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.

The study is to examine the status and identify factors that affect the participation of dairy cooperatives and its impact on household income. The study employed both quantitative and qualitative data. The two-stage stratified sampling method was employed purposive sampling technique was used to select dairy cooperative for the study. A total of 582 households were sampled using proportion to the sample size methods and the study unites were selected through systematic sample random sampling technique. Primary and secondary data sources were consulted to collect the necessary data. Focus group discussion, Key informant interview, and interview schedule survey questionnaire were the primary data collection methods used in the study. Descriptive and econometric analyses were employed to analyze the collected data. Binary logit model was employed to assess variables affecting the participation of dairy cooperative and its impact on household income by using propensity score much.The household Age, Family size, fair price of milk, sex, TLU, number of milking cow, credit access and distance from the home to diary cooperative office significantly influenced the decision to participate dairy cooperative. Age, fair price of milk, credit access, number of milking cows, sex and credit access positively influenced the participation whereas family size and distance from the home to dairy cooperative office negatively influenced the participate of in dairy cooperative . The study found that membership of dairy cooperative has significantly increased on income of households. Thus, farmers should be encouraged to participate dairy cooperative. Therefore, the government and other concerned bodies should focus encourage households to promote the membership of dairy cooperative.

ABSTRACT While it is dependent on erratic rainfall and subject to drought and low productivity, agriculture is still the dominant economic activity in Ethiopia. Climate-Smart Agriculture (CSA) technology adoption enhances productivity, resilience, and climate mitigation, yet its adoption by smallholder farmers in Ethiopia’s West Gojjam Zone remains limited despite government promotion. However, research on the factors behind the determinants of the low adoption rate is limited in the study area. The main objectives of this study were to investigate the factors influencing the adoption of five CSA-aligned practices: crop diversification, livestock diversification, irrigation, agroforestry, and the application of chemical fertilizers across selected woredas. Data were generated using structured questionnaires, key informant interviews, and focus groups from a total of 236 households selected using a multistage sampling technique. The analysis made by a multivariate probit model revealed that significant determinants included the gender of the household head, education, farm size, income, irrigation access, credit availability, extension services, and farming experience. Findings suggest that enhancing crop and livestock diversification requires expanding irrigation access, strengthening extension services, and integrating climate-smart advisory programs to equip farmers with essential skills and resources. Additionally, improving credit access, providing climate information through mobile phone SMS for free, and promoting farmer training can boost irrigation adoption, while targeted awareness campaigns can encourage experienced farmers to adopt modern irrigation technologies. Keywords: Adoption; Climate-Smart Agricultural Practices; Multivariate probit, West Gojjam

This study was conducted to estimate the technical, allocative and economic efficiency levels, identify the determinant factors of technical and allocative inefficiencies, Debre Markos City and Sinan District of the Amhara National Regional State, Ethiopia. The data were collected from 397 smallholder sheep fatting farmers in all kebeles in debremarkos and two kebeles in sinan district of the study area. Maximum likelihood techniques were used to estimate a Truncated-Normal Model production frontier. The mean estimated technical, allocative and economic efficiencies were 83.07, 91.84.61 and 76.5 respectively with consecutive SD of .1645 , 0.1490 and 0.1985. The estimated results provide evidence that the sheep fatting farmers are technical, allocatively and economically inefficient. The coefficients estimated from the Truncated-Normal Model stochastic production frontier model show the effect of different inputs on sheep fatting farmers. Ln (fodder) has a positive coefficient of .0481792, significant at the 1% level, meaning that the improvement in feed quality increases read met output. Likewise, Ln (heredsize) showed a highly significant coefficient value of .9518208 significant at the 1%, showing its importance to increase fatting sheep.Also, Ln (cost fodder) has a negative coefficient of 1.628079, significant at the 1% . Likewise, Ln (cost of animal health) showed a highly significant coefficient value of 1.838712significant at 10%. The most vital factors include sex, education, age, family size of household, availability of feed supply, extension and training on significant effect on technical inefficient of small scale sheep fatting farmers. The most vital factors include education, non-farm activities, Total livestock unit, availability of feed supply, family size of the household and training on significant effect on allocative inefficient of small scale sheep fatting farmers.The government and the concerned body should be encouraging sheep fatting farmers to grow, properly harvest and store high-protein fodder on their farms reduce reliance on expensively purchased fodder. The government and the concerned body should be expanding animal health centers to keep animal health for fulfill small scale sheep fatting sheep to bring productive the fatting sheep and improve the livelihood. Extension of the household has been shown to significantly improve technical efficiency by providing advice the way of fatting, how to feed

Method Twenty inactive males (BMI 27.67 ± 0.88 kg/m2 , age 49.15 ± 2.58 years) participated in an eight-week wererandomly assigned to one of three intervention groups (combined (CT), resistance (RT), and aerobic (AT)) exercisemodalities to assess within-subject and between group changes in glycolipid profile. Data were analyzed usingrepeated measures ANCOVA.Result Pre-post mean values of body fat percentage (%BF), area under the curve (AUC), low density lipoprotein (LDL),high density lipoprotein (HDL) and total cholesterol (TC) decreased in all three groups. The main effect of exercisemodality on the AUC (F (2, 26) = 10.577, P = 0.001, η2 = 0.569) was significant. Post-hoc analyses revealed that the RTgroup (-30.653 ± 6.766, p = 0.001) with 11.53% and the CT group (M = -0.896, SE = 3.347, P = 0.015) with 3.79% exhib-ited significantly greater reductions in AUC compared to the AT group. LDL levels showed significant differentbetween groups (F (2, 26) = 6.33, p = 0.009, η2 = 0.442), specially significantly 3.7% lowered in AT (MD = 4.783, SE = 1.563,P = 0.002) and 3.79% lower in CT (MD = 4.57, SE = 1.284, P = 0.008) groups compared to the RT group. AT significantlyreduced TC by 17.716 ± 5.705 mg/dL (p = 0.02) compared to RT, representing a 7.97% decrease.Conclusion Exercise type significantly influences lipid profiles and glycemic control. Notably, both aerobic and com-bined training demonstrated a superior ability to modulate the lipid profile, and resistance training and combinedtraining were more effective in reducing the AUC.Trial registration May, 31st 2024. Registration no: PACTR202405463745521 “Retrospectively registered”.Keywords Glucose tolerance, Lipid profile, Resistance training, Aerobic training and combind training

Background: Hepatitis B virus (HBV) is highly infectious and poses significant global health challenges. Healthcare workers (HCWs) are particularly at risk of HBV infection due to occupational exposure through contact with infected blood or body fluids. To mitigate this risk, hepatitis B vaccination is recommended for all healthcare workers and is administered in three doses at 0, 1, and 6 months, aiming to reduce exposure and provide immunity against the virus. However, the effectiveness of the HBV vaccine remains uncertain in the study area.
Objective: This study aimed to evaluate hepatitis B vaccine efficacy and factors affecting vaccine effectiveness among healthcare workers in all Hospitals of East Gojjam Zone Amhara Region, North West Ethiopia
Materials and Methods: A hospital-based cross-sectional study was conducted among 422 healthcare workers from March 25, 2024, to November 30, 2024. Simple random sampling technique was used to recruit the study participants. Total sample size was allocated proportionally to each hospital. Socio-demographic and clinical data were collected using a pretested structured questionnaire. Moreover, venous blood samples (4–5 ml) were collected from the study participants, and serum samples were analyzed to measure and detect the concentrations of anti-hepatitis B surface antigen (anti-HBs), hepatitis B surface antigen (HBsAg), and anti-hepatitis B core antibody (anti-HBc) using a sandwich enzyme-linked immunosorbent assay (ELISA). Additionally, hepatitis B virus DNA (HBV DNA) was assessed using real-time polymerase chain reaction (qPCR). Data were analyzed using SPSS software version 25. Logistic regression model with 95% CI was used to show the statistical association. P value < 0.05 was considered as statistically significant.
Results: The overall sero-prevalence of HBsAg among all study participants was 23/422 (5.5%) (95% CI: 3.0-8.0). In multivariable logistic regression, blood transfusion (AOR: 16.5, 95% CI: 1.53, 29.24) (P<0.011) and dental extraction (AOR: 13.5, 95% CI: 3.99, 45.57) (P<0.000) were significantly associated with HBsAg positivity. In addition, the overall sero-reactivity of anti-HBc was 30/422 (7.1%) (95% CI: 5.0-10.0). Injectable medication (AOR: 4.3, 95% CI: 1.73, 10.72) (P<0.002) was significant determinant for anti-HBc sero-positivity. Furthermore, of fully vaccinated healthcare workers, 346/422 (82.0%) (95% CI: 78.0- 86.0 %) of them were sero-protected (had anti-HBs titer ≥ 10 mIU/ml). The paradoxical sero-positivity of HBsAg and anti-HBs among fully vaccinated healthcare workers was 16(4.6%). Moreover, among HBsAg-positive individuals, HBV DNA was detected in 17 (73.9%) of them.
Conclusions and recommendations: The study identified intermediate HBV seroprevalence among vaccinated healthcare workers, indicating suboptimal vaccine efficacy. These findings emphasize the necessity of monitoring post-vaccination anti-HBs antibody levels to address gaps in protection.
Keywords: Hepatitis B vaccine effectiveness, Healthcare workers, Hospitals

This study suggests an enhanced version of the adaptive fuzzy fast terminal synergetic controller(AF-FTSC) for controlling the uncertain DC/DC buck converter based on the synergetic theory ofcontrol (STC) and newly developed terminal attractor technique (TAT). The benefits of the proposedSC algorithm involve the features of finite-time convergence, unaffected by parameter variations, andchattering-free phenomenon. A type-1 fuzzy logic system (T1-FLS) make the considered controllermore robust and is utilized to estimate the undefined converter nonlinear dynamics without resortingto the usual linearization and simplifications of the converter model. Taking a switching DC-DC buckconverter as a demonstration, the suggested AF-FTSC is thoroughly analyzed and executed on adSPACE ds1103 controller board. The outcomes of the experiment confirm the competence andapplicability of the suggested regulator.Keywords: Synergetic control, Fuzzy logic system, Fast terminal method, Finite-time convergence, DC/DCbuck converter

This study aims at exploring the potentials and drawbacks of utilizing social media to promote tourism industry in East Gojjam Zone. The study will be geographically limited to East Gojjam Zone and will not include media platforms other than social media. The research will bring significance to the culture and tourism offices, agencies that work on tourism industry and an input for the government organizations in policy formulation as well as for future researchers. Qualitative research approach with descriptive design will be employed. The population of this study is social media pages of Culture and Tourism Offices of all the woredas found in East Gojjam Zone and of the Zones’ Culture and Tourism Department. The sample will be purposive sampling of all social media pages of the woredas and the zone. Focus group discussion and indepth interview will be conducted in eight selected woredas and zonal culture and tourism office. East Gojjam Zone has 19 woredas including Debre Markos town. The data will be gathered using content analysis of the social media posts, focus group discussion and in-depth interview. In addition, data will also be collected from reports, and publications like newsletters and articles.To collect the data official support letter will be submitted to the Culture and Tourism Department of East Gojjam Zone. The authenticity of social media pages of the woreda tourism offices will be confirmed with the concerned bodies at the zonal level. The collected data using online content, in-depth interview and focus group discussion will be triangulated for data analysis. The researchers expect to find out social media usage patterns and preferences in tourism promotion, social media promotion strategies and implementation, social media regulation and governance in tourism promotion. Atotal budget of 201, 722 ETB will be allocated to conduct the whole study from April to September, 2024.

Abstract: Food insecurity in peri-urban areas is exacerbated by high living costs, limited access tohealthy food, and economic inequality. Despite its growing prevalence due to factors like land lossfrom urban expansion, food insecurity has received limited attention. In Ethiopia, drastic urbanizationcreates competition for land between agriculture and urban development, which is becoming extremein peri-urban areas., This study aims to assess the impact of urban expansion on food security amongexpropriated peri-urban households in Ethiopia. Using a calorie intake-based food security line, wecategorize respondents as food-secure or -insecure. The research analyzed data from 350 expropriatedperi-urban households through a structured questionnaire, employing descriptive statistics andbinary logistic regression. About 67% of the respondents were classified as food-insecure. The binarylogit model identified several significant determinants of food security, including compensationamount and type, household head demographics, agricultural land rent participation, irrigationand credit access, off-farm income, and organic fertilizer use. To address food insecurity amongexpropriated households, policymakers must prioritize these factors. Government attention andpolicy consideration are crucial to ensure the well-being of these vulnerable populations.Keywords: urban expansion; food insecurity; calorie intake; expropriation; Ethiopia

ABSTRACT Background: Blood donation is vital for saving lives, yet Ethiopia faces chronic shortages. Bridging the gap between willingness and actual donation is essential for sustaining blood supplies. This study examined socio-demographic, psychological, and contextual factors influencing blood donation intention and practice in East Gojjam Zone. Methods: A community-based cross-sectional survey of 1,332 urban adults who met inclusion criteria was conducted using multistage cluster sampling. Data were collected via a structured, pre-tested questionnaire. Descriptive statistics summarized donation patterns, while binary logistic and Zero-Inflated Negative Binomial regressions identified predictors of donation intention and frequency, respectively. Structural Equation Modeling (SEM) examined associations among socio-demographic characteristics, psychological factors, donation intention, practice, and behavior. Results: Although 74.8% (95% CI: 72.5–77.1) expressed willingness to donate, only 28.8% (95% CI: 26.4–31.2) had ever donated, and 20.7% (95% CI: 18.5–22.9) had donated in the past two years. Male gender, younger age, higher education, and employment in health or education sectors positively predicted intention and practice. Psychological factors—including self-efficacy (β = 0.53), positive attitudes (β = 0.46), knowledge (β = 0.38), altruism, and social influence (β = 0.28)—were strongly associated with donation. SEM confirmed that intention strongly predicted actual donation (β = 0.62). Barriers included fear of needles, health concerns, and limited awareness. Conclusions: Despite high willingness, actual donation remains low. Multi-sectoral, culturally sensitive strategies—addressing fears, improving knowledge, leveraging social influence, and enhancing accessibility—are critical, especially for women, older adults, and less-educated individuals, to build a resilient, community-driven blood supply. Keywords: Blood donation, intention, practice, socio-demographic factors, psychological determinants, Ethiopia, Structural Equation Modeling