scholarly journals Translating new evidence into clinical practice: a quasi-experimental controlled before–after study evaluating the effect of a novel outreach mentoring approach on knowledge, attitudes and confidence of health workers providing HIV and infant feeding counselling in South Africa

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e034770
Author(s):  
Ameena Goga ◽  
Tanya Doherty ◽  
Samuel Manda ◽  
Tshifhiwa Nkwenika ◽  
Lyn Haskins ◽  
...  
Keyword(s):  
South Africa ◽  
Infant Feeding ◽  
Health Workers ◽  
Likert Scale ◽  
Attitude Score ◽  
Score Difference ◽  
Comparison Groups ◽  
Quasi Experimental ◽  
The Mean

ObjectivesWe report the effectiveness of a mentoring approach to improve health workers’ (HWs’) knowledge, attitudes and confidence with counselling on HIV and infant feeding.DesignQuasi-experimental controlled before–after study.SettingRandomly selected primary healthcare clinics (n=24 intervention, n=12 comparison); two districts, South Africa.ParticipantsAll HWs providing infant feeding counselling in selected facilities were invited.InterventionsThree 1–2 hours, on-site workshops over 3–6 weeks.Primary outcome measuresKnowledge (22 binary questions), attitude (21 questions—5-point Likert Scale) and confidence (19 questions—3-point Likert Scale). Individual item responses were added within each of the attitude and confidence domains. The respective sums were taken to be the domain composite index and used as a dependent variable to evaluate intervention effect. Linear regression models were used to estimate the mean score difference between intervention and comparison groups postintervention, adjusting for the mean score difference between them at baseline. Analyses were adjusted for participant baseline characteristics and clustering at health facility level.ResultsIn intervention and comparison sites, respectively: 289 and 131 baseline and 253 and 114 follow-up interviews were conducted (August–December 2017). At baseline there was no difference in mean number of correctly answered knowledge questions; this differed significantly at follow-up (15.2 in comparison; 17.2 in intervention sites (p<0.001)). At follow-up, the mean attitude and confidence scores towards breast feeding were better in intervention versus comparison sites (p<0.001 and p=0.05, respectively). Controlling for confounders, interactions between time and intervention group and preintervention values, the attitude score was 5.1 points significantly higher in intervention versus comparison groups.ConclusionA participatory, low-intensity on-site mentoring approach to disseminating updated infant feeding guidelines improved HWs’ knowledge, attitudes and confidence more than standard dissemination via a circular. Further research is required to evaluate the effectiveness, feasibility and sustainability of this approach at scale.

Quasi-Experimental study of effects of lighting on rest, activity and melatonin in postpartum women

2021 ◽  
Vol 74 (6) ◽  
Author(s):  
Cristina Furtado Volcov ◽  
Eliana Moreira Pinheiro ◽  
Miriam Harumi Tsunemi ◽  
Fernanda Gaspar do Amaral ◽  
Ariane Ferreira Machado Avelar ◽  
...  
Keyword(s):  
Experimental Study ◽  
Comparison Group ◽  
Total Load ◽  
Long Wavelength ◽  
Light Regimen ◽  
Early Postpartum ◽  
Comparison Groups ◽  
Quasi Experimental ◽  
The Mean ◽  
Experimental Group

ABSTRACT Objectives: to compare the parameters of the activity/rest cycle of early postpartum breastfeeding women under a controlled and uncontrolled long wavelength ray light regimen. Methods: quasi-experimental study with breastfeeding women and their babies during postnatal rooming-in, São Paulo, Brazil. Participants were allocated to either an experimental (intervention) or a comparison group. The intervention involved exposure of the woman in a controlled room with artificial long wavelength ray light at night. Each woman’s level of 6-sulfatoxymelatonin at 24 hours and activity/rest times was analyzed. Results: the mean activity/rest times of women in the experimental and comparison groups were similar. The mean percentages of total load of 6-sulfatoxymelatonin during the day and night were similar (p=0.09). At 24 hours, the experimental group presented a significantly lower mean percentage of total load compared to the comparison group (p=0.04). Conclusions: women who stayed in the room with long-wavelength artificial light showed no difference in activity/rest and 6-sulfatoxymelatonin levels in the early postpartum period.

The panty condom: a pilot study of the function and acceptability of an alternative female condom design

2019 ◽  
Vol 30 (11) ◽  
pp. 1080-1086 ◽  
Author(s):  
Mags Beksinska ◽  
Jennifer Smit ◽  
Nonhlanhla Mphili ◽  
Ross Greener ◽  
Virginia Maphumulo
Keyword(s):  
South Africa ◽  
Pilot Study ◽  
Failure Mode ◽  
Lower Cost ◽  
Female Condom ◽  
Clinical Failure ◽  
Primary Endpoints ◽  
Total Female ◽  
The Mean

New female condom (FC) products, different in design and materials that have the potential to lower cost and improve acceptability are being developed. A pilot study of the Panty Condom was conducted among experienced FC users in Durban, South Africa. This pilot function trial enrolled 19 women who were asked to use five Panty Condoms each and collect information on use in a condom diary at home, followed by one follow-up interview. Primary endpoints were total clinical failure and total female condom failure. Non-inferiority of component modes, clinical breakage, non-clinical breakage, slippage, misdirection, and invagination were also determined. Frequencies and percentages were calculated for each failure mode. The mean age of the participants was 27.8 years (SD 4.9). Safety and acceptability data were also assessed. In 95 condom uses nine failure events occurred in eight condoms. Clinical breakage occurred in 8.4% (n = 8) of condoms and slippage in one condom. Total FC failure was 8.4% of all condom uses. Of the eight breakage events there were two reports of the condom ripping during sex and six reports of the condom detaching from the panty. Fifteen women either liked very much or liked somewhat using the Panty Condom. Total clinical failure was approximately twice that seen in other FC functionality studies.

scholarly journals An intervention of physical activity promotion in an university hospital. A prospective cohort study

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
J Ladner ◽  
S D Mihailescu ◽  
D Cerasuolo
Keyword(s):  
Physical Activity ◽  
Health Workers ◽  
Public Health Intervention ◽  
Physical Activity Promotion ◽  
University Hospital ◽  
Activity Promotion ◽  
The Mean ◽  
High Level ◽  
The Impact

Abstract Background Rouen University Hospital implements a policy of health promotion hospital since 2016. The objective of this study was to evaluate prospectively the impact of physical activity promotion in hospital health workers (HW), using pedometers over a period of six months. Methods Physical activity was measured by electronic pedometers distributed to HW, with the aim to improve their physical activity and to measure it during six months. Online questionnaires collected at different points of follow-up, from inclusion to sixth month (a total of seven points of follow-up). Socio-demographic and characteristics on type of health work were collected as well as the number of steps and the behavior regarding their routine physical activity. Results A total of 680 HW were included in the cohort. The sex ratio M:W was 0.16. The mean age was 41.6 years (SD = 10.7). 44.0% were non-medical caregivers, 32.1% were in administrative section, 14.3% were technical workers and 9.7% were physicians or pharmacists; 53.7% of HW reported doing sport regularly. At inclusion the mean number of daily steps was 8662. The mean progression for all professional profiles between first week and sixth month was of 1082 steps daily, with difference according to position: 1319 in physicians, 1234 in non-medical caregivers, 1106 in administrative workers and 314 in technical workers. In linear regression model, the mean number of progression of daily steps was 964 in physicians, 752 in non-medical caregivers. Conclusions The study shows a significant increase in the number of daily steps measured objectively using an incentive tool, as pedometer during six months of intervention. Further researches are needed to determine if these changes are sustainable over a long period of time Key messages Despite high level of daily steps at baseline, the longitudinal study shows an increase of daily steps over a 6-month period. Such public health intervention is a relevant method to engage people in self-monitoring their physical activity.

scholarly journals Subconjunctival Bevacizumab as an Adjunct to 5-Fluorouracil Enhanced Trabeculectomy: 1 Year Outcomes

2021 ◽  
Vol 37 (3) ◽  
Author(s):  
Sana Nadeem
Keyword(s):  
Intraocular Pressure ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Exclusion Criteria ◽  
Quasi Experimental ◽  
Added Benefit ◽  
Bleb Formation ◽  
The Mean

Purpose:  To compare the results of trabeculectomy with subconjunctival Bevacizumab and 5-Fluorouracil (5-FU); with trabeculectomy with 5-FU alone; in terms of intraocular pressure (IOP) lowering, bleb formation, and complications, in the long term. Study Design:  Quasi experimental study. Place and Duration of Study:  Fauji Foundation Hospital, Rawalpindi, from December 2013 to August, 2019. Methods:  A total of 30 eyes (15 in each group) with glaucoma were recruited. Exclusion criteria were previous trabeculectomy, congenital, traumatic, uveitic, neovascular glaucomas, aphakia, or ocular surface disease. Trabeculectomy with 5FU was performed in both groups. In one group, subconjunctival Bevacizumab was injected into the bleb at the end of surgery. The patients were observed for IOP control, bleb configuration, and complications for 1 year. Results:  Primary open angle glaucoma was the predominant diagnosis in 17 (56.7%) eyes. The mean pre-operative IOP in the 5-FU group was 30.8 ± 17.03 mmHg, & in the 5-FU+Bevacizumab group it was 28.9 ± 18.9 mmHg. The mean IOPs of the 5-FU group at 1 Year was 14.5 ± 5.04 mmHg. In 5-FU+Bevacizumab group, mean IOPs at 1 year was 12.7 ± 4.38 mmHg. The differences between pre-operative and post-operative IOPs in both groups at 6, 9 and 12 months were statistically significant. However, differences in mean IOPs between the two groups, bleb morphology and complications were not statistically significant. Conclusion:  No added benefit of subconjunctival Bevacizumab used as an adjunct to 5-FU enhanced trabeculectomy was found at the end of 1 year follow-up. Key Words:  Trabeculectomy, 5-Fluorouracil, Bevacizumab, Glaucoma, Intraocular pressure.

scholarly journals A Healthy Retirement Program for Thai government teachers: a quasi-experimental and comparison groups study

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Numporn Insin ◽  
Chanuantong Tanasugarn ◽  
Sarunya Benjakul
Keyword(s):  
Chronic Disease ◽  
Health Information ◽  
Healthy Lifestyle ◽  
Subjective Health ◽  
Content Type ◽  
Comparison Groups ◽  
Quasi Experimental ◽  
One Year ◽  
Experimental Group

PurposeThe purpose of this study is to evaluate the Healthy Retirement Program's effectiveness toward skills improvement and evaluate changes in subjective health.Design/methodology/approachA quasi-experimental, pre and posttest of the comparison groups was conducted. Teachers who were going to retire within one year were recruited into the experimental (n = 47) and the comparison groups (n = 43). Questionnaires were administered at baseline, posttest and at the 6-months follow-up. An independent t-test and Mann–Whitney U test were applied to determine the differences in outcomes between groups.FindingsThe results revealed different effects regarding teachers' health status. In those who had no chronic disease, the experimental group had higher skills to understand health information at posttest and at follow-up (p = 0.036, 0.028). Skills to apply health information was also greater at follow-up (p = 0.042). Among those suffering from a chronic disease, skills to access and apply health information were significantly higher in the experimental group than that of the comparison at follow-up (p = 0.011, 0.046). Greater perceived health of the experimental group was also indicated (p = 0.032).Originality/valueWhile the health conditions of teachers at the preretirement period are inconsistent, healthy lifestyle management after retirement is a crucial skill for retirement adjustment. Supporting teachers to be health literate should be included in the retirement planning program which emphasizes preretiree's ability to understand and take control of their health.

Characteristics and Outcomes of Autoimmune Hepatitis from a Tertiary Paediatric Centre, Cape Town, South Africa

2020 ◽  
Vol 66 (4) ◽  
pp. 448-457
Author(s):  
Sawsan Yassin ◽  
Ronalda De Lacy ◽  
Komala Pillay ◽  
Elizabeth Goddard
Keyword(s):  
South Africa ◽  
Autoimmune Hepatitis ◽  
Remission Rate ◽  
Significant Risk ◽  
Red Cross ◽  
Unfavourable Outcome ◽  
Ethical Approval ◽  
Autoimmune Sclerosing Cholangitis ◽  
The Mean

Abstract Objectives To describe the clinical characteristics, biochemical and histological features, outcomes and predictors of prognosis of children with autoimmune hepatitis (AIH) from a paediatric centre in South Africa. Methods Thirty-nine children diagnosed with AIH at Red Cross War Memorial Children’s Hospital between 2005 and 2015 were included. Relevant patient’s data were retrieved from the hospital’s medical records and database. Liver biopsy slides were reviewed. Ethical approval was obtained. Data were analysed using SPSS. Results Females were 29 (74%). Mean age at presentation was 7.27 ± 3.35 years and the mean follow-up was 4.5 ± 2.4 years. Jaundice was present in 97% of patients at presentation. An acute presentation was observed in 26 (67%) even though cirrhosis was detected in 22 (56%). Autoantibody screening was completed in 35 patients, 20 (57%) were AIH-1, 1 (3%) was AIH-2 and 14 (40%) were seronegative AIH. Of the 25 patients who underwent magnetic resonance cholangiography 17 (68%) had associated autoimmune sclerosing cholangitis. The remission rate was 79%. However, 11 children relapsed later. One child required liver transplantation and one demised. Seronegative and seropositive patients have comparable characteristics and outcomes. While a higher alanine transaminase (ALT) level at presentation is a significant predictor of remission, a lower ALT level and cirrhosis are significant risk factors for unfavourable outcome. Overall survival rate was 97%. Conclusion AIH responds well to therapy with excellent survival. Hence, it should be considered in any child presenting with viral screen negative hepatitis and start therapy timeously to prevent disease progression.

scholarly journals (P2-48) Improve Nursing Disaster Preparedness by Education and Maneuver

2011 ◽  
Vol 26 (S1) ◽  
pp. s151-s151
Author(s):  
H.R. Khankeh ◽  
G.R. Masoomi ◽  
A.R. Jallali ◽  
V. Ghanbari ◽  
S. Madah ◽  
...  
Keyword(s):  
Disaster Preparedness ◽  
Health Management ◽  
Basic Principles ◽  
Preparedness Plan ◽  
Quasi Experimental ◽  
Training Courses ◽  
The Mean ◽  
Effectiveness Of Training ◽  
And Performance

IntroductionNurses have pivotal roles before, during, and after disasters. Enhancing their professional skills to help the injured is one the basic principles in health management in disasters. The aim of this study is to investigate the effectiveness of training disaster nursing preparedness on improving the preparedness of nurses.MethodUsing a quasi-experimental method, 113 nurses were selected randomly. The preparedness program, which consisted of a one-day workshop on disaster management, a tabletop exercise, and an operational maneuver, was executed for the participants. The preparedness of all participating nurses was measured by disaster preparedness questionnaire, one week and also one month after the program. Data analysis was performed by using the ANOVA test.ResultsThe mean scores of knowledge, attitude, and performance improved from 5.55 to 19.88, from 66.18 to 72.41, and from 3.36 to 12.48, respectively (p < 0.001). In addition, the mean of total preparedness score was increased from 75.14 in pretest to 104.77 in the follow up (p < 0.001).ConclusionsPreparedness plan training improves participants' preparedness for responding disasters, because preparedness and reliability for responding to disasters is influenced directly by the training courses and previous experiments. Therefore, based on the results obtained in this project, in order to improve the preparedness of nursing staff, including a disaster preparedness plan in academic, educational curriculum and as a continuing educational program is recommended.

scholarly journals Effectiveness of Ponseti Versus Kite Method for the Management of Club Foot- A Quasi Experimental Trial

2021 ◽  
Vol 15 (6) ◽  
pp. 1871-1873
Author(s):  
Shabana Sharif ◽  
Rehan Ramzan Khan ◽  
Saima Riaz ◽  
Sajid Rashid ◽  
Zaigham Rasool Athar ◽  
...  
Keyword(s):  
Club Foot ◽  
Rapid Improvement ◽  
Treatment Groups ◽  
Experimental Trial ◽  
Score Difference ◽  
Pirani Score ◽  
Quasi Experimental ◽  
Group A ◽  
Group B

Objective: To determine the effectiveness of ponseti versus kite method for the management of club foot among children. Methods: A quasi experimental trial was conducted to determine the most effective conservative method for managing idiopathic club foot. This study was carried out in District Head Quarter Hospital, Layyah. A total of 46 children (60 Feet) aged less than six months of both genders were included in this study using convenience sampling technique. The study sample was divided into Group A (Ponseti) and Group B (Kite). Each treatment group comprises of 30 feet. Patients were called for weekly follow up till ten weeks consecutively. At every follow-up visit, patients were assessed to check the improvement of deformity with the help of the Pirani scoring system for the foot. Pirani score difference was measured in both treatment groups from the baseline until the last follow-up interval until the 10th Week. Pirani score difference was measured in both treatment groups from the baseline until the last follow-up interval until the 10th Week. A greater negative value signified better correction. SPSS 23 was used for data entry and analysis. Results: Children's mean age in both treatment groups (A and B) was 10.83±4.59 and 10.20±4.75 weeks. At presentation mean Pirani score in both treatment groups (A and B) was 5.85±0.67 and 5.86±0.45, respectively, while at 10th follow up it was 1.42±0.39 and 2.35±0.54 for group A and group B, respectively. Conclusion: This study demonstrates that the Ponseti technique significantly improved the management of club foot as that of the Kites method. Ponseti's method is more effective in terms of rapid improvement in the involved group. Key words: Non operative Management, Idiopathic Club foot, Kites method, Ponseti method.

Neurodevelopmental outcome in extremely low birth weight infants in Johannesburg, South Africa

2020 ◽  
Author(s):  
Tanusha Ramdin ◽  
Yoliswa Magadla ◽  
Robin T Saggers ◽  
Aripfani Veronica Mphaphuli ◽  
Rossella M Bandini ◽  
...  
Keyword(s):  
South Africa ◽  
At Risk ◽  
Cerebral Palsy ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Subscale Score ◽  
Extremely Low Birth Weight ◽  
Low Birth Weight Infants ◽  
The Mean

Abstract Background: Improved survival in preterm infants whether due to technological progress or treatment like antenatal steroids, surfactant administration or nasal continuous positive airway pressure (NCPAP) and aggressive resuscitation have raised the question about whether the survivors would be more prone to increased morbidity and adverse neurodevelopmental disability. Methods: This was a prospective follow-up study conducted in the neonatal unit of a tertiary hospital in Johannesburg, South Africa. Bayley scales of infant and toddler development, version III, were conducted on a group of extreme low birth weight infants (ELBWI). The mean composite cognitive, language and motor sub-scales were reported. Infants were considered to be “at risk” if the composite subscale score was below 85 and “disabled” if the composite subscale score was below 70. Infants identified with cerebral palsy were also reported.Results: The mean birth weight of the study group was 858.5grams (95% CI 839.2- 877.8) and the mean gestational age was 27.5 weeks (95% CI 27.1-27.9). The majority of ELBWI enrolled in the study had at least one Bayley at a mean corrected age of 17.09 months (CI 16.04 to 18.14). The mean composite scores for cognition were 98.4 (CI 95.1-101.7), language 90.0 (CI 87.5-92.6) and motor 97.9 (CI 94.8-101.0). All mean scores fell within the normal range, but the composite language score was the lowest. The study did not diagnose cerebral palsy in any of the infants. The study found 28 (36.3%) infants to be “at risk” for neurodevelopmental delay. Significantly more males were classified as “at risk” than females (13/25 (52%) vs. 15/52 (28.8%). Late onset sepsis (sepsis18/37 (48.6%) vs. no sepsis 10/40 (25%) p=0.031) and longer duration of ventilation (median of 12 days (IQR 46) vs. median of 4.0 days (IQR 5) p=0.048) were significantly associated with an “at risk” classification. Conclusion: Rates of early neurodevelopmental impairment have altered minimally despite significant improvements in the overall survival of ELBWI. It is of paramount importance to ensure that early neurodevelopmental outcomes are accurately assessed so as to assist doctors and families in establishing a foundation for advocacy for the immediate intensive care and post discharge follow up.

scholarly journals Video directly observed therapy for supporting and monitoring adherence to tuberculosis treatment in Uganda: a pilot cohort study

2020 ◽  
Vol 6 (1) ◽  
pp. 00175-2019 ◽  
Author(s):  
Juliet N. Sekandi ◽  
Esther Buregyeya ◽  
Sarah Zalwango ◽  
Kevin K. Dobbin ◽  
Lynn Atuyambe ◽  
...  
Keyword(s):  
Cohort Study ◽  
Primary Outcome ◽  
Health Workers ◽  
Secondary Analysis ◽  
Directly Observed Therapy ◽  
Tb Control ◽  
Tb Treatment ◽  
Kampala City ◽  
The Mean

IntroductionNonadherence to treatment remains an obstacle to tuberculosis (TB) control worldwide. The aim of this study was to evaluate the feasibility of using video directly observed therapy (VDOT) for supporting TB treatment adherence in Uganda.MethodsFrom May to December 2018, we conducted a pilot cohort study at a TB clinic in Kampala City. We enrolled patients aged 18–65 years with ≥3 months remaining of their TB treatment. Participants were trained to use a smartphone app to record videos of medication intake and submit them to a secured system. Trained health workers logged into the system to watch the submitted videos. The primary outcome was adherence measured as the fraction of expected doses observed (FEDO). In a secondary analysis, we examined differences in FEDO by sex, age, phone ownership, duration of follow-up, reasons for missed videos and patients' satisfaction at study exit.ResultsOf 52 patients enrolled, 50 were analysed. 28 (56%) were male, the mean age was 31 years (range 19–50 years) and 35 (70%) owned smartphones. Of the 5150 videos expected, 4231 (82.2%) were received. The median FEDO was 85% (interquartile range 66%–94%) and this significantly differed by follow-up duration. Phone malfunction, uncharged battery and VDOT app malfunctions were the commonest reasons for missed videos. 92% of patients reported being very satisfied with using VDOT.ConclusionVDOT was feasible and acceptable for monitoring and supporting TB treatment. It resulted in high levels of adherence, suggesting that digital technology holds promise in improving patient monitoring in Uganda.

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