Care Check-up Research Articles

Lived experiences of women who survived from pre-eclampsia and eclampsia in public hospitals of Shashemene Town, Oromia Region, Ethiopia: a qualitative study.

Objective: The main purpose of this study was to explore experiences of women who survived pre-eclampsia and eclampsia in Shashemene referral hospital and Melka Oda general hospital, 2021. Design: An institution-based exploratory qualitative study with a descriptive phenomenological study design Setting: The present study was conducted in Shashemene referral hospital and Melka Oda general hospital from March 03 to May 18, 2021. Participants: A total of 17 individual in-depth interviews (IDIs) were conducted with women who experienced and survived pre-eclampsia and eclampsia. Data were analyzed through thematic analysis using Atlas-ti software. Result: The present study revealed that women’s level of awareness on raised blood pressure and or convulsion occurring during pregnancy was poor. Barriers that limit pregnant women from getting treatment at the earliest point included misconception, lack of insight, failure to accept counseling from health care providers, low income, and influence from husbands. Discussions with the women in this study showed that these mothers were not counseled on danger signs during antenatal care check-ups. Almost all of the women were very concerned and frustrated due to their diagnosis. Conclusions: Women’s awareness of pre-eclampsia and eclampsia was poor and antenatal care was not offered as per expected quality. Improving awareness of hypertensive disorders in pregnancy and enhancing the quality of antenatal care is essential.

The primary nursing model of remote monitoring in patients with implantable cardiac devices (CIED)

Abstract Introduction The treatment of cardiac pathologies with devices has led to an exponential increase in patients with CIED, who need more frequent, more careful check-ups, with a consequent increase in the number and clinical complexity of patients who refer to cardiac stimulation centers. Aim The use of remote monitoring makes it possible to have a continuous flow of information relating not only to the performance of the device but also to clinical events such as arrhythmias and heart failure without the need for direct contact, drastically reducing hospital accesses and at the same time promptly detecting any critical issues that require intervention in a more or less short time. The benefits of remote monitoring, as we have seen over the years, intervene at multiple levels, economic, social and clinical. Materials and methods Numerous studies have shown how remote monitoring can replace outpatient check-ups without compromising patient safety, reducing resource consumption, while scheduling at least one outpatient follow-up per year as recommended by international guidelines. With the introduction of telecardiology and remote monitoring in clinical practice, new organizational models have been implemented, which harmonize and codify the activity of the various professionals involved in the diagnostic and therapeutic process. This model must guarantee a precise definition of roles and responsibilities, traceability of actions, continuity of care, low consumption of resources, patient satisfaction and acceptance, integration with traditional hospital and out-of-hospital diagnosis and treatment pathways. A model that encompasses all these peculiar features is the PRIMARY NURSE MODEL. Primary nursing is a relationship based and resource driven system of care delivery, the building blocks are: attribution and acceptance by each individual of personal responsibility in making decisions; assignment of day to day care according to the case method; direct person to person communication; a person operationally responsible for the quality of care provided to patients. The decentralised decision making approach is based on three basic concepts: the nurse's decision making authority, responsibility and accountability. Results and conclusions The real CORE of this model is represented by the responsibility for the decisions made by a single nurse. Then each patient is assigned to a nurse responsible for continuity of care, whose duties include patient and caregiver education and training, website data entry, review of critical case transmissions and assessments, and submission of critical cases to the physician.

Birth Preparedness and Complication Readiness Among Rural Pregnant Women of Tamilnadu: A Cross Sectional Study

Background: Birth preparedness and complication readiness serve as valuable tactics for enhancing the provision of maternal and child care services, consequently reducing morbidity and mortality associated with childbirth. Anticipating childbirth and possessing prior awareness of potential complications enables women to access services promptly. Methods: In 2022, a community-based cross-sectional study was conducted involving a sample of 480 pregnant women. Data on Birth Preparedness and Complication Readiness (BPCR) were gathered using a pretested and standardized questionnaire. Data analysis was performed utilizing SPSS version 20. The questionnaire encompassed inquiries regarding birth preparedness, such as the selection of a health facility, designation of a birth attendant, arrangement for transportation, securing a blood donor, and whether the woman had saved money for delivery. Complication readiness was assessed through questions concerning complications during pregnancy, delivery, and the neonatal period. Results: Out of the 480 pregnant women included in the study, 30.8% were classified as belonging to the upper middle class. Additionally, 55% of the participants had experienced multiple pregnancies, while 74.2% were identified as being in their third trimester. Furthermore, 70% of the women had undergone their initial Antenatal Care (ANC) checkup before reaching 12 weeks of gestation. Despite these demographics, the study found a general lack of awareness regarding Birth Preparedness and Complication Readiness (BPCR) among the participants. Conclusion: The study indicates a low level of birth preparedness and complication readiness within Rural Tamilnadu. To address this issue effectively, targeted health education strategies should be directed towards young couples and adolescent girls, who represent the future mothers. Implementing both individual and community-level interventions focused on birth preparedness and complication readiness has the potential to enhance maternal service delivery and ultimately reduce both morbidity and mortality rates associated with childbirth.

Timely initiation of complementary feeding and associated factors among mothers having children aged 6 to 24 months in North-West Ethiopia: a comparative cross-sectional study

BackgroundThe timely introduction of complementary foods during infancy is necessary for nutritional reasons, and to enable the transition from milk feeding to family foods. In the past years, despite efforts that have been put to increase the utilization of timely initiation of complementary feeding practice in Ethiopia, improvements are not satisfactory.ObjectiveTo compare the prevalence of timely initiation of complementary feeding and its associated factors among mothers who have Children 6–24 months in Debre Tabor town and rural Farta district, North-west Ethiopia, 2021.MethodsA community-based comparative cross-sectional study was employed from December 1/2020 to 30/ 2020 among 1100 mothers. Data were collected using a structured questioner and analyzed using Statistical Product and Service Solutions. Logistic regression analysis with a 95% confidence interval carried out to determine the association between explanatory and the outcome variables. A P-value of < 0.05 was considered statistically significant.ResultsThe prevalence of timely initiation of complementary feeding among urban and rural mothers was 69.8% with (95% CI: 66%, 74%) and 51.9% with (95% CI: 48- 56%) respectively. Urban residence [AOR = 1.39, 95% CI: (1.02–1.94)], had antenatal care visits [AOR = 0.24 (95%CI: (0.13, 0.44)], had post natal care checkups [AOR = 0.44, 95%CI: (0. 27- 0.72)] and being a governmental employee [AOR = 2.82; 95% CI: (1.91–6.1)] were factors associated with timely initiation of complementary feeding among urban mothers. Whereas in rural settings: institutional delivery [(AOR = 2.21, CI: 1.35–3.65)], post natal care checkups [(AOR = 0.53, CI: (0.36–0.77)] being daily laborer [AOR = 3.47; 95% CI: (1.78–6.75)] were associated with timely initiation of complementary feeding.ConclusionThe prevalence of timely introduction of complementary feeding in children aged 6–24 months is still low in the study areas. There was also disparity between urban and rural mothers in which urban mothers practiced better.

School electrocardiography screening program prompts the detection of otherwise unrecognized atrial septal defect in children in Japan.

Atrial septal defect (ASD) is a congenital heart disease that often presents without symptoms or murmurs. If left untreated, children with ASD can develop comorbidities in adulthood. In Japan, school electrocardiography (ECG) screening has been implemented for all 1st, 7th, and 10th graders. However, the impact of this program in detecting children with ASD is unknown. This is a retrospective study that analyzed consecutive patients with ASD who underwent catheterization for surgical or catheter closure at ≤18 years of age during 2009-2019 at a tertiary referral center in Japan. Of the overall 116 patients with ASD (median age: 3.0 years of age at diagnosis and 8.9 years at catheterization), 43 (37%) were prompted by the ECG screening (Screening group), while the remaining 73 (63%) were by other findings (Non-screening group). Of the 49 patients diagnosed at ≥6 years of age, 43 (88%) were prompted by the ECG screening, with the 3 corresponding peaks of the number of patients at diagnosis. Compared with the non-screening group, the screening group exhibited similar levels of hemodynamic parameters but had a lower proportion of audible heart murmur, which were mainly prompted by the health care and health checkups in infancy or preschool period. Patients positive for a composite parameter (rsR' type of iRBBB, inverted T in V4, or ST depression in the aVF lead) accounted for 79% of the screening group at catheterization, each of which was correlated with hemodynamic parameters in the overall patients. The present study shows that school ECG screening detects otherwise unrecognized ASD, which prompted the diagnosis of the majority of patients at school age and >one-third of overall patients in Japan. These findings suggest that ECG screening program could be an effective strategy for detecting hemodynamically significant ASD in students, who are asymptomatic and murmurless.

Early initiation of complementary feeding practice and its associated factors among children aged 6 to 24 months in Northeast Ethiopia

BackgroundEven if there is currently no research on food integration practices, there is an unreliable hole in the data for the first motives, especially 6 to 24 months, research at ages varies in different ways, always, but the child’s development affects an important part of both the child and the parents. This gap limits our comprehensive knowledge of strategic choices and—their potential impact on children’s overall health and well-being. Therefore, the aim of this study was factors shaping complementary feeding for 6 to 24-Month-Olds in Northeast Ethiopia.MethodsA community-based survey was conducted in northeastern Ethiopia from June to July 2022. A sample of 409 mothers with infants aged 6 to 24 months was selected using a simple random sampling method. A structured questionnaire was adopted and data were collected by an interviewer. Collected data were entered into Epi Data version 4.6 and subsequently converted to SPSS version 21 for further analysis. Variables with a P-value < = 0.25 in the bivariate analysis were included in the multivariable logistic regression model. Multivariable logistic regression analyses aimed at identifying independent associations between early initiation of supplement feeding and determinants-adjusted odds ratios with corresponding 95% confidence intervals were calculated to determine the strength of associations. P-values less than or equal to 0.05 were considered statistically significant.ResultsA total of 409 mothers with their children were included in the analysis, revealing a prevalence of 38.1% for early initiation of complementary feeding among children aged 6–24 months. Factors associated with -early initiation included place of residence (Adjusted Odds Ratio (AOR) 3.63, 95% Confidence Interval (CI) 1.1–11.95), husband’s educational status (AOR 16.83, 95% CI 1.98–24.8), maternal occupation (AOR 21.2, 95% CI 1.11–46.9), number of antenatal care (ANC) visits (AOR 25.94, 95% CI 22.7–85.67), initial breastfeeding time (AOR 4.98, 95% CI 1.22–14.9), and medical illness (AOR 2.81, 95% CI 1.12–3.6.ConclusionSignificant associations with Complementary Feeding were identified with the number of antenatal care (ANC) visits, postnatal care (PNC) check-ups, current residency, breastfeeding initiation time, maternal medical illness, and occupational status. To mitigate the early initiation of complementary feeding, it is recommended to enhance ANC/PNC services and educate mothers about the precise timing for introducing complementary foods to their infants.

ANALYSIS OF FACTORS RELATING TO PREGNANT WOMEN'S IRRANGEMENT IN CARRYING OUT PREGNANCY EXAMINATION AT THE KRUENG BARONA JAYA PUBLIC HEALTH CENTER, ACEH BESAR

Pregnancy is a physiological process that requires special attention in efforts to maintain the health of both mother and baby. One of the efforts that can be done is regular antenatal care (ANC) check-ups. However, there are still many pregnant women who have not undergone ANC with the desired regularity. Therefore, this study was conducted to identify factors related to the irregularity of prenatal check-ups. This study is a quantitative analytic study with a cross-sectional approach. The population in this study consisted of 294 pregnant women who had given birth in the Krueng Barona Jaya region, Aceh Besar. The sampling method used total sampling, where out of 294 pregnant women, 7 of them did not have or bring their KIA book, 39 could not be found or contacted, and 3 individuals were unwilling to become respondents. Hence, a total sample of 245 respondents was used in this study. The results of the analysis showed that factors related to the irregularity of ANC check-ups were poor knowledge (OR=15.61; 95% CI=2.50-97.39; P=0.003), lack of media exposure (OR=4.87; 95% CI=1.51-15.70; P=0.008), and previous experience (OR=2.99; 95% CI=1.02-8.76; P=0.046). The conclusion of this study is that knowledge, media exposure, and prior experiences influence the irregularity of prenatal check-ups. Here, prior experiences refer to the healthcare experiences received during previous check-ups or pregnancies. Attitude, as well as pregnancy intentions and planning, do not significantly correlate with irregular ANC check-ups. Therefore, efforts are needed to enhance knowledge and provide better media resources regarding the importance of prenatal examinations, as well as to improve the overall healthcare experience for pregnant women.

Role of Primary Care Clinician Concern During Screening for Early Identification of Autism.

The aim of this study was to evaluate the added value of primary care clinician (PCC)-indicated concern during primary care universal standardized screening in early identification of autism. Toddlers were screened for autism during primary care checkups (n = 7,039, aged 14.24-22.43 months) in 2 studies. Parents completed the Modified Checklist for Autism in Toddlers, Revised, with Follow-Up. For each participant, PCCs indicated whether they had autism concerns (optional in 1 study-before or after viewing screening results, required before viewing screen results in the other). Children at high likelihood for autism from screen result and/or PCC concern (n = 615) were invited for a diagnostic evaluation; 283 children attended the evaluation. Rates of PCC-indicated autism concerns were similar whether PCCs were required or encouraged to indicate concerns. High likelihood of autism indication on both screen and PCC concern resulted in the highest positive predictive value for autism and positive predictive value for any developmental disorder, as well as the highest evaluation attendance, with no significant difference between the positive screen-only and PCC concern-only groups. Although the frequency of PCC-indicated autism concern did not differ significantly based on the child's cognitive level, PCCs were more likely to identify children with more obvious autism characteristics compared with more subtle autism characteristics as having autism. The findings support the recommendation of the American Academy of Pediatrics that both screening and surveillance for autism be incorporated into well-child visits. High likelihood of autism on either screen or PCC concern should trigger a referral for an evaluation.

NIAAA reports primary care checkups “plus” SBIRT works

As the name suggests, screening, brief intervention, and referral to treatment (SBIRT) for alcohol can both identify people who are at risk for, or who have alcohol‐related problems, and for those who need treatment, provide connections, the National Institute on Alcohol Abuse and Alcoholism (NIAAA) reported last week. But more is needed, and a recent study showed that primary care follow‐ups and checkups can work for alcohol use disorder (AUD).

Regional disparities in antenatal care utilization among pregnant women and its determinants in Ethiopia.

Antenatal care primarily focuses on health care checkups, the provision of advice on healthy behaviors, and the delivery of psychological, social, and emotional support for women with pregnancy. The national target set by the Ethiopian government is to achieve 95% of at least four ANC visits. Nevertheless, 43.11% of women had four or more checkups, according to the 2019 Ethiopian Demographic and Health Survey. Despite this achievement, antenatal care visits differ significantly between Ethiopian regions. Consequently, the purpose of this study was to assess regional disparities in pregnant women's utilization of antenatal care and its determinants in Ethiopia. We have used 2019 intermediate Ethiopian Demographic and Health Survey data for analysis. The analysis comprised a total of 3,917 weighted women age 15-49 who had a live birth in the 5 years preceding the survey. Poisson regression analysis was done using SAS software version 9.4. To show the strength and direction of the association, an incidence rate ratio with a 95% confidence interval was used. Variables with a p-value <0.05 were declared as significant factors associated with the number of ANC visits. In Ethiopia, the number of ANC visits differs between regions. With a mean of 4.74 (95% CI: 4.49, 4.99), Addis Ababa reported the highest percentage of ANC visits (82.7%), while the Somali Region reported the lowest percentage (11.3%) with a mean of 0.73 (95% CI: 0.57, 0.88). Maternal age, educational level, religion, household wealth index, place of delivery, and household size show significant associations with the number of antenatal care visits. In Ethiopia, there is the highest regional disparity in the number of ANC visits. The number of ANC visits was influenced by the mother's age, education, religion, household wealth index, place of delivery, and household size. Regarding the ANC visits, there should be initiatives that address the demands of pastoralist and agro-pastoralist communities to increase ANC utilization. As with many other health outcomes, education and low socio-economic status were associated with low ANC visit but these are tied to the overall social development of a country and are not immediately amenable to public health interventions.

An analysis of Psychological Issues during Menopause and its integrative management

Menopause is indeed a normal physiological stage in a woman's life, typically occurring in the late 40s to early 50s, although the exact timing can vary from person to person. This transitional phase is frequently associated with a spectrum of physical, mental and cognitive symptoms. During the menopausal transition, many women commonly encounter physical symptoms like hot flashes, night sweats, vaginal dryness, irregular menstruation, sleep disturbances, depletion of bone health, weight gain and a decrease in sexual desire. Additionally, this phase can contribute to fluctuating hormone levels which can precipitate mental issues like mood swings, anger and irritability, heightened anxiety, loss of self-esteem, loss of confidence, low mood and feelings of sadness or depression. Memory and cognitive changes like forgetfulness and difficulty in concentration are often reported during menopause, sometimes referred to as "brain fog" or "menopausal cognitive impairment." For some, these symptoms serve as early indicators of the onset of this life transition. Integrative management of mental health problems during menopause involves a holistic approach that combines conventional medical treatments with complementary and alternative therapies to address both the physical and emotional aspects of menopausal symptoms. It includes stress reduction techniques, lifestyle modifications, counselling and psychotherapy, dietary supplements, internal- external medications and regular health care check-ups. Many women consider menopause as inherently a negative experience as it comes with various challenges and symptoms. Seeking medical advice and support can help women navigate this transition more smoothly and positively.

Improving health indicators of mothers and newborns by empowering communities in urban slums of Mumbai, Maharashtra, India

Abstract Background: Newborns represent the most vulnerable segment of our society, constituting nearly 30% of all under-5 mortality cases. Despite well-established healthcare systems in metropolitan areas, urban slum dwellers, comprising approximately 50%–60% of the population, often lack access to these services. The Society for Nutrition, Education, and Health Action (SNEHA) operates within urban slums, aiming to enhance health outcomes for mothers and children. At SNEHA, we firmly believe that a healthy society starts with the well-being of mothers and infants. Our organization is dedicated to empowering communities to improve the health status of newborns in urban slums. Material and Methods: As part of the intervention, 7819 households with a population of 35,000 were targeted. SNEHA’s field workers conducted regular visits to these households, providing counseling on breastfeeding immunization and identifying potential health risks. Married women of reproductive age were specifically identified and consistently educated about the significance of early pregnancy registration. Pregnant women received support for registering their pregnancies, attending regular antenatal care (ANC) check-ups, adhering to ANC visit schedules, and maintaining adequate iron, calcium, and nutrition intake. Additionally, they were informed about the advantages of institutional delivery and encouraged to prepare for childbirth. Mothers of children under 2 years were urged to bring them to primary health centers for routine immunizations. Furthermore, they were advised on contraception methods to ensure proper spacing between children. Results: Our endeavors have resulted in a 34% rise in early pregnancy registration, a 22% increase in the number of women attending four antenatal check-ups, an 11% uptick in institutional deliveries, a 24% improvement in exclusive breastfeeding rates, and a notable 67% surge in the prevalence of contraception. Conclusion: Our intervention has proven that it is possible to improve the health indicators of women and children through behavior change communication, regular home visits, and community awareness.

Utilization of maternal health care services in a rural community of Nepal

Introduction: Nepal has made progress in declining maternal mortality; but not up to the target. One of the important aspects in this regard is to know about the base line maternal health care utilization among women and to develop intervention accordingly. This study aims to identify the utilization of maternal health care services among women of rural municipality of Nepal. Method: A cross sectional analytical study with purposive sampling among 323 married women having at least one child less than five years old was conducted in Bagnaskali rural municipality of Palpa district using face to face interview technique with self-developed structured interview schedule. Descriptive statistics frequency, percentage, mean and standard deviations were used and association between descriptive variables and utilization was done using Chi square and Fisher Exact test as applicable using Statistical Package for Social Sciences (SPSS) version 16. Result: The study showed 21.05% of respondents had completely utilized maternal health care services (four Antenatal Care (ANC) checkups, institutional delivery and three Postnatal Care (PNC) checkups), 78.94% of the respondents had partially utilized services. There was no significant difference in health care utilization between maternal age, education of both mothers and husbands, occupation, types of families and distance to nearest health facility as seen by Chi Square and Fisher Exact Test. Conclusion: Almost all the respondents had ANC checkup and institutional delivery. More than half of the respondents had PNC checkup and the demographic variables had no association with utilization of maternal health care services.

FACTORS ASSOCIATED WITH SERVICE UTILIZATION AMONG OLDER ADULTS WITH FUNCTIONAL OR COGNITIVE IMPAIRMENT

Abstract Social services (e.g., senior centers, adult day care centers) and home health services (e.g., in-home personal care, visiting nurses) have been found to provide numerous benefits, such as opportunities for social interaction, physical activity, cognitive stimulation, as well as personal care and regular medical check-ups for older adults. These services may have greater positive impacts among older adults with disabilities or impairments given their limited mobility and reduced capacities to perform daily tasks. However, as most previous studies have focused on the general population, our understanding of factors associated with service utilization among those with disabilities or impairments is limited. This study examined individual characteristics associated with social and home health service utilization among older adults with functional limitations or cognitive impairments using data from the Health and Retirement Study. Results from logistic regression models suggest that older age and being not married were positively associated with utilization of both social and home health services, while being foreign-born was negatively associated with the outcomes, adjusting for sociodemographic characteristics. Respondents with higher educational attainment tend to use social services more and are less likely to use home health services than those with less than a high school education. Rural residence was negatively associated with the utilization of social services, but not with home health services. Providing information on available services and enhancing access by increasing the number of service providers, transportation options, and financial assistance would promote utilization of supportive services among older adults with functional limitations and cognitive impairments.

DIFFICULTIES EXPERIENCED BY PREGNANT WOMEN DURING THE COVID 19 PANDEMIC PROCESS IN TURKEY: A QUALITATIVE STUDY

Pregnant women were in the risk group in the Covid 19 pandemic as in previous pandemics. Being in a risk group can make coping even more difficult. This study was conducted to determine the difficulties experienced by pregnant women during the pandemic process. This is a phenomenological and qualitative study. The study was conducted with 33 participants. An interview form consisting of 10 unstructured questions was used to collect the data. Qualitative data were evaluated with content analysis. The study data were categorized using codes, and then themes and sub-themes were created. &#x0D; We found four themes and twelve sub-themes related to the strengths that participants experienced during the Covid 19 pandemic. These four themes were determined as (a)emotional burden, (b)challenge, (c)support and (d)prenatal care checkups. Pregnant women were emotionally affected and compulsory social isolation caused pregnant women to feel lonely during periods when support is needed such as pregnancy, childbirth and postpartum period. Pregnant women wanted to be isolated, on the other hand, they felt a sense of loneliness. Pregnant women had to postpone their prenatal care checkups, and some pregnant women could not reach their doctor. Pregnant women were most concerned about the health of their babies. They had ambivalent feelings about social support during pregnancy.

Lived experiences of women who survived from pre-eclampsia and eclampsia in public hospitals of Shashemene Town, Oromia Region, Ethiopia: a qualitative study.

Objective: The main purpose of this study was to explore experiences of women who survived pre-eclampsia and eclampsia in Shashemene referral hospital and Melka Oda general hospital, 2021. Design: An institution-based exploratory qualitative study with a descriptive phenomenological study design Setting: The present study was conducted in Shashemene referral hospital and Melka Oda general hospital from March 03 to May 18, 2021. Participants: A total of 17 individual in-depth interviews (IDIs) were conducted with women who experienced and survived pre-eclampsia and eclampsia. Data were analyzed through thematic analysis using Atlas-ti software. Result: The present study revealed that women’s level of awareness on raised blood pressure and or convulsion occurring during pregnancy was poor. Barriers that limit pregnant women from getting treatment at the earliest point included misconception, lack of insight, failure to accept counseling from health care providers, low income, and influence from husbands. Discussions with the women in this study showed that these mothers were not counseled on danger signs during antenatal care check-ups. Almost all of the women were very concerned and frustrated due to their diagnosis. Conclusions: Women’s awareness of pre-eclampsia and eclampsia was poor and antenatal care was not offered as per expected quality. Improving awareness of hypertensive disorders in pregnancy and enhancing the quality of antenatal care is essential.

Abstract 17665: School Electrocardiography Screening Program Prompts the Detection of Otherwise Unrecognized Atrial Septal Defect in Children in Japan

Background: Atrial septal defect (ASD) is a congenital heart disease that often presents without symptoms or murmurs. If left untreated, children with ASD can develop comorbidities in adulthood. In Japan, school electrocardiography (ECG) screening has been implemented for all 1st, 7th, and 10th graders. However, the impact of this program in detecting children with ASD is unknown. Hypothesis: School ECG screening program prompts the detection of otherwise unrecognized ASD in children in Japan. Methods: This is a retrospective study that analyzed consecutive patients with ASD who underwent catheterization for surgical or catheter closure at ≤18 years of age during 2009-2019 at a tertiary referral center in Japan. Results: Of the overall 116 patients with ASD (median age of 3.0 years at diagnosis and 8.9 years at catheterization), 43 (37%) were prompted by the ECG screening (Screening group), while the remaining 73 (63%) were by other findings (Non-screening group). Of the 49 patients diagnosed at ≥6 years of age, 43 (88%) were prompted by the ECG screening, with the 3 corresponding peaks of the number of patients at diagnosis. Compared with the non-screening group, the screening group exhibited similar levels of hemodynamic parameters but had a lower proportion of audible heart murmur (Levine 2/6 or higher) and coexisting diseases at catheterizarion (p=0.016), which were mainly prompted by the health care and health checkups in infancy or preschool period. Patients positive for a composite parameter (iRBBB, inverted T in V4, or ST depression in the aVF lead) accounted for 79% of the screening group at catheterization, each of which was correlated with hemodynamic parameters in the overall patients (p&lt;.05). Conclusions: The present study showed that school ECG screening detected otherwise unrecognized ASD, which prompted the diagnosis of the majority of patients at school age and &gt; one-third of overall patients in Japan. These findings suggest that ECG screening program could be valuable for detecting hemodynamically significant ASD in students, who are asymptomatic and murmurless.

Syrian Women Knowledge and Attitudes Towards Hepatitis B Prevention

Abstract Background Globally, mother-to-child transmission during childbirth is the most prevalent transmission method of hepatitis B (HBV). However, early immunization following birth is a safe and effective method of preventing this disease. This study evaluates Syrian mothers’ and pregnant females’ knowledge, attitude, and practice regarding HBV prevention and immunization. Methods This online cross-sectional study was performed in Syria between 2 October and 12 November. The inclusion criteria for this study were Syrian pregnant women who visited obstetrics and gynaecologist clinics for prenatal care, delivery, and postpartum checkups. The survey was adapted from a previous study, which contains 33 items divided into three sections. Data were analyzed using descriptive and multivariate logistic regression. Results This study enrolled 419 participants with a mean age of (28.4±5.9). More than half of the participants agreed that HBV could be transmitted from mother to her child at birth, and about two-thirds of them agreed that HBV vaccination is necessary for their infant (87.4%). Among participants with a university education degree, 35.7% revealed good knowledge, while only 12.3% of respondents with a primary school education level have good knowledge. More than half of housewife participants have shown positive attitudes (52.4%). Females with academic careers have a higher probability of good knowledge and positive attitudes than housewife women (OR = 107.09, P value&amp;lt;0.05) and (OR = 16.31, P value&amp;lt;0.05), respectively. Conclusions Syrian women have a moderate knowledge level about HBV prevention, with gaps in knowledge and attitudes among low-educated women. Performing local awareness campaigns about HBV and its vaccination for women can increase their knowledge and attitudes about this topic. Obstetric care providers should provide more information for pregnant females about HBV prevention for their children which may limit the occurrence of this phenomenon. Key messages • Syrian women have moderate knowledge of HBV prevention for their children, while lower-educated women have gaps in knowledge and attitudes. • Local awareness campaigns about HBV and its vaccination for women can improve their knowledge and attitudes.

A distinctive subgingival microbiome in patients with periodontitis and Alzheimer's disease compared with cognitively unimpaired periodontitis patients.

Periodontitis is caused by dysbiosis of oral microbes and is associated with increased cognitive decline in Alzheimer's disease (AD), and recently, a potential functional link was proposed between oral microbes and AD. We compared the oral microbiomes of patients with or without AD to evaluate the association between oral microbes and AD in periodontitis. Periodontitis patients with AD (n = 15) and cognitively unimpaired periodontitis patients (CU) (n = 14) were recruited for this study. Each patient underwent an oral examination and neuropsychological evaluation. Buccal, supragingival and subgingival plaque samples were collected, and microbiomes were analysed by next-generation sequencing. Alpha diversity, beta diversity, linear discriminant analysis effect size, analysis of variance-like differential expression analysis and network analysis were used to compare group oral microbiomes. All 29 participants had moderate to severe periodontitis. Group buccal and supragingival samples were indistinguishable, but subgingival samples demonstrated significant alpha and beta diversity differences. Differential analysis showed subgingival samples of the AD group had higher prevalence of Atopobium rimae, Dialister pneumosintes, Olsenella sp. HMT 807, Saccharibacteria (TM7) sp. HMT 348 and several species of Prevotella than the CU group. Furthermore, subgingival microbiome network analysis revealed a distinct, closely connected network in the AD group comprised of various Prevotella spp. and several anaerobic bacteria. A unique microbial composition was discovered in the subgingival region in the AD group. Specifically, potential periodontal pathogens were found to be more prevalent in the subgingival plaque samples of the AD group. These bacteria may possess a potential to worsen periodontitis and other systemic diseases. We recommend that AD patients receive regular, careful dental check-ups to ensure proper oral hygiene management.

Investigation of the Relationship Between Spiritual Well-Being, Prenatal Stress and Attachment Level of Turkish Women Conceiving Spontaneously or with Assisted Reproductive Techniques.

The aim of the study is to examine the relationship between spiritual well-being, prenatal stress and attachment level of Turkish women conceiving spontaneously or with assisted reproductive techniques (ART). The comparative descriptive study type was conducted between November 2021 and June 2022 with 202 pregnant women, including 87 women conceiving with ART and 115 women conceiving spontaneously, who applied for routine prenatal care checkup in a state hospital in the west of Turkey. Both groups have a high level of spiritual well-being. Pregnant women in the ART group experience higher prenatal distress (9.6% for spontaneous, 12.6% for ART, p = 0.487) and low level of attachment (69.72 ± 7.98 for spontaneous, 66.24 ± 8.88 for ART, p = 0.006) compared to the other group. Additionally, as insufficient partner involvement in the prenatal process increases in pregnant women in both groups, prenatal attachment decreases. It is extremely important that midwives and nurses evaluate the spiritual well-being of pregnant women and provide holistic care in line with their spiritual needs.