considered for inclusion. Data extraction and organization were carried out using Microsoft Excel, while analysis was performed using STATA/MP 17.0. The quality of the included studies was evaluated using the Newcastle–Ottawa Scale (NOS). To analyze the pooled data, a weighted inverse variance random effects model with a 95% confidence interval was applied. Heterogeneity among studies was assessed using Cochrane’s I2 statistics, and Egger’s test was conducted to detect potential publication bias. The association between dyslipidemia and its associated factors was examined using the log odds ratio, with a p-value of less than 0.05 considered statistically significant.
Results
A total of 44 articles involving 12,395 participants were included. The overall pooled prevalence of dyslipidemia in Ethiopia was 56.60% (95% CI 50.40–62.80). Dyslipidemia was observed across various population groups, with notable prevalence rates associated with different risk factors. Among individuals with insufficient physical activity, the prevalence was 30.12% (95% CI 22.53–37.70). In those who smoked cigarettes, it was observed in 6.81% (95% CI 4.27–9.34). Among chronic alcohol consumers, the prevalence of dyslipidemia was 15.75% (95% CI 9.65–21.86). Furthermore, 30.12% (95% CI 22.53–37.70) of dyslipidemia was reported among individuals with inadequate physical exercise.
Conclusions
The prevalence of dyslipidemia in Ethiopia was 56.60%, indicating a significant public health concern. The condition is particularly prevalent among individuals with insufficient physical activity, smoking habits, and chronic alcohol consumption, suggesting strong associations with these modifiable risk factors. To reduce dyslipidemia, public health initiatives should focus on promoting physical activity, anti-smoking campaigns, and educating on the risks of excessive alcohol use. Health professionals should also prioritize early detection and management in high-risk groups to reduce long-term cardiovascular risks.

Introduction: The increasing prevalence of diabetes mellites (DM), especially type 2 diabetes mellitus, presents significant challenges for healthcare systems. Effective blood glucose management is essential for preventing serious complications, and telehealth offers a promising approach to improve patient engagement and adherence. The effectiveness of telehealth on blood glucose management should be investigated. The evaluated metric for diabetes management plans in this study was the change in blood glucose levels, specifically HbA1c, as an indicator of glycemic control. The impact of telehealth interventions on these outcomes was analyzed across various patient groups. This review conducts a comprehensive analysis of the current literature to offer insights that can guide clinical practices and inform policymakers about the advantages of telehealth in managing diabetes.
Methods: In this study, several evidence-based databases and relevant clinical trial registries were searched to evaluate the effects of telehealth on blood glucose management among patients with diabetes. The included studies were randomized controlled trials that compared telehealth with traditional in-person management. Microsoft Excel was used to extract and sort the data before it was exported to STATA/MP 17.0 for analysis. A weighted inverse variance random-effects model with a 95% confidence interval was employed to pool the data. Egger's test and Cochrane I2 statistics were used to assess publication bias and heterogeneity, respectively.
Result: This review identified six randomized controlled trials (RCTs) involving a total of 3,995 patients, with 2,022 in the telehealth intervention group and 1,973 in the control group, conducted across the USA, Asia, and Europe. The analysis showed a significant improvement in blood glucose control for patients using telehealth, evidenced by a Standard Mean Difference (SMD) of 0.20 (95% CI: 0.10-0.29; p < 0.001), with USA studies reflecting the highest SMD of 0.24 and diabetic veterans showing an even greater SMD of 0.41.
Conclusion and recommendations: This study demonstrates that telehealth interventions significantly enhance blood glucose management among patients with diabetes. The findings highlight the need for healthcare systems to prioritize telehealth integration into diabetes management protocols while developing tailored interventions to meet the diverse needs of various patient populations.

Keywords:  Blood glucose; Diabetes mellitus; HbA1c; Meta-analysis; Systematic review; Telehealth.

Background: Armed conflicts significantly disrupt healthcare systems, leading to infrastructure destruction, shortages of medical supplies, and reduced access to essential health services. The Amhara region has experienced prolonged conflict, raising concerns about its impact on healthcare delivery. Understanding the extent of these disruptions is crucial for informing policy responses and humanitarian interventions.
Objectives: This systematic review and meta-analysis aimed to assess the impact of armed conflict on healthcare delivery in the Amhara region.
Study design: Systematic review and meta-analysis.
Methods: Conducted between June 1 and July 10, 2024, this meta-analysis followed PRISMA guidelines. A comprehensive search was performed across PubMed/MEDLINE, EMBASE, CINAHL, Google Scholar, ScienceDirect, and the Cochrane Library. Eligible studies included English-language observational studies and grey literature addressing healthcare disruptions, infrastructure damage, and health crises. Data were analyzed using STATA Version 14, and study quality was assessed using a modified Newcastle-Ottawa Scale.
Results: Twelve studies, encompassing 12,037,279 participants, were included. The pooled prevalence of health impacts was 76.71 % (95 % CI: 76.63-76.78). The conflict rendered 60 % of healthcare facilities nonfunctional, disrupted medical supplies for 70 % of the population, and reduced service availability by 80 %. Chronic disease management, mental health services, maternal care, and immunization programs experienced significant declines. Subgroup analyses indicated a higher prevalence of health impacts in studies published after 2022 (70.72 %) compared to those published before 2022 (28.35 %).
Conclusion: Armed conflict in the Amhara region has severely disrupted healthcare services, leading to facility closures, medical supply shortages, and significant declines in essential health services. Urgent interventions are required to restore healthcare infrastructure and services.

Keywords:  Amhara; Armed conflict; Meta-analysis; Prevalence; Systematic review.

IntroductionCancer is a leading cause of global morbidity and mortality, significantly impairing patients’quality of life (QoL). Integrated Palliative Care (IPC) has been proposed as a holisticapproach to enhance quality of life by addressing patients’ physical, emotional, and psy-chosocial needs. While some studies suggest Integrated Palliative Care improves qualityof life more than standard care, the evidence remains inconclusive. This systematic reviewand meta-analysis aim to evaluate the comparative impact of Integrated Palliative Careversus standard care on the quality of life in cancer patients.MethodsA comprehensive search of databases including PubMed, Cochrane Library, and Embase wasconducted. We selected randomized controlled trials (RCTs) comparing Integrated Palliative Careand standard care for cancer patients, focusing on the quality of life as measured by validatedtools such as the EORTC QLQ-C30 and FACT-G. Data were pooled using a random-effectsmodel to account for study heterogeneity. Subgroup and sensitivity analyses were also performed.ResultsNine randomized controlled trials involving 1,794 patients met the inclusion criteria.Meta-analysis showed that Integrated Palliative Care significantly improved quality oflife compared to standard care (SMD = 3.25; 95% CI: 1.20–5.30; p < 0.001). Studiesconducted in Asia showed the highest standardized mean difference (SMD = 6.15; 95%CI: 3.07–9.23; p < 0.001), followed closely by studies from Africa (SMD = 6.0; 95% CI:5.13–6.87; p < 0.001), compared to those from other regions. Similarly, research focusingon lung cancer patients showed the greatest standardized mean difference of (SMD =6.15; 95% CI: 3.07–9.23; p < 0.001) relative to other cancer types. Furthermore, studies
involving newly diagnosed cancer patients recorded the highest standardized mean differ-ence of (SMD = 5.69; 95% CI: 4.57–6.80; p < 0.001).ConclusionIntegrated Palliative Care significantly enhances the quality of life in cancer patients comparedto standard care. These findings support integrating Integrated Palliative Care into oncologypractices to provide comprehensive, patient-centered care that addresses both physical andemotional needs. Further research should explore long-term benefits across diverse populations.

Introduction Depression and anxiety are prevalent psychological disorders that significantly affect physical,emotional, and social well-being, reducing quality of life and increasing medical costs. These issues are especiallychallenging for cancer survivors, complicating treatment management, affecting adherence, and potentiallyimpacting survival rates. Thus, this umbrella review aimed to evaluate the global prevalence of pain, depression, andanxiety, as well as their determinants among cancer patients.Method An exhaustive umbrella review was conducted to systematically assess the prevalence and determinants ofpain, depression, and anxiety among cancer survivors worldwide by analyzing systematic reviews and meta-analyses.The review involved a thorough search of multiple databases and included studies published in English up to July2024 that reported on these symptoms. The process involved screening and selecting studies based on specificcriteria, assessing the risk of bias using the AMSTAR tool, and analyzing data with statistical methods to determineoverall prevalence and identify predictors. This comprehensive approach aimed to provide a detailed understandingof these psychological issues in cancer survivors and guide future research and interventions.Result The global summary prevalence of depression among cancer survivors was 33.16% (95% CI 27.59–38.74),while anxiety had a prevalence of 30.55% (95% CI 24.04–37.06). Pain prevalence after treatment was 39.77% (95%CI 31.84–47.70). Before treatment, 65.22% (95% CI 62.86–67.57) of cancer patients reported pain, which persistedin 51.34% (95% CI 40.01–62.67) during treatment. The analysis also found that during the COVID-19 pandemic,depression and anxiety rates among cancer patients were at their highest, with prevalences of 43.25% (95% CI41.25–45.26) and 52.93% (95% CI 50.91–54.96), respectively.Conclusion The umbrella review found that depression and anxiety prevalence among cancer survivors was33.16% and 30.55%, respectively, with significantly higher rates during COVID-19 at 43.25% and 52.93%. Key factorscontributing to depression included poor social support, advanced cancer stage, and inadequate sleep, while anxietywas significantly linked to advanced cancer stage and poor sleep quality.
Clinical trial number Not applicable.Keywords Cancer, Oncology, Pain, Depression, Anxiety, Cancer survivors, Systematic review, Meta-analysis, Umbrellareview

Introduction: The rising global prevalence of cancer reveals significant regional disparities in palliative care adoption. While some countries have incorporated palliative care into their systems, over half of the world lacks such services, and oncology-specific palliative care integration is sparse. This study evaluates the global prevalence of palliative care use among cancer patients.
Methods: A comprehensive search across multiple databases was conducted to identify relevant studies. Data extraction and organisation were managed using Microsoft Excel, and analysis was performed with STATA/MP 17.0. A weighted inverse variance random-effects model was applied, and heterogeneity was assessed with Cochrane I² statistics. Subgroup analyses, sensitivity analyses and Egger's test were used to explore heterogeneity, publication bias and influential studies.
Results: The global prevalence of palliative care among cancer patients was 34.43% (95% CI: 26.60 to 42.25). Africa had the highest utilisation rate at 55.72% (95% CI: 35.45 to 75.99), while the USA had the lowest at 30.34% (95% CI: 19.83 to 40.86). Studies with sample sizes under 1000 showed a higher utilisation rate of 47.51% (95% CI: 36.69 to 58.32). Approximately 55% (95% CI: 35.26 to 74.80) of patients had a positive attitude towards palliative care, and 57.54% (95% CI: 46.09 to 69.00) were satisfied with the services. Positive attitudes were significantly associated with higher palliative care utilisation.
Conclusion: Only about one-third of cancer patients globally receive palliative care, with the highest utilisation in Africa. Nearly half of patients have a favourable attitude towards palliative care, and a similar proportion are satisfied with the services.

Keywords:  Cancer; End of life care; Nursing Home care; Palliative Care.

Abnormal lipid profiles are a major risk factor for atherosclerosis and cardiovascular diseases andrepresent a growing public health concern influenced by socioeconomic, cultural, and ethnic factors. inethiopia, where chronic illnesses are increasingly prevalent, dyslipidemia poses a significant healthburden. this systematic review and meta-analysis aimed to estimate the pooled prevalence of abnormallipid profiles and identify associated risk factors among chronically ill patients in ethiopia. Relevantstudies were systematically retrieved from multiple databases, and data were extracted and analyzedusing StAtA/MP 17.0. A weighted inverse variance random-effects model was employed to compute thepooled estimates. the analysis revealed a pooled prevalence of abnormal lipid profiles of 54.14%, withthe highest burden found among diabetic patients (75.75%) and in the Southern Nations, Nationalities,and Peoples Region (69.28%). the likelihood of abnormal lipid profiles was significantly higher amongfemales, individuals older than 40 years, and those with hypertension. these findings highlight theurgent need for routine lipid screening and targeted interventions for high-risk populations to addressthe rising burden of dyslipidemia among chronically ill patients in ethiopia.
Keywords: Lipid profile, dyslipidemia, chronic disease, hypertension, systematic review, meta-analysis, Ethiopia

 

Background: In any field, professionalism is essential. A profession can fulfill itsresponsibilities when professionals develop their knowledge in various ways, suchas continuing professional development, expanding their skill levels, adhering tothe norms of the profession, and demonstrating high levels of commitment.Developing professionalism in nurses is a key strategy for improving the qualityof nursing care and healthcare. However, no study has shown a comprehensiveoverview of professionalism in nursing in Ethiopia. Thus, this systematic reviewand meta-analysis aim to present a comprehensive assessment of the overalllevel of professionalism in nursing in Ethiopia.Methods: The Preferred Reporting Items for Systematic Review and Meta-Analysis standard was followed in the reporting of this systematic review andmeta-analysis. An extensive exploration of digital repositories, including PubMed(MEDLINE), EMBASE, Cochrane, Africa Journal of Online, Google Scholar, and anadvanced Google search, was conducted to obtain published studies detailingprofessionalism in nursing in Ethiopia. STATA version 17 commands created thepooled estimate with a 95% confidence interval. The I2 test and Egger’s test wereused to identify the presence of heterogeneity and publication bias, respectively.To manage heterogeneity, a subgroup analysis and random effect model wereused.Results: A total of 11 articles with a total of 3,581 participants were includedin the final systematic review and meta-analysis. The pooled estimate ofprofessionalism in nursing in Ethiopia was 54% (95% CI: 44, 66%). In thesubgroup analysis, the highest pooled estimate of professionalism in nursingwas observed in South Ethiopia, which is 64% (95% CI: 43–86%).Conclusion: The level of professionalism in nursing in Ethiopia is suboptimal.Being female, having a higher educational level, having long years of experience,having a low workload, having favorable job satisfaction, being a member ofa nursing organization, having a good working environment, working in non-stressful units, and having a good organizational culture were the major factorsthat had a positive association with professionalism in nursing. Therefore,healthcare professionals, the Ministry of Health, and other stakeholders shouldfocus on interventions to enhance the organizational culture, job satisfaction,working unit, and working schedule for nurses.KEYWORDSnursing, nurses, Ethiopia, caring behavior, factors, professionalism in nursing