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Background: Pain is the main complaint felt by mothers during childbirth. Pain management can be done with non-pharma-cological techniques, one of which is using the Rebozo technique. Objective(s): This study aimed to determine the effectiveness of the rebozo technique for active phase 1 labour pain in primipa-rous women. Method(s): The study used a quasi-experimental design with a pretest and posttest control group. An accidental sampling technique divided a sample of 30 people into control and intervention groups. The intervention group received Rebozo therapy, a therapy using a traditional cloth wrapped around the pelvis and buttocks with the mother kneeling, then shaking it slowly. The pain was measured using the Visual Analogue Scale (VAS), ranging from 0-10. Bivariate test using Wilcoxon. Result(s): The majority of respondents were aged 21-29 years (56.7%), had high school education (83.3%) and were house-wives (50%). The majority of the control group showed moderate pain (53.3%), while the intervention group showed severe (60%). The reduction in pain in the intervention group was more significant than in the control group (2.27 > 0.73). Both the control group and the intervention group showed p < 0.001. Conclusion(s): The Rebozo technique effectively reduces labour pain in the active phase of the first stage in primiparous women. This technique is easy and inexpensive, so it can be an option for non-pharmacological therapy to treat labour pain.Copyright © 2023 Japan University of Health Sciences.
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This study compares the serological antibody level post-COVID-19 vaccine among healthy subjects and psychiatric patients on antidepressant therapy. It also examines the difference in antidepressants' side effects experienced by psychiatric patients following the completion of two vaccine doses. A comparative posttest quasi-experimental study was conducted among healthy subjects and psychiatric patients on antidepressant medication in a teaching hospital in Malaysia. Elecsys Anti-SARS-CoV-2 assay was used to detect the antibody titre between weeks 4 and 12 post vaccination. The antidepressant side-effect checklist (ASEC) was used to monitor the occurrence of antidepressant-related side effects pre-and post-vaccination. 24 psychiatric patients and 26 healthy subjects were included. There was no significant difference in the antibody level between the patients (median = 1509 u/ml) and the healthy subjects (median = 995 u/ml). There was no significant worsening in the antidepressant-related side effects. The antibody level post-COVID-19 vaccine did not differ significantly between patients on antidepressant therapy and healthy subjects. Additionally, there was no change in the antidepressant side effects experienced by the patients following the completion of the vaccine.Copyright © 2022, Research Trends (P) LTD.. All rights reserved.
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The COVID-19 pandemic created disruptions in HIV testing service utilization among men who have sex with men (MSM). The present study was to evaluate the effectiveness of an online health promotion program implemented by a community-based organization (CBO) in increasing the uptake of any type of HIV testing and home-based HIV self-testing (HIVST) over a six-month follow-up period. Participants of an observational prospective cohort study conducted during the same period served as the comparison group. This study was conducted between September 2020 and December 2021. Participants were Chinese-speaking adult MSM who were HIV-negative/unknown sero-status recruited through multiple sources in Hong Kong, China. Participants in the intervention group were exposed to the following health promotion components: (1) viewing an online video promoting HIVST, (2) visiting the project webpage, and (3) having access to a chargeable HIVST service implemented by the CBO. Among 400 and 412 participants in the intervention group and the comparison group, 349 (87.3%) and 298 (72.3%) completed follow-up evaluation at Month 6. Multiple imputation was used to replace missing values. At Month 6, participants in the intervention group reported significantly higher uptake of any type of HIV testing (57.0% versus 49.0%, adjusted odds ratios [AOR]: 1.43, p = .03) and HIVST (25.8% versus 14.8%, AOR: 2.04, p = .001), as compared to those in the comparison group. Process evaluation of the health promotion components for the intervention group was positive. Promoting HIVST is a potentially useful strategy to increase HIV testing service utilization among Chinese MSM during the pandemic.
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Intro: Dexamethasone, a corticosteroid, was recently demonstrated to be the only medication capable of reducing mortality in severe COVID disease in the UK's Recovery Trial. There is a need to compare different steroids because it is well recognised that different corticosteroids have varied pharmacodynamic properties. The aim of our study was to compare outcomes in severe or critical COVID-19 when treated with Dexamethasone versus Methyl prednisolone. Method(s): We conducted a retrospective quasi-experimental, non-randomized study to determine whether intravenous or oral dexamethasone reduces mortality compared with intravenous methylprednisolone in patients with severe or critical COVID-19.The study was conducted on all patients aged 18 and over admitted at a 700-bedded academic medical center.The primary outcome was the mortality. The secondary outcome included length of stay. Finding(s): A total of 706 hospitalized patients with moderate to severe COVID- 19 were included in the study. There were n=217 patients in Dexamethasone group, n= 393 patients in Methylprednisolone group and n=96 patients who did not receive steroids.Among the baseline characteristics between the groups, there was no significant difference in median age (55 years in dexamethsone group vs 57 years in methyl prednisolone group p=0.09). There was male predominance in methylprednisolone group (74% versus 54% p<0.001) and a greater proportion of patients who required invasive mechanical ventilation (13.7% versus 3.2% p<0.001). Mortality was found to be significantly higher in methylprednisolone group compared to dexamethasone group on univariate logistic regression analysis (13.7% versus 3.2% p<0.001) and longer length of stay (7 days versus 4 days p<0.001). In multivariable model, dexamethsone was found to be associated with lower risk of mortality (aOR: 0.24;95% CI: (0.09- 0.62)(p=0.003) and lesser length of stay (aOR: 0.87;95% CI: (0.82-0.92) (p<0.001). Conclusion(s): Dexamethasone was associated with lower mortality and lesser length of stay when compared to Methyl prednisolone in moderate to critical COVID-19.Copyright © 2023
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Within Australia, the prevalence of food insecure individuals increased from 2.6 million in 2014-2016 (10.8%) to 3.1 million in 2018- 2020 (12.3%) due to the COVID-19 pandemic.(1) OzHarvest is a not-for-profit organisation that prioritises food salvaging, food waste prevention and nutrition education.(2) OzHarvest's education sector facilitates a programme known as Nutrition Education Skills Training (NEST). NEST is a 6-week programme providing weekly workshops of 2.5-hour duration offering skills training on cooking simple, healthy, and affordable meals to adults at risk of food insecurity. This study aimed to determine the immediate and longerterm impacts of participation in NEST. A quasi-experimental study with pre-post surveys (n = 258) and follow-up surveys (n = 20) was conducted from June 2019 to July 2022. Survey results were obtained from NEST program participants (18 years) from Adelaide Canberra, Melbourne, Newcastle, Queensland, and Sydney. Baseline (pre-) and post-surveys (at program completion) were administered to participants, with an option for a 6-month follow-up survey. Participants were required to complete both surveys to be eligible for this study. Questionnaires included 23 core questions adapted from previous studies,(3) allowing evaluation of nutrition knowledge confidence and self-efficacy, shopping, and food preparation behaviours, and eating behaviours. Food security was assessed using the standard 6-item indicator set for classifying households by food security status level. Using paired t-tests, Shapiro Wilks, and Wilcoxon sign-ranked tests for pre and post survey data, participants demonstrated overall improvement in nutrition knowledge (p < 0.001), confidence and self-efficacy (n = 222;p < 0.001) and food preparation behaviours (p < 0.001). The intake of discretionary foods overall decreased (p < 0.001) while fruit, vegetable and water intake increased (p < 0.001). Food security improved from 57% to 68% immediately within the population (p < 0.001). Using RMANOVA and Shapiro Wilks tests, the 6-month survey results were compared to the pre surveys suggested longer lasting improvements in nutrition knowledge (p < 0.001), cooking confidence (n = 8;p = 0.033), food preparation behaviours (p = 0.003), and increased vegetable intake (p = 0.032) and fruit intake (p = 0.012) Participation in OzHarvest's NEST programme results in short-term improvements in food security levels and dietary behaviours Over the longer term, these changes were sustained but to a lesser degree, indicating that systemic changes are required to address underlying socioeconomic disadvantage.
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Background: The cellular inflammation generated by SARS-COV-2 has been linked with different psychological impairments to long-term. The Mindfulness-based cognitive therapy can generate positive changes in these patients. Aim(s): To know the effects of a brief behavioural cognitive e-therapy on emotional symptoms, and cellular inflammation in COVID-19 survivors. Method(s): A quasi-experimental study was carried out. Participated two groups of survivors COVID-19 patients;experimental group (TG;4) and wait-list group (WLG;6). Both groups were evaluated using The General Anxiety Disorder Questionnaire, the Patient Health Questionnaire, and the brief Davidson Trauma Scale. Cellular inflammation was evaluated by an assessment of salivary IL-6 in a three-phase paradigm: baseline, stress, and recovery. The TG has received eight virtual mindfulness-based cognitive therapy sessions lasting two hours. The statistical analysis was performed using the software SPSS version 26. Result(s): The average age was about 58+/-11.57 years (TG), and 44.33+/- 17.18 years (WLG). The TG showed a only a clinical differences in the psychological symptoms (anxiety;Mepre = 15.50, Mepost = 8, depression;Mepre =13, Mepost =6 and PTSD;Mepre = 10, Mepost = 5.50), and in the il-6 levels (Base line Mepre = 7.11 pg/mL, Mepost = 16 pg/mL, stress phase Mepre = 10.07 pg/mL, Mepost = 8.77 pg/mL, and recovery phase Me = 14.08 pg/mL, Me = 16.29 pg/mL). Conclusion(s): This type of therapy can helps to reduce the levels of the emotional alterations and generate a modulation of the il-6 levels. The effects of this type of treatment need to continue in research as a therapeutic option for the population that survives COVID-19.
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Background: Abderrahmane Mami Hospital of pneumophtisiology was dedicated COVID-19 hospital since the beginning of COVID-19 pandemic. Health care workers (HCW) were led to provide medical care to the consulting or hospitalized patients suffering from a very contagious and unknown disease. A training was carried out to initiate good attitudes in order to respond to this emergent disease care. The purpose of this study was to evaluate the impact of one training session on the knowledge of HCW about SARS-CoV-2 and the appropriate preventive measures. Method(s): A quasi experimental study was carried out on march 2020 among Abderrahmane Mami HCW. A test containing 10 items was distributed for the participants before and after the training sessions. Result(s): The total number of participants was 226. The number of filled questionnaires before was 139 (54.7%) and 115 (45.3%) after. women represented 79%. The average age was 37+/-11.4 years. The training helped enhancing knowledge about the contagiosity which has raised from 30% to 60% (p=0.01, OR:3.142 [1.146-8.612]) and the mortality from 79.2% to 95% (p<10-3, OR: 0.750[0.582-0.966]). Conclusion(s): The awareness training has helped enhancing the knowledge of health professionals about a lot of COVID-19 aspects. Training in the workplace must be oriented, actualised and repeated in order to fill gaps of the preventive measures in pandemic time.
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Purpose: This quasi-experimental study examined the effectiveness of audio-visual and written feedback (AVF + WF) on undergraduate students versus only receiving WF in the context of an English as a Foreign Language (EFL) online classroom during the coronavirus disease 2019 (COVID-19) lockdown. Design/methodology/approach: The study used the estimator Difference in Difference (DID) to compare a treated and control group in a pre-and post-test under the application of six treatment sessions, plus a student's perception survey at the end of the treatment. The treated group that received the multimodal feedback showed higher improvement rates in the paragraph content between the first and final drafts than students in the control group. Findings: Results indicated that receiving a combination of AVF + WF had a statistically significant effect on mechanics (p < 0.001) and the use of transition words (p = 0.003). Practical implications: These findings will benefit educational agents, professors and stakeholders for social and economic development. Originality/value: While previous studies have only used student perceptions of the feedback, this study contributes with empirical data through quasi-experimental analysis and measures the effectiveness of feedback in online learning environments. © 2023, Emerald Publishing Limited.
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OBJECTIVE: Diverting lower urgency ED presentations to more suitable healthcare is a key goal of several healthcare systems. During the early stages of the COVID-19 pandemic in 2020, there was a substantial drop in ED presentations in New South Wales (NSW), potentially because of lower risk of illness and injury through social restrictions, or ED avoidance for lower urgent care. The present study aimed to better understand the impact of social restrictions during the pandemic on ED presentations, to inform potential shifts to alternative modes of care in emergency medicine. METHODS: We conducted a quasi-experimental study of public ED presentations in NSW. We compared changes in weekly ED presentation counts by urgency, during and after the period of tightest social restrictions in contrast to the baseline period. Expected weekly counts were estimated using segmented quasi-Poisson regression, accounting for age and seasonality. RESULTS: Lower urgency presentations fell more than mid-high urgency presentations, both during and after the period of tightest social restrictions. Lower urgency presentations reduced 30.9% compared to the baseline period during tightest restrictions, in contrast to 20.9% reduction for mid-high urgency presentations. Lower urgency presentations remained 14.4% lower after the tightest restrictions compared to the baseline period, whereas mid-high urgency presentations returned to usual levels. CONCLUSIONS: This finding suggests that reducing lower urgency ED presentation beyond the COVID-19 pandemic maybe feasible, by supporting alternative, more appropriate sources of care.
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Objective: To investigate the effect of nasal irrigation on the duration of symptoms and nucleic acid conversion in adults infected with the Omicron variant of COVID-19. Methods: This quasi-experimental study enrolled patients diagnosed with asymptomatic, mild, or moderate Omicron infection at the Shandong Public Health Clinical Center between April 1, 2022 and May 1, 2022. Patients were divided into two groups to receive Lianhua Qingwen granules and traditional Chinese medicine (TCM) prescriptions (conventional group) and 3% hypertonic saline nasal irrigation based on conventional treatment (nasal irrigation groups), respectively. Primary outcomes were symptom disappearance time and nucleic acid negative conversion time. Secondary outcomes were peripheral blood white blood cell (WBC), lymphocyte (LYM) count, neutrophil (NEU) count, C-reactive protein (CRP) level, and chest CT examination findings. Results: Eighty patients were included (40 patients/group). Multiple linear regression analysis showed that, after adjustment for comorbidities, smoking history, LYM count, and Ct values of N gene, the patients in the nasal irrigation group were more likely to get lower nucleic acid negative conversion time (ß = -11.052, 95% CI: -8.277-13.827, P < 0.001) compared with the conventional group. The symptom disappearance time showed no significant improvement (P > 0.05). Subgroup analysis for treatment-naïve patients in the nasal irrigation group showed similar nucleic acid negative conversion time improvement (P = 0.038). Conclusion: Early nasal irrigation shortens the nucleic acid negative conversion time in adults infected with the Omicron variant but without improvements in symptom disappearance time.
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COVID-19 , Nasal Lavage , Adult , Humans , COVID-19/therapy , Saline Solution, Hypertonic/therapeutic use , SARS-CoV-2ABSTRACT
Background: Restless legs syndrome (RLS), also known as Willis-Ekbom disease, is a widely known, prolonged, multifactorial limb movement disorder wherein patients have an insatiable desire to move their legs. This is frequently associated with abnormal, non-painful sensations that begin at rest and improve with activity and pain may be the distressing symptom in a few. Ropinirole, a dopamine agonist, is a proven drug for this disease. Method(s): In this study of thirty-two post covid restless leg syndrome, selected by well-established criteria, a course of ropinirole 2 mg in the night was given for three weeks. The drug compliance was maintained more than 95% by telephonic interview. The pain scores (VAS 0- 10), Likert scores of satisfactions, were observed after three weeks and three months. Result(s): The scores significantly decreased after three weeks which maintained the same and an insignificant decrease after three months. The median score decreased from 7 to 3 (three weeks) to 2 in three months. The Likert satisfaction scores improved to 1.81 from three (p value= 0.00). There was improvement in scores from three weeks to three months. There were no side effects. Conclusion(s): In this single centre, quasi experimental study on the efficacy of ropinirole on post covid restless syndrome, we found the drug dosage of 2 mg in the night for three weeks is effective in the control of symptoms. The drug gives better satisfaction which prolonged to three months even if the drug is stopped in three weeks. There were no clinically significant side effects. Copyright © 2022 Wolters Kluwer Medknow Publications. All rights reserved.
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Objective: To describe the probability of appropriate hand hygiene behaviors among outpatients and visitors at a primary care unit before and after installation of additionally strategically placed hand rub dispensers and empirically-designed behavioral nudges. Material and Methods: We conducted a quasi-experimental study at a suburban primary care unit in southern Thailand. The intervention consisted of included installation of hand rub dispensers and attachment of behavioral nudges. We designed the behavioral nudges using qualitative data from a focus-group discussion with local residents, who identified disgust and normative expectations from children as the main behavioral drivers for following appropriate hand hygiene behaviors. We then conducted surreptitious observations of hand hygiene behaviors among outpatients and visitors before intervention delivery during Wave 1 and Wave 2 of the pandemic (Phase 1 and Phase 2, respectively), after installation of the hand gel dispensers alone (Phase 3), and after attaching behavioral nudge signs to the dispensers (Phase 4). Results: The probability of appropriate hand hygiene behavior increased from 0.6 percent in Phase 1 to 13.5 percent in Phase 4. However, the increase was statistically significant only from Phase 2 to Phase 3 in the zones where the dispensers were located (adjusted odds ratio 10.58;95% confidence interval 1.95, 57.24). Conclusion: The probability of appropriate hand hygiene behavior after installation of the dispensers was significantly higher than at pre-intervention, but the difference in appropriate hand hygiene before and after attachment of the nudges to the dispensers was not statistically significant. The study findings could nonetheless contribute empirical evidence on observed changes in hand hygiene behaviors in a primary care setting. © 2022 JHSMR. Hosted by Prince of Songkla University. All rights reserved.
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Aim. To assess the prevalence of non-alcoholic fatty liver disease (NAFLD) using the liver obesity index - FLI (Fatty Liver Index), and to study its associations with socio-demographic indicators and behavioral risk factors for NAFLD. Material and methods. The data from the multicenter ESSE-RF study (Epidemiology of cardiovascular diseases in the regions of the Russian Federation) - samples from the unorganized male and female population aged 25-64 years were used. 5,161 respondents were included, of which 2,275 (44,1%) were men. To assess the prevalence of NAFLD, the liver obesity index FLI was used, calculated according to the formula by Bedogni G, et al. (2006). A high FLI index =60 was considered a predictor of liver steatosis. Results. High FLI =60 was detected in 38,5% of men and 26,6% of women. Multivariate analysis of associations of high FLI index in men and women showed a strong relationship with age: men - odds ratio (OR) 5,01, 95% confidence interval (CI): 3,82-6,59 (p<0,0001) and women - OR 8,58, 95% CI: 6,39-11,64 (p<0,0001), living in rural areas: men - OR 1,32, 95% CI: 1,06-1,63 (p=0,011) and women - OR 1,4, 95% CI: 1,15-1,71 (p=0,001). The FLI index >=60 was significantly associated with low physical activity (p=0,001) in men and current smoking in women (p=0,013). Conclusion. A high FLI index >=60 is most common among men, significantly associated with age, living in rural areas, currently smoking women, and low physical activity men. Higher education, in relation to FLI >=60, had a protective effect on women. Copyright © 2022 Vserossiiskoe Obshchestvo Kardiologov. All rights reserved.
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BACKGROUND: Longitudinal evidence on how Internet use affects the psychological wellbeing of older adults has been mixed. As policymakers invest in efforts to reduce the digital divide, it is important to have robust evidence on whether encouraging Internet use among older adults is beneficial, or potentially detrimental, to their wellbeing. METHODS: We observe depressive symptoms and loneliness of adults aged 50 + in the nationally representative English Longitudinal Study of Ageing, from before (2018/19) to during the coronavirus disease 2019 (COVID-19) pandemic (June/July and November/December 2020). Our quasi-experimental difference-in-differences strategy compares within-individual wellbeing changes between older adults who desired to use the Internet more but experienced barriers including lack of skills, access, and equipment, with regular Internet users who did not desire to use the Internet more. To reduce selection bias, we match both groups on demographic and socioeconomic characteristics that are predictive of Internet use. We assume that in the absence of COVID-19 - a period of increased reliance on the Internet - the wellbeing trajectories of both groups would have followed a common trend. RESULTS: Compared with matched controls (N = 2983), participants reporting barriers to Internet use (N = 802) experienced a greater increase in the likelihood of depressive symptoms from before to during the pandemic, but not worse loneliness levels. This effect was stronger for women, those aged above 65 years, and those from lower-income households. CONCLUSIONS: Besides enabling access to digital services, efforts to ensure older adults continue to be engaged members of an increasingly digital society could deliver returns in terms of a buffer against psychological distress.
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Background: Vaccines to prevent SARS-CoV-2 infection are considered the most promising approach for curbing the pandemic. There are many concerns about the effectiveness of vaccination in patients with multiple sclerosis (MS). Few studies have examined the effectiveness of mRNA COVID vaccine in MS patients treated with high potency disease modifying therapies (DMTs). The aim of this study was to evaluate the efficacy of BBIBP-CorV (Sinopharm) vaccine in patients treated with 7 different DMTs. Material(s) and Method(s): This quasi-experimental study was conducted on the patients of MS clinics of Imam Hossein hospital in Tehran (capital of Iran) and Ghaem hospital in Mashhad (northeast of Iran). MS patients with:1- no history of COVID infection in the past 6 month, 2- no history of relapse or steroid use in the past 4 weeks, 3- regular use of a DMT for at least 6 months (9 month for glatiramer acetate) and 4- at least 2 months interval between the previous rituximab infusion and vaccination, were enrolled and vaccinated with Sinopharm vaccine (2 doses, 4 weeks apart). In the case of relapse, COVID infection, or If any of the antibodies (anti neucleocapsid IgM and IgG and anti RBD IgG) were positive at the first injection of the vaccine, the patient was excluded from the study. The amount of IgG class antibodies against virus RBD were measured using ELISA SARS-CoV-2 IgG DIAZIST after 28 days of the first vaccination and on the day 56 (28 days after the second vaccination). An index value higher than 1.1 was considered reactive for anti RBD antibodies. Result(s): Out of the 208 patients included in the study, 91 patients were excluded and 117 patients were finally analyzed. Humoral response to vaccination based on the DMT used by the patient was as follows: beta interferons: 89.47% (17 out of 19 patients), dimethyl fumarate: 85.71% (12 out of 14 patients), patients without DMT treatment:83.33% (5 out of 6 patients), Natalizumab 83.33% (5 out of 6 patients), glatiramer acetate:71.42% (5 out of 7 patients), teriflunomide: 50% (4 out of 8 patients), rituximab: 38.46% (15 out of 39 patients), and fingolimod: 21.05% (4 out of 19 patients). Conclusion(s): According to our findings, the response to vaccination is maintained in patients treated with beta interferons, dimethyl fumarate and natalizumab, but is less than acceptable in patients treated with rituximab and fingolimod.
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Introduction: Among the CDC's Core Elements of Outpatient Antibiotic Stewardship is tracking antibiotic prescribing and reporting back to providers. Feedback and audit systems allow for targeted identification of prescribing issues. Prior studies have been conducted mostly in primary care or pediatric clinics. Research Question or Hypothesis: Do antibiotic prescribing dashboards and feedback decrease antibiotic prescribing rates and alter antibiotic class prescribing across multiple specialty clinics? Study Design: Quasi-experimental study in multiple outpatient clinics and survey. Methods: Seven clinics with high levels of antibiotic prescribing were identified for intervention. Seven low prescribing clinics and one offsite clinic were monitored for comparison. Antibiotic prescribing data was used for the creation of quarterly dashboards and feedback reports. Baseline reports were sent in October 2020 and then each subsequent quarter. January through September 2020 was considered baseline and October 2020 to June 2021 was intervention. Quarter 1 (Q1) of 2020 and 2021 were compared to correct for seasonality and COVID19. Prescribers who received dashboards received a survey to reflect upon the intervention. Antibiotic prescriptions per 1000 visits (Rx/1000) were evaluated compared to baseline for total and antibiotic classes using chi-square goodness of fit in SPSS. Results: Antibiotic prescribing decreased in the entire intervention group (93.76 to 73.35 Rx/1000), but this was not significant (p=.104). Control also did not change significantly from baseline (p=0.114). Similar results were seen comparing Q1-2020 and Q1-2021. No antibiotic class varied significantly in the intervention group. When considering individual clinic performance, 2 of 7 intervention clinics decreased prescribing, significantly. When comparing Q1-2020 and Q1-2021, 5 of 7 clinics decreased significantly. Based on the survey, prescribers (n=24) felt they prescribed less (67%), prescribed better durations (71%), and chose better empiric antibiotics (57%). Conclusion: While overall prescribing did not decrease significantly, total or by class, select clinics did when accounting for seasonality. However, providers felt that they were making better prescribing decisions.
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Introduction/Rationale: People with multiple chronic diseases, such as heart failure (HF) or chronic obstructive pulmonary disease (COPD), are at elevated risk of unplanned repeated hospitalization. Transitional care has been recognized as reducing unexpected rehospitalization after discharge from hospital to home. As the COVID-19 pandemic is prolonged, individual home healthcare services are getting increased attention for post-acute care. However, less is known about the effectiveness of nurse-led transitional care programs, including home-visit intervention. Objectives: This study aimed to identify the effectiveness of nurse-led home-visit transitional care programs in improving health service utilization, functional status, and quality of life (QoL) among people discharged from hospital to home. Methods: We conducted a scoping review of the EBSCOMedline, Cochrane Library and Embase databases searching for articles containing a combination of “home care,” “transitional care,” and “care coordination” between 1973 and 2021. Inclusion criteria were: randomized controlled trials (RCTs) or quasi-experimental studies, adults who need continuing healthcare after discharged to home, and affecting at least one of the following outcomes: hospital readmission, functional status, and QoL. Results: Initial searching identified 1552 potential records, 1328 s were screened, and 105 full texts were retrieved. A total of 16 studies met the selection criteria. Seven studies were conducted in North America and most were RCTs (n=14). Most participants (mean=73 years) had multiple chronic diseases, such as stroke, COPD, or HF. Regarding discharge plans, two-thirds of the studies included a pre-and a post-discharge plan (n=11). All studies included a home-visit intervention regularly or as needed over a period from one week to two years. Intervention team providers were the research team only (n=2), a collaboration with a hospital team (n=4), a community team (n=4), or a hospital team plus a community team (n=6). Hospital readmissions were assessed in 12 studies and found to be significantly lower in the intervention group (n=4). Physical function status was assessed in seven studies and was significantly better in the intervention group (n=2). QoL was assessed in eight studies and was significantly greater in the intervention group (n=3). Conclusions: About 30% of the studies reported that home-visit transitional care interventions had positive effects on hospital readmissions, physical function status, and QoL. More studies are required to include patient engagement and the use of technology, such as telehealth, in transitional care plans to improve selfcare at home.
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During the novel COVID-19 pandemic, many universities globally shifted from on-campus-based teaching to online education. During this emergency educational situation, modifications are done abruptly. Important elements of education that contribute to student success need to be carefully monitored. This study analyzed the effect of sudden shift to e-learning during the COVID-19 pandemic on student engagement. The study involved the same group of students who used to learn in the traditional classroom before the pandemic and shifted to online education during the pandemic. A 5-point Likert scale online survey was created using Google form and the link was sent to students Emails. Two validated questionnaires were used, one for measurement of student engagement in e-learning and the other for measurement of engagement in the traditional classroom. Factor analysis of the two questionnaires showed good results. Values of Alfa Cronbach were greater than 0.85. Values of validity were higher than 0.9. Both values indicated the high reliability and validity of the questionnaires. The Wilcoxon signed test showed that students were significantly less engaged in the e-learning (p-value 0.006). Emotional, behavioral, and social engagement were lower in e-learning (p-values 0.001, 0.001, 0.024, respectively). However, cognitive engagement was higher in e-learning (p-value 0.001). The sudden shift to online education during COVID 19 pandemic was associated with decreased but differential effects on student engagement. Institutions should carefully monitor student engagement and implement practices that improve it during this contingency situation.
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Objective(s): A quasi-experimental design, using one group, test-retest approach, is employed to determine the effectiveness of education program on high school female students' knowledge about coronavirus disease in Al-Diwanyia City from October10th2021 to April 2nd2022. Methodology: A non-probability, purposive sample of (30) high school female student, is selected for the purpose of the study. All subjects have signed consent form to present their agreement for participation in the study. The confidentiality of the data is also safeguard and they will be securely maintained during and after conducting the study. An education program and selfreport questionnaire are constructed for the purpose of the study through review of related literature. The program is comprised of (4) lectures and the questionnaire is consisted of (2) main parts;the high school female students' demographic characteristics and high school female students' knowledge about coronavirus disease questionnaire. Content validity is determined for the education program and the study instrument through panel of experts and test-retest reliability is obtained for the study instrument in a pilot study. Data are gathered through the use of the study instrument as mean of data collection and analyzed through the application of descriptive statistical data analysis and inferential statistical data analysis approaches. Results: The study results depict that all high school female students' knowledge about coronavirus disease has been improved as being exposed to the education program. Conclusion: The study concludes that the education program is confirmed to be an effective mean for improving high school female students' knowledge about coronavirus disease. Recommendation: The study recommends that the education program can be utilized as an educational mean for enhancing the high school female students' knowledge about coronavirus disease and further and a nation-wide research can be conducted with large sample size and wide-range scale of variables.
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Background: Around one and half years ago in the December of 2019 a flu like disease emerged in the city Wuhan located in China. This was termed by WHO as a global pandemic due to its rapid widespread. Aim: To compare the efficacy of high dose dexamethasone (8 mgx tds) vs low dose methylprednisoslone (100 mgx bd) therapy for two weeks, in resolution of acute inflammatory markers in patients with covid pneumonia. Study Design: Quasi experimental study. Methodology: Patients (n=72) with an age range of 18-70 years with Covid 19 PCR positive having Covid associated pneumonia were enrolled. Group 1 containing 36 patients receiving high dose dexamethasone (8 mgx TDS) and group 2 with 36 participants receiving low dose methylprednisolone (100 mgx BD). Inflammatory markers (CRP, ESR and Ferritin) were recorded on Day 1 (T1) on day 7 (T2) and day 14 (T3). Patients who required ventillatory support and those who died was also recorded.All this information was recorded on Performa. Data was analyzed using SPSS version 26. Results: Mean age of the patients was 50.11±11.7 years. When we compared the inflammatory markers among group 1 and group 2 at T1, T2 and T3 no statistically significant difference was obtained. Conclusion: It was concluded that high dose dexamethasone and low dose methylprednisoslone therapy for two weeks were equally effective in resolution of acute inflammatory markers in patients with covid pneumonia.