scholarly journals Assessment of the Feasibility, Acceptability, and Impact of Implementing Seasonal Malaria Chemoprevention in Nampula Province, Mozambique: Protocol for a Hybrid Effectiveness-Implementation Study (Preprint)

2021 ◽  
Author(s):  
Alexandra Wharton-Smith ◽  
Kevin Baker ◽  
Arantxa Roca-Feltrer ◽  
Maria Rodrigues ◽  
Sol Richardson ◽  
...  
Keyword(s):  
Protective Effect ◽  
Controlled Trial ◽  
Pilot Project ◽  
World Health ◽  
Unique Contribution ◽  
Feasibility Assessment ◽  
Seasonal Malaria Chemoprevention ◽  
Ethical Approval ◽  
Marker Study ◽  
Health Organization

BACKGROUND Malaria is a significant cause of morbidity and mortality in children aged under 5 years in Mozambique. The World Health Organization recommends seasonal malaria chemoprevention (SMC), the administration of four monthly courses of sulfadoxine-pyrimethamine (SP) and amodiaquine (AQ), to children aged 3-59 months during rainy season. However, as resistance to SP is widespread in East and Southern Africa, SMC has so far only been implemented across the Sahel in West Africa. OBJECTIVE This protocol describes the first phase of a pilot project that aims to assess the protective effect of SP and AQ when used for SMC and investigate the levels of molecular markers of resistance of <i>Plasmodium falciparum</i> to antimalarial medicines in the study districts. In addition, it is important to understand whether SMC is a feasible and acceptable intervention in the context of Nampula Province, Mozambique. METHODS This study will adopt a hybrid effectiveness-implementation design to conduct a mixed methods evaluation with six objectives: a molecular marker study, a nonrandomized controlled trial, an analysis of reported malaria morbidity indicators, a documentation exercise of the contextual SMC adaptation, an acceptability and feasibility assessment, and a coverage and quality assessment. RESULTS Ethical approval for this study was granted by the Mozambican Ministry of Health National Bioethics Committee on September 15, 2020. Data collection began in October 2020, and data analysis is expected to be completed by August 2021. CONCLUSIONS This research will make a unique contribution to our understanding of whether the combination of SP and AQ, when used for SMC, can confer a protective effect against malaria in children aged 3-59 months in a region where malaria transmission is seasonal and SP resistance is expected to be high. If the project is successful, subsequent phases are expected to provide a more comprehensive assessment of the effectiveness and sustainability of SMCs. INTERNATIONAL REGISTERED REPORT DERR1-10.2196/27855

scholarly journals Azithromycin Reduction to Reach Elimination of Trachoma (ARRET): study protocol for a cluster randomized trial of stopping mass azithromycin distribution for trachoma

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Abdou Amza ◽  
Boubacar Kadri ◽  
Beido Nassirou ◽  
Ahmed M. Arzika ◽  
Ariana Austin ◽  
...  
Keyword(s):  
Primary Outcome ◽  
Controlled Trial ◽  
Clinical Signs ◽  
Cluster Randomized Trial ◽  
World Health ◽  
Baseline Assessment ◽  
Randomized Controlled ◽  
Registration Number ◽  
Cluster Randomized ◽  
Health Organization

Abstract Background The World Health Organization (WHO) recommends annual mass azithromycin distribution until districts drop below 5% prevalence of trachomatous inflammation—follicular (TF). Districts with very low TF prevalence may have little or no transmission of the ocular strains of Chlamydia trachomatis that cause trachoma, and additional rounds of mass azithromycin distribution may not be useful. Here, we describe the protocol for a randomized controlled trial designed to evaluate whether mass azithromycin distribution can be stopped prior to the current WHO guidelines. Methods The Azithromycin Reduction to Reach Elimination of Trachoma (ARRET) study is a 1:1 community randomized non-inferiority trial designed to evaluate whether mass azithromycin distribution can be stopped in districts with baseline prevalence of TF under 20%. Communities in Maradi, Niger are randomized after baseline assessment either to continued annual mass azithromycin distribution or stopping annual azithromycin distribution over a 3-year period. We will compare the prevalence of ocular C. trachomatis (primary outcome), TF and other clinical signs of trachoma, and serologic markers of trachoma after 3 years. We hypothesize that stopping annual azithromycin distribution will be non-inferior to continued annual azithromycin distributions for all markers of trachoma prevalence and transmission. Discussion The results of this trial are anticipated to provide potentially guideline-changing evidence for when mass azithromycin distributions can be stopped in low TF prevalence areas. Trial registration number This study is registered at clinicaltrials.gov (NCT04185402). Registered December 4, 2019; prospectively registered pre-results.

Cancer and Peripheral Deep Vein Thrombosis are Both Independent Diseases Causes, Pathogenesis, Conclusions

2020 ◽  
Vol 2 (1) ◽  
pp. 1-3
Author(s):  
Drozdova Elena Viktorovna ◽  
Keyword(s):  
Deep Vein Thrombosis ◽  
World Health Organization ◽  
Cause Of Death ◽  
Controlled Trial ◽  
World Health ◽  
Peripheral Vein ◽  
Vein Thrombosis ◽  
Sickness Rate ◽  
Health Organization ◽  
Deep Vein

There is an undisputed thesis: CANCER has an often COMPLICATION such as DEEP VEIN THROMBOSIS. Cancer is the second leading cause of death globally, and is responsible for an estimated 9.6 million deaths in 2018. (according to World Health Organization). Sickness rate of deep vein thrombosis is approximately 100 per 100 000 population annually. Sickness rate of cancer in different countries is approximately 130-500 per 100 000 population annually. Thus, if deep vein thrombosis is considered to be a complication of cancer we must identify both these diseases simultaneously with frequency of 20 -76.9% The Research Objective To determine whether peripheral vein thromboses are the complications of cancer. The Method of the Research Randomized prospective parallel controlled trial.

Functioning in Schizophrenia: Similarities and Differences Between Clinical, Patient and Expert Perspectives

2017 ◽  
Vol 41 (S1) ◽  
pp. S105-S105
Author(s):  
M. Barrios ◽  
G. Guilera ◽  
O. Pino ◽  
E. Rojo ◽  
S. Wright ◽  
...  
Keyword(s):  
Health Professionals ◽  
Health Condition ◽  
World Health ◽  
International Classification Of Functioning ◽  
Unique Contribution ◽  
Disability And Health ◽  
Clinical Patient ◽  
Competing Interest ◽  
Health Organization ◽  
Icf Core Sets

IntroductionIn 2001, the World Health Organization (WHO) created the International Classification of Functioning, Disability and Health (ICF) to offer a comprehensive and universally accepted framework to describe functioning, disability and health. The ICF Core Sets (ICF-CS) are a selection of categories that serve as a minimal standard for the assessment of functioning and disability in a specific health condition. The ICF-CS for schizophrenia was created in 2015 based on four preliminary studies that intend to capture different perspectives.ObjectivesThe aim of this study is to describe the similarities (i.e. overlap) and discrepancies (i.e. unique contribution) between the clinical, patient and expert perspectives on the most relevant problems in functioning of individuals with schizophrenia, being focused on the European WHO region.MethodsForty-four experts from 14 European countries participated in an expert survey, patients with schizophrenia were involved in four focus groups, and health professionals assessed 127 patients in relation to daily life functioning. Information gathered from these three preliminary studies was linked to the ICF.ResultsData showed that although a considerable number of second-level ICF categories agreed on the three preparatory studies (n = 54, 27.7%), each perspective provided a unique set of ICF categories. Specifically, experts reported 65 unique ICF categories, patients 23 and health professionals 11.ConclusionsEven though there were similarities between perspectives, each one underlined different areas of functioning, showing the importance of including different perspectives in order to get a complete view of functioning and disability in individuals with schizophrenia.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Impact of the ICD–10 Primary Health Care (PHC) diagnostic and management guidelines for mental disorders on detection and outcome in primary care

2003 ◽  
Vol 182 (1) ◽  
pp. 20-30 ◽  
Author(s):  
Tim Croudace ◽  
Jonathan Evans ◽  
Glynn Harrison ◽  
Deborah J. Sharp ◽  
Ellen Wilkinson ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Mental Disorders ◽  
Controlled Trial ◽  
General Health Questionnaire ◽  
World Health ◽  
Detection Rates ◽  
Primary Health ◽  
Icd 10 ◽  
Health Organization

BackgroundThe World Health Organization (WHO) ICD–10 Primary Health Care (PHC) Guidelines for Diagnosis and Management of Mental Disorders (1996) have not been evaluated in a pragmatic randomised controlled trial (RCT).AimsTo evaluate the effect of local adaptation and dissemination of the guidelines.MethodPragmatic, pair-matched, cluster RCT involving 30 practices.ResultsGuideline practices were less sensitive but more specific in identifying morbidity, but these differences were not significant. Guideline patients did not differ from usual-care patients on 12-item General Health Questionnaire scores at 3-month follow-up or in the proportion who were still cases. There were no significant differences in secondary outcomes.ConclusionsAttempts to influence clinician behaviour through a process of adaptation and extension of guidelines are unlikely to change detection rates or outcomes.

scholarly journals Promoting the Practice of Exclusive Breastfeeding: A Philosophic Scoping Review

2021 ◽  
Author(s):  
Tumilara Busayo Amoo ◽  
Ruth Lucas
Keyword(s):  
Scoping Review ◽  
Exclusive Breastfeeding ◽  
Self Efficacy ◽  
Theory Of Planned Behaviour ◽  
Controlled Trial ◽  
World Health ◽  
Planned Behaviour ◽  
Breastfeeding Promotion ◽  
Global Rate ◽  
Health Organization

Abstract Background The World Health Organization recommends exclusive breastfeeding for the first 6 months of an infant’s life and continued breastfeeding for 2 years. The global rate of exclusive breastfeeding is low at 33%. Thus, it is important to identify philosophical and theory-based strategies that can promote exclusive breastfeeding. The aim of the study is to identify philosophical schools of thought and theories used in research on promoting the practice of exclusive breastfeeding. Methods A scoping review using Arksey and O'Malley's framework explored the phenomenon of exclusive breastfeeding practice promotion. Searches were conducted using CINAHL Plus full-text, PubMed, APA PsycInfo and Academic Search Premier. Search terms included theory, philosophy, framework, model, exclusive breastfeeding, promotion, support, English, and publication between 2000 - 2020. Results The online search yielded 877 articles, however, only 40 met the inclusion criteria for the scoping review. The articles promoting exclusive breastfeeding used pragmatism (n=1) or phenomenology (n = 2) philosophies and theories of self-efficacy (n = 10), theory of planned behaviour (n = 10) and social cognitive theories (n = 17). Theories of self-efficacy and planned behaviour were the most effective theories that increased exclusive breastfeeding rates. Conclusions Theory-based exclusive breastfeeding promotion strategies are effective to increase the rates of exclusive breastfeeding. Theory of planned behaviour is better compared with theories of self-efficacy for program content development and implementation in Randomized Controlled Trial studies. Future breastfeeding interventions should be based on relevant philosophies and guided by theories of self-efficacy and planned behaviours.

scholarly journals Cómo fomentar la práctica de ejercicio físico a través de los deberes activos en estudiantes universitarios (How to promote exercise among university students through active homework)

Retos ◽  
2019 ◽  
pp. 518-526
Author(s):  
Aina Maria Galmés Panadés ◽  
Josep Vidal Conti
Keyword(s):  
Health Status ◽  
Physical Exercise ◽  
Physical Inactivity ◽  
Eating Habits ◽  
Pilot Project ◽  
Overweight And Obesity ◽  
World Health ◽  
Healthy Habits ◽  
Unhealthy Eating ◽  
Health Organization

En España el sedentarismo y la inactividad física son elevados en población adulta e infantil, lo que puede influir en las elevadas tasas de sobrepeso y obesidad. El objetivo fue valorar la acogida de los alumnos ante una intervención sobre los hábitos de ejercicio físico a través de los deberes activos y obtener información para el diseño del estudio principal. Así como innovar en estrategias educativas en el ámbito universitario para el fomento y la concienciación de los hábitos saludables. Desde la asignatura de educación para la salud, optativa del grado en educación primaria, especialidad de educación física, se propuso abordar la problemática del sedentarismo y la inactividad física a través de los deberes activos. Los alumnos (n=47) debían realizar un registro de ejercicio físico, cumpliendo con las recomendaciones de la Organización Mundial de la Salud, de manera semanal, a lo largo de toda la asignatura. Para realizar dicho registro los alumnos podían utilizar, en función de la actividad realizada, aplicaciones móviles, pulsómetros o pulseras de actividad, entre otros. Se utilizó la información del registro de los alumnos, así como el foro virtual de la asignatura para la recogida de información.  Con los resultados obtenidos en el proyecto piloto se ha diseñado la intervención para el estudio principal, en el que se recogerán diversos parámetros relacionados con el estado de salud, la actividad física y el sedentarismo, con mayor tamaño muestral, diferenciando entre grupo control y grupo intervención.  Los deberes activos para la promoción del ejercicio físico han resultado ser un trabajo motivante e innovador, que permite el aprendizaje significativo, positivo para el alumno en el aprendizaje, la salud, y el futuro laboral como maestro. Abstract. Sedentarism, physical inactivity, and unhealthy eating habits are lifestyle factors that could have an influence on health status. In Spain, sedentarism and physical inactivity are high in both adults and children, which could have a role in the elevated rates of overweight and obesity in these populations. The aim of the present study was to evaluate the effects of an intervention promoting healthy habits to improve students’ global health status by means of the methodology of active homework, as well as to work on self-evaluation as a competence. Moreover, to introduce innovative educational strategies promoting and raising awareness on healthy habits at the university level. From the subject of education for health, an elective course within the bachelor program in primary education, specialty of physical education, we attempt to solve the problem of sedentarism and physical inactivity with active homework. Students (n=47) were asked to create a weekly log of their physical exercise throughout the duration of the course, according to the World Health Organization recommendations. To make this log, students could use apps, heart rate monitors, activity wristbands, etcetera. Students’ log information was combined with that obtained from a virtual forum of the course. We designed the intervention for the principal study based on the results from the pilot project, including the collection of health parameters related with physical activity and sedentarism. The intervention was applied to a larger sample, split into control and intervention groups. The active homework represented a motivational and innovative means to promote physical exercise, giving students the chance to acquire significative learnings, which are positive during the teaching-learning process, as well as better health and professional future.

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