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 Installation of pedal-operated alcohol gel dispensers with behavioral nudges and changes in hand hygiene behaviors during the COVID-19 pandemic: a hospital-based quasi-experimental study

2020 ◽  
Vol 9 (4) ◽  
Author(s):  
Wit Wichaidit ◽  
Sommanas Naknual ◽  
Nanta Kleangkert ◽  
Tippawan Liabsuetrakul
Keyword(s):  
Experimental Study ◽  
Hand Hygiene ◽  
Tertiary Hospital ◽  
Pathogen Transmission ◽  
P Value ◽  
Intervention Period ◽  
Post Intervention ◽  
Observation Area ◽  
Before And After ◽  
Quasi Experimental

We conducted a quasi-experimental study and compared hand hygiene behaviors at potential pathogen transmission events among outpatient visitors (according to structured observations a trained enumerator) before and after installation of 12 pedal-operated alcohol gel dispensers with behavioral nudges (signs attached to the dispensers) at a tertiary hospital in southern Thailand during the COVID-19 pandemic. The enumerator observed 243 events during the pre-intervention period and 223 events during the post-intervention period. Prevalence of hand hygiene was significantly different between the pre-intervention and post-intervention periods (0 vs 24 events, or 0% vs 11%, respectively; p-value <0.001). However, 21 of 24 hand hygiene events were of participants who came from outside the observation area, used the dispensers, then left. Nonetheless, the intervention might have helped to increase access to hand hygiene materials and created opportunities for hand hygiene among hospital visitors in general.

Improvement in adherence to antibiotic duration of therapy recommendations for uncomplicated cystitis: a quasi-experimental study

2019 ◽  
Author(s):  
Stephanie E Giancola ◽  
John M Higginbotham ◽  
Deena E Sutter ◽  
Steven E Spencer ◽  
James K Aden ◽  
...  
Keyword(s):  
Experimental Study ◽  
Outpatient Setting ◽  
National Guidelines ◽  
Post Intervention ◽  
Academic Medical Centre ◽  
Duration Of Therapy ◽  
Days Of Therapy ◽  
Before And After ◽  
Quasi Experimental ◽  
Uncomplicated Cystitis

Abstract Background Acute uncomplicated cystitis is one of the most common diagnoses for which antibiotic treatment is prescribed in the outpatient setting. Despite the availability of national guidelines, there remains a wide pattern in prescriber choices for therapy. Recent data portray a picture of consistently longer durations than recommended prescribed in outpatient settings. Objective The objective was to evaluate the effect of a system-based intervention on adherence to guideline-recommended durations of therapy for uncomplicated cystitis in the outpatient setting. Methods This quasi-experimental study included women aged 18–64 years who were seen at five family medicine clinics at an academic medical centre and were prescribed targeted antibiotics for uncomplicated cystitis (nitrofurantoin monohydrate/macrocrystals 100 mg, trimethoprim-sulfamethoxazole 160/800 mg or ciprofloxacin 250 mg). The intervention involved revising or adding pre-filled, but modifiable, default prescribing instructions in the electronic health record (EHR) for the targeted antibiotics. We evaluated adherence to guideline-recommended duration of therapy as well as days of therapy (DOT) before and after the intervention. Results A total of 787 pre-intervention and 862 post-intervention cases were included. Adherence to recommended duration of therapy increased from 29.4% to 76.3% (P < 0.01). The average DOT decreased by 23% from 6.6 to 5.1 (P < 0.01). Conclusion A stewardship intervention consisting of revising/adding default prescribing instructions to targeted antimicrobials in an EHR was associated with increased adherence to recommended durations of therapy for uncomplicated cystitis and reduction of unnecessary antibiotic exposure. More studies are needed to confirm effectiveness across multiple medical record platforms.

scholarly journals THE EFFECTS OF A BRIEF SUPPORTIVE PSYCHOTHERAPEUTIC INTERVENTION AMONG HEMODIALYZED PATIENTS: A QUASI-EXPERIMENTAL STUDY

2021 ◽  
Vol 30 ◽  
Author(s):  
Carlene Souza Silva Manzini ◽  
Vanessa Almeida Maia Damasceno ◽  
Diana Gabriela Mendes dos Santos ◽  
Milton Miranda Neto ◽  
Clemente Neves de Sousa ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Experimental Study ◽  
Linear Regression ◽  
Short Form ◽  
Wilcoxon Test ◽  
Psychotherapeutic Intervention ◽  
Post Intervention ◽  
Before And After ◽  
Quasi Experimental

ABSTRACT Objectives to assess health-related quality of life and resilience among hemodialyzed patients in the city of Porto, Portugal, before and after the Relaxation, Mental Images and Spirituality psychotherapeutic intervention, and identify factors interfering in these patients’ levels of resilience. Method a quasi-experimental study was conducted from November 2018 to April 2019 among 17 patients attending two dialysis centers located in Porto, Portugal. A questionnaire addressing sociodemographic and clinical information was applied together with the Kidney Disease Quality of Life-Short Form, a resilience scale, and a brief psychotherapeutic intervention. Each patient attended three intervention sessions, and the instruments were applied before and after the intervention. The Shapiro-Wilk test was performed to verify the normality of data, while the Student’s t-test and Wilcoxon test were performed to compare the means, and linear regression was used to identify resilience-associated factors. Results after the intervention, quality of life perception improved in virtually all the scale’s domains, with statistically significant differences in the physical function (p=0.006) and emotional function (p=0.021). The resilience assessment revealed a statistically significant improvement in the post-intervention (p=0.002); linear regression analyses showed that having a religion, other pathologies, or a history of transplant is related to increased resilience levels while taking antidepressants or anti-hypertensive medications negatively affect it. Conclusion the intervention contributed to improving resilience and some domains concerning the patients’ quality of life. Thus, it can be implemented among patients undergoing hemodialysis.

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

The Effect of Breastfeeding Calendar Training on Knowledge and Attitudes of Mothers in Exclusive Breastfeeding

2021 ◽  
Vol 10 (1) ◽  
pp. 80-87
Author(s):  
Ari Indra Susanti ◽  
Aminarista Aminarista ◽  
Neneng Martini ◽  
Nur Rahmah ◽  
Sri Astuti
Keyword(s):  
Exclusive Breastfeeding ◽  
Health Workers ◽  
Sampling Technique ◽  
Wilcoxon Test ◽  
Test Design ◽  
Knowledge And Attitudes ◽  
Lactating Mothers ◽  
Before And After ◽  
Post Test ◽  
Quasi Experimental

Background: Lactating mothers were successful in giving exclusive breastfeeding as much as 42% based on SDKI (Survei Demografi Kesehatan Indonesia) in 2012. This is depend on the support of husbands and families as well as health workers. Thus, the husband or family should remind and motivate mothers as well as monitor the breastfeeding activity every day for 6 months using breastfeeding calendar.Objectives: This study aimed to determine the increase in knowledge and attitudes of mothers in providing exclusive breastfeeding after the exclusive breastfeeding calendar training.Materials and Methods: The research design used a quasi-experimental one group pre-test post-test design. This research was conducted on mothers who had babies (age 0-12 months) in Pasawahan Village and Pasawahan Kidul Village, Pasawahan District, Purwakarta Regency in April to November 2018, with 96 respondents. The sampling technique was conducted by purposive sampling. Data were collected by giving questionnaires to respondents, before and after the breastfeeding calendar training were given. The Wilcoxon test was used for the analysis of the data in this study.Results: The results showed that there were differences in the knowledge of mothers before and after training on breastfeeding calendar (p <0,000) and there were differences in the attitudes of mothers before and after the training on breastfeeding calendar (p <0,000).Conclusions: There was an increase in knowledge and changes in the attitude of mothers towards exclusive breastfeeding after being given the breastfeeding Calendar training. Therefore, suggestions for health workers, especially midwives and nutrition workers, can use the breastfeeding calendar as an educational medium to increase husband and family support in exclusive breastfeeding.

scholarly journals Immunization competence retention in medical students: a comparation between conventional lectures and lectures with simulations method

2016 ◽  
Vol 55 (6) ◽  
pp. 339 ◽  
Author(s):  
Hartono Gunadi ◽  
Rini Sekartini ◽  
Retno Asti Werdhani ◽  
Ardi Findyartini ◽  
Muhammad Arvianda Kevin Kurnia
Keyword(s):  
Experimental Study ◽  
Medical Students ◽  
Medical School ◽  
Intervention Group ◽  
Control Group ◽  
Vaccine Preventable Diseases ◽  
Before And After ◽  
Quasi Experimental

Background Immunization is recognized as one of the strategiesto reduce vaccine preventable diseases. Competency related toimmunization are consequently important for medical students andthe medical school needs to assure the competence acquisition.Objective To assess competence related to immunization andits retention following lectures with simulations compared tolectures only.Methods A quasi-experimental study was conducted to the 5th yearstudents of University of Indonesia Medical School during the ChildAdolescent Health Module in 2012-2013. The intervention grouphad lectures with simulations and the control group had lecturesonly. Immunization knowledge was assessed with a 30 multiplechoice question (MCA) items performed before and after themodule. Competence retention was assessed by MCQ (knowledge)and OSCE (skills) 2-6 months afterwards.Results Sixty eight subjects for each group with similarcharacteristics were analyzed. There was significant differenceafter module MCQ score between two groups. Competenceretention in 2-6 months after module completion was betterin intervention group, both for the knowledge (median MCQscore of 70.00 (range 37-93) vs. mean score of 58.01 (SD 12.22),respectively; P<0.001) and skill (OSCE mean scores of 75.21 (SD10.74) vs. 62.62 (SD 11.89), respectively; P < 0.001). Proportionof subjects in the intervention group who passed both the MCQand OSCE were also significantly greater.Conclusion Lectures with simulations are proved to bemore effective in improving medical students’ immunizationcompetence as well as its retention compared to lectures onlyapproach.

scholarly journals PENINGKATAN PENGETAHUAN DAN SIKAP IBU PRAKONSEPSI MELALUI EDUKASI SERIBU HARI PERTAMA KEHIDUPAN: STUDI KUASI-EKSPERIMENTAL Enhancing Knowledge and Attitude of Preconception Mother through the First Thousand Days of Life Education: a Quasi-Experimental Study

2021 ◽  
Vol 16 (2) ◽  
pp. 96
Author(s):  
Betty Yosephin Simanjuntak ◽  
Anang Wahyudi
Keyword(s):  
Experimental Study ◽  
Exclusive Breastfeeding ◽  
Health Sector ◽  
P Value ◽  
Breastfeeding Initiation ◽  
Knowledge And Attitudes ◽  
Pocket Book ◽  
Quasi Experimental ◽  
Book Group ◽  
Knowledge And Attitude

Stunting is one of nutritional problem in children which the manifestation started since preconception period. Sensitive intervention is a program outside the health sector that can accelerate the improvement of nutrition, especially stunting. The purpose of this study was to increase the knowledge and attitudes of the preconception period of women regarding the fi rst 1000 days of life in order to prevent stunting. This research was a quasi-experimental study with two intervention groups. The sample was registered women, consisted of 60 women who were given education on 1000 days of life using leafl et media and 60 women using pocket book. Education was carried out by offi cers at 6 Religious Aff airs Offi ce. Women knowledge in leafl et group showed no signifi cant diff erences before and after education, especially in topics of chronic energy defi ciency (p = 0.791), anemia (p = 0.503), early breastfeeding initiation (p = 0.581), exclusive breastfeeding (p = 0.832), complementary feeding (p = 1.000), and stunting in children (p = 0.327). Among pocket book group, the increament of knowledge was better compared to leafl et group, especially in the topic of anemia (p <0.001), early breastfeeding initiation (p = 0.002), exclusive breastfeeding (p = 0.021), and stunting in children (p = 0.05). Meanwhile, the increase in attitude for all educational materials using pocket books increased with p value <0.05. Conclusion of this study was the increase in knowledge and attitudes of preconception is better in the pocket book group.

Do Flexible Silicone Tubes Immersed in Water Combined With Vocalise Improve the Immediate Effect on Voice?

2021 ◽  
pp. 1-28
Author(s):  
Nathália Suellen Valeriano Cardoso ◽  
Jonia Alves Lucena ◽  
Zulina Souza de Lira ◽  
Silvio José de Vasconcelos ◽  
Leonardo Wanderley Lopes ◽  
...  
Keyword(s):  
Acoustic Measurements ◽  
Post Intervention ◽  
Silicone Tube ◽  
Maximum Phonation Time ◽  
Range Profile ◽  
Before And After ◽  
Quasi Experimental ◽  
Vocal Effort ◽  
Cepstral Peak Prominence ◽  
Voice Range

Purpose: This study aimed to analyze the immediate effect on a singer's voice of a flexible silicone tube immersed in water combined with ascending and descending vocalise scales compared with ascending and descending vocalise scales alone. Method: A pre- and post-intervention quasi-experimental study was conducted. Thirty adult singers between 18 and 45 years old with no laryngeal disorders performed the two techniques for 3 min each on different days. Acoustic measurements of frequency, jitter, shimmer, glottal-to-noise excitation ratio, noise, smoothed cepstral peak prominence (CPPS), maximum phonation time (MPT), voice range profile, and self-perceived vocal effort (Borg Category Ratio 10-BR Scale adapted for vocal effort) were assessed before and after performing the techniques. Results: The results indicated an increase in singers' CPPS and MPT values and a decrease in shimmer and noise when performing with a flexible silicone tube immersed in water combined with vocalise. The singers reported a perception of decreased vocal effort after both methods. However, the diminished perceived vocal effort became more pronounced with the tube phonation technique combined with vocalise. Conclusions: Phonation in tubes combined with vocalise improved the vocal acoustic parameters (including cepstral measurements), increased MPT, and diminished perceived vocal effort. Although using vocalise alone diminished perceived vocal effort, this decrease was more pronounced in the tube phonation technique combined with vocalise.

scholarly journals Depressão e ideação suicida na adolescência: implementação e avaliação de um programa de intervenção

2020 ◽  
Vol 19 (3) ◽  
pp. 1-35
Author(s):  
Ana Paula Amaral ◽  
Josiane Uchoa Sampaio ◽  
Fátima Regina Ney Matos ◽  
Margarida Tenente Santos Pocinho ◽  
Rafael Fernandes de Mesquita ◽  
...  
Keyword(s):  
Experimental Study ◽  
Depressive Symptoms ◽  
Suicidal Ideation ◽  
Suicide Prevention ◽  
Prevention Program ◽  
Intervention Program ◽  
Educational Institution ◽  
Assessment Instruments ◽  
Before And After ◽  
Quasi Experimental

Objetivo: Desarrollar, implementar y evaluar un programa de prevención del suicidio dirigido a adolescentes.Materiales y Métodos: Estudio cuasi experimental, del tipo antes y después, con adolescentes de una institución educativa en São Luís, Maranhão, Brasil. El estudio siguió las etapas de desarrollo, implementación y evaluación de un programa de intervención para la prevención del suicidio. Se administraron tres instrumentos de evaluación antes y después de la intervención: la escala de ideación suicida de Beck; el Inventario de Depresión de Beck y la Escala de Desesperanza de Beck.Resultados: Antes de la intervención, participaron 102 adolescentes, 30 (29.4%) tenían ideación suicida y síntomas depresivos. Después de la intervención, los instrumentos se aplicaron a los 30 adolescentes seleccionados, 12 (40.0%) continuaron con la ideación. Antes de la intervención, el Inventario de depresión promedio fue de 23.83 y luego de 7.17 (p <0.0001). En cuanto a la desesperanza, el promedio obtenido antes fue 7.23 y luego 2.17 (p <0.0001); Con respecto a la ideación suicida, el promedio obtenido antes fue de 10.50 y luego de 2.57 (p <0.0001).Conclusión: Hubo una disminución en los síntomas depresivos, la desesperanza y la ideación suicida después de la implementación del elaborado programa de intervención. Objective: To develop, implement and evaluate a suicide prevention program aimed at adolescents.Material and Methods: A quasi-experimental study, before and after, with adolescents from an educational institution in São Luís, Maranhão, Brazil. The study followed the stages of development, implementation and evaluation of a suicide prevention intervention program. Three assessment instruments were administered before and after the intervention: Beck's Suicidal Ideation Scale; Beck's Depression Inventory and Beck's Hopelessness Scale. Results: Before the intervention, 102 adolescents participated, 30 (29.4%) had suicidal ideation and depressive symptoms. After the intervention the instruments were applied to the 30 selected adolescents, 12 (40.0%) continued with ideation. Prior to intervention, the average Depression Inventory was 23.83 and then 7.17 (p <0.0001). As for hopelessness, the average obtained before was 7.23 and then 2.17 (p <0.0001); Regarding suicidal ideation, the average obtained before was 10.50 and then 2.57 (p <0.0001). Conclusion: There was a decrease in depressive symptoms, hopelessness and suicidal ideation after the implementation of the elaborated intervention program.

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