Data Collection Points Research Articles

Responsive Complementary Feeding Practices in Rural Muhanga District of Rwanda: A Mixed Methods Study

ABSTRACTBackgroundResponsive feeding among infants and young children (IYC) determines their food acceptance and adequate dietary intake, which enhances growth and developmental opportunities. However, little is known about responsive feeding practices among IYC in Rwanda. This study explored the status and barriers of responsive feeding practices among mothers from rural areas of Muhanga District in Rwanda.MethodThis descriptive longitudinal and exploratory mixed methods study was conducted among 29 mothers from 2 rural health centers in Muhanga District. Mothers were interviewed, and their interactions with children during lunch meals at 6, 9, and 12 months were observed. The interviews were recorded, transcribed, and thematically analyzed using Atlas.ti software.ResultsThe study shows that the number of mothers who reported to verbally encourage their children to eat during feeding increased with the child's age. Less than half of mothers, at all three time points of data collection (at 6, 9, and 12 months), reported and were observed allowing their children to self‐feed, smiling and talking to them during feeding. The perceived major barriers to mother–child interaction during feeding were lack of time due to the burden of other responsibilities, and poverty. In addition, fear of messing up and food waste were barriers to child self‐feeding opportunities.ConclusionFindings indicate that responsive feeding was less practiced among study mothers due to lack of time, poverty, and fear of food waste during child self‐feeding. Nutrition interventions in this community should consider raising awareness of responsive feeding practices through education and encouraging mothers to devote sufficient time to interact with their children during feeding episodes.

The prognostic role of albumin levels in lung cancer patients receiving third-line or advanced immunotherapy: a retrospective study.

Immunotherapy functions by leveraging immunoregulation drugs to bolster the immune system's capacity to identify and eliminate cancerous cells. In contrast to radiotherapy and chemotherapy, immunotherapy exhibits diminished side effects, heightened efficacy, and prolonged survival rates. Nevertheless, meticulous exploration into the determinants governing the advantageous effects of immunotherapy among patients who have previously undergone multiple prior therapies has yet to be conducted. Albumin (ALB) as a nutritional indicator has not been thoroughly studied for its prognostic effect on efficacy or survival. This study aims to identify factors that influence treatment outcomes among patients undergoing third-line or later immunological therapies. A cohort of 250 lung cancer patients undergoing toripalimab or tislelizumab immunotherapy was the focal point of data collection. The determination of the median value facilitated the establishment of a cut-off point, enabling the categorization of continuous variables. After data collection, a series of statistical analyses of various clinical factors at baseline were performed, including nonparametric tests, logistic regression, and Cox proportional risk modeling. The last follow-up was in May 2022. The primary study endpoint was overall survival (OS). A total of 250 patients were enrolled in the study, of which 129 patients received first- or second-line immunotherapy and 121 patients received third-line or subsequent immunotherapy. According to Cox multifactor regression analysis, in patients receiving either first- or second-line therapy, the ALB level exhibited negligible prognostic relevance (P>0.05). However, in patients subjected to immunotherapy beyond the second line, the ALB level manifested significant prognostic importance (P=0.039). Notably, patients demonstrating elevated ALB levels achieved a higher disease control rate (DCR) (70.0% vs. 52.5%, P=0.05) and displayed a tendency towards a heightened objective response rate (ORR) (20.0% vs. 16.4%, P=0.61) in comparison to those with lower ALB levels. Among patients undergoing immunotherapy in the third line or subsequent treatment phases, elevated ALB levels in baseline correlated with DCR and OS. Thus, the pre-immunotherapy ALB level emerges as an autonomous predictor of OS in patients subjected to third- or later line immunotherapy interventions.

A Comprehensive Framework for Hospital@Home Care Models.

To develop a framework of relevant features for describing hospital@home care models. The framework was developed based on a literature review and thematic analysis. We considered 42 papers describing hospital@home care approaches. Extracted features were grouped and aggregated in a framework. The framework consists of nine dimensions: Persons involved, target patient population, service delivery, intended outcome, first point of contact, technology involved, quality, and data collection. The framework provides a comprehensive list of required roles, technologies and service types. The framework can act as a guide for researchers to develop new technologies or interventions to improve hospital@home, particularly in areas such as tele-health, wearable technology, and patient self-management tools. Healthcare providers can use the framework as a guide or blueprint for building or expanding upon their hospital@home services.

A Study on Scan Trajectory Based Effective Localization Method Using Mobile Anchor in Wireless Sensor Networks

A Wireless Sensor Network (WSN) is a collection of different nodes working together in a networked fashion in an ordered way. For many applications, sensor location in wireless sensor networks (WSN) is crucial. It is expensive to equip each sensor node with a GPS receiver. Numerous methods, including range-based and range-free methods, have been put forth in the past to determine the locations of sensor nodes that are randomly distributed. The majority of them make use of unique nodes known as anchor nodes, which are thought to be aware of their own positions. These anchor nodes supply the information that other sensors use to calculate their locations. Massive numbers of sensor nodes are used in wireless sensor networks (WSNs) to gather data about the immediate environment. However, this data is useless until the precise location of the data collection points is known. Sensor node localization in wireless sensor networks (WSNs) is important for a number of applications. The current research study develops a path planning technique to apply mobile anchors to the localization systems that are currently in use. The two mobile anchors supported by the effective trajectories, or effective SCAN, is the focus of the proposed research project. To localise the sensor node and transmit data, this method involves setting the mobile anchors to move in the opposite direction. The advantages of this dual movable anchor are demonstrated by the research study in terms of decreased localization time, localization error, and other factors.

Measuring the effects of nurse-led frailty intervention on community-dwelling older people in Ethiopia: a quasi-experimental study

BackgroundDespite the critical need, interventions aimed at frailty in sub-Saharan Africa are scarce, attributed to factors such as insufficient healthcare infrastructure, the pressing need to address infectious diseases, maternal and child health issues, and a general lack of awareness. Hence, the aim of this research was to develop, implement, and evaluate the effect of a nurse-led program on frailty and associated health outcomes in community-dwelling older individuals in Ethiopia.MethodsThis study utilised a pre-test, post-test, and follow-up single-group quasi-experimental design. The main outcome measure was to determine changes in the frailty levels of older individuals living in communities at three different intervals: initially (T0), immediately after the intervention (T1), and 12 weeks following the intervention (T2). Secondary outcomes were the observed changes in daily living activities, nutritional status, depression levels, and quality of life (QOL), evaluated at each of these data collection points. To analyse changes in frailty and response variables over these periods, Friedman’s ANOVA and Cochran’s Q test were employed, setting the threshold for statistical significance at P < 0.05.ResultsSixty-six older people with a high adherence rate of 97% completed the intervention and the follow-up measurements. Participants had an average age of 66.7 ± 7.9 years, with females comprising 79.4% of the group. Notably, 12 weeks post-intervention, there was a marked decrease in frailty (χ2(2) = 101.05, p < 0.001) and depression scores (χ2(2) = 9.55, p = 0.008) compared to the baseline. However, the changes in depression, physical, mental, and environmental domains of QOL were not sustained for 12 weeks post-intervention. Study participants showed an improvement in nutritional status (χ2(2) = 25.68, p < 0.001), activity of daily living (χ2(2) = 6.00, p = 0.05), and global quality of life (χ2(2) = 20.64, p < 0.001).ConclusionsThe nurse-led intervention notably, 12 weeks post-intervention reduced frailty and depression. The intervention improved the nutritional status and some components of the quality of life of the participants. There is a need for further studies, especially with larger participant groups and stronger research designs such as randomized controlled trials (RCTs).Trial registrationClinicalTrials.gov: NCT05754398 (03/03/2023).

Randomised controlled trial of preoperative antibiotic prophylaxis in the prevention of surgical site infections in tertiary care hospital of central India

Background Surgical site infections (SSI) remain a significant concern in the realm of surgical interventions, posing a threat to both patient well-being and healthcare systems. This study protocol outlines a rigorous investigation aimed at assessing the effectiveness of pre-operative antibiotic prophylaxis in the prevention of SSIs in clean and clean-contaminated surgical cases within the tertiary care setting of central India. The primary aim is to determine the best suitable antibiotic regimen, optimal timing for administration, and the associated economic burden of SSIs. Method The study utilizes a Randomized Controlled Trial (RCT) design with four intervention groups, each receiving distinct antibiotic prophylaxis protocols. Comprehensive post-operative monitoring, adhering to the Centers for Disease Control and Prevention (CDC) guidelines, will be employed to identify SSI occurrences. Key data collection points include clinical evaluations, temperature monitoring, wound inspection, pain assessments, and culture and sensitivity testing. Expected outcome The study also emphasizes post-operative follow-up assessments, incorporating outpatient visits at 15-, 30-, and 90-days post-surgery. These evaluations will be instrumental in assessing the time duration for effective prophylactic antibiotic administration and determining the economic burden associated with SSI. The findings of this research endeavor hold the potential to enhance patient outcomes, minimize SSI incidences, and reduce the economic impact of SSIs on healthcare systems. By optimizing pre-operative antibiotic prophylaxis practices, this study aims to advance evidence-based guidelines for SSI prevention in clean and clean-contaminated surgical cases. CTRI REF/2023/07/070549

Investigating midwives and nurses reporting of ‘infant feeding at hospital discharge’: an online survey across NSW Australia

BackgroundThe collection of data on ‘infant feeding at hospital discharge’ is used to monitor breastfeeding outcomes, health service benchmarking, and research. While some Australian states have clear definitions of this data collection point, there is no operational definition of ‘infant feeding at hospital discharge’ in the Australian state of New South Wales. Little is known about how midwives interpret the term ‘infant feeding at hospital discharge’, in particular, the timeframe used to calculate these important indicators. The purpose of this study was to explore midwives’ and nurses’ practices of reporting ‘infant feeding at hospital discharge’ in the Australian state of New South Wales.MethodsAn online survey was distributed across public and private maternity hospitals in New South Wales, Australia. The survey asked midwives and nurses their practice of reporting ‘infant feeding at discharge’ from categories offered by the state Mothers and Babies report of either “full breastfeeding”, “any breastfeeding”, and “infant formula only”. The Qualtrics survey was available from December 2021 to May 2022.ResultsThere were 319 completed surveys for analysis and all 15 NSW Health Districts were represented. Some participants reported using the timeframe ‘since birth’ as a reference (39%), however, the majority (54%, n = 173) referenced one of the feeding timeframes within the previous 24 h. Most midwives and nurses (83%, n = 265) recommended 24 h before discharge as the most relevant reference timeframe, and 65% (n = 207) were in favour of recording data on ‘exclusive breastfeeding’ since birth.ConclusionThis study identified multiple practice inconsistencies within New South Wales reporting of ‘infant feeding at hospital discharge’. This has ramifications for key health statistics, state reporting, and national benchmarking. While the Baby Friendly Hospital Initiative accreditation requires hospitals to demonstrate and continuously monitor at least a 75% exclusive breastfeeding rate on discharge, only 11 New South Wales facilities have achieved this accreditation. We recommend introducing an option to collect ‘exclusive breastfeeding’ on discharge’ which is in line with participant recommendations and the Baby Friendly Hospital accreditation. Other important considerations are the updated World Health Organization indicators such as, “Ever breastfed”; “Early initiation of breastfeeding” (first hour); “Exclusively breastfed for the first two days after birth”.

Acceptance, Adherence, and Side Effects of Depot Medroxyprogesterone Acetate: A Prospective Observational Study.

Introduction In India, one of the world's most populous and swiftly growing countries, it is crucial to prioritize the utilization of safe and effective contraception, as contraceptive strategies play a pivotal role in bolstering community health. It is widely acknowledged that ensuring appropriate timing and spacing of pregnancies is crucial for the well-being of reproductive, maternal, neonatal, child, and adolescent health. Adoption of reversible or spacing contraceptive methods can significantly enhance women's health outcomes by reducing the occurrence of undesired, closely timed, and mistimed pregnancies. Consequently, in response to the pressing need for dependable contraception in India, this study seeks to assess the acceptance, adherence, and side effects of the injectable contraceptive depot medroxyprogesterone acetate (DMPA) among its users. Methods This prospective observational study was done at the State Government Taluk Hospital in the Cuddalore District of Tamil Nadu from July 2022 to October 2022. A total of 40 women of reproductive age who opted for DMPA as their contraceptive method and met the inclusion criteria were recruited through a purposive sampling method. A structured questionnaire was used to collect the data. Results The majority of the participants were women aged 21-25 years (n=14; 35%). The participants were predominantly Hindu(n=39; 97.5%), and 35 (87.5%) had completed higher secondary education. All participants (n=40; 100%) resided in rural areas and the majority were homemakers. A significant proportion of the participants had two children (n=21; 52.5%), and all of them received information on DMPA primarilyfrom health personnel. At the initial point of data collection, three-fourths of them took the first dose(n=13; 32.5%)and only a few took more than three doses (n=3; 7.5%).In the third month, the results showed a drop in DMPA use, which indicates a lower adherenceparticularly linked to side effects like irregular bleeding (n=15; 37.5%) and amenorrhea (n=9; 22.5%). Furthermore, 35 (87.5%) of the women chose DMPA for birth spacing due to its efficacy and convenience, with few initiating it during postpartum (n=4; 10%) and post-abortal (n=1; 2.5%) periods.The reasons for continuing DMPA use included efficacy (n=20; 50%), discreet usage (n=15; 37.5%), and curiosity (n=13; 32.5%). Half of the participants reported no side effects.The study identified associations between DMPA users and the number of living children and occupational statusinferring that DMPA contraception is used forspacing births. Conclusion The results of this study imply that the use and adherence to injectable contraceptive DMPA need to be strengthened among rural women. Thus, the study suggests incorporating information, education, and communication strategies, to enhance awareness among rural women about injectable contraceptives.

The Study of Merger and Acquisitions: Value Creation and Risk Management

This master thesis explores the intricate dynamics of Mergers and Acquisitions (M&amp;A) with a focus on understanding the dual dimensions of value creation and risk management. In the contemporary corporate landscape, M&amp;A activities have emerged as pivotal strategic tools for companies seeking growth, diversification, and competitive advantage. The research aims to provide a comprehensive analysis of how these transactions contribute to shareholder value while effectively navigating associated risks. The literature review establishes the foundation by synthesizing existing knowledge on M&amp;A, spanning historical context, economic impact, financial performance, and corporate governance. Special attention is given to theories and models related to value creation and risk management in M&amp;A, providing a comprehensive overview of the multifaceted nature of these transactions. The research methodology adopts a mixed-methods approach, incorporating both quantitative and qualitative techniques. A carefully selected sample of companies engaged in M&amp;A activities serves as the focal point for data collection. Financial analyses, surveys, and content analysis of relevant documents constitute the primary tools for gathering insights into the chosen topic. Variables related to value creation and risk management are defined and measured using a combination of financial metrics, qualitative assessments, and established measurement scales. The study pays close attention to ethical considerations, ensuring participant privacy and data confidentiality throughout the research process. The anticipated findings aim to shed light on the factors influencing successful value creation in M&amp;A, providing insights into post-merger integration strategies, financial performance, and the broader economic implications of these transactions. Additionally, the research seeks to identify effective risk management practices that contribute to mitigating challenges associated with M&amp;A, including cultural differences, regulatory compliance, and integration hurdles. By presenting a rigorous and well-justified research methodology, this thesis seeks to contribute to the existing body of knowledge on M&amp;A, providing valuable insights for practitioners, policymakers, and academics interested in understanding the intricacies of value creation and risk management in the context of mergers and acquisitions Index Terms- Mergers, Acquisitions, Risk management, Value creation, Facebook, Du Pont, WhatsApp.

The Relationship Between Healthcare Organizational Magnet® Status and Scores on the Human Rights Campaign Healthcare Equality Index: A Comparative Temporal Analysis

The Human Rights Campaign's annual Healthcare Equality Index (HEI) evaluates participating organizations' (n = 906) treatment of LGBTQ+ employees and clients. Higher HEI scores reflect greater equitable treatment of LGBTQ+ persons, a mark of merit for the organization. The American Nurses Credentialing Center recognizes nursing excellence in healthcare organization by designating them Magnet® institutions (n = 612). Blackwell and colleagues showed a significant relationship between organizational HEI scores and recognition as Magnet®. The purpose of this study was to determine if this relationship changed between 2018 and 2022. Chi-square tests analyzed statistical relationships between aggregate HEI score as well as each sub-criterion within the HEI, and the organization's Magnet® status. HEI score and Magnet® status-maintained association (p = <.001). Three of four individual scoring criteria were also related to Magnet® recognition, an improvement from just one of the criteria in 2018. Organizations with greater commitment to LGBTQ+ equality continue to be associated with Magnet® recognition, suggesting a continued commitment to healthcare excellence. Future research should focus analysis efforts across the same organizations between HEI and Magnet® data collection points and assess LGBTQ+-inclusive care and employment practices and organizational nursing excellence with tools external to the HEI and Magnet® recognition.

The Effect of a Combined Intermittent Fasting Healthy Plate Intervention on Anthropometric Outcomes and Body Composition Among Adults With Overweight and Obesity: Nonrandomized Controlled Trial.

Adult obesity and overweight pose a substantial risk to global public health and are associated with various noncommunicable diseases. Although intermittent fasting (IF) is increasingly used as a relatively new dietary strategy for weight loss, the effectiveness of 2 days per week of dry fasting remains unknown. This study aims to evaluate the effectiveness of a combined dry IF and healthy plate (IFHP) and healthy plate (HP) intervention in improving anthropometric outcomes and body composition. This nonrandomized controlled trial involved 177 adults who were overweight and obese. Among them, 91 (51.4%) were allocated to the IFHP group and 86 (48.6%) were allocated to the HP group. The overall study duration was 6 months (October 2020 to March 2021). The intervention was divided into 2 phases: supervised (3 months) and unsupervised (3 months). The data were collected at baseline, after the supervised phase (month 3), and after the unsupervised phase (month 6). Anthropometric (weight, height, waist circumference, and hip circumference) and body composition (body fat percentage, body fat mass, skeletal muscle mass, and visceral fat area) data were measured at all 3 data collection points. Sociodemographic data were obtained using a questionnaire at baseline. Most participants were female (147/177, 83.1%) and Malay (141/177, 79.7%). After 3 months, there were significant reductions in weight (difference -1.68; P<.001), BMI (difference -0.62; P<.001), body fat percentage (difference -0.921; P<.001), body fat mass (difference -1.28; P<.001), and visceral fat area (difference -4.227; P=.008) in the IFHP group, whereas no significant changes were observed in the HP group. Compared to baseline, participants in the IFHP group showed a significant decrease in weight (difference -1.428; P=.003), BMI (difference -0.522; P=.005), body fat percentage (difference -1.591; P<.001), body fat mass (difference -1.501; P<.001), visceral fat area (difference -7.130; P<.001), waist circumference (difference -2.304; P=.001), and hip circumference (difference -1.908; P=.002) at month 6. During the unsupervised phase, waist (IFHP difference -3.206; P<.001, HP difference -2.675; P=.004) and hip (IFHP difference -2.443; P<.001; HP difference -2.896; P<.001) circumferences were significantly reduced in both groups (P<.01), whereas skeletal muscle mass (difference 0.208; P=.04) and visceral fat area (difference -2.903; P=.003) were significantly improved in the IFHP group only. No significant difference in the between-group comparison was detected throughout the intervention (all P>.05). A combined IFHP intervention was effective in improving anthropometric outcomes and body composition in adults with overweight and obesity. RR2-10.2196/33801.

Child acute illness presentation and referrals at primary health clinics in Malawi: a secondary analysis of ASPIRE

ObjectivesWe aimed to assess the prevalence, presentation and referral patterns of children with acute illness attending primary health centres (PHCs) in a low-resource setting.Design, setting and participantsWe conducted a secondary...

Exploring the Impact of a 7-Week Heart Rate Variability Biofeedback Protocol on Skin Severity, Quality of Life, and Mental Health in a Proof-of-Concept Pre–Post Trial of Individuals with Psoriasis

Background: Psoriasis often coexists with psychiatric disorders and decreased quality of life (QoL), with treatments commonly overlooking the psychological impact of the disease. Heart rate variability biofeedback (HRVB) may offer a mind–body solution by providing real-time feedback on autonomic functions, teaching individuals to manage stress via controlled breathing. Objective: To examine the impact of a 7-week HRVB protocol on skin severity (SS), QoL, and mental health (MH) in individuals with psoriasis and determine the sustainability of any outcomes post-intervention. Methods: A single-arm, proof-of-concept pre–post trial was conducted at Bastyr University Clinic in San Diego, CA. Five individuals were recruited, screened, and underwent a 7-week HRVB protocol. Assessments included SS through the Psoriasis Area and Severity Index (PASI-P and PASI-C), QoL via the Cardiff Dermatology Life Quality Index (DLQI), and MH using the Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9). Data collection points were baseline, post-protocol, and 1-month follow-up. Results: Notable improvements were observed between baseline and post-protocol for PASI-P, DLQI, and GAD-7. A significant change remained for GAD-7 between baseline and follow-up. No major differences were identified for PASI-C and PHQ-9 across any timeframe, and other scales remained consistent between post-protocol and follow-up. Conclusion: HRVB showed promise in enhancing perceived SS, QoL, and anxiety over 7 weeks. Further studies should expand participant numbers and diversify initial scores, comparing HRVB with a control group. Trial registration: ClinicalTrials.gov NCT05506644, retrospectively registered on 16 August 2022.

Robot-assisted mobilisation in the intensive care unit: does it offer relief to mobilising specialists? A qualitative longitudinal study at a German university hospital

BackgroundImmobility among intensive care patients can result in significant impairments. Reasons for this issue include a lack of specialised staff and equipment, as well as safety concerns associated with transferring patients to a therapy device. Nevertheless, early mobilisation is recognised as beneficial for improving patient outcomes. This study explores the perspectives of healthcare professionals on the use of a robotic system for patient mobilisation and identifies related stress and relief factors.MethodThis qualitative longitudinal study was conducted at a German university hospital, where 29 interviews were conducted with nurses at three different data collection points. The data were analysed using qualitative content analysis in accordance with Mayring.FindingsThe utilisation of the VEMOTION® robotic system generally did not lead to any physical discomfort. However, the adoption of this technology presented certain challenges. Non-routine users initially experienced psychological strain, primarily due to the extensive preparation required and the need to integrate the system into established routines. Additionally, structural factors, such as nurse-to-patient ratios and the layout of the care facilities, were identified as significant determinants affecting both the practicality of mobilisation and associated stress levels.ConclusionsRobotic systems like VEMOTION® can alleviate the physical workload of nurses. Successful integration and psychological adaptation depend on familiarity and routine use of the technology. Addressing structural and staffing factors is crucial for optimising robotic assistance in patient care. Further research should delve into these dynamics and explore the broader implications of technology adoption in healthcare.Trial registration: clinicaltrials.org TRN: NCT05071248, Date: 2021/10/21 URL: https://clinicaltrials.gov/ct2/show/NCT05071248

A systematic review of dietary data collection methodologies for diet diversity indicators.

The purpose of the current study was to critically assess the gaps in the existing methodologies of dietary data collection for diet diversity indicators. The study proposed the importance of smartphone application to overcome the drawbacks. The review paper identified and assessed the conventional methodologies used in diet diversity indicators including Minimum Dietary Diversity for Women (MDD-W), Minimum Dietary Diversity of Infant and Young Child Feeding Practices (IYCF-MDD), and Household Dietary Diversity Score (HDDS). The 80 research studies from 38 countries were critically assessed on the basis of their research aim, study design, target audience, dietary data collection methodology, sample size, dietary data type, dietary data collection frequency, and location point of dietary data collection. Results indicated that most studies employed interviewer-administered 24-h recall assessing the dietary diversity. The review paper concluded that smartphone application had potential to overcome the identified limitations of conventional methodologies including recall bias, social-desirability bias, interviewer training, and cost-time constraints.

LoRa-based IoT platform for remote soil parameter monitoring

The objective of this work was to develop an innovative LoRa-based platform that provides a low-cost and customizable solution for real-time monitoring of soil parameters. The system architecture was based on four levels: environmental (rural), sensors and actuators, communication network, and application, with the code made available for operation. The collected data were transmitted to data collection points using LoRa technology. The application level allowed for data storage, analysis, and visualization, enabling end-users to remotely monitor and control environmental measurement operations. With LoRa technology range tests, results indicated the capability to cover a maximum area between 95 and 120 hectares in the studied areas. Additionally, the collected data were sent to ThingSpeak.com and a mobile application called Thingsview. This demonstrated the efficiency and viability of LoRa technology for industrial communication sensor and IoT applications in rural environments, offering automation, increased efficiency, and savings in human resources for environmental monitoring tasks.

Decentralising chronic disease management in sub-Saharan Africa: a protocol for the qualitative process evaluation of community-based integrated management of HIV, diabetes and hypertension in Tanzania and Uganda

IntroductionSub-Saharan Africa continues to experience a syndemic of HIV and non-communicable diseases (NCDs). Vertical (stand-alone) HIV programming has provided high-quality care in the region, with almost 80% of people living...

Developing offshore fatigue assessment application to measure fatigue among offshore workers in Malaysia

AbstractFatigue is a significant concern in the offshore oil and gas industry, posing risks to both resources and lives. This study aims to assess fatigue levels among daily trippers on offshore platforms and compare them across different job roles. The Offshore Fatigue Assessment Application (OFAA) was developed to measure fatigue in Malaysian offshore workers, focusing on alert response and lapses. A total of 51 participants were involved, with 31 in Crew A and 20 in Crew B. Based on the results, Crew A exhibited fatigue, with only 3 out of 12 data collection points showing an average reaction time (RT) below 500 ms, mainly during post‐work periods. Crew B also experienced fatigue, with only 1 out of 12 data collection points showing an average RT below 500 ms, occurring during mid‐work. While Crew B displayed fatigue during pre‐work and mid‐work, they generally maintained alertness during their sessions. Overall, Crew A consistently faced lapses in alertness, while Crew B showed fatigue during pre‐work and mid‐work but remained alert during their sessions. These findings highlight varying fatigue levels among offshore personnel, emphasizing the need for targeted fatigue management strategies in this industry.

Handwriting Skills and Their Role in Text Generation: A Longitudinal Study with Graphonomic Measures

&lt;p&gt;This study sought to examine the influence of transcription skills, evaluated using graphonomic measures, on the proficiency of text generation in students attending primary schools in Spain. A longitudinal design was employed involving 278 Spanish students distributed across three cohorts (cohort 1: 1st-2nd-4th grade; cohort 2: 2nd-3rd-5th grade; and cohort 3: 3rd-4th-6th grade). Two data collection points were used to administer the graphonomic measures, and a composition letter task was conducted at the conclusion of the study. Four multigroup structural equation models were employed, examining the direct pathways from graphonomic measures (i.e., pressure, speed, pauses, and road length) on text generation (i.e., length, fluency, planning, revision, and organization). The models demonstrated a good fit to the data. The findings from the four models, analyzed within the three cohorts, indicated that the significant effect of transcription (i.e., handwriting) on text production was primarily observed in Cohort 1 (early grades), while no significant effects were found in Cohort 2 (intermediate grades). This suggests that the importance of handwriting in text production in a transparent orthography may be more pronounced during the initial stages of writing development when students are acquiring foundational writing skills.&lt;/p&gt;

Healthy together Victoria and childhood obesity study: effects of a large scale, community-based cluster randomised trial of a systems thinking approach for the prevention of childhood obesity among secondary school students 2014–2016

BackgroundHealthy Together Victoria (HTV) was a Victorian Government initiative that sought to reduce the prevalence of overweight and obesity through targeting chronic disease risk factors including physical activity, poor diet quality, smoking, and harmful alcohol use. The intervention involved a boosted workforce of > 170 local-level staff in 12 communities; employed to deliver system activation around health and wellbeing for individuals, families and communities. A cluster randomised trial (CRT) of a systems thinking approach to obesity prevention was embedded within HTV. We present the two-year changes in overweight and obesity and associated behaviours among secondary school students across Victoria, Australia.MethodsTwenty-three geographically bounded areas were randomised to intervention (12 communities) or comparison (11 communities). Randomly selected secondary schools within each community were invited to participate in the trial in 2014 and 2016. Students in Grade 8 (aged approximately 13–15 years) and Grade 10 (aged approximately 15–16 years) at participating schools were recruited using an opt-out approach across July–September 2014 and 2016. Primary outcomes were body mass index (BMI) and waist circumference. Secondary outcomes were physical activity, sedentary behaviour, diet quality, health-related quality of life, and depressive symptoms. Linear mixed models were fit to estimate the intervention effect adjusting for child/school characteristics.ResultsThere were 4242 intervention children and 2999 control children in the final analysis. For boys, the two-year change showed improvement in intervention versus control for waist circumference (difference in change: − 2.5 cm; 95% confidence interval [CI]: − 4.6, − 0.5) and consumption of sugar-sweetened beverages per day (< 1 serve: 8.5 percentage points; 95% CI: 0.6, 16.5). For girls, there were no statistically significant differences between conditions.ConclusionsHTV seemed to produce favourable changes in waist circumference and sugar-sweetened beverage consumption for boys, however, no effect on BMI was observed. Although the HTV intervention was cut short, and the period between data collection points was relatively short, the changes observed in HTV contribute to the growing evidence of whole-of-community interventions targeting childhood obesity.Trial registrationThis trial is unregistered. The intervention itself was a policy setting delivered by government and our role was the collection of data to evaluate the effect of this natural experiment. That is, this study was not a trial from the classical point of view and we were not responsible for the intervention.