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2021 ◽  
Vol 21 (1) ◽  
Fazean Idris ◽  
Ihsan Nazurah Zulkipli ◽  
Khadizah Haji Abdul-Mumin ◽  
Siti Rohaiza Ahmad ◽  
Shahid Mitha ◽  

Abstract Background In keeping with nation-wide efforts to contain the spread of COVID-19, Universiti Brunei Darussalam (UBD) transformed fully its pedagogical delivery to online mode, where we investigated teaching and learning experiences, physical and mental health of undergraduate students and lecturers during the COVID-19 pandemic. Methods We conducted a cross-sectional study on undergraduate students and lecturers in a health science faculty using a self-developed pretested questionnaire through anonymous online data collection method. Results Fifty-six lecturers (100% response rate) and 279 students (93.3% response rate) participated. The positive experiences reported by students include becoming independent (72.8%) and adapting to online learning (67.4%), while lecturers learned new teaching techniques (50.0%) and became more innovative (50.0%) by learning new tools (48.2%). However, studying at home caused students to feel more distracted (72.0%) with a feeling of uncertainty towards examinations (66.7%), while lecturers felt that students’ laboratory skills were compromised (44.6%). Even though online delivery of assessments enabled lecturers to explore all options (50.0%), they found it difficult to maintain appropriate questions (41.1%) and fair assessments (37.5%). Majority of students missed eating out (68.8%) and felt a lack of participation in extracurricular activities (64.9%), while lecturers reported more time for exercise (51.8%), despite having more screen time (50.0%) and computer-related physical stress (44.6%). In terms of mental health, increased stress in students was reported (64.9%), though they had more time for self-reflection (54.8%). Although lecturers reported a closer relationship with family (44.6%), they also felt more stressed due to deadlines, unexpected disruptions and higher workloads (44.6%) as well as concerns related to work, family and self (39.3%). Conclusion In this abrupt shift to online teaching, students and lecturers in our study identified both positive and negative experiences including the impact on their physical and mental health. Our findings are important to provide the evidence for online pedagogical benefits and can serve to promote the enhancement and adaptation of digital technology in education. Our findings also aim to promote the importance of addressing physical and mental health issues of the university community’s well-being through provision of emotional and mental health support and appropriate programs.

2021 ◽  
Vol 6 (3) ◽  
pp. 57-81
Isaac Eremugo ◽  
John Micheal Maxel Okoche

Purpose: The purpose of this study was to examine the influence of Monitoring and Evaluation (M&E) system components on the performance of National Non-Governmental Organizations (NNGOs) in Uganda: A case of Global Aim Uganda. The study focused on the i) influence of organizational structure on the performance of Global Aim Uganda (GAU), ii) influence of routine M&E on the performance of GAU and the influence of utilization of M&E information on the performance of GAU. Methodology: The study used a cross sectional study design employing both qualitative and quantitative research approaches. The population of the study consisted of the staff of Global Aim Uganda, implementing partners and project beneficiaries to which stratified random sampling was applied. 164 respondents (100% response rate) were reached for the survey and 15 respondents out of 17 (88.23% response rate) were reached for interviews. Qualitative data were collected using interview guides analyzed using content analysis and presented as text in normative form. Quantitative data was collected using researcher administered questionnaires. Responses were rated on a 5-Likert scale and were coded, cleaned and analyzed for descriptive and inferential statistic using SPSS software (version 20.0) presented in tables. Findings: Correlational analysis showed a significant and positive correlation between performance of Global Aim Uganda and organizational structure (r=.244**, p=.002, <0.05), routine M&E (r=.403**, p=.000, <0.01) and utilization of M&E information (r=.526**, p=.000, <0.01). Results from regression analysis revealed a non-significant and negative influence of organizational structure (β= -.013, p=.873, >0.05) on performance. While, there is a positive and significant influence of routine M&E (β=.199, p=.001, <0.05) and utilization of M&E information (β=.327, p=.000, <0.05) on the performance. The coefficient of determination (r2) between predictor variables and performance of Global Aim Uganda is 0.322 (32.2%). Unique contribution to theory, practice and policy: There is need to strengthen the M&E system components. These can be done through improved internal reporting, broadening the functions of the M&E unit, incorporating aspects of M&E in staff roles and responsibilities, conducting project specific baseline surveys, starting to conduct project evaluations and increasing the utilization of M&E information in decision making. Further study should focus on the M&E capacity of the organization.

Narmeen Mallah ◽  
Rubén Rodríguez-Cano ◽  
Danielle A. Badro ◽  
Adolfo Figueiras ◽  
Francisco Caamaño-Isorna ◽  

Tranquilizer misuse is an emerging international public health concern. The psychosocial determinants of this misuse remain understudied. Instruments to measure the Knowledge, Attitudes and Practices (KAP) of tranquilizer misuse are unavailable, except for a recently published questionnaire validated in the Spanish language. We translated the KAP questionnaire into Arabic and French, adapted it and undertook a complete validation procedure in the general adult population in Lebanon. The content validity indicators were good: item content validity index ranged between 0.89 and 1.00, the content validity index scale average was ≥0.95 and the modified Kappa statistic for each of the KAP items was equal to I-CVI. The intra-class correlation coefficient values (n = 100) were ≥0.62 for all Knowledge and Attitudes items, demonstrating the item reliability. Confirmatory factorial analysis (n = 1450) showed that the selected model of Knowledge and Attitude constructs has adequate fit indicators and encompassed three factors that showed acceptable internal reliability: Knowledge (Cronbach’s alpha = 0.72), personal Attitudes towards tranquilizers (Cronbach’s alpha = 0.79) and Attitudes towards healthcare providers (Cronbach’s alpha = 0.65). The Arabic/French questionnaire was highly accepted, with a response rate of 95.72% and item non-response rate ≤3.6%. The availability of a cross-cultural adapted and multilingual validated questionnaire would stimulate research on tranquilizer misuse.

2021 ◽  
Vol 21 (1) ◽  
Olaf M. Neve ◽  
Peter Paul G. van Benthem ◽  
Anne M. Stiggelbout ◽  
Erik F. Hensen

Abstract Background Patient Reported Outcomes (PROs) are subjective outcomes of disease and/or treatment in clinical research. For effective evaluations of PROs, high response rates are crucial. This study assessed the impact of the delivery method on the patients’ response rate. Methods A cohort of patients with a unilateral vestibular schwannoma (a condition with substantial impact on quality of life, requiring prolonged follow-up) was assigned to three delivery methods: email, regular mail, and hybrid. Patients were matched for age and time since the last visit to the outpatient clinic. The primary outcome was the response rate, determinants other than delivery mode were age, education and time since the last consultation. In addition, the effect of a second reminder by telephone was evaluated. Results In total 602 patients participated in this study. The response rates for delivery by email, hybrid, and mail were 45, 58 and 60%, respectively. The response rates increased after a reminder by telephone to 62, 67 and 64%, respectively. A lower response rate was associated with lower level of education and longer time interval since last outpatient clinic visit. Conclusion The response rate for PRO varies by delivery method. PRO surveys by regular mail yield the highest response rate, followed by hybrid and email delivery methods. Hybrid delivery combines good response rates with the ease of digitally returned questionnaires.

2021 ◽  
Nanna Bjerg Eskildsen ◽  
Lone Ross ◽  
Clara Rübner Jørgensen ◽  
Susanne S Pedersen ◽  
Thora Grothe Thomsen ◽  

Abstract PurposeTo investigate levels of empowerment, possibilities for empowerment and perceived importance of empowerment among Danes in cancer follow-up. MethodsFrom nation-wide registers a randomly selected group of people diagnosed with one of ten different cancer diagnoses between one and five years ago were invited to complete the newly developed ‘Cancer Patient Empowerment Questionnaire’ (CPEQ). Respondents who reported that they were in a follow-up program were included in the analysis. Frequencies of answers to the items in the questionnaire were calculated. ResultsIn total, 1,418 people with a diagnosis of cancer returned the questionnaire (response rate 54%). Of these, 1,042 reported being in follow-up and were included in the analysis. Most respondents experienced that there was a plan for their follow-up (83%) and felt at ease with both the frequency (80%) and content of the follow-up (78%). However, many also reported lack of possibilities for and/or low levels of empowerment. They were not aware of any decisions being made during their follow-up, had not received information about relevant patient associations, or had any conversations with healthcare professionals regarding their needs and wishes for their follow-up. Furthermore, almost 20% lacked information on and confidence in managing treatment-related side-effects, late complications and alarm symptoms. ConclusionMany respondents reported lack of possibilities for and/or low levels of empowerment in their cancer follow-up. This may have consequences for their quality of life and capabilities and opportunities for managing their own care.

O. M. Romantsova ◽  
D. V. Nisichenko ◽  
D. B. Khestanov ◽  
V. V. Khairullova ◽  
A. Z. Dzampaev ◽  

Introduction. Over the past decades, a significantly greater understanding of the morphology and molecular biological characteristics of tumors of the Ewing sarcoma family (ESFT) has been achieved. More than 70 % of relapses occur within 2 years from the date of diagnosis. In about 2/3 of cases, relapse occurs in distant places; this type of relapse is especially common in patients who initially have metastases. On the contrary, isolated local metastasis most often (in 1/5 of cases) occurs in patients with a localized form of the disease. In half of the patients, a relapse of the disease was detected during a routine examination, was asymptomatic and was a chance find.Purpose of the study – to evaluate the effectiveness of anti-relapse treatment in patients with ESFT, to develop an algorithm for a personalized approach, to improve the results of overall and relapse-free survival in children and adolescents with ESFT.Materials and methods. Our study included patients with a confirmed diagnosis of Ewing sarcoma (ES), who received treatment from 2008 to 2019. The analysis of follow-up data was closed on 19.02.2021. The study included 274 patients aged 6 months to 18 years, the average age was 11.6 years. Up to 1 year in our study there were 2 children. Twelve (4.3 %) patients went out of follow-up within 2 to 9 months from the start of treatment; we did not include them in the subsequent analysis. Analyzed were 262 patients with ES who received treatment according to the protocols at the Research Institute of Pediatric Oncology and Hematology of the N.N. Blokhin National Medical Research Center of Oncology. A relapse of the disease was revealed in 48 (18.3 %) children out of 262 – the study group; 58 (22.1 %) patients showed disease progression during treatment. In 70.8 % (34/48) patients had an isolated relapse, in 14 (29.2 %) cases – a combined one. The defeat of only the lung tissue with a relapse of the disease occurred in 19/48 (39.6 %) cases, local relapse without metastasis – 7/48 (14.5 %) cases. In general metastatic lung disease occurred in 66.6 % of cases. The defeat of the brain and lymph nodes occurred in 4 %. Most of the patients were in the group from 11 to 17 years, inclusive – 38/48 patients, which amounted to 79 %. All 48 patients from the study group received anti-relapse therapy depending on the duration of the disease relapse. For late relapses the primary treatment regimen was used: alternating courses of chemotherapy with vincristine/doxorubicin/cyclophosphamide and etoposide/ifosfamide. In early relapses two regimens were most used: vincristine/topotecan/cyclophosphamide and vincristine/irinotecan/temozolomide (VIT). The positive response rate with the antirelapse VIT regimen was 60 %, and the time to progression was 7.6 months. With the topotecan regimen the response rate was 45 % and the time to progression – 7 months.Results. The overall survival (OS) rate of patients when a relapse was detected was significantly (p £ 0.05) higher when compared with the group of patients who had progression of the disease, which is associated with the effect of anti-relapse chemotherapy. When analyzing OS of patients with ES it should be noted that the 5-year survival rate of all patients (n = 262) was 66.3 ± 3.3 %, compared with the group of patients with confirmed relapse (n = 48) – 53 ± 8.1 %. The median in the group of patients with relapse was 39.3 months. The follow-up time in the group with recurrent ES disease averaged 52.2 ± 32.3 months (from 12.6 to 142 months). OS of patients was analyzed depending on the interval of disease recurrence. The Interval No. 1 was from the beginning of the main treatment to the first relapse, with a median of 37.2 months. Interval No. 2 – from the date of the first relapse to the date of the second relapse with a follow-up time of 58.8 ± 29.1 months (from 28.6 to 108 months), the median was not reached. The second relapse occurred significantly less frequently than the first relapse (p = 0.000001).Conclusion. The outcome for patients with recurrent ES remains poor, and a standard approach to their treatment has not yet been established. Standard first and second lines chemotherapy can be effective in most patients in terms of reducing symptoms and increasing the time to further progression, but complete remission remains hard to reach. Further multidisciplinary study of prognostic factors, effects of various treatment regimens and protocols, study of the inclusion of targeted drugs in the therapy program is required.

2021 ◽  
Vol 13 (5) ◽  
pp. 26-33
V. V. Gafarov ◽  
E. A. Gromova ◽  
D. O. Panov ◽  
I. V. Gagulin ◽  
A. N. Tripelhorn ◽  

Objective: to establish associations of awareness and attitude towards cardiovascular diseases (CVDs) prevention in people with sleep disorders in an open population of Novosibirsk aged 25–64 years.Patients and methods. We carried out screening surveys of representative samples of the 25–64 years old population: in 2013–2016 – V screening (427 men, mean age– 34±0.4 years, response rate – 71%; 548 women, mean age– 35±0.4 years, response rate – 72%); in 2015–2018 – VI screening (275 men, mean age – 49±0.4 years, response rate – 72%; 390 women, mean age – 45±0.4 years, response rate – 75%) using the protocol of the WHO international program «MONICA-psychosocial». Jenkins sleep evaluation questionnaire was used to evaluate sleep disorders in the study population.Results and discussion. Participants with sleep disorders believed that they were «not entirely healthy» (men – 65.5%, χ2 =57.825, df=8, p<0.001 and women – 69.6%, χ2 =96.883, df=4, p<0.001); had health related complaints (men – 78.2%, χ2 =24.179, df=2, p<0.001 and women – 85.2%, χ2 =55.144, df=2, p<0.001), and clearly did not care enough about their health (men – 32.7%, χ2 =29.31, df=4, p<0.001 and women – 34.1%, χ2 =28.116, df=4, p<0.001). Men with sleep disorders more often assumed that they were more likely to get a serious illness within the next 5–10 years (χ2 =12.976, df=4, p<0.01). Participants with sleep disorders were confident that modern medicine can prevent (men – 10.9%, χ2 =19.079, df=2, p<0.001 and women – 13.3%, χ2 =21.944, df=2, p<0.01) and successfully treat (men – 3.6%, χ2 =24.142, df=8, p<0.01 and women – 3.7%, χ2 =15.538, df=8, p<0.05) only some heart diseases. Men and women with sleep disorders are more likely to seek medical attention in case of severe pain or discomfort in the heart area, but do not seek medical advice if this pain or unpleasant sensation is mild (men – 63.6%, χ2 =14.867, df=6, p<0.05 and women – 60%, χ2 =17.872, df=6, p<0.01). Among the participants with sleep disorders men more often believe that the doctor «knows more than me» (36.4%), and women (48.1%) chose an answer: «I will not necessarily agree with the opinion of the doctor after a general examination, until a thorough evaluation has been carried out by specialists» (χ2 =5.917, df=2, p<0.05). Women with sleep disorders were more likely to continue to work if they did not feel very well (54.1%, χ2 =12.455, df=4, p<0.05) or their body temperature rose (37.8%, χ2 =12.937, df=4, p<0.05).Conclusion. People with sleep disorders generally have a more negative attitude towards their health and are skeptical about the possibilities of modern medicine to prevent and treat CVDs, which is reflected in their attitude to work and preventive check-ups.

The main purpose of this paper is to know about the recent status of big data analytics (BDA) on various manufacturing and reverse supply chain levels (RSCL) in Indian industries. In particular, it emphasises on understanding of BDA concept in Indian industries and proposes a structure to examine industries’ development in executing BDA extends in reverse supply chain management (RSCM). A survey was conducted through questionnaires on RSCM levels of 330 industries. Of the 330 surveys that were mailed, 125 completed surveys were returned, corresponding to a response rate of 37.87 percent, which was slightly greater than previous studies (Queiroz and Telles, 2018).The information of Indian industries with respect to BDA, the hurdles with boundaries to BDA-venture reception, and the connection with reverse supply chain levels and BDA learning were recognized.

Li-Chao Zhang ◽  
Jun Yang ◽  
Yuan-Bo Huang ◽  
Ming-Ye Bi

Background: Port-wine stains occur in 0.3–0.5% newborns, mainly on the face and neck. Pulsed dye laser is recognized as the gold standard treatment; nevertheless, it is associated with a low cure rate and a high recurrence rate. Aims: This study aims to evaluate the efficacy of hemoporfin photodynamic therapy for pulsed dye laser-resistant port-wine stains in children. Methods: We studied 107 children who received hemoporfin photodynamic therapy for port-wine stains on the face and neck that were resistant to pulsed dye laser. After intravenous injection of 5 mg/kg hemoporfin, the local lesion was irradiated with 532 nm LED green light for 20 min with a power density of 80–100 mW/cm2. A total of 65 patients were given a second treatment after eight weeks. The efficacy and therapeutic responses were recorded at four days and eight weeks after each treatment. Results: The efficacy was positively correlated with the number of treatments received; two treatment sessions yielded significantly better results compared to a single treatment with a response rate of 96.9%, a significant response rate of 50.8% and a cure rate of 21.5%, respectively (P < 0.001). After two treatment sessions, the efficacy was negatively correlated with age (P = 0.04). The efficacy for port-wine stains located on the lateral part was better than that of the central face (P = 0.04). The efficacy for the pink type was better than that for the red and purple types (P = 0.03). No allergic or systematic adverse reactions were reported. Limitations: No objective measurement data were available. Conclusion: Hemoporfin photodynamic therapy is effective and safe for pulsed dye laser-resistant facial port-wine stains in children.

2021 ◽  
Vol 21 (1) ◽  
Rebecca Jessup ◽  
Samantha Hanna ◽  
Jaspreet Kaur ◽  
Iman Bayat ◽  
Cassandra Bramston

Abstract Background There are more than 10,000 admissions each year in Australia for foot disease, with an average length of hospital stay of 26 days. Early supported discharge (ESD) has been shown to improve patient satisfaction and reduce length of stay without increasing the risk of 30-day readmissions. This research aims to gain consensus on an optimal model of early supported discharge for foot disease. Methods Three focus groups were held where preliminary components for an early discharge model, as well as inclusion and exclusion criteria, were identified with a purposefully sampled group of medical, nursing, allied health staff and consumers. Two researchers independently systematically coded focus group transcripts to identify components of an ESD model using an iterative constant comparative method. These components then formed the basis of a three phase Delphi study, with all individuals from the focus groups were invited to act as panellists. Panellists rated components for their importance with consensus established as a rating of either essential or very important by ≥80% of the panel. Results Twenty-nine experts (including 5 consumers) participated across the two study phases. Twenty-three (3 consumers) participated in the focus groups in phase one. Twenty-eight of the twenty-nine experts participated in the phase 2 Delphi. 21/28 completed round 1 of the Delphi (75% response rate), 22/28 completed round 2 (79% response rate), and 16/22 completed round 3 (72% response rate). Consensus was achieved for 17 (29%) of 58 components. These included changes to the way patients are managed on wards (both location and timeliness of care by the multidisciplinary team) and the addition of new workforce roles to improve co-ordination and management of the patients once they are at home. Conclusions A model of early supported discharge that would allow individuals to return home earlier in a way that is safe, acceptable, and feasible may result in improving patient satisfaction while reducing health system burden. Future trial and implementation of the ESD model identified in this study has the potential to make a significant contribution to the experience of care for patients and to the sustainability of the health system.

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