scholarly journals 97Effectiveness of baby-friendly workplace support interventions on exclusive breastfeeding in Kenya: a propensity score-weighted analysis

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Elizabeth Kimani-Murage ◽  
Calistus Wilunda ◽  
Tadesse Zerfu ◽  
Teresia Macharia ◽  
Eva Kamande ◽  
...  
Keyword(s):  
Propensity Score ◽  
Exclusive Breastfeeding ◽  
Treated Group ◽  
Post Intervention ◽  
Day Care Centers ◽  
Support Intervention ◽  
Workplace Support ◽  
Weighted Analysis ◽  
Home Based ◽  
Quasi Experimental

Abstract Background Exclusive breastfeeding (EBF) during the first six months of life is crucial for optimising child’s growth, development and survival. Mother’s employment may hinder optimal breastfeeding. We assessed the effectiveness of a workplace support intervention on EBF in Kenya. Methods This quasi-experimental study employing a pre-post intervention design was conducted between 2016 and 2018 on an agricultural farm in Kericho County. The intervention targeted pregnant/breastfeeding women residing on the farm and consisted of: day-care centers, sensitization on available workplace baby-friendly policies, and home-based nutritional counselling of pregnant and breastfeeding women. The effect of the interventions on EBF was estimated using propensity score weighting. Results The study included 223 and 146 mother-infant dyads in the non-treated (pre-intervention) and treated (intervention) groups, respectively. The prevalence of EBF was 20.2% in the non-treated group and 80.8% in the treated group; corresponding to a 4-fold increased probability of EBF (RR 3.99; 95% CI 2.95–5.15). In age-stratified results, the effect of the interventions was stronger among children aged 3-5 months (RR 8.13; 95% CI 4.23–15.64) than among those aged < 3 months (RR 2.79; 95% CI 2.09–3.73). Conclusions The baby-friendly workplace support intervention promoted EBF especially beyond three months in this setting. Key messages Maintaining EBF while working is more likely when employers provide the support that women need to do so. Workplace policies and programmes to support women to combine work with breastfeeding are needed.

scholarly journals Promotion of Early and Exclusive Breastfeeding in Neonatal Care Units in Rural Rwanda: a Quasi-experimental Study

2020 ◽  
Author(s):  
Saidath Gato ◽  
Francois Biziyaremye ◽  
Catherine M. Kirk ◽  
Chiquita Palha De Sousa ◽  
Alain Mukuralinda ◽  
...  
Keyword(s):  
Experimental Study ◽  
Exclusive Breastfeeding ◽  
Child Survival ◽  
Neonatal Care ◽  
Post Intervention ◽  
Factors Associated ◽  
Before And After ◽  
Quasi Experimental ◽  
Evidenced Based ◽  
Additional Support

Abstract Background: Early initiation of breastfeeding after birth and ongoing exclusive breastfeeding for the first 6 months improves child survival, nutrition and health outcomes. However, only 42% of newborns worldwide are breastfed within the first hour of life. Small and sick newborns are at greater risk of not receiving breastmilk and often require additional support for feeding. This study compares breastfeeding practices in Rwandan neonatal care units (NCUs) before and after the implementation of a package of interventions aimed to improve breastfeeding, aligned with the Baby Friendly Hospital Initiative for small and sick newborns.Methods: A pre-post quasi experimental study was conducted at two District hospital NCUs in rural Rwanda from October 2017–December 2017 (pre-intervention) and September 2018–March 2019 (post-intervention). Only newborns admitted before their second day of life (DOL) were included. Data was extracted from patient charts for clinical and demographic characteristics, feeding throughout admission, and patient outcomes. Bivariate analyses were conducted using Fisher’s exact and Wilcoxon rank sum tests. Logistic regression was used to evaluate factors associated with exclusive breastfeeding at discharge following a backwards stepwise procedure.Results: Pre-intervention, 255 newborns were admitted in the NCUs and 793 were admitted in the post-intervention period. The percentage of infants who were exclusively breastfed on their day of birth, or day-of-life zero (DOL0) increased from 5.4% to 35.9% (p<0.001). For newborns discharged alive, the proportion exclusively breastfeeding increased from 69.6% to 87.0% (p<0.001). The mortality rate for all admitted newborns decreased from 16.1% to 10.5% (p<0.019). Factors associated with greater odds of exclusive breastfeeding at discharge included post-intervention time point (Odds Ratio (OR): 4.91, 95% Confidence Interval (CI) 1.99-12.11, p<0.001), and admission for infection (OR 2.99, 95%CI 1.13-7.93, p=0.027). Home deliveries (OR 0.15, 95%CI 0.05-0.47, p=0.001), preterm delivery (OR 0.36, 95%CI 0.15-0.87, p=0.0260 and delayed first breastmilk feed (OR=0.04 for DOL3 vs. DOL0, 95%CI 0.01, 0.35, p=0.004) reduced odds of exclusive breastfeeding at discharge. Conclusion: Expansion and adoption of evidenced-based guidelines, using innovative approaches, aimed at the unique needs of small and sick newborns should be expanded and adapted in similar settings to improve outcomes for these infants.

scholarly journals Effects of clown activities on patients eligible for palliative care in primary health care

2021 ◽  
Vol 74 (5) ◽  
Author(s):  
Fernando Ribeiro dos Santos ◽  
Sandra Pinto ◽  
Juliana Dias Reis Pessalacia ◽  
Bruna Moretti Luchesi ◽  
Lucimeire Aparecida da Silva ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Social Support ◽  
Health Care ◽  
Palliative Care ◽  
Primary Health Care ◽  
Post Intervention ◽  
Primary Health ◽  
Home Based ◽  
Quasi Experimental

ABSTRACT Objective: Evaluate the effects of clown activities on quality of life, depression, stress, anxiety, aid, and social support in patients eligible for palliative care (PC) attended in Primary Health Care (PHC). Method: A quasi-experimental study, with pre-intervention and post-intervention evaluation, carried out with 16 patients eligible for early PC in PHC in a Midwestern city. Patients received 24 visits with home-based clown activities. Results: The interventions evidenced improved quality of life and social support, with significant results for the Social Activities dimension (p = 0.023). Increased scores for Anxiety (p = 0.007) and Depression (p = 0.023) were also observed. Conclusion: Clown activities can bring positive results for the quality of life and social support of patients eligible for PC at home. They should be encouraged to interact with family knowledge and enhance humanized care, integral and centered on human relationships in PHC.

scholarly journals Effectiveness of a support intervention for family caregivers and stroke survivors

2021 ◽  
Vol 29 ◽  
Author(s):  
Jaine Kareny da Silva ◽  
Rita Narriman Silva de Oliveira Boery
Keyword(s):  
Family Caregivers ◽  
Effect Size ◽  
Intervention Group ◽  
Group Method ◽  
Control Group ◽  
Stroke Survivors ◽  
Post Intervention ◽  
Support Intervention ◽  
Bonferroni Adjustment ◽  
Quasi Experimental

Objective: to analyze the effectiveness of a support intervention on the burden and stress of family caregivers and on the stroke survivors’ independence level, compared to the Control Group. Method: a quasi-experimental study conducted with 37 participants (Intervention Group, n=20; and Control Group, n=17). The intervention lasted 8 months. The outcomes of the caregivers (burden and stress) and of the survivors (independence level) were measured by the Zarit, Perceived Stress and Katz scales, at the following moments: pre-intervention, the fourth month of the intervention and post-intervention. The differences of these outcomes between groups and intra-group and the effect size were calculated using the Mann-Whitney and Friedman tests (Bonferroni adjustment by Wilcoxon) and the Kendall’s W coefficient. Results: the Intervention Group reduced burden (p=0.039) and stress (p=0.009), mainly, after 8 months of intervention, which was not observed in the Control Group. The independence level did not change between the groups or moments (p>0.05). The intervention presented moderate effect size (p=0.45 and p=0.54). Conclusion: the intervention was effective to reduce the burden and stress of family caregivers, but did not alter the stroke survivors’ independence level, when compared to the Control Group.

scholarly journals Effect of a baby‐friendly workplace support intervention on exclusive breastfeeding in Kenya

2021 ◽  
Author(s):  
Elizabeth W. Kimani‐Murage ◽  
Calistus Wilunda ◽  
Teresia Njoki Macharia ◽  
Eva Watiri Kamande ◽  
Peter Muriuki Gatheru ◽  
...  
Keyword(s):  
Exclusive Breastfeeding ◽  
Support Intervention ◽  
Workplace Support

Peningkatan Pengetahuan Calon Pengantin Melalui Konseling ASI Eksklusif di Kecamatan Darul Imarah Aceh Besar

2017 ◽  
Vol 19 (1) ◽  
pp. 36-42
Author(s):  
Agus Hendra Al-Rahmad
Keyword(s):  
Experimental Study ◽  
Exclusive Breastfeeding ◽  
Action Plan ◽  
Scaling Up ◽  
Random Assignment ◽  
Nutrition And Health ◽  
Face To Face ◽  
Child Stunting ◽  
Quasi Experimental ◽  
Breastfeeding Counseling

Background : Scaling Up Nutrition movement is a global effort to strengthen our commitment and accelerating action plan to improve nutrition, particularly the handling of nutrition in the first 1,000 days of life is exclusive breastfeeding and it until 24 months. One of the way is with exclusive breastfeeding counselling that can reduce stunting. The counseling is addressed to brides who need special attention in improving the nutrition and health. Objective : The aim of research to improve knowledge about exclusive breastfeeding counseling the bride through the use of leaflets. Method : This quasi-experimental study was a sample of 30 person a brides with non-random assignment, the variable a knowledge obtained through interviews using questionnaires while the method of counseling does face to face with an exclusive breastfeeding leaflet. The data was analyzed by dependent t-test. Result : The results showed exclusive breastfeeding counseling can improve knowledge bride (p= 0,000) with a mean difference is 6,13 and a deviation is 3,71. Conclusion : Increase of knowledge among ‘bride-to be’ about exclusive breastfeeding could be improved through the use of exclusive breastfeeding leaflet. Each health center must be in collaboration with Office of Religious Affairs to have exclusive breastfeeding counseling, and set one of the priority programs in the prevention of child stunting.   Keywords: Bride, counseling, knowledge of exclusive breastfeeding

Efficacy of one-dose intramuscular rabies vaccine as pre-exposure prophylaxis in travellers

2021 ◽  
Author(s):  
Deborah J Mills ◽  
Colleen L Lau ◽  
Christine Mills ◽  
Luis Furuya-Kanamori
Keyword(s):  
Immune System ◽  
Rapid Development ◽  
Age Groups ◽  
Rabies Vaccine ◽  
Post Exposure Prophylaxis ◽  
Post Intervention ◽  
Quasi Experimental ◽  
Alternative Schedule ◽  
Insufficient Time ◽  
Exposure Prophylaxis

Abstract Background Current guidelines for rabies pre-exposure prophylaxis (PrEP) recommend multiple vaccine doses. Travellers sometimes present for pre-travel consultation with insufficient time to complete standard PrEP schedules. We investigated the efficacy of one-dose intramuscular (IM) vaccine in priming the immune system (as PrEP) by measuring antibody response to simulated post-exposure prophylaxis (PEP). Methods A quasi-experimental pre–post intervention clinical trial was conducted at a specialist travel clinic in Australia. Adults (≥18 years) without a history of rabies vaccination were included. At Visit 1, seronegative status was confirmed and one dose of 0.5 ml IM rabies vaccine (Verorab®) administered. At Visit 2 (≥60 days after Visit 1), serology was repeated and a simulated PEP dose (0.5 ml IM) given on this day and again 3 days later (Visit 3). Serology was repeated at Visit 4 (7 days after Visit 2). Results A total of 94 antibody-negative participants were included (&lt;50 years [n = 50]; ≥50 years [n = 44]). At Visit 2, 38.0 and 31.8% of participants aged &lt;50 and ≥50 years were antibody-positive (≥0.5 EU/ml). At Visit 4, all participants were antibody-positive; 82.0 and 47.7% of participants aged &lt;50 and ≥50 years had antibody levels &gt;4 EU/ml, respectively. Conclusions One-dose IM vaccine was effective as PrEP for priming the immune system in both age groups, resulting in rapid development of antibodies 7 days after commencing simulated PEP. If there is insufficient time to complete a standard PrEP schedule, one-dose IM could be considered as an alternative schedule for short trips, rather than not offering travellers any doses at all. Clinical trials registration: ACTRN12619000946112.

scholarly journals P05.08 A Propensity Score-Weighted Analysis for SBRT, Lobectomy and Sublobar Resection in Elderly Patients with cStage I NSCLC

2021 ◽  
Vol 16 (3) ◽  
pp. S271
Author(s):  
N. Kishi ◽  
Y. Matsuo ◽  
T. Menju ◽  
M. Hamaji ◽  
A. Nakakura ◽  
...  
Keyword(s):  
Propensity Score ◽  
Elderly Patients ◽  
Sublobar Resection ◽  
Weighted Analysis

Effectiveness of a vancomycin dosing protocol guided by area under the concentration-time curve to minimal inhibitory concentration (AUC/MIC) with multidisciplinary team support to improve hospital-wide adherence to a vancomycin dosing protocol: A pilot study

2021 ◽  
pp. 1-6
Author(s):  
Panipak Katawethiwong ◽  
Anucha Apisarnthanarak ◽  
Kittiya Jantarathaneewat ◽  
David J. Weber ◽  
David K. Warren ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Multidisciplinary Team ◽  
Kidney Injury ◽  
University Hospital ◽  
Routine Practice ◽  
Post Intervention ◽  
Coagulase Negative Staphylococci ◽  
Time Curve ◽  
Concentration Time ◽  
Quasi Experimental

Abstract Background: Limited data are available on the implementation of an area under the concentration-time curve (AUC)–based dosing protocol with multidisciplinary team (MT) support to improve adherence with vancomycin dosing protocol. Objective: To evaluate the effectiveness of an AUC-based dosing protocol with MT support intervention with adherence to a hospital-wide vancomycin dosing protocol at Thammasat University Hospital. Method: We conducted a quasi-experimental study in patients who were prescribed intravenous vancomycin. The study was divided into 2 periods; (1) the preintervention period when the vancomycin dosing protocol was already applied in routine practice and (2) the post-intervention period when the implementation of an AUC-based dosing protocol with MT support was added to the existing vancomycin dosing protocol. The primary outcome was the rate of adherence, and the secondary outcomes included acute kidney injury events, vancomycin-related adverse events, and 30-day mortality rate. Results: In total, 240 patients were enrolled. The most common infections were skin and soft-tissue infections (24.6%) and bacteremia (24.6%). The most common pathogens were coagulase-negative staphylococci (19.6%) and Enterococcus spp (15.4%). Adherence with the vancomycin dosing protocol was significantly higher in the postintervention period (90.8% vs 55%; P ≤ .001). By multivariate analysis, an AUC-based dosing protocol with MT support was the sole predictor for adherence with the vancomycin dosing protocol (adjusted odds ratio, 10.31; 95% confidence interval, 4.54–23.45; P ≤ .001). The 30-day mortality rate was significantly lower during the postintervention period (8.3% vs 20%; P = .015). Conclusions: AUC-based dosing protocol with MT support significantly improved adherence with vancomycin dosing protocol and was associated with a lower 30-day mortality rate.

scholarly journals Effects and Responsiveness of a Multicomponent Intervention on Body Composition, Physical Fitness and Leptin in Overweight/Obese Adolescents

2021 ◽  
Vol 18 (14) ◽  
pp. 7267
Author(s):  
Leticia Borfe ◽  
Caroline Brand ◽  
Letícia Schneiders ◽  
Jorge Mota ◽  
Claudia Cavaglieri ◽  
...  
Keyword(s):  
Body Composition ◽  
Physical Fitness ◽  
Intervention Group ◽  
Interleukin 10 ◽  
Control Group ◽  
Post Intervention ◽  
Necrosis Factor Alpha ◽  
Obese Adolescents ◽  
Quasi Experimental ◽  
Multicomponent Program

Physical exercise reduces the biochemical markers of obesity, but the effects of multicomponent interventions on these markers should be explored. The present study aimed to elucidate how overweight/obese adolescents respond to a multicomponent program approach on body composition, physical fitness, and inflammatory markers, using a quasi-experimental study with 33 overweight/obesity adolescents (control group (CG) = 16; intervention group (IG) = 17). The intervention consisted of 24 weeks with physical exercises and nutritional and psychological guidance. Both groups were evaluated at the pre/post-intervention moments on body mass index (BMI); body fat (%Fat); waist circumference (WC); waist/hip ratio (WHR); waist-to-height ratio (WHtR), cardiorespiratory fitness (CRF); abdominal strength, flexibility; leptin; interleukin 6; interleukin 10; and tumor necrosis factor-alpha. Mixed-analysis of variance and generalized estimation equations were used for statistical analysis. There was an interaction effect between groups and time on %Fat (p = 0.002), WC (p = 0.023), WHR (p < 0.001), WHtR (p = 0.035), CRF (p = 0.050), and leptin (p = 0.026). Adolescents were classified as 82.4% responders for %Fat, 70.6% for WC, 88.2% for WHR, and 70.6% for CRF. Further, there was an association between changes in %Fat (p = 0.033), WC (p = 0.032), and WHR (p = 0.033) between responders and non-responders with CRF in the IG. There was a positive effect on body composition, physical fitness, and leptin. In addition, reductions in body composition parameters were explained by CRF improvements.

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