Background: Heart failure is a leading cause of hospital readmissions in the Amhara region, Northwest Ethiopia.Aim: This study aimed to determine the number of readmissions and identify the determinants among patients with heartfailure at referral hospitals in the Amhara region, Northwest Ethiopia, in 2023.Methods: A cross‐sectional study was conducted with 663 heart failure patients in Amhara region referral hospitals fromSeptember 2022 to February 2023. Simple random sampling was used for patient selection, and data were collected throughchart reviews and interviewer‐administered questionnaires. Zero‐inflated negative binomial models were applied for dataanalysis. Data collection tools were pre‐tested for reliability and validity.Results: Among 663 patients, 237 (35.7%) were readmitted at least once. An increased respiratory rate (IRR = 1.015; 95%CI: 1.0004, 1.031; p < 0.044) and longer medication duration (IRR = 1.011; 95% CI: 1.016, 1.051; p < 0.0001) were asso-ciated with more readmissions. Patients with poor social support had 59.4% fewer readmissions compared to those withgood social support (IRR = −1.595; 95% CI: −0.02, −0.005; p < 0.041). A higher body mass index (IRR = 0.115; 95% CI:0.035, 0.196; p < 0.004) was linked with a higher likelihood of remaining in the “always‐zero” group, while an increasedpulse rate reduced the odds (IRR = −0.013; 95% CI: −0.025, −0.008; p < 0.036). The mortality rate among readmittedpatients was 11.39%.Conclusion: This study found significant readmission rates among HF patients. Factors such as respiratory rate andmedication duration were linked to increased readmissions, while poor social support was associated with fewerreadmissions, this likely reflects limited healthcare access in low‐ and middle‐income countries among individuals withlower social support. The high mortality rate underscores the need for targeted interventions to improve patientoutcomes.

Introduction One of the most important but underappreciated roles of nurses is patient advocacy. To advocatefor patients effectively, the nurses should have a favorable attitude towards patient advocacy. Despite this fact, thenurses’ attitude towards patient advocacy was not known in Ethiopia. Thus, this study aimed to assess nurses’ attitudetowards patient advocacy and its associated factors in East Gojjam Zone Public Hospitals, Northwest in 2023.Methods Institutional-based cross-sectional study design was conducted among 385 nurses in East Gojjam ZonePublic Hospitals from March 1 to April 30, 2023. Nurses were selected using simple random sampling techniquesfrom 11 public hospitals. The data were collected in a self-administered way. Binary logistic regression was used fordata analysis. All independent variables having a P value of < 0.25 in the bivariable logistic regression were fitted intoa multivariable logistic regression. The AOR at a 95% confidence interval was used to identify the strength of theassociation, and a p value of 0.05 was used to declare it statistically significant at the final model.Result A total of 385 nurses participated in the study, for a 91% response rate. Among these, 49.9% of nurses hadan unfavorable attitude. Being working in a primary hospital [AOR = 2.3; 95% CI: (1.4–3.8)], poor cooperation ofnurses [AOR = 1.7; 95% CI: (1.1–2.8)], being unsatisfied with the job [AOR = 1.7; 95% CI: (1.1–2.7)], and poor perceivedsupervision of work [AOR = 6.2; 95% CI: (3.7–9.8)] were factors associated with nurses’ attitudes towards patientadvocacy.Conclusion The number of nurses who had an unfavorable attitude towards patient advocacy was high. Workingin a primary hospital, poor cooperation with others, being dissatisfied with the job, and having an unfavorableperception towards the supervision of work were the factors associated with the unfavorable attitude of nursestowards patient advocacy. It is recommended that all hospitals better support the nurses to increase their jobsatisfaction and have good supervision of the nurses’ activities.Keywords Advocacy, Attitude, Nurse

Background: Evidence-based practice is clinical decision-making using the best evidence available in the context of individual patients' preferences and clinical expertise. It is serving as a crucial instrument for the health science disciplines to minimize the theory-practice gap although the level of practice is unknown. Thus, this study aimed to assess nurses' implementation of evidence-based practice in nursing process and its associated factors in South Wollo Zone Public Hospitals.
Methods: An explanatory sequential mixed method was employed from April 1 to May 29, 2023, among 419 nurses for the quantitative part and 15 others for the qualitative part. The data were collected using structured, pretested, self-administered questionnaires. Simple random and purposive sampling techniques were used to select participants for the quantitative and qualitative studies, respectively. The bivariable analysis was done primarily, and variables with a p-value < 0.25 were further examined using a multivariable logistic regression model to control con-founders. Then, variables having a p-value less than 0.05 with a 95% CI were used to declare significantly associated factors. The key informants were interviewed using pre-made interview guidelines, and then open code software was utilized to conduct a thematic analysis.
Result: Nurses who had poor implementation of evidence-based practice in the nursing process were 228 [54.42%; 95% CI: (49.8-59.3)]. Similarly, the key informants concluded that the implementation of evidence-based practice in the nursing process was low. Participants who were 31- 40 years old [AOR = 0.61, 95% CI: (0.38-0.99)], 41-50 years [AOR = 0.32, 95% CI: (0.15-0.65)], working at general hospitals [AOR = 3.37, 95% CI: (1.39-8.18)] and comprehensive specialized hospitals [AOR = 7.29, 95% CI: (3.06 - 17.31)], lack of training about evidence-based practice (AOR = 2.50, 95% CI: (1.36-4.56)], and lack of internet access [AOR = 2.46, 95% CI: (1.43-4.23)] were factors associated with poor levels of nurses' implementation of evidence-based practice in the nursing process. The absence of computers, libraries, and updated guidelines were other factors identified on the quality analysis.
Conclusion: Nurses' implementation of evidence-based practice in the nursing process was low. Age, working in general hospitals, and comprehensive and specialized hospitals, lack of training, and internet access were factors that had significant associations. Hence, hospital managers should give an attention to internet access and training about utilization of evidence-based practice in nursing process, particularly for those aged above thirty years old.

Keywords: Ethiopia; Evidence-based practice; Nurses; Nursing process.

Background and Purpose: Staphylococcus aureus is a common pathogen responsible for causing various human and animalinfections and is well known for its ability to develop resistance to multiple antibiotics. This study aimed to evaluate the occurrence ofmethicillin-resistant Staphylococcus aureus (MRSA) in bulk milk and dairy farms in northwestern Ethiopia and to determine theirphenotypic and genotypic antimicrobial susceptibility patterns.Methods: We collected 50 bulk milk samples from 50 dairy farms and 50 hand swabs from dairy milkers. The cefoxitin disk diffusiontest and PCR-based assays were used to identify MRSA isolates. In addition, cefoxitin-resistant isolates were tested for susceptibilityto other antibiotics using the Kirby-Bauer disk diffusion method.Results: The results showed that MRSA was detected in 8 samples: 6 from bulk milk samples (12%) and 2 from hand swabs (4%). AllMRSA isolates exhibited a high resistance rate to penicillin (100%), followed by tetracycline (75%), ciprofloxacin (25%), chloram-phenicol (25%), erythromycin (25%), gentamycin (12.5%), and trimethoprim-sulfamethoxazole (12.5%). Moreover, 72% of theisolates showed resistance to three or more antibiotic classes and were classified as multidrug-resistant.Conclusion: This study identified methicillin-resistant Staphylococcus aureus and multidrug-resistant MRSA in bulk milk and dairyfarms in northwestern Ethiopia. These findings highlight the potential risk of transmission of these antibiotic-resistant bacteria tohumans and the need for improved antibiotic stewardship in the dairy sector using the One Health approach.Keywords: dairy farms, Ethiopia, humans, MRSA, bulk milk, resistance

Object tracking is a technique for finding moving objects of interest and estimating their trajectoryor path with regard to time in a series of images. It involves object representation, detection,and tracking. It becomes an important field of study due to the need in video surveillance, trafficmonitoring, live sport video analysis and many other applications. In this paper, both static camera-based and dynamic camera-based object tracking techniques have been developed. The static camera-based object tracking was developed with NI LabVIEW, and Shape adaptive mean-shift algorithmhas been used for tracking. In case of dynamic camera-based object tracking, an optimal Fuzzy-PIDcontroller has been designed to adjust the position of the pan/tilt mechanism so as to trace the object’strajectory. Genetic algorithm (GA) was used to find the optimal values of the operating ranges (scalingfactors) of the membership functions. The performance of the system has been tested by differenttrajectories like step, sinusoidal, circular and elliptical at different frequencies 1, 50 and 100 rad/sec.The system has best performance at low frequencies and when the frequency or speed of the objectincreases, the system performance decreases which complies for real systems. The simulation resultsdemonstrate that GA tuned Fuzzy-PID controller has given us the best results in terms of reducedsteady-state error, faster rise time and settling time, and object position stabilization than PID,Fuzzy and Fuzzy-PID controllers, which shows that optimal Fuzzy-PID controller designed is moreappropriate and efficient.Keywords: Object tracking, LabVIEW, Fuzzy-PID, Pan/Tilt system, Genetic algorithm

This paper introduces the Efficient Metaheuristic BitTorrent (EM-BT) algorithm, aimed at optimizingthe placement and sizing of photovoltaic renewable energy sources (PVRES) and capacitor banks(CBs) in electric distribution networks. The main goal is to minimize energy losses and enhance voltagestability over 24 h, taking into account varying load profiles, solar irradiance, and temperature effects.The algorithm is rigorously tested on standard distribution networks, including the IEEE 33, IEEE69, and ZB-ALG-Hassi Sida 157-bus systems. The results reveal that EM-BT outperforms establishedmethods like Particle Swarm Optimization (PSO), Grey Wolf Optimizer (GWO), and Whale OptimizationAlgorithm (WOA), demonstrating its effectiveness in reducing energy losses and maintaining stablevoltage profiles. By effectively combining PVRES and CBs, this research highlights a robust approach toenhancing both technical performance and operational reliability in distribution systems. Additionally,the consideration of temperature effects on PVRES efficiency adds depth to the study, making it avaluable contribution to the field of power system optimization.Keywords: Efficient Metaheuristic BitTorrent (EM-BT) algorithm, Photovoltaic renewable energy sources(PVRES), Capacitor banks (CBs), Energy loss minimization, Particle Swarm Optimization (PSO), Grey WolfOptimizer (GWO), Whale Optimization Algorithm (WOA), Operational reliability

O. abyssinica, known in Ethiopia as lowland bamboo, is a solid-stemmed clump-forming bamboo species widelydistributed in the western dry regions of Ethiopia. The versatility of the species means that it has enormouspotential for land restoration in arid and semi-arid areas, in addition to bringing socio-economic benefits. It alsodisplays remarkable adaptability, allowing it to thrive in the challenging ecological conditions of areas such asthe Abay Gorge. The Abay Gorge, situated within the Upper Blue Nile River Basin of Northwestern Ethiopia ischaracterized by problems associated with soil erosion and land degradation. This study, therefore, aimed toevaluate and recommend a suitable spatial analysis for the adoption and development of lowland bamboo(O. abyssinica). Fifteen primary influencing factors were chosen according to the needs of O. abyssinica, theaccessibility of data, and the financial implications associated with data analysis, particularly the expensesrelated to soil laboratory testing. Eight composite soil samples were taken directly by dividing the watershed intotwo categories (upper and lower catchment areas). These composite soil samples were analyzed. Data analysiswas performed via Analytical Hierarchy Process (AHP) in conjunction with Multi-Criteria Decision-Making(MCDM) analysis and the use of Remote Sensing (RS) and Geographic Information System (GIS). The spatialanalysis employed in this study was a weighted sum overlay analysis, which was applied by considering thecriteria weight assigned to each factor. The analysis revealed that 21.2 % (666.5 ha) of the total area was highlysuitable for the growth and development of O. abyssinica. About 56 % (1753 ha) of the land was moderately andmarginally suitable for the desired land utilization type. However, 23 % (723.8 ha) of the study area was un-suitable for O. abyssinica. O. abyssinica has the potential to rehabilitate large parts of challenging areas such as theAbay Gorge due to its naturally invase rhizomes and drought-tolerance. It can also be introduced into agrofor-estry systems and used as living fences for villages.
Keywords: AHP, GIS, Land evaluation, Lowland bamboo, MCDM, Remote sensing

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.

Background: An edible oil factory is a labor-intensive and technologically complex industry, with workers potentially exposed to a variety of dangers associated with such industries. Personal protective equipment is a universal, legal requirement, and an important strategy for preventing occupational injuries and illnesses caused by workplace hazards. However, such industries receive little attention, especially in Ethiopia.
Objective: To assess personal protective equipment utilization and its associated factors among workers in the PhiBela edible oil factory in Burie, Ethiopia, in 2022.
Methods: A cross-sectional study was employed among the PhiBela edible oil factory workers in Burie. A simple random sampling technique was used to select 389 PhiBela edible oil factory workers. Face-to-face interviews and self-administered structured questionnaires were used to collect data on workers' protective equipment utilization practice, socio-demographic, work-related, environmental, and organizational factors. Data was analyzed using SPSS version 25. The logistic regression method was used to see factors associated with workers' protective equipment utilization. The strength of the association was calculated using an odds ratio at 95% confidence intervals.
Results: Of the total workers, 216, 55.52% (48.33-57.78) workers utilize personal protective equipment in the factory. The study showed safety training [AOR (4.68, 95%CI (2.76-7.45)], availability of personal protective equipment [AOR = 4.86; 95%CI: 2.23-6.98], regular health and safety supervision [AOR = 2.751; 95%CI: 1.806-3.801], availability of safety guideline at workplace [AOR = 3.798; 95%CI: 1.248-6.173], having work experience 3 years and above [AOR = 1.64; 95%CI: 1.06-2.18], not using alcohol [AOR = 3.07; 95%CI: 2.11-4.76], and not smoking cigarette [AOR = 1.88; 95%CI: 1.55-3.11] were predictors of personal protective equipment utilization.
Conclusion: The level of personal protective equipment utilization among Phibela edible oil factory workers is 55.52%, which is moderate when compared to other studies done in developing countries. The presence of Safety training, availability of personal protective equipment, regular health and safety supervision, availability of guidelines at workplaces, having work experiences, not using alcohol, and cigarrete smoking were factors found to be a significant predictors of personal protective equipment utilization. As a result, close workplace supervision, safety training, and availing guidelines are the recommendations to be in place.

Keywords: Ethiopia; Utilization; factory worker; personal protective equipment.

Background: An edible oil factory is a labor-intensive and technologically complex industry, with workers potentially exposed to a variety of dangers associated with such industries. Personal protective equipment is a universal, legal requirement, and an important strategy for preventing occupational injuries and illnesses caused by workplace hazards. However, such industries receive little attention, especially in Ethiopia.
Objective: To assess personal protective equipment utilization and its associated factors among workers in the PhiBela edible oil factory in Burie, Ethiopia, in 2022.
Methods: A cross-sectional study was employed among the PhiBela edible oil factory workers in Burie. A simple random sampling technique was used to select 389 PhiBela edible oil factory workers. Face-to-face interviews and self-administered structured questionnaires were used to collect data on workers' protective equipment utilization practice, socio-demographic, work-related, environmental, and organizational factors. Data was analyzed using SPSS version 25. The logistic regression method was used to see factors associated with workers' protective equipment utilization. The strength of the association was calculated using an odds ratio at 95% confidence intervals.
Results: Of the total workers, 216, 55.52% (48.33-57.78) workers utilize personal protective equipment in the factory. The study showed safety training [AOR (4.68, 95%CI (2.76-7.45)], availability of personal protective equipment [AOR = 4.86; 95%CI: 2.23-6.98], regular health and safety supervision [AOR = 2.751; 95%CI: 1.806-3.801], availability of safety guideline at workplace [AOR = 3.798; 95%CI: 1.248-6.173], having work experience 3 years and above [AOR = 1.64; 95%CI: 1.06-2.18], not using alcohol [AOR = 3.07; 95%CI: 2.11-4.76], and not smoking cigarette [AOR = 1.88; 95%CI: 1.55-3.11] were predictors of personal protective equipment utilization.
Conclusion: The level of personal protective equipment utilization among Phibela edible oil factory workers is 55.52%, which is moderate when compared to other studies done in developing countries. The presence of Safety training, availability of personal protective equipment, regular health and safety supervision, availability of guidelines at workplaces, having work experiences, not using alcohol, and cigarrete smoking were factors found to be a significant predictors of personal protective equipment utilization. As a result, close workplace supervision, safety training, and availing guidelines are the recommendations to be in place.

Keywords: Ethiopia; Utilization; factory worker; personal protective equipment.