What Happened in ‘The HERizon Project’?—Process Evaluation of a Multi-Arm Remote Physical Activity Intervention for Adolescent Girls

This mixed-methods process evaluation examines the reach, recruitment, fidelity, adherence, acceptability, mechanisms of impact, and context of remote 12-week physical activity (PA) interventions for adolescent girls named The HERizon Project. The study was comprised of four arms—a PA programme group, a behaviour change support group, a combined group, and a comparison group. Data sources included intervention deliverer and participant logbooks (100 and 71% respective response rates, respectively), exit surveys (72% response rate), and semi-structured focus groups/interviews conducted with a random subsample of participants from each of the intervention arms (n = 34). All intervention deliverers received standardised training and successfully completed pre-intervention competency tasks. Based on self-report logs, 99% of mentors adhered to the call guide, and 100% of calls and live workouts were offered. Participant adherence and intervention receipt were also high for all intervention arms. Participants were generally satisfied with the intervention components; however, improvements were recommended for the online social media community within the PA programme and combined intervention arms. Autonomy, sense of accomplishment, accountability, and routine were identified as factors facilitating participant willingness to adhere to the intervention across all intervention arms. Future remote interventions should consider structured group facilitation to encourage a genuine sense of community among participants.

Combination pelvic rocking exercises with belly dance to reduce labor pain

Background: Labor pain will get more substantial along with the increase in cervical dilatation and can affect the mother's psychological condition and the welfare of the fetus. Pelvic rocking exercises help reduce pain during labor, but the combined pelvic rocking exercises with belly dance for birth have not been studied. In this study, combining pelvic rocking exercises with belly dance for birth as physical preparation and exercise, especially in the pelvic area, can reduce pain effectively and efficiently so that mothers can give birth vaginally.Purpose: Analyze the effect of intervention combination of pelvic rocking exercises with belly dance for birth to pain intensity of first stage the active phase in mother birth.Methods: This is Quasy experimental research with pretest and posttest with control group design. Respondents were primigravida mothers during the first stage of the active phase. Determination of respondents by accidental sampling obtained the treatment group (n=17) and control group (n=17). The intervention was given for 20 minutes every 1 hour during the first stage of the active phase.Result: The combined intervention of pelvic rocking exercises with belly dance for birth was effective in reducing pain intensity as seen from the average decrease in pain intensity every hour, at the 1st hour of 4.0, the 2nd hour of 3.0, the 3rd hour of 2.7, and the 4th hour of 2.6 (p<0.001)Conclusion: The combination of pelvic rocking exercises with belly dance for birth is effective to pain intensity of the first stage, the active phase in women giving birth.

Correlation Analysis of Chaige Qinlian Decoction and Acupuncture Combined Intervention on Prognosis of Children with Pneumonia

Background. Traditional Chinese medicine (TCM) treatment is of great importance to improve the clinical symptoms of children with pneumonia, and this study was conducted in this context. Methods. The clinical data of 82 child patients with pneumonia admitted to our hospital from February 2019 to February 2020 were retrospectively analyzed, and the patients were divided into the conventional group and the combined group according to the parity of their admission numbers, with 41 cases each. Conventional Western medicine therapy was given to children in the conventional group, and on this basis, acupuncture combined with Chaige Qinlian decoction was performed on children in the combined group, so as to evaluate the clinical application value of combined treatment and analyze its relationship with prognosis by recording the recovery time of each symptom, serum indicators, and immune indicators. Results. Children in the combined group had significantly shorter recovery time of each symptom and lower mean CPIS scores after treatment than the conventional group ( P < 0.001 ); the TCM symptom scores at T1 (1 d after treatment), T2 (3 d after treatment), T3 (7 d after treatment), and T4 (10 d after treatment) of children in the combined group were significantly higher than those in the conventional group ( P < 0.05 ); various immune indicators of the combined group before and after treatment were significantly different ( P < 0.001 ), and after treatment, the combined group obtained significantly higher IgG levels and lower IgA, complement C3, and complement C4 levels than the conventional group ( P < 0.001 ); and there was a positive correlation between the CPIS scores and serum IL-8, IL-6, and CRP levels at the first day (r = 0.706, 0.712, 0.734, P < 0.001 ). Conclusion. Acupuncture combined with Chaige Qinlian decoction can effectively shorten the course of disease, reduce the levels of serum inflammatory factors, and improve the immune function of body for child patients with pneumonia. Serum IL-8, IL-6, and CRP levels in child patients can reflect the clinical prognosis, with higher levels indicating worse prognosis.

Deep Cervical Muscle Exercise Versus Soft Tissue Mobilization In Non-Specific Neck Pain

Background: Neck pain is a common health problem in the working population. When studied by the International Classification of Functioning, Disability and Health (ICF), the problems that arise in non-specific neck pain include: neck pain, limited joint motion, and decreased functional ability in carrying out daily activities. The aim of this study was to compare the effectiveness of combination ultrasound therapy (UST) and deep cervical muscle exercise (DCME) versus combination ultrasound therapy (UST) and soft tissue mobilization (STM) on non-specific neck pain. Methods: This research was experimental with a randomized pre-test and post-test control group design, in which the study participants were divided into two groups randomly. The study participants were 20 people who were divided into the control group (n = 10) who were given the combined intervention of UST and DCME while the treatment group (n = 10) were given the combined intervention of UST and STM. Therapeutic evaluation measurement tools include: pain scale in the form of numeric rating scale and neck disability in the form of neck disability index. The research was carried out in the independent physiotherapy practice in Denpasar and Badung. The intervention was given 3 times in 3 weeks. Results: The results showed a decrease in neck pain and disability in each intervention group (p <0.05). However, there were no significant differences when compared between groups. Conclusion: Based on these results, it can be concluded that the combination of UST and DCME has the same results as the combination of UST and STM in reducing neck pain and disability in non-specific neck pain.

Effectiveness of a pre-adolescent inter-generational intervention to address HIV and obesity in South Africa, using a pretest-posttest design

Background Strengthening pre-adolescents knowledge and skills through an age- and culturally-appropriate intervention could prevent health issues later in life. Early interventions could influence the trajectory of future risky behaviour, and may influence health behaviour amongst their parents. The CIrCLE of Life Initiative was developed to address HIV and obesity. We evaluated whether the combined intervention increased knowledge, enhanced skills, and/or promoted healthy behaviour among students (9–12 years old) and their parents. Methods The study was conducted from May to December 2018. Trained educators delivered 30-min lessons over ten consecutive weeks with 537 Grade 6 students at five government-run schools, in a district, in South Africa. Schools were purposively selected based on socioeconomic status and urban-rural classification. Students communicated with parents through shared homework activities. A pretest-posttest study design was used, with a 3-month follow up. Both groups completed self-administered paper-based questionnaires. A score of subscales was used in analysis. The pretest and posttest scores were compared for students and parents using a dependent t-test. Differences in outcomes by school quintile were compared using one-way ANOVA. Results Response rates were high for both students (80.6%) and their parents (83.4%). Statistically significant differences were observed in HIV knowledge in students pretest (mean 8.04, SD 3.10) and posttest scores (mean 10.1, SD 2.70; p < 0.01), and their parents (mean 10.32, SD 2.80 vs 11.0, SD 2.50; p < 0.01). For both students and parents, pre- and post-test obesity awareness mean scores were similar, 1.93, SD 0.92 and 2.78, SD 0.57; p < 0.01, for students; and 2.47, SD 0.82 and 2.81, SD 0.54; p < 0.01, for parents. In the posttest, statistically significant changes were also observed in both groups, enhancing skills in measuring body mass index and pulse rate, and interpreting food labels. Students had a high intention to share gained knowledge with parents who had a high intention to receive it (89.4 and 89.5%, respectively). Conclusion The intervention increased knowledge about HIV and obesity-related awareness, and it enhanced skills in selected outcomes among pre-adolescents and parents. Accurate messages and enhanced communication skills could support inter-generational knowledge transfer. Trial registration ClinicalTrials.gov Identifier: NCT04307966 retrospectively registered on 12 March 2020.

Modeling the Effects of Chemotherapy and Immunotherapy on Tumor Growth

Mathematical modeling has been used to simulate the interaction of chemotherapy and immunotherapy drugs intervention with the dynamics of tumor cells growth. This work studies the interaction of cells in the immune system, such as the natural killer, dendritic, and cytotoxic CD8+ T cells, with chemotherapy. Four different cases were considered in the simulation: no drug intervention, independent interventions (either chemotherapy or immunotherapy), and combined interventions of chemotherapy and immunotherapy. The system of ordinary differential equations was initially solved using the Runge-Kutta method and compared with two additional methods: the Explicit Euler and Heun’s methods. Results showed that the combined intervention is more effective compared to the other cases. In addition, when compared with Runge-Kutta, the Heun’s method presented a better accuracy than the Explicit Euler technique. The proposed mathematical model can be used as a tool to improve cancer treatments and targeted therapy.

Integrated PCR testing and extended window contact tracing system for COVID-19 to improve comprehensiveness and speed

Testing and contact tracing are standard tools for controlling the spread of COVID-191. Their effectiveness hinges on a sequence of processes encompassing testing coverage and timeliness, testing quality and speed of reporting, contact tracing speed and comprehensiveness and compliance with advice given2–6. We optimized this sequence of processes in the context of a public health program targeting around 33,000 higher education students through a combination of low barrier PCR testing with rapid turn-around-time, close integration of testing and tracing teams and IT infrastructure, community engagement and the implementation of bidirectional contact tracing by extending the contact tracing window from 2 to 7 days before symptom onset or test of the index case. We anticipate this combined intervention to help improve epidemic control.

Optimal design for a psychosocial intervention on severely acute malnourished children in humanitarian settings: results of an expert survey

Background: Common psychosocial interventions focus on feeding, stimulation, emotional responsiveness and childcare and parenting. Inclusion of such a component in the outpatient management of severe acute malnutrition (SAM) children is recommended. However, clinical assessment of such interventions is tedious in humanitarian settings and modalities evidence on the impact of psychosocial interventions alongside nutrition protocol for SAM is scarce. This survey aimed to gather expert opinions on the optimal design of a combined psychosocial and nutrition intervention feasible in humanitarian settings. Methods: From March to May 2018, an online survey was emailed to international experts in nutrition and mental health and psychosocial support, mainly from academia and international non-governmental organisations (INGOs). It included multiple choices questions on the key components of an optimal combined intervention. Results: Of the 76 experts targeted, 20 responded. 11 (55%) belonged to INGOs, 2 (10%) to academia, and 4 (20%) to international organizations and donors. For most respondents, a combined intervention should be provided in weekly 45-minuites counselling sessions, provided individually (rather than in a group) and at home (rather than at a health center). None of the proposed ideal duration (two, four or six months) gained the majority of votes. Experts thought that 35% staff training should be in “Active listening for psychosocial support”, and 30% in “Early child development”, 25% in “Maternal depression” and 9% in “Anthropometric measurements”. They estimated that a combined intervention could improve SAM recovery rate by 10% (min-max: 0-19%) vs. the nutritional protocol alone. Qualitative results highlighted the importance of tailoring the intervention to the individual, the population and the settings; as well as considering feasibility and scalability at the design stage. Conclusion: These findings could guide further research on the impact of psychosocial interventions on SAM children’s health and development, and help designing innovative approaches to treat undernutrition.