scholarly journals Impact of community participation on treatment outcomes and compliance of DOTS patients in Iraq

2003 ◽  
Vol 9 (4) ◽  
pp. 709-717
Author(s):  
A. D. Niazi ◽  
A. M. Al Delaimi
Keyword(s):  
Treatment Outcomes ◽  
Community Participation ◽  
Health Centre ◽  
Intervention Group ◽  
Control Group ◽  
Local Health ◽  
Directly Observed Therapy ◽  
Conversion Rates ◽  
Local Health Centre ◽  
At Home

We assessed the effect of community participation on treatment outcomes for tuberculosis patients undergoing directly-observed therapy, short course [DOTS]. From February to December 2001 172 newly diagnosed patients in Baghdad were allocated into 2 treatment groups. The intervention group were visited daily at home for the 2-month initial phase by trained members of the Iraqi Women’s Federation while the control group attended the local health centre for treatment. Cure rates for patients treated at home were significantly better than controls [83.7% versus 68.6%], so too was compliance [100.0% versus 14.0%]. Smear conversion rates were significantly better in intervention cases compared with controls at all stages. Default rates were similar in both groups [11.6% versus 10.5%], as was mortality [1 patient each]

scholarly journals Knowledge, Attitude, and Skill of Family to Treat Elderly with Diabetes Mellitus at Home through the Empowerment of Elderly Cadre in Lampung

2021 ◽  
Author(s):  
Komang Achjar ◽  
Dwi Agustanti ◽  
Sri Parasitha ◽  
Moses Glorino Rumambo Pandin
Keyword(s):  
Diabetes Mellitus ◽  
Intervention Group ◽  
Sampling Technique ◽  
The Elderly ◽  
T Test ◽  
Control Group ◽  
Attitude Score ◽  
Control Group Design ◽  
Significant Difference ◽  
At Home

Diabetes is a chronic disease that often causes progressive complications in the elderly. Along with the decline in cognitive function in the elderly, it causes dependence on disciplined management of diabetes mellitus. This dependence causes a very important mentoring role to be given. The purpose of this study is to provide knowledge, attitudes, and family skills to care for the elderly with diabetes mellitus at home through the empowerment of elderly cadres in Lampung. This research method is a quasi-experimental research with a control group design with a total of 64 elderly respondents and 64 families selected by simple random sampling technique. The assessment used an instrument for assessing family abilities that the researcher developed included aspects of knowledge, attitudes, and skills. The results of the dependent t-test analysis showed a significant increase in the knowledge and skills variable in the intervention group (0.000) but decreased in the attitude variable with p 0.198. Meanwhile, the increase in value also occurred in the attitude and skill variables in the control group. So that the results of the independent t-test only showed a significant difference in the attitude score (0.000) with the highest score in the control group. So that there is no significant increase in the ability of the family after the implementation of elderly cadres empowerment.

scholarly journals Breast Screening Reminder Letters and Phone Calls to Women in Their Language

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 39s-39s
Author(s):  
M. Scanlon ◽  
V. Pridmore ◽  
M. Davis ◽  
A. Cooper ◽  
A. Beauchamp ◽  
...  
Keyword(s):  
Breast Screening ◽  
Intervention Group ◽  
Target Population ◽  
Control Group ◽  
Reminder Letter ◽  
Breast Screen ◽  
Phone Calls ◽  
Italian Women ◽  
Reminder Letters ◽  
At Home

Background: BreastScreen Victoria (BSV) provides free breast screening to women aged 40+; targeting women aged 50-74. The program reduces breast cancer-related deaths by up to 28%. BSV aims to ensure equitable participation by all women in the target population. However, women from Arabic and Italian speaking backgrounds have lower breast screening participation compared with English-speaking women. A needs analysis involving consultation with Arabic and Italian speaking women found that invitation letters and calls are important enablers to breast screening, however language is a barrier. Women suggested sending reminder letters and making outbound reminder calls in their language. Aim: The aim of this study was to determine whether, and to what extent, reminder letters and phone calls in language resulted in increased screening rates in Arabic and Italian women. Methods: Two randomized control trials ran in 2017. TRIAL 1: Women due for a routine breast screen who speak Italian or Arabic at home were randomized into one of two trial arms: women in the intervention arm received a reminder letter in language (with the English version enclosed also), and women in the control arm received a reminder letter in English only. 1032 women were included in the study; comprising 322 Arabic and 710 Italian women. TRIAL 2: Lapsed women (had not had a breast screen within 27 months) who speak Italian or Arabic at home were randomized into one of two trial arms: women in the intervention arm received an outbound call in language inviting them to book an appointment; women in the control arm did not receive a call. 219 lapsed screeners were included; comprising 93 Arabic and 126 Italian women Results: TRIAL 1: • Women in the intervention arm more frequently booked (61.2%) compared with the control group (59.8%). However, this difference was not statistically significant. • For Italian women, 64.5% in the intervention group and 66.2% in the control group booked a screening appointment within 30 days of the mail out. Among Arabic women, the rates were 53.1% and 47.5% respectively. TRIAL 2: • Women in the intervention group were 10.7 times more likely to make a booking (42.9%) compared with the control group (4%). The effect was larger for Arabic than for Italian women. Conclusion: Sending reminder letters to Italian and Arabic women in their own language did not result in a statistically significant increase in bookings. Making reminder phone calls to Italian and Arabic women in their own language did result in a large, statistically significant increase in bookings and attendance.

scholarly journals A Phase 1 Randomized Controlled Trial of an At-Home Positive Psychology Intervention for Individuals with Multiple Sclerosis

2020 ◽  
Author(s):  
Melanie E. Freedman ◽  
Brian C. Healy ◽  
Jeff C. Huffman ◽  
Tanuja Chitnis ◽  
Howard L. Weiner ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Positive Psychology ◽  
Controlled Trial ◽  
Phase 1 ◽  
Intervention Group ◽  
Well Being ◽  
Control Group ◽  
Randomized Controlled ◽  
Phone Calls ◽  
At Home

Abstract Background: Positive psychology (PP) uses targeted activities to increase the frequency and intensity of positive feelings and may improve overall well-being in medically ill populations. In this pilot study, we examined the feasibility, acceptability and potential impact of a five-week, telephone-delivered, PP intervention for individuals with multiple sclerosis (MS). Methods: Participants were randomized 1:1 to a five-week at-home PP intervention or waitlist control condition. Participants engaged in weekly phone calls with a study trainer and completed one PP exercise, such as recalling a past success, each week. Feasibility was determined by the number of sessions completed, and acceptability was assessed by weekly post-exercise participant ratings (0–10) of ease and utility. Efficacy was explored by examining between-group differences in changes from baseline on psychological variables, health-related quality of life (HRQOL), and self-reported functional activities at five and ten weeks. Results: Thirty patients enrolled in the study. Ninety-three percent of participants (n = 28) completed all exercises. Ease scores ranged from 7.7–8.7 and utility scores ranged from 8.2–8.7. The PP intervention was associated with significantly greater increases (P < .05) in positive affect, optimism, state and trait anxiety, general health, and resilience in the intervention group compared to the control group. Approximately half of the PP participants maintained ≥ 50% of the improvement at 10 weeks. Conclusions: This five-week, telephone-based PP intervention was feasible and acceptable to individuals with MS. Larger randomized controlled trials are warranted to further investigate the utility of this intervention to improve well-being and other health outcomes in MS.

scholarly journals Results from HART-c: innovations in prehospital triage for acute cardiac symptoms, a multicentre prospective study

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
E R De Koning ◽  
S L M A Beeres ◽  
J Bosch ◽  
B E Backus ◽  
W J Tietge ◽  
...  
Keyword(s):  
Real Time ◽  
Intervention Group ◽  
Control Group ◽  
Case Review ◽  
Hospital Data ◽  
Study Objective ◽  
Coronary Syndrome ◽  
Cardiac Symptoms ◽  
Prehospital Triage ◽  
At Home

Abstract Introduction Cardiac symptoms are one of the most prevalent reasons for emergency department (ED) visits [1], however most of these patients do not have acute cardiovascular disease. This leads to ED overcrowding which subsequently leads to worse patient outcomes and increased costs [2,3]. Attempts to reduce overcrowding have focused mostly on in-hospital triage. The Hollands-midden Acute Regional Triage – cardiology (HART-c) study uses a newly developed triage platform which includes live monitoring, real-time admission capacity, in-hospital data and cardiologist consultation for improved prehospital triage. Purpose The HART-c study aims to safely increase the percentage of patients with cardiac symptoms not referred to the hospital after emergency medical service (EMS) consultation. Methods Patients aged 18 years or older visited by the EMS for cardiac symptoms were included in the region Hollands-Midden from September 2019 till March 2020 (non-COVID period) and compared with the year earlier. Patients were excluded when primary PCI was indicated. EMS consultation consisted of medical history, physical examination, vital parameters and ECG. All data were transferred to a newly developed platform combining pre-hospital data, shown in real-time, and hospital data, such as medical records and admission capacity. The paramedic contacted an on-call triage cardiologist and decided whether admission was necessary and, if so, which regional hospital was most appropriate (figure 1). The study objective was defined as the percentage of patients not referred to the hospital after EMS consultation. Safety of the triage method was defined in the non-referred patients in the intervention as the percentage of MACE (death and acute coronary syndrome) 30 days after non-referral. Results In the intervention group 1755 patients (age 69±15 years, 53% men), and in the control group 1629 patients (age 68±15 years, 53% men) were consulted by the EMS during the HART-c study. In the intervention group 11.4% of patients consulted to the EMS were left at home, compared to 5.5% in the control group (figure 2). Logistic regression was performed to evaluate the effect of the triage intervention. The model was corrected for gender, age and seasonal changes. The chance of being left at home after EMS consultation was 2.29 (95% CI 1.73–3.02, p<0.001) times higher in the intervention group compared to the control. All patients left at home in the intervention group and their GP's were contacted for adverse events, after case-by-case review the MACE rate was <1%. Furthermore a decrease in interhospital transfers was seen, from 206 in the intervention to 173 in the control. Conclusion Implementation of an innovative triage method successfully increased the percentage of patients with cardiac symptoms safely left at home. FUNDunding Acknowledgement Type of funding sources: None. Triage without (A) and with (B) platform Non-referral in intervention and control

scholarly journals Mobile Phone Virtual Reality Game for Pediatric Home Burn Dressing Pain Management, a Randomized Clinical Trial

2022 ◽  
Author(s):  
Megan Armstrong ◽  
Jonathan Lun ◽  
Jonathan I Groner ◽  
Rajan K Thakkar ◽  
Renata Fabia ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Virtual Reality ◽  
Randomized Clinical Trial ◽  
Intervention Group ◽  
Ease Of Use ◽  
Control Group ◽  
Perceived Pain ◽  
English Speaking ◽  
Dressing Change ◽  
At Home

Importance: Virtual Reality (VR) gaming is considered a safe and effective alternative to standard pain alleviation in the hospital, we advocate for its use during repeated redressing at home. Objective: This study will address the effectiveness and feasibility of the Virtual Reality Pain Alleviation Tool (VR-PAT) that was developed by the research team for repeated at-home burn dressing changes. Design, Setting and Participants: Randomized clinical trial among patients recruited at the Nationwide Childrens Hospital (NCH) outpatient burn clinic between September 2019 and June 2021. We included English-speaking burn patients 5-17 years old requiring daily dressing changes for at least one week after first outpatient dressing change. Interventions: One group played an interactive VR-PAT game during dressing changes, while the other utilized standard distraction techniques available in the home for a week. Both child and caretaker were later asked to assess perceived pain. Those in the intervention group were asked to evaluate convenience and enjoyment of the VR-PAT game. Outcomes: Patients were asked to rate perceived pain on a scale of 1-10, and caregivers were asked to rate observed pain on a scale of 1-10. For the VR-PAT group, patients were also asked to rate various aspects of the VR game on a scale of 1-10 and caregivers were asked questions assessing ease of use. Conclusions: Subjects found the VR-PAT to be a useful distraction during home dressing changes and reported it be easy to implement. In the VR-PAT group, child and caregiver reported pain decreased as the week of dressing changes progressed and was lower than those in the control group after the fourth dressing change. Children playing the VR-PAT reported consistent happiness and fun as the week went on and increased realism and engagement, which means our results were not just due to the novel experience of VR-PAT.

Community Case Study: Suicide Cluster in a Small Manitoba Community

1998 ◽  
Vol 43 (8) ◽  
pp. 823-828 ◽  
Author(s):  
Clarke Wilkie ◽  
Sharon Macdonald ◽  
Keith Hildahl
Keyword(s):  
Suicidal Ideation ◽  
First Nations ◽  
Suicide Attempts ◽  
Health Centre ◽  
Public Health Problem ◽  
Local Health ◽  
Local Health Centre ◽  
Treatment Plans ◽  
Suicide Cluster ◽  
Nations Community

Objectives: To review a cluster of suicides and suicidal ideation in a First Nations community. Method: The medical records and autopsy reports of the victims are reviewed. Collateral information obtained in the community is presented. A series of psychiatric assessments conducted at the local health centre in a 3-day period is outlined. The dilemma of developing appropriate treatment plans is discussed. Results: In the period from February 3 to May 5, 1995, an isolated northern Manitoba First Nations community had 6 suicides in a population of less than 1500. Several other suicide attempts occurred. Community resources were strained. Alcohol was a factor in 4 of the suicides. Previous sexual assault was cited in 4 of 5 female cases presenting with suicidal ideation. Conclusions: Cluster suicide is a shared psychiatric and public health problem of major concern. Dreams of beckoning are common following a suicide. Communities should have a prepared plan to deal with a suicide. Resources should be provided quickly in an effort to prevent a cluster of suicides from occurring. High-risk individuals must be identified. Substance abuse must be addressed. Resources to assess and treat victims of sexual abuse must be available.

EFFECT OF INBREEDING ON WEIGHT GAIN OF OFFSPRING FROM BIRTH TO 12 MONTHS AFTER BIRTH: A STUDY FROM IRAN

2009 ◽  
Vol 42 (2) ◽  
pp. 195-200 ◽  
Author(s):  
SAMANE NAFISSI ◽  
MARYAM ANSARI-LARI ◽  
MOSTAFA SAADAT
Keyword(s):  
Weight Gain ◽  
Parental Education ◽  
Health Centre ◽  
Repeated Measurements ◽  
Local Health ◽  
Fars Province ◽  
Child Health Outcomes ◽  
Local Health Centre ◽  
Study Population ◽  
Low Prevalence

SummaryConsanguinity, the marriage between relatives, has been associated with adverse child health outcomes. The objective of the present study was to assess the effect of consanguinity on offspring weight gain from birth to 12 months after birth. Data were collected on 250 consecutive live-born singleton newborns referred to a local health centre in Shiraz (Fars province, southern Iran). Collected data covered socio-demographic characteristics (such as parental age at delivery and parental education), sex, birth order, weights from birth to 12 months after birth and consanguinity of marriages of parents. Considering the low prevalence of double first cousin, first cousin once removed, second cousin, and beyond second cousin marriages, only first cousin and unrelated marriages were included in the study. The study population consisted of a total of 207 newborns (57 offspring of first cousins, 150 offspring of unrelated marriages). Based on the results of repeated measurements analysis of variance, weight gain was associated with type of marriage (p=0.018), sex of offspring (p=0.001) and paternal education (p<0.001). There was no interaction between type of marriage and sex (p=0.831). Birth weight was not affected by type of marriage (p=0.46). There was significant interaction between inbreeding and time (p=0.034). Offspring of consanguineous marriages showed lower weight gain in comparison with those of unrelated marriages during 3–12 months after birth.

scholarly journals Consuming Mung Beans (Phaseolus radiatus L.) Increase Hemoglobin Levels among Pregnant Women with Anemia in The Second Trimester at Klenang Public Health Centre, Probolinggo District

2021 ◽  
Vol 14 (3) ◽  
pp. 250-256
Author(s):  
Tutik Hidayati ◽  
Roviatun Holila
Keyword(s):  
Pregnant Women ◽  
Health Centre ◽  
Intervention Group ◽  
Control Group ◽  
Second Trimester ◽  
Control Group Design ◽  
Public Health Centre ◽  
Measuring Device ◽  
Significant Difference ◽  
Quasi Experimental

Anemia in pregnancy is a pregnant mother with hemoglobin levels below 11g/dL in the first and third trimesters or hemoglobin levels less than 10.5 g/dLin the second trimester. This paper investigates the effect of consuming mungbeans (Phaseolus radiatus L.) on hemoglobin levels in the Second trimester ofpregnant women with anemia. This research used a quasi-experimental designwith randomized pretest-Posttest with a control group design. The populationwas 37 pregnant women in the second trimester who experienced anemia atKlenang PHC. Meanwhile, the sample was 34 respondents by simple randomsampling. The independent variable was consuming mung beans, while thedependent variable was the hemoglobin levels. In the control group, theauthors observed the consumption of Fe tablets once a day for 20 days in 17respondents. While in the intervention group, we monitored the consumptionof Fe tablets once a day and were given mung bean juice every day for 20days in 17 respondents. The instrument used an observation sheet and a digitalhemoglobin measuring device. Then, data analysis utilized the paired samplet-test with a significance of 0.05. After consuming mung beans and Fesupplements, the average hemoglobin levels in the intervention group were12.1588g/dL. Meanwhile, in the intervention group, after Fe observation were10.6412d/dL. There was a significant difference between the control andintervention groups p=0.000 (p<0.05). In conclusion, consuming mung beansincreases hemoglobin levels among pregnant women with anemia in thesecond trimester.

scholarly journals A randomized controlled trial of the effect of supervised progressive crosscontinuum strength training in older medical patients: the STAND-Cph trial

2019 ◽  
Author(s):  
Mette Merete Pedersen ◽  
Janne Petersen ◽  
Nina Beyer ◽  
Helle Gybel Juul-Larsen ◽  
Pia Søe Jensen ◽  
...  
Keyword(s):  
Strength Training ◽  
Intervention Group ◽  
Lower Extremities ◽  
Protein Supplementation ◽  
Secondary Outcome ◽  
Control Group ◽  
Medical Patients ◽  
Daily Number ◽  
Secondary Outcomes ◽  
At Home

Abstract Background: During hospitalization, older adults (+65) are inactive, which puts them at risk of functional decline and loss of independence. Systematic strength training can prevent loss of functional performance. However, we lack knowledge about the effect of strength training commenced during hospitalization and continued after discharge in older medical patients. This assessor-blinded, randomized study investigated the effect of a simple, supervised strength training program for the lower extremities, combined with post-training protein supplementation during hospitalization and 4 weeks at home after discharge on change in mobility in older medical patients. Methods: Older medical patients (≥65 yrs) admitted acutely from their home to the Emergency Department were randomized to either standard care or supervised progressive strength training and an oral protein supplement during hospitalization and at home 3 days/week for 4 weeks after discharge. The primary outcome was between-group difference in change in mobility from baseline to 4 weeks after discharge assessed by the De Morton Mobility Index. Secondary outcomes were 24-hour mobility, lower extremity strength, gait speed, grip strength and Activities of Daily Living. Results: Eighty-five patients were randomized to the intervention (N=43) or control group (N=42). In the intervention group, 43% were highly compliant with the intervention. Our intention to treat analysis revealed no between-group difference in mobility (difference baseline to 4 weeks: -4.17 (IQR -11.09;2.74; p=0.24) nor in any of the secondary outcomes. The per protocol analysis showed that the intervention group increased significantly more in the daily number of steps taken compared to the control group (difference in change from baseline to 4 weeks: 1024.7 steps (IQR 0.7;2048.6); p<0.05; adjusted for mobility at baseline). Conclusions: Simple supervised strength training for the lower extremities, combined with protein supplementation initiated during hospitalization and continued at home for 4 weeks after discharge was not superior to usual care on change in mobility at 4 weeks in older medical patients. For the secondary outcome, daily number of steps, high compliance with the intervention resulted in a higher daily number of steps. Less than half of the patients were compliant with the intervention indicating that a simpler intervention might be needed. Trial registration: NCT01964482, https://clinicaltrials.gov/ct2/show/NCT01964482, registration date: October 14, 2013, trial protocol: PubMed ID (PMID): 27039381.

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