Effectiveness of Early Essential Newborn Care Implementation In Four Provinces of Western China

2021 ◽  
Author(s):  
Chenran Wang ◽  
Yun Lin ◽  
Hanxiyue Zhang ◽  
Ge Yang ◽  
Kun Tang ◽  
...  
Keyword(s):  
Intervention Group ◽  
Newborn Care ◽  
Western China ◽  
World Health ◽  
Health Concern ◽  
Control Group ◽  
Neonatal Health ◽  
Post Intervention ◽  
Essential Newborn Care ◽  
Postpartum Mothers

Abstract Introduction: Neonatal survival remains a public health concern globally. Early Essential Newborn Care (EENC) recommended by World Health Organization is a package of cost-effective interventions to improve neonatal health and development outcomes. In this study we aimed to explore the effectiveness of EENC implementation in four provinces of western China.Methods: A pre- and post-intervention investigations were conducted in 4 selected EENC intervention counties and 4 control counties of four western provinces of China, during June to August 2017 and December 2020 to April 2021 respectively. A mixed quantitative and qualitative approach was used for data collection and analysis. Data on the coverage of EENC practices were collected through post-intervention face-to-face questionnaire interview with postpartum mothers before hospital discharge. Hospital-reported data on neonatal health outcomes were obtained through mail surveys in both investigations. We also performed semi-structured interviews with stakeholders of policymakers, health staff, and postpartum mothers to learn their perceived usefulness of EENC implementation. Results: 599 mother-newborn pairs in the intervention group and 699 pairs in the control group participated in the post-intervention survey. With the confounding factor of province being controlled for, proportions of newborns receiving any skin to skin contact (99.50% vs. 49.07%), exclusive breastfeeding before discharge (92.57% vs. 63.80%), no applied medicine to the umbilical cord (98.50% vs. 9.73%), routine eye care (93.16% vs. 8.73%), and vitamin K1 administration (98.33% vs. 88.98%) were higher in the intervention group compared with the control group (P<0.05). Lower incidences of neonatal diarrhea (0.07% vs. 0.22%) and eye infection (0.04% vs. 0.29%) were reported in the intervention group than the control group (P<0.05). The enhanced satisfaction of stakeholders primarily manifests in belief acknowledgement, policy promotion, emotional support, health improvement, widely-acknowledged sustainability, and work support. Conclusion: EEEC-recommended core practices have been successfully introduced in pilot hospitals. The efficacy of EENC implementation should be highly recognized to accelerate the progress towards its national rolling out.

scholarly journals Effect of “Spatially Separated Speech in Noise Training” on speech perception in noise in children with bimodal fitting

2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Younes Lotfi ◽  
Mahdieh Hasanalifard ◽  
Abdollah Moossavi ◽  
Enayatollah Bakhshi ◽  
Mohammad Ajalloueyan
Keyword(s):  
Speech Perception ◽  
Intervention Group ◽  
Auditory Training ◽  
Control Group ◽  
Interventional Study ◽  
Post Intervention ◽  
Speech Perception In Noise ◽  
Speech In Noise ◽  
Significant Difference ◽  
Recognition Ability

Abstract Background The objective of this study was to evaluate the effect of “Spatially separated speech in noise” auditory training on the ability of speech perception in noise among bimodal fitting users. The assumption was that the rehabilitation can enhance spatial hearing and hence speech in noise perception. This study was an interventional study, with a pre/post-design. Speech recognition ability was assessed with the specific tests. After performing the rehabilitation stages in the intervention group, the speech tests were again implemented, and by comparing the pre- and post-intervention data, the effect of auditory training on the speech abilities was assessed. Twenty-four children of 8–12 years who had undergone cochlear implantation and continuously used bimodal fitting were investigated in two groups of control and intervention. Results The results showed a significant difference between the groups in different speech tests after the intervention, which indicated that the intervention group have improved more than the control group. Conclusion It can be concluded that “Spatially separated speech in noise” auditory training can improve the speech perception in noise in bimodal fitting users. In general, this rehabilitation method is useful for enhancing the speech in noise perception ability.

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.

scholarly journals Early essential newborn care is associated with improved newborn outcomes following caesarean section births in a tertiary hospital in Da Nang, Vietnam: a pre/post-intervention study

2021 ◽  
Vol 10 (3) ◽  
pp. e001089
Author(s):  
Hoang Thi Tran ◽  
John Charles Scott Murray ◽  
Howard Lawrence Sobel ◽  
Priya Mannava ◽  
Le Thi Huynh ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Relative Risk ◽  
Caesarean Section ◽  
Environmental Changes ◽  
Newborn Care ◽  
Adverse Outcomes ◽  
National Guidelines ◽  
Post Intervention ◽  
Essential Newborn Care ◽  
Newborn Outcomes

BackgroundTo improve maternal and neonatal outcomes, Vietnam implemented early essential newborn care (EENC) using clinical coaching and quality improvement self-assessments in hospitals to introduce policy, practice and environmental changes. Da Nang Hospital for Women and Children began EENC with caesarean section births to inform development of national guidelines. This study compared newborn outcomes after caesarean sections pre/post-EENC introduction.MethodsMaternity records of all live in-born hospital caesarean births and separate case records of the subpopulation admitted to the neonatal intensive care unit (NICU) were reviewed pre-EENC (November 2013–October 2014) and post-EENC (November 2014–October 2015) implementation. NICU admissions and adverse outcomes on NICU admission were compared using descriptive statistics.FindingsA total of 16 927 newborns were delivered by caesarean section: 7928 (46.8%) pre-EENC and 8999 post-EENC (53.2%). Total NICU admissions decreased from 16.7% to 11.8% (relative risk 0.71; 95% CI 0.66 to 0.76) after introduction of EENC. Compared with the pre-EENC period, babies with hypothermia on admission to the NICU declined from 5.0% to 3.7% (relative risk 0.73; 95% CI 0.63 to 0.84) and cases of sepsis from 3.2% to 0.8% (relative risk 0.26; 95% CI 0.20 to 0.33) post-EENC implementation. While more than half of all newborns in the NICU were fed something other than breastmilk pre-EENC introduction, 85.8% were exclusively breast fed post-EENC (relative risk 1.86; 95% CI 1.75 to 1.98). Preterm newborns <2000 g receiving kangaroo mother care (KMC) increased from 50% to 67% (relative risk 1.33; 95% CI 1.12 to 1.59).ConclusionThe EENC quality improvement approach with caesarean section births was associated with reduced NICU admissions, admissions with hypothermia and sepsis, and increased rates of exclusive breast feeding and KMC in the NICU.

Efficacy of ‘Foundations’, a Digital Mental Health App to Improve Mental Well-Being, during COVID-19: A Proof-of-Principle Randomised Controlled Trial (Preprint)

2021 ◽  
Author(s):  
Silvina Catuara-Solarz ◽  
Bartlomiej Skorulski ◽  
Inaki Estella ◽  
Claudia Avella-Garcia ◽  
Sarah Shepherd ◽  
...  
Keyword(s):  
Mental Health ◽  
Perceived Stress ◽  
Intervention Group ◽  
Well Being ◽  
Self Report ◽  
World Health ◽  
Randomised Control Trial ◽  
Control Group ◽  
Mental Well Being ◽  
Proof Of Principle

BACKGROUND Against a long-term trend of increasing demand, the COVID-19 pandemic has led to a global rise in common mental disorders. Now more than ever, there is an urgent need for scalable, evidence-based interventions to support mental well-being. OBJECTIVE The aim of this proof-of-principle study was to evaluate the efficacy of a mobile-based app in adults with self-reported symptoms of anxiety and stress in a randomised control trial that took place during the first wave of the COVID-19 pandemic in the UK. METHODS Adults with mild to severe anxiety and moderate to high levels of perceived stress were randomised to either the intervention or control arm. Participants in the intervention arm were given access to the app, Foundations, for the duration of the 4-week study. All participants were required to self-report a range of validated measures of mental well-being (10-item Connor-Davidson Resilience scale [CD-RISC-10]; 7-item Generalised Anxiety Disorder scale [GAD-7]; Office of National Statistics Four Subjective Well-being Questions [ONS-4]; World Health Organisation-5 Well-Being Index [WHO-5]) and sleep (Minimal Insomnia Scale [MISS]) at baseline and weeks 2 and 4; and, in addition, on perceived stress weekly (10-item Perceived Stress Score [PSS]). RESULTS 136 participants completed the study and were included in the final analysis. The intervention group (n=62) showed significant improvements compared to the control group (n=74) on measures of anxiety (GAD-7 score, delta from baseline to week 2 in the intervention group: -1.35 [SD 4.43]; control group: -0.23 [SD 3.24]; t134= 1.71 , P=.04), resilience (CD-RISC score, delta from baseline to week 2 in the intervention group: 1.79 [± SD 4.08]; control group: -0.31 [± SD 3.16]; t134 -3.37, P<.001), sleep (MISS score, delta from baseline to week 2 in the intervention group: -1.16 [± SD 2.67]; control group: -0.26 [± SD 2.29]; t134= 2.13, P=.01), and mental well-being (WHO-5 score, delta from baseline to week 2 in the intervention group: 1.53 [5.30]; control group: -0.23 [± SD 4.20]; t134= -2.16, P=.02) within 2 weeks of using Foundations, with further improvements emerging at week 4. Perceived stress was also reduced within the intervention group, although the results did not reach statistical significance relative to the control group (PSS score, delta from baseline to week 2 in the intervention group: -2.94 [± SD 6.84]; control group: -2.05 [± SD 5.34]; t134= 0.84, P=.20). CONCLUSIONS This study provides proof-of-principle that the digital mental health app, Foundations, can improve measures of mental well-being, anxiety, resilience, and sleep within 2 weeks of use, with greater effects after 4 weeks. It therefore offers potential as a scalable, cost-effective, and accessible solution to enhance mental well-being, even during times of crisis such as the COVID-19 pandemic.

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 Tempe Nuggets Provision Improves Energy Adequacy and Protein Intake in Underweight Underfive Children

2018 ◽  
Vol 6 (1) ◽  
pp. 89-96 ◽  
Author(s):  
Oktavina Permatasari ◽  
Retno Murwani ◽  
M. Zen Rahfiludin
Keyword(s):  
Body Weight ◽  
Energy Intake ◽  
Protein Intake ◽  
Local Community ◽  
Intervention Group ◽  
Control Group ◽  
Post Intervention ◽  
Control Group Design ◽  
Soybean Food ◽  
And Control

Tempe is a well known fermented soybean food, inexpensive, and a good source of dietary protein and energy. To improve fresh Tempe as an attractive food to children, Tempe is processed into nugget. A study using pre and post control group design was conducted to determine the effect of the Tempe nugget provision on energy and protein intake, and body weight/age (W/A) of 24-59 months old children. Forty six subjects were selected according to inclusion criteria from local Community Health Center (Puskesmas) and grouped into intervention (provision of Tempe nugget) and control group (no provision). Data of energy and protein intake of subjects before intervention were obtained by 2x24 food recall to determine deficiency in intake for the respective age. The amount of the nugget given to each underweight child in intervention group was calculated on the basis of deficiency in energy and protein intake of each child (W/A) per day. Body weight was recorded pre and post intervention. The deep-fried nuggets contained 276.53 calories per 100 g, 8.60% protein, 28.41% carbohydrate, 13.28% lipid, and 44.28% fiber. The mean age of the subjects in intervention and control group were homogeneous i.e. 40.52±10.88 months and 42.39±12.35 months respectively. Tempe nugget provision for 30 days improved significantly energy intake (p 0.001) in intervention compared to control group. Protein intake and W/A in intervention group were higher compared to control although not significant and further study with higher amount of Tempe nugget provision is needed. This study provides evidence that deep fried Tempe nugget can be used as inexpensive and nutritious food to improve protein and energy intake for underweight underfive children.

scholarly journals The Effect of Health Literacy Counselling on Self-Care in Women after Mastectomy: a Randomized Clinical Trial

2020 ◽  
Vol 9 (1) ◽  
pp. 39-45
Author(s):  
Masoume Rastegar ◽  
Zohreh Mahmoodi ◽  
Sara Esmaelzadeh Saeieh ◽  
Nasibeh Sharifi ◽  
Kourosh Kabir
Keyword(s):  
Breast Cancer ◽  
Clinical Trial ◽  
Health Literacy ◽  
Intervention Group ◽  
Self Care ◽  
Essential Element ◽  
World Health ◽  
Control Group ◽  
Fars Province ◽  
The Mean

Introduction: Breast cancer has a high prevalence, constituting a major cause of mortality in women around the world. Health literacy has a vital role in the self-care of chronic diseases such as cancer and is an essential element in the ability of each person to engage with health promotion. The aim of this study was to determine effect of health literacy counselling on selfcare in women after mastectomy. Methods: This study is a randomized, controlled, clinical trial carried out on 72 women with breast cancer after mastectomy in Fars province. The eligible women entered the study using convenience sampling and were then divided into an intervention and a control group through randomized blocks of four. Health literacy questionnaire and self-care questionnaire were distributed among the participants before, immediately after and three weeks following the intervention. Data analysis was performed in SPSS ver.13. Results: The results showed no significant differences between the two groups in terms of their health literacy and self-care scores before the intervention (P=0.299 and 0.059). A comparison of the mean values showed a greater increase in the mean score of health literacy and score of selfcare immediately and three weeks after the intervention in the intervention group compared to the control group. Also, the mean score of the dimensions of self-care in chemotherapy increased over time in the intervention group. Conclusion: The findings of this study confirm the higher effectiveness of counseling with a health literacy approach on overall self-care in chemotherapy and all its dimensions.

scholarly journals Equol effects on AGE skin products, visceral fat and climacteric symptoms in post-menopausal women: A randomized controlled trial

2021 ◽  
Author(s):  
Remi Yoshikata ◽  
Khin Zay Yar Myint ◽  
Hiroaki Ohta ◽  
Yoko Ishigaki
Keyword(s):  
Randomized Controlled Trial ◽  
Visceral Fat ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Climacteric Symptoms ◽  
Post Intervention ◽  
Randomized Controlled ◽  
Menopausal Women ◽  
Post Menopausal

Abstract Introduction: Equol, an isoflavone derivative whose chemical structure is similar to estrogen, is considered as a potentially effective agent for relieving climacteric symptoms, for the prevention of the lifestyle-related diseases, and for aging care in post-menopausal women. We investigated the effect of an equol-containing supplement on metabolism and aging, and climacteric symptoms, with respect to internally-produced equol in post-menopausal women.Methods: A single center, randomized controlled trial (registration number: UMIN000030975) on 57 post-menopausal Japanese women (mean age: 56±5.37 years), was conducted. Twenty-seven women received the equol supplement, while the remaining received Control. Metabolic and aging-related biomarkers were compared before and after the 3-month intervention. Climacteric symptoms were assessed every month using a validated self-administered questionnaire in Japanese post-menopausal women. Results: Three months post intervention, the treatment group showed significant improvement in climacteric symptoms, when compared to the Control group (81% vs. 53% respectively, p=0.045). We did not observe any beneficial effect on metabolic and aging-related biomarkers in the intervention group. However, in certain populations significant improvement in skin auto-fluorescence, which is a measurement of AGE skin products, and visceral fat area was observed, especially among equol producers. Conclusion: Women receiving equol supplement showed improved climacteric symptoms. This study offered a new hypothesis that there may be a synergy between supplemented equol and endogenously-produced equol to improve skin aging and visceral fat in certain populations.

scholarly journals The Efficacy of Transdiagnostic Cognitive Behavioral Therapy on Migraine Headache: A Randomized Clinical Trial

2022 ◽  
Author(s):  
Forouzandeh Soleimanian-Boroujeni ◽  
Negin Badihian ◽  
Shervin Badihian ◽  
Vahid Shaygannejad ◽  
Yousef Gorji
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Behavioral Therapy ◽  
Intervention Group ◽  
Cognitive Behavioral ◽  
Control Group ◽  
Post Intervention ◽  
Therapy Termination ◽  
Protocol Registration ◽  
And Control

Abstract Introduction: Psychological interventions are shown to be effective in migraine, but not utilized routinely yet. We aimed to evaluate the efficacy of transdiagnostic cognitive behavioral therapy (TCBT) on people with migraine (PwM). Method: This study was conducted on 40 PwM aged 20-50 years. We randomly assigned participants to two groups of intervention, receiving 10 sessions of TCBT, and control. Days with headache, headache severity, migraine-related disability and effects on daily life, number of pain-relivers taken for headache, depression, and anxiety were assessed pre-intervention, post-intervention (three-month follow-up), and one-month after TCBT termination (four-month follow-up).Results: Thirty-five participants suffering moderate to severe migraine completed the study (16 and 19 in TCBT and control groups, respectively). TCBT improved all measured items between study time-points (p<0.05) in the intervention group, while such an improvement was not observed in the control group. Between group comparisons revealed superiority of TCBT group compared to the control group in most measured items at three- and four-month follow-ups (p<0.05).Conclusion: Ten sessions of TCBT improved migraine severity, associated disability, anxiety, and depression in PwM, with persistent effects after one month of therapy termination. TCBT is an affordable, practical, and feasible intervention to be utilized for PwM.Protocol registration: The study protocol was registered in clinicaltrial.gov (NCT03701477) prior to enrollment.

scholarly journals Perceptions of caregivers on immunization in Ntungamo district, Uganda

2021 ◽  
Vol 8 (12) ◽  
pp. 5729
Author(s):  
Byamukama Topher ◽  
Keraka M. Margaret ◽  
Gitonga Eliphas
Keyword(s):  
Risk Factor ◽  
Intervention Group ◽  
Cost Effective ◽  
Systematic Sampling ◽  
Control Group ◽  
Post Intervention ◽  
Mortality And Morbidity ◽  
Significant Difference ◽  
Quasi Experimental ◽  
And Control

Background: Immunization is one of the most cost-effective public health interventions to reduce child mortality and morbidity associated with infectious diseases. The objective of this study was to determine the perceptions of caregivers on immunization in Ntungamo district.Methods: Quasi-experimental study was used with health centres assigned to intervention and control groups. Purposive sampling was used to select the two counties where the study was done. Proportional sampling was done to get study samples from each health facility, while systematic sampling was done to get study participants. A total of 787 children from twelve health facilities provided the study sample. A post intervention evaluation was conducted to determine the effect of these interventions. Association of variables was tested using Mann Whitney U-test and Chi-square.Results: On benefits, most caregivers in the intervention group (85.3%) and in the control group (54.3%) regarded immunization as very highly and moderately beneficial to their children respectively. On risks, most caregivers in the intervention group (85.5%) and control group (43.1%) regarded the risk factor associated with immunization as very low and moderate respectively. From hypothesis testing, there was a significant difference on the perceived benefits and risks of immunization between the intervention and control group.Conclusions: Most caregivers in the intervention and control group regarded immunization as very highly beneficial and moderately to their children respectively. Most of the caregivers in the intervention and control group regarded the risk factor associated with immunization as very low and moderate respectively. 

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