Profile and Predictors of Maternal Quality of Life During Physiological Pregnancy: A Cross-Sectional Analysis

BackgroundQuality of Life (QoL) and its determinants are significant in all stages of life, including pregnancy. The physical and emotional changes during pregnancy affect the QoL of pregnant women, affecting both maternal and infant health. Hence, assessing the QoL of pregnant women is gaining interest in literature. We, therefore, aimed to describe the QoL of pregnant women during physiological pregnancy and to identify its associated predictors in women attending a public healthcare institute of Quetta city, Pakistan.MethodsA cross-sectional study was conducted at the Obstetrics and Gynecology Department of Sandeman Provincial Hospital Quetta city, Pakistan. The respondents were asked to answer the Urdu (lingua franca of Pakistan) version of the Quality of Life Questionnaire for Physiological Pregnancy. Data were coded and analyzed by SPPS v 21. The Kolmogorov–Smirnov test was used to establish normality of the data and non-parametric tests were used accordingly. Quality of Life was assessed as proposed by the developers. The Chi-square test was used to identify significant associations and linear regression was used to identify the predictors of QoL. For all analyses, p < 0.05 was taken significantly.ResultsFour hundred and three pregnant women participated in the study with a response rate of 98%. The mean QoL score was 19.85 ± 4.89 indicating very good QoL in the current cohort. The Chi-Square analysis reported a significant association between age, education, occupation, income, marital status, and trimester. Education was reported as a positive predictor for QoL (p = 0.006, β = 2.157). On the other hand, trimester was reported as a negative predictor of QoL (p = 0.013, β = −1.123).ConclusionImproving the QoL among pregnant women requires better identification of their difficulties and guidance. The current study highlighted educational status and trimester as the predictors of QoL in pregnant women. Health care professionals and policymakers should consider the identified factors while designing therapeutic plans and interventions for pregnant women.

Knowledge Regarding HIV/AIDS among Nepalese Army

Introduction: A global pandemic threat HIV/AIDS is also matter of concern of developing countries like Nepal where the first case was identified in July 1988 and later became epidemic and then concentrated epidemic among risk group for HIV. Several studies reflected HIV is associated to many factors, Literacy and Socio-economic conditions being at the highest rank. Members of Nepal army are generally with less educational background and few with higher educational status are at higher post. Thus knowledge regarding HIV/AIDS among this group need to be assessed. Aims: The overall objective of our study was to assess knowledge regarding HIV/AIDS among Nepal army in Banke district. Methods: A Cross-sectional descriptive study with population size of 146 Army was performed which covered the entire population of Shree Shreemehar Army Camp in Banke, starting from 18th June to 27th August, 2018. A pre-tested questionnaire containing structural, semi-structural and open ended questions were made as data collection tool. All the soldiers in Army camp were interviewed after receiving consent as an ethical clearance. Results: All 146 Army of our study were aware about HIV/AIDS mainly via mass media (83.56%). 33 respondents still didn’t know about availability of its treatment. Misconception about its complete cure and vaccination was seen in 12 and 39 respondents respectively. 58 respondents were found knowing about the free health services by government. 141 respondents knew certain things about prevention. 28 respondents admitted of having multiple sex partners and only 24 among them used preventive measure. Conclusion: Though all the respondents of our study had known about HIV/AIDS still they had misconception regarding its treatment and prevention. Many respondents do not even know about the free health services of government. Few of them still don’t use preventive measure.

An exploration of attributes effecting the relationship between competencies and performance of CHWs in a rural block.

Introduction: Induction of Community Health Workers (CHWs) into various health programs is considered as an integral strategy to achieve universal health coverage. Thus, it is prudent to explore and understand the CHWs individual and the system level interactions and their further translation into performance and actionable domains. Objective: To quantify the relationship structure between envisioned competencies and CHW performance with factors operating at individual and the immediate system level as effect modifiers. Methodology: A cross-sectional study was done in primary rural health care settings of Madhya Pradesh state in Central India. CHWs were stratified as relatively low performing (RLP) and relatively high performing (RHP) based on their annual performance-based incentives for the year (April 2017- March 2018). CHWs were administered a self-reported questionnaire that included socio demographic details, knowledge, skills assessment and availability of logistics. Results: Among the 90 eligible CHWs, 31 RLP and 30 RHP CHWs were interviewed. The CHWs performance was found to be significantly associated with age, education, caste, presence of under 5 children, knowledge and competency scores. However, while adjusting for the confounders only age and educational status were found to be significant. Further cluster analysis revealed two clusters based on individual and system characteristics which was found to influence the CHWs performance. Conclusion: The relationship between the CHWs truest competencies and performance based incentivisation tends to have been influenced by age and education which could help in developing a more focused supportive supervision catering to their needs. Keywords: community health worker, performance, health system, competency.

Determinants of Health Service Utilization Among Adults at High Risk of Developing Type 2 Diabetes in Kerala, India

The purpose of this study was to examine the determinants of health service utilization in a population at high risk of developing type 2 diabetes mellitus in India. Using Andersen’s behavioral model of healthcare utilization, multivariate logistic regression analysis was performed on baseline data of the Kerala Diabetes Prevention Program. We examined the association between predisposing, enabling, and need factors with outpatient health service use in the past four weeks and inpatient health service use in the past 12 months. More than a quarter (27.9%) and 12.9% of 1007 participants used outpatient services and inpatient services, respectively. Men were less likely to use outpatient services (odds ratio [OR] = 0.56; 95% confidence interval [CI] [0.39, 0.82]). Outpatient service utilization was positively associated with low social support (OR = 1.69; 95% CI [1.09, 2.62]), low general health status (OR = 5.71; 95% CI [2.42, 13.47]), and time off from work due to illness (OR = 8.01; 95% CI [5.32, 12.07]). Higher educational status (OR = 0.63; 95% CI [0.41, 0.95]), low general health status (OR = 3.59; 95% CI [1.54, 8.34]), and time off from work due to illness (OR = 1.21; 95% CI [0.76,1.93]) were associated with increased utilization of inpatient services. Although gender, educational status, and social support had important roles, health service utilization in this study population was largely dependent on general health status and presence of illness.

CSF Upward Motion Is Crucial for ETV Success

Purpose: ETV is indicated for treating obstructions of major CSF pathways. The outcome evaluation often yields success rates of only +- 70% for shunt independency. Hence, compromised CSF absorption seems to occur more often than expected. We searched for parameters suitable to assess the involved CSF dynamics. Material and Methods: This was a prospective study in 58 paediatric patients (7.7 yrs. mean age) between 2000 and 2020 with aqueductal stenosis (11/58), obstruction of the aqueduct due to tumor growth (22/58),and connatal hydrocephalus (9/58). The average follow-up interval was 4.7 years. Head circumferences, Evans- and fronto-occipital horn ratios before and 3 months after ETV were obtained as Delta-indices. Furthermore ETV success score (ETVSS), the patency of the aqueduct pre- and postoperatively as well as of the stoma were assessed by flow void signs on MRI. Evaluation on MRI also included the shape of the floor of the 3rd ventricle and whether or not the septum pellucidum showed signs of perforation. Four patients were analysed pre- and postoperatively via real-time MRI. At least the educational status regarding protected or unprotected education was analyzed. Results:The prevalence of a bowing of the floor of the 3rd ventricle was 72%, and the ETVSS was 71.0%. In 26 children a septal perforations or an open aqueduct prior to ETV (19) could be identified. Mean ER and FOHR were reduced by 0.03 and 0.05 , respectively. Maintained open (flow void on postop MRI) or perforation could successfully be carried out during endoscopic surgery in 44 patients (79%). The disproportionate increase of head circumference abated in 79.4% of patients. New shunt insertion occurred in 16 patients (27.5%). Intraoperatively upward CSF flow was detected in all cases. Statistical analyses(ANOVA) showed significant results for unprotected education, postoperative ER and FOHR but not for open stoma. Conclusion: The identification of flow through the stoma on postoperative MRI seems to be a necessary but not sufficient condition for ETV success. In our study, ventricular volumes were used as parameters to determine success rates as well as unprotected education. Furthermore, enabling upward CSF flow driven by inspiration seems crucial for successful ETV.

Monitoring of the Village Malaria Workers to conduct activities of Malaria Elimination Demonstration Project in Mandla, Madhya Pradesh

Background The capacity of the field staff to conduct activities related to disease surveillance, case management, and vector control has been one of the key components for successfully achieving malaria elimination. India has committed to eliminate malaria by 2030, and it has placed significance on monitoring and evaluation at the district level as one of the key strategies in its national framework. To support and guide the country’s malaria elimination objectives, the Malaria Elimination Demonstration Project was conducted in the tribal district of Mandla, Madhya Pradesh. Robust monitoring of human resources received special attention to help the national programme formulate a strategy to plug the gaps in its supply chain and monitoring and evaluation systems. Methods A monitoring tool was developed to test the capabilities of field workers to conduct activities related to malaria elimination work. Between November 2018 to February 2021, twenty-five Malaria Field Coordinators (MFCs) of the project utilized this tool everyday during the supervisory visits for their respective Village Malaria Workers (VMWs). The data was analysed and the scores were tested for variations against different blocks, educational status, duration of monitoring, and post-training scores. Results During the study period, the VMWs were monitored a total of 8974 times using the monitoring tool. Each VMW was supervised an average of 1.8 times each month. The critical monitoring indicators scored well in all seven quarters of the study as monitored by the MFCs. Monitoring by MFCs remained stable at 97.3% in all quarters. Contrary to expectations, the study observed longer diagnosis to treatment initiation time in urban areas of the district. Conclusion This study demonstrated the significance of a robust monitoring tool as an instrument to determine the capacity of the field workers in conducting surveillance, case management, and vector control related work for the malaria elimination programme. Similar tools can be replicated not only for malaria elimination, but other public health interventions as well.

Knowledge, Attitude and Practice Regarding Exclusive Breastfeeding Among Mothers Attending Tertiary Care Hospital

OBJECTIVES: To determine knowledge, attitude, and practice regarding exclusive breastfeeding among mothers attending tertiary care hospitals. METHODOLOGY: A descriptive cross-sectional study was conducted at the Department of Pediatrics in Hayatabad Medical Complex, Peshawar. A total of 162 mothers were selected who were practicing breastfeeding of ages between 20 to 35 years, having a full-term baby of age up to 6 months old. The data is collected through a pre-planned questionnaire and then was analyzed using statistics version 24.0. The duration of the study was from 1st June 2020 to 30th October 2020. RESULTS: The results showed that no significant association was found between age groups, socio-economic status regarding knowledge, attitude, and practice (p>0.05). However, there was a significant difference between knowledge, attitude, and practice with respect to educational status (p<0.05). 123 (73.21%) mothers had unsatisfactory; whereas 39 (24.07%) mothers had excellent knowledge regarding breastfeeding. 39 (27.07%) of breast-feeding mothers had a positive attitude towards breastfeeding. 123 (73.21%) women showed a negative response regarding the practice of breastfeeding. CONCLUSION: Most of the mothers didn’t have adequate knowledge of exclusive breastfeeding (EBF) practice. As a result, it is suggested that media can be used as a medium to educate women about the benefits of exclusive breastfeeding (EBF).

Awareness, Knowledge and Attitude towards ‘Superfood’ Kale and Its Health Benefits among Arab Adults

This cross-sectional online survey aimed to determine the awareness of Arab adults on the benefits of consuming nutrient-dense foods, such as kale. A total of 1200 respondents completed the survey. The questionnaire included questions related to socio-economic information, e.g., whether the participants have consumed kale, if they observed any health effects, and 13 other questions to test their knowledge on this superfood. Only 276 (23%) of the participants had previously consumed kale, with 64.5% reporting favorable health outcomes, the most common of which was weight reduction, and only 17.8% reporting side effects, such as constipation and gastrointestinal irritation. From the 13 kale knowledge questions, the average total knowledge score, scaled from 0 to 10, was 3.5 and 3.7 for males and females, respectively. The regression analysis revealed that age, income, and educational status were significant contributors for predicting better knowledge scores, as older individuals with a higher income and higher education scored higher (odds ratio of 2.96, 2.00 and 4.58, respectively). To summarize, there is a dearth of awareness about kale and its health benefits in Saudi Arabia. Kale should be promoted as a super food in all segments, particularly among the younger, lower-income, and less-educated sections of the population.

Comparative Study of Knowledge of Urban and Rural Mothers about Neonatal Care

Objectives: The purpose of this study is to assess and compare the knowledge about the neonatal care among the mothers in urban and rural area in district Ajmer province of Rajasthan Materials and methods: Comparative randomized descriptive study was conducted among mothers who willingly gave consent to participate in the study. A structured questionnaire were framed and mothers were interviewed, the answers were recorded. To judge the knowledge score of the mothers closed ended questions having four alternatives were also framed. One mark was allocated for correct response. Results: Among 5800 deliveries, 400 mothers (205 mothers were Urban and 195 mothers were from Rural area) were randomly selected. Mothers with Antenatal check-up had knowledge score of 61% compared to 24% who had no regular antenatal checkup. Knowledge about “Exclusive Breastfeeding” was 84.39% and 68.20% urban mothers and rural mothers and regarding adequacy was 73.17% in Urban and 44.61% in rural mothers. Knowledge about Hygiene was 89.75% and 53.33% in Urban and rural mothers. Skin care and baby bath was 28.29% and 18.46% in Urban and Rural mothers respectively. Knowledge about danger signs was 81.95% and 60% in Urban and Rural mothers respectively. Knowledge regarding immunization at birth was 70.7% and 35.89% in Urban and Rural mothers respectively. Conclusions: Main factors affecting the knowledge score of the mothers about neonatal care were Educational status and Antenatal checkup. Knowledge about adequacy of breastfeeding, Immunization at birth, Danger signs, Temperature maintenance and hygiene was less in rural mothers as compared to urban mothers.

Influences of Parents on 7-9-year-old Children’s Physical Activity and Cardiopulmonary Endurance (Preprint)

BACKGROUND - OBJECTIVE To explore and discuss the influences on 7～9-year-old children’s physical activity and cardiopulmonary endurance. METHODS Recruiting 1st and 2nd-grade elementary school students and their parents at an elementary school in Changping District, Beijing. The study made an investigation of PA level, economic and educational status on the subject families, and the other main contents including medical history and family history. The PA data of the parents were measured by the ActiGraph GT3X + accelerometer (Actigraph, Pensacola, FL, USA), and the children’s PA data were obtained by the revised PAQ-A. 50m*8 shuttle run were carried out to test the children’s cardiopulmonary endurance. RESULTS 36 families were recruited and completed the examination. There was a significant difference in the children’ PA scores between sPAf(PA sufficient family) (3.02±0.53) and iPAf(PA insufficient family) (2.61±0.58)(P<0.05), and the BMI of the two groups (15.63±1.95 vs17.77±3.67) showed great difference(P<0.01). The child from sPAf had better cardiopulmonary endurance than those from iPAf. The parent of high income, a high educational background had higher moderate to vigorous PA, and so did their child. There was a high positive correlation of the sedentary time and light PA every day of the husband and wife in a family. CONCLUSIONS The influence factors that affected the 7~9-year-old children’s PA level and cardiopulmonary endurance included their parent’s PA level, economic income, educational background, especially the mother’s PA played a prominent part. The study found there existed interaction of respective PA levels inside the couple.