scholarly journals Impact of multi-professional, scenario-based training on postpartum hemorrhage in Tanzania: a quasi-experimental, pre- vs. post-intervention study

2017 ◽  
Vol 17 (1) ◽  
Author(s):  
Signe Egenberg ◽  
Gileard Masenga ◽  
Lars Edvin Bru ◽  
Torbjørn Moe Eggebø ◽  
Cecilia Mushi ◽  
...  
Keyword(s):  
Postpartum Hemorrhage ◽  
Intervention Study ◽  
Post Intervention ◽  
Quasi Experimental

scholarly journals Family-centered postnatal training and adherence to newborn care practices in district hospitals in two Indian states: A quasi-experimental intervention study

2021 ◽  
Author(s):  
Sehj Kashyap ◽  
Amanda F Spielman ◽  
Nikhil Ramnarayan ◽  
Sahana SD ◽  
Rashmi Pant ◽  
...  
Keyword(s):  
Health Outcomes ◽  
Intervention Study ◽  
Intervention Group ◽  
Newborn Care ◽  
Post Intervention ◽  
Indian States ◽  
District Hospitals ◽  
Quasi Experimental ◽  
Care Practices ◽  
Family Centered

Background and Objectives: Globally, 2.5 million newborns die within the first month of life annually. The majority of deaths occur in low- and middle-income countries (LMICs), and many of these deaths happen at home. The study assessed if the Care Companion Program (CCP) an in-hospital, skills-based training given to families improves post-discharge maternal and neonatal health outcomes. Methods: This quasi-experimental pre-post intervention study design compared self-reported behavior and health outcomes among families before and after the CCP intervention. Intention to treat analysis included families regardless of their exposure to the intervention. Mixed effects logistic regression model, adjusted for confounders, was fit for all observations. Effects were expressed as Relative Risks (RR) with 95% Confidence Intervals (CI). Results: At 2-weeks post-delivery, telephone surveys were conducted in the pre (n = 3510) and post-intervention (n = 1474) groups from 11 district hospitals in the states of Karnataka and Punjab. The practice of dry cord care improved significantly by 4%, (RR = 1.04, 95%CI [1.04,1.06]) and skin to skin care by 78% (RR=1.78, 95%CI [1.37,2.27]) in the post-intervention group as compared to pre-intervention group. Furthermore, newborn complications reduced by 16% (RR=0.84, 95%CI [0.76,0.91]), mother complications by 12% (RR=0.88, 95%CI [0.79,0.97]) and newborn readmissions by 56% (RR=0.44, 95%CI [0.31,0.61]). Outpatient visits increased by 27% (RR=1.27, 95%CI [1.10,1.46]). However, outcomes of breastfeeding, mothers diet, hand-hygiene, and process indicator of being instructed on warning signs were not different. Conclusion: Postnatal care should incorporate pre-discharge multi-pronged training of families to improve essential maternal and newborn care practices. The CCP model runs on a public-private partnership and is integrated into existing health systems. Our findings demonstrate that it is possible to improve outcomes through a family-centered approach in India. The CCP model can be integrated into formalised hospital processes to relieve overburdened healthcare systems in LMIC settings.

scholarly journals The Safety and Feasibility of a Family First Aid Approach for the Management of Postpartum Hemorrhage in Home Births: A Pre-post Intervention Study in Rural Pakistan

2020 ◽  
Author(s):  
Meighan Mary ◽  
Sadiqua Jafarey ◽  
Rasha Dabash ◽  
Imtiaz Kamal ◽  
Arjumand Rabbani ◽  
...  
Keyword(s):  
Rural Communities ◽  
Postpartum Hemorrhage ◽  
Intervention Study ◽  
First Aid ◽  
Post Intervention ◽  
Excessive Bleeding ◽  
Home Births ◽  
Intervention Phase ◽  
Home Deliveries ◽  
At Home

Abstract Objective To evaluate the safety and feasibility of a Family First Aid approach whereby women and their families are provided misoprostol in advance to manage postpartum hemorrhage (PPH) in home births. Methods A 12-month prospective, pre-post intervention study was conducted from February 2017 to February 2018. Women in their second and third trimesters were enrolled at home visits. Participants and their families received educational materials and were counseled on how to diagnose excessive bleeding and the importance of seeking care at a facility if PPH occurs. In the intervention phase, participants were also given misoprostol and counselled on how to administer the four 200 mcg tablets for first aid in case of PPH. Participants were followed-up postpartum to collect data on use of misoprostol for Family First Aid at home deliveries (primary outcome) and record maternal and perinatal outcomes. Results Of the 4008 participants enrolled, 97% were successfully followed-up postpartum. Half of the participants in each phase delivered at home. Among home deliveries, the odds of reporting PPH almost doubled among in the intervention phase (OR 1.98; CI 1.43, 2.76). Among those reporting PPH, women in the intervention phase were significantly more likely to have received PPH treatment (OR 10.49; CI 3.37, 32.71) and 90% administered the dose correctly. No maternal deaths, invasive procedures or surgery were reported in either phase after home deliveries. Conclusions The Family First Aid approach is a safe and feasible model of care that provides timely PPH treatment to women delivering at home in rural communities.

scholarly journals Written narratives of Grade 5 learners with developmental language difficulties: A group discussion intervention study

Per Linguam ◽  
2021 ◽  
Vol 37 (1) ◽  
pp. 45-67
Author(s):  
Sharon Moonsamy
Keyword(s):  
Intervention Study ◽  
Group Discussion ◽  
Post Intervention ◽  
Group Discussions ◽  
Written Narratives ◽  
Grade 5 ◽  
Language Difficulties ◽  
Quasi Experimental ◽  
Cognitive And Metacognitive Strategies ◽  
Analysis Protocol

Increased demand on a learner’s linguistic, cognitive and metacognitive abilities is expected at higher grades in schools. The application of cognitive and metacognitive strategies when learning is, however, not always automatic, therefore explicit mediation to retrieve and apply these processes appropriately, is essential. This paper aims to compare the linguistic experiences of Grade 5 learners with Developmental Language Difficulties (DLD) when writing a narrative, pre- and post-discussion intervention. The intervention approach is grounded in Feuerstein (2006) and Vygotsky’s (1934/1987) theories of cognitive development. This quantitative and qualitative study was a quasi-experimental, pre- and posttest design. The sample consisted of 10 Grade 5 learners from a remedial school. The pretest written narratives preceded the intervention phase and were followed by the posttest narratives. The macro- and microstructure of the written narratives were analysed, using an adapted framework based on Fey’s (2001) and Moonsamy’s (2009) analysis protocol. Explicit discussions on writing processes should generalise to familiar and novel tasks required in all learning situations. The findings suggest that interventions, using group discussions, were beneficial for learners with DLD where knowledge was coconstructed. Improvements in microstructure were evident while the macrostructure remained the same at post-intervention. This study contributes to evidence-based practice for learner instruction in mainstream and special needs environments.

scholarly journals Evaluation of Modified Melasma Area and Severity Index in Hyperthyroid Patients Receiving Anti-thyroid Drugs

2021 ◽  
Vol 9 (B) ◽  
pp. 344-349
Author(s):  
Irma Bernadette S. Sitohang ◽  
Benny Nelson ◽  
Melani Marissa ◽  
Wresti Indriatmi ◽  
Wismandari Wisnu
Keyword(s):  
Outpatient Clinic ◽  
Mixed Type ◽  
Intervention Study ◽  
Severity Index ◽  
Interventional Study ◽  
Post Intervention ◽  
Before And After ◽  
The Face ◽  
Quasi Experimental ◽  
Hyperthyroid Patients

BACKGROUND: Melasma is a common hyperpigmentation disorder, which causes brownish discoloration of the face. Despite unclear mechanisms, thyroid hormones were thought to play a role in melasma. AIM: This study aims to determine and compare the clinical improvement of melasma in hyperthyroid patients receiving anti-thyroid drugs. METHODS: An interventional study with a quasi-experimental design (pre-post-intervention study) was conducted at the Internal Medicine Outpatient Clinic and Dermatology and Venereology Outpatient Clinic, Cipto Mangunkusumo Hospital, Jakarta, Indonesia, from July 2019 to March 2020. A comparative analysis was done to compare the modified melasma area and severity index (mMASI) in hyperthyroid patients before and after 12 weeks of anti-thyroid drugs. All subjects did not receive any additional topical therapies for their melasma. The clinical features were evaluated objectively at baseline and 12th-week visit, by mMASI score on different areas of the face (forehead, left-right malar, and chin) and Wood’s lamp examination. RESULTS: All areas showed a decline in mMASI score components (e.g., involvement areas and darkness degree) after 12 weeks of treatment. However, only the malar area showed a significant decline (p < 0.05). Wood’s lamp examination at baseline revealed dermal type melasma on 17 subjects, mixed type on six subjects, and epidermal type on one subject. All types remained unchanged after 12 weeks of treatment. CONCLUSIONS: Our study demonstrated that mMASI score in malar area improved significantly, this might be because malar area included this study were comprised of epidermal, dermal, and mixed type. On the other hand, based on Wood’s lamp examination, all types of melasma remained unchanged after 12 weeks of treatment.

scholarly journals The Effect of An mLearning Application on Nurses’ and Midwives’ Knowledge and Skills for The Management of Postpartum Hemorrhage and Neonatal Resuscitation: Quasi-Experimental Study.

2020 ◽  
Author(s):  
Aurore Nishimwe ◽  
Latifat Ibisomi ◽  
Marc Nyssen ◽  
Daphney Nozizwe Conco
Keyword(s):  
Postpartum Hemorrhage ◽  
Healthcare Workers ◽  
Neonatal Resuscitation ◽  
Continuous Training ◽  
Post Intervention ◽  
Knowledge And Skills ◽  
Service Training ◽  
Quasi Experimental ◽  
The Mean ◽  
Nurses And Midwives

Abstract Background: Globally, mobile learning (mLearning) tools have attracted considerable attention as a means of continuous training for healthcare workers. Rwanda like other low-resource settings with scarce in-service training opportunities requires innovative approaches that adapt technology to context to improve healthcare workers’ knowledge and skills. One such innovation is the safe delivery application (SDA), a smartphone mLearning application for Basic Emergency Obstetric and Neonatal Care (BEmONC) content. This study assessed the effect of the SDA intervention on nurses’ and midwives’ knowledge and skills for the management of postpartum hemorrhage (PPH) and neonatal resuscitation (NR).Methods: The study used a pre-post, quasi-experimental design to compare knowledge and skills of nurses and midwives in the management of PPH and NR at two measurement points: immediately prior SDA intervention and after 6 months SDA intervention. The intervention took place in two district hospitals in Rwanda and included 54 participants. A paired-sample t-test was used to measure the pre-post intervention, mean knowledge and skills scores differences. Confidence intervals (CIs) and effect size were calculated. A t-test and a one-way Anova was used to test for potential confounders. Results: The analysis included 54 participants. Knowledge scores and skills scores on PPH management and NR increased significantly from baseline to endline measurements. The mean difference for PPH knowledge is 17.1 out of 100; 95% CI = 14.69 to 19.49 and 2.6% for PPH skills; 95% CI = 1.01 to 4.25. The mean difference for NR knowledge is 19.1 out of 100; 95% CI = 16.31 to 21,76 and 5.5% for NR skills; 95% CI = 3.66 to 7.41. Increases were unaffected by participants’ attendance to in-service training six months prior and during SDA intervention and previous smartphone use. However, pre- and post-intervention skills scores were significantly different by years of experience in obstetric care.Conclusion: The SDA intervention improved the knowledge and skills of nurses and midwives on the management of PPH and NR as long as 6 months after SDA introduction. The results are highly relevant in low-income countries like Rwanda, where quality of delivery care is challenged by a lack of in-service continuous training for healthcare providers.

Efficacy of an activity tracker-and app intervention to increase physical activity in the entire family: Pilot single-arm intervention study (Preprint)

2019 ◽  
Author(s):  
Stephanie Schoeppe ◽  
Jo Salmon ◽  
Susan L. Williams ◽  
Deborah Power ◽  
Stephanie Alley ◽  
...  
Keyword(s):  
Physical Activity ◽  
Intervention Study ◽  
Post Intervention ◽  
Entire Family ◽  
Physical Activity Guidelines ◽  
Mothers And Fathers ◽  
Activity Tracker ◽  
Activity Trackers ◽  
Family Program ◽  
Intervention Efficacy

BACKGROUND Interventions using activity trackers and smartphone apps have demonstrated their ability to increase physical activity in children and adults. However, they have not been tested in entire families. Further, few family-centred interventions have actively involved both parents, and assessed intervention efficacy separately for children, mothers and fathers. OBJECTIVE This study aimed to examine the short-term efficacy of an activity tracker and app intervention to increase physical activity in the entire family (children, mothers and fathers). METHODS This was a pilot single-arm intervention study with pre-post measures. Between 2017-2018, 40 families (58 children aged 6-10 years, 39 mothers, 33 fathers) participated in the 6-week Step it Up Family program in Queensland, Australia. Using commercial activity trackers combined with apps (Garmin Vivofit Jr for children, Vivofit 3 for adults), the intervention included individual and family-level goal-setting, self-monitoring, performance feedback, family step challenges, family social support and modelling, weekly motivational text messages, and an introductory session delivered face-to-face or via telephone. Parent surveys were used to assess intervention efficacy measured as pre-post intervention changes in moderate-to-vigorous physical activity (MVPA) in children, mothers and fathers. RESULTS Thirty-eight families completed the post intervention survey (95% retention). At post intervention, MVPA had increased in children by 58 min/day (boys: 54 min/day, girls: 62 min/day; all P < .001). In mothers, MVPA increased by 27 min/day (P < .001), and in fathers, it increased by 31 min/day (P < .001). Furthermore, the percentage of children meeting Australia’s physical activity guidelines for children (≥60 MVPA min/day) increased from 34% to 89% (P < .001). The percentage of mothers and fathers meeting Australia’s physical activity guidelines for adults (≥150 MVPA min/week) increased from 8% to 57% (P < .001) in mothers, and from 21% to 68% (P < .001) in fathers. CONCLUSIONS Findings suggest that an activity tracker and app intervention is an efficacious approach to increasing physical activity in entire families to meet national physical activity guidelines. The Step it Up Family program warrants further testing in a larger, randomised controlled trial to determine its long-term impact. CLINICALTRIAL No trial registration as this is not an RCT. It is a pilot single-arm intervention study

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.

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.

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