Improvement In Level Of Knowledge Research Articles

Effect of Nutrition Health and Hygiene Education on Knowledge Attitude and Practices KAP among Selected Transgender Community

The Transgender (TG) community has been steadily growing over the decades, yet they face a unique set of challenges. Apart from communicable diseases many transgenders suffer from nutrition deficiency associated non communicable diseases, which decreases the quality of living. The purpose of this study was to examine how nutritional, health and hygiene education influences the knowledge, attitudes, and practices (KAP) of the TG population. The participants were TG individuals over 18 years old. TG individuals visiting ESI hospital Gulbarga and few TG from Bengaluru city were selected for the research. A total of 300 TG individuals were initially screened, out of which 120 were selected for the study. The study comprised administering a detailed socio-economic demographic questionnaire, pre-KAP questionnaire, conducting an awareness program with distribution of education material, and then having a gap period of 60 days a post-KAP assessment was done. The results were statistically analysed, before the awareness session (Group I), the majority of participants (60.83%) were categorized as having "Poor" knowledge, only (7.5%) had "Good" knowledge, after the awareness session (Group II), there was a significant improvement in knowledge levels. The percentage of participants with "Poor" knowledge decreased drastically to only 1.67%, with "Good" knowledge increased to 36.67%. Before the awareness session (Group I), the majority of TG participants (66.67%) held "Unfavourable" attitudes, a smaller percentage (24.17%) held "Neutral" attitudes, the least common attitude was "Favourable," held by 9.17% of participants. After the awareness session (Group II), there was a noticeable shift in attitudes. The percentage of participants with "Unfavourable" attitudes decreased dramatically to only 2.50%, with "Neutral" attitudes increased substantially to 67.50%, similarly, with "Favourable" attitudes increased to 30.00%. Before the intervention (Group I), the majority of participants (70.83%) exhibited "Poor" practices. After the intervention (Group II), "Poor" practices decreased to 7.50%, with "Average" practices increased substantially to 65.83%, similarly, with "Good" practices increased to 26.67%. Rank correlation between pre and post KAP and socioeconomic domains had significant association These findings suggest that educational qualification, family size, facilities available, are important factors associated with knowledge, attitude, and practice regarding the subject under study.

Increasing the competency of midwives through credential management training at RSU Islam Harapan Anda, Tegal City

In the era of globalization, hospitals are required to ensure high performance among midwives in delivering services to the community, particularly to patients. However, a lack of knowledge among midwives regarding midwifery credential management has been noted to impact their performance and the quality of midwifery services within hospitals. The objective of midwifery credential training activities is to enhance the quality of midwifery services at RSU Islam Harapan Anda in Tegal City. This community service initiative engaged 30 midwives from RSU Islam Harapan Anda. The training employed two methods: lectures and practical sessions. Results from the training indicated significant improvements in knowledge levels among midwives (p < 0.05). Consequently, training on credential management through lectures and practical sessions can enhance midwives' understanding of credential management and reinforce their knowledge of competencies and authorities, thus enabling them to provide better midwifery services and improve overall service quality within hospitals.

Pendidikan Kesehatan Batuk, Pilek Dan Pijat Common Cold Dalam Upaya Mengatasi Ketidakefektifan Bersihan Jalan Napas Pada Balita

Cough and cold symptoms are indicative of respiratory system disturbances that commonly affect toddlers (1-5 years old). Respiratory disorders, or Acute Respiratory Infections (ARIs), are a leading cause of mortality in children. The disease can quickly spread to others through droplets, and its transmission is particularly rapid during the current rainy season due to the weakened immune systems of toddlers. However, parents often perceive coughs and colds as common occurrences, leading them to neglect providing treatment to their children. This becomes problematic when children experience respiratory distress, prompting confusion among parents who then rush their children to the hospital. The community engagement activities involve interactive lectures and training sessions, including role-playing with phantom children, for 15 mothers with toddlers. The activities are conducted over a period of two weeks in Alalak Island RT 3. The mothers' knowledge is assessed before and after the sessions through questionnaires. To evaluate the effectiveness of the common cold massage technique, observations are made following established Standard Operating Procedures (SOPs). The results of the community engagement show an improvement in knowledge levels before and after health education. Regarding the common cold massage technique, a small percentage can perform the procedure directly, while the majority can follow the SOPs using phantom children. It is hoped that the increased knowledge and skills of mothers will enable them to promptly address cough and cold symptoms in their children.

Radio-Led Education: Fostering Awareness of Unique and Natural Resources in Bicol Region among Elementary and High School Students in Selected Schools of Tabaco City, Albay, Philippines

This study examined the effectiveness of radio-based instruction in enhancing students' knowledge of Bicol's unique and natural resources across different educational levels. The research encompasses elementary, junior high school (JHS), and senior high school (SHS) students, evaluating their pretest and posttest scores in response to radio programs on various environmental topics. The radio intervention significantly improved knowledge levels among elementary students, particularly in the tilapia topic, showcasing a 70.31% gain. For JHS students, notable progress was observed, with a remarkable 123.08% gain in invertebrates. SHS students also exhibited enhanced knowledge, achieving a 50.85% gain, emphasizing the positive impact of radio-based instruction on environmental education. While acknowledging contextual challenges and evolving technology trends, this study underscores the vital role of radio in fostering environmental awareness and positive conservation behaviors among students in the Bicol Region. The results suggest that radio programs are potent tools for promoting environmental education and empowering students to contribute actively to conservation efforts.

Learning Package Outcome on Sibling Rivalry Management among Parents

Sibling rivalry is one of humanity’s oldest problems. By “sibling rivalry” we mean the antagonism or hostility between brothers or sisters which manifests it in circumstances such as in the common children’s family fights. Therefore, present study aims to assess the effectiveness of Planned Teaching Program (PTP) on knowledge regarding sibling rivalry and its management among parents in selected community area. Pre experimental one group pre-test and post-test research design was selected to conduct the study. 60 Parents of siblings were selected for this study by using purposive sampling technique. Result revealed that 71.7% parents scored inadequate knowledge, 28.3% moderate knowledge in pre-test while in post-test 21.7% scored adequate knowledge level, 73.3% moderately adequate knowledge and 5% scored inadequate knowledge regarding sibling rivalry and its management. The overall mean percentage of the pre-test and post-test knowledge scores was 41.55%, and 67% respectively and mean difference was 8.650 and ‘t’ value 26.275 was found significant. It shows that learning package was effective in improvement of knowledge level regarding sibling rivalry and its management among parents. Socio demographic variables like age, sex, religion family income, number of children and education were significantly associated with the pretest knowledge score of the parents. Conclusion: The study concluded that learning package was effective in improvement of knowledge level among parents about sibling rivalry.

Radiation Safety Practices and Improvement of Knowledge Level in Intensive Care Unit Working Conditions: An Experimental Study on Nurses

Radiation Safety Practices and Improvement of Knowledge Level in Intensive Care Unit Working Conditions: An Experimental Study on Nurses

KNOWLEDGE, WORKLOAD, ATTITUDE, AND ELECTRONIC HEALTH RECORDS COMPLIANCE AMONG HEALTHCARE PROFESSIONALS

Electronic health record (EHR) has replaced conventional medical records in Indonesia. Until now, its utilization is still not optimal, and there are still frequent problems with incomplete filling of the EHR form due to individual factors. To examine the association between knowledge and workload with healthcare professionals' (HCPs) compliance in filling out HER, considering the mediating role of attitude. We performed a cross-sectional study on 80 HCPs who worked at the Intensive Care Unit of the National Cardiovascular Centre Harapan Kita. We observe the level of knowledge and workload as independent variables, attitudes as mediating variables, and compliance as the dependent variable. Primary data were obtained by using questionnaires. The association among observed variables was analyzed using path analysis. As a result, we found that knowledge, workload, and attitude simultaneously had a significant association with compliance in EHR filling. Attitude is the most dominant independent variable that directly affected compliance, while knowledge and workload were associated with compliance mediated by attitude. It was concluded that increasing HCPs' compliance in filling out the EHR would be directly associated with a positive attitude of HCPs. A higher level of knowledge and a lighter workload do not directly associate with better compliance, but affect attitude improvement. Thus improving knowledge levels and adjusting the workload will increase EHR filling compliance by mediating positive attitudes among HCPs.

An omni-channel, outcomes-focused approach to scale digital health interventions in resource-limited populations: a case study.

Populations in resource-limited communities have low health awareness, low financial literacy levels, and inadequate access to primary healthcare, leading to low adoption of preventive health behaviours, low healthcare-seeking behaviours, and poor health outcomes. Healthcare providers have limited reach and insights, limiting their ability to design relevant products for resource limited settings. Our primary preventive health intervention, called the Saathealth family health interventions, is a scaled digital offering that aims to improve knowledge levels on various health topics, nudge positive behaviour changes, and drive improved health outcomes. This case study presents our learnings and best practices in scaling these digital health interventions in resource-limited settings and maximising their impact. We scaled the Saathealth interventions to cumulatively reach >10 million users across India using a multi-pronged approach: (1) ensuring localization and cultural relevance of the health content delivered through user research; (2) disseminating content using omni-channel approaches, which involved using diverse content types and multiple digital platforms; (3) using iterative product features such as gamification and artificial intelligence-based (AI-based) predictive models; (4) using real-time analytics to adapt the user's digital experience by using interactive content to drive them towards products and services and (5) experiments with sustainability models to yield some early successes. The Saathealth family health mobile app had >25,000 downloads and the intervention reached >873,000 users in India every month through the mobile app, Facebook, and Instagram combined, from the time period of February 2022 to January 2023. We repeatedly observed videos and quizzes to be the most popular content types across all digital channels being used. Our AI-based predictive models helped improve user retention and content consumption, contributing to the sustainability of the mobile apps. In addition to reaching a high number of users across India, our scaling strategies contributed to deepened engagement and improved health-seeking behaviour. We hope these strategies help guide the sustainable and impactful scaling of mobile health interventions in other resource-limited settings.

Usage and the effect on knowledge about atrial fibrillation of an educational application, AF-EduApp

Abstract Funding Acknowledgements Type of funding sources: Private company. Main funding source(s): The AF-EduApp study is supported by an BMS/Pfizer European Thrombosis Investigator Initiated Research Program (ERISTA) grant. Introduction As the management of atrial fibrillation patients (AF) is complex, an integrated care approach is suggested, including tackling modifying risk factors together with rate and rhythm control and anticoagulation therapy. Patients often underestimate the effect of these pillars on their health and often have poor knowledge about these aspects. As smart devices have become more important in the past decades, they create opportunities to educate patients and improve the follow-up of these patients. Purpose We aimed to evaluate the usage of an in-house developed application, AF-EduApp, and its effect on patients’ AF knowledge levels. Methods A total of 152 patients with AF were included in this multicenter study with a follow-up of 12 to 15 months. One of the modules of the AF-EduApp contains information on AF, its treatment and related self-care. Knowledge about AF and its treatment was assessed through the Jessa Atrial fibrillation Knowledge Questionnaire (JAKQ) with direct feedback on incorrectly answered questions. The JAKQ (and immediate feedback) were given to the patients via the application at baseline and after 1, 3, 6 and 12 months. Patients are free to decide how frequently they want to use the app (except when questionnaires are available). Results The 152 patients had a total follow-up of 386.8±108.1 days and used the application on 130.1±144.7 days (33.6%). The education module was visited by 135 patients with a median time of 3.1 (IQR: 1.3-21.8) min (mean: 18.6±32.9 min) spent on education. The most visited education chapters were AF treatment (3.1 (0.4-9.5) min) and selfcare (3.1 (0.9-7.1) min)(Fig1). A significant increase in the knowledge level was seen in the 130 patients who completed all 5 moments (p<0.001, Fig 2A). This increase was driven by a significant increase during the first month of follow-up (baseline: 70.4±14.4 vs FU1: 82.4±14.4; p<0.001). The number that one of the 8 questions on AF in general was correctly answered at these 5 time points ranged from 2.7±1.6 to 4.8±0.7 (p<0.001, Fig 2B). The questions ‘Why are most patients with AF prescribed with oral anticoagulation?’ and ‘What is AF?’ were answered best, whereas the questions ‘Is AF always accompanied by symptoms?’ and ‘Can medication prevent AF?’ were most difficult to get right. Conclusion The AF application was reasonably used, about 1 out of every 3 days. Targeted education focused on JAKQ answers that were answered incorrectly significantly improved knowledge level over time. Stronger incentives need to be developed to have patients effectively look at the educational sections that pertain to incomplete knowledge.

A Descriptive Study to Assess Child Nutrition and Health Information Related Knowledge among Mothers of Under Six Years Children in Selected Areas of Dadra & Nagar Haveli

Background: The Health of a country depends on healthy citizens. Healthy children grow up to be healthy adults. Young children, especially those under the age of six are in a vulnerable stage of physical development. Malnutrition during this time can have long-term and irreversible consequences. Mothers have to be made more aware about feeding practices and health-care practices only then it can go a long away in reducing the severity of malnutrition. As per ICDS guidelines on convergence initiatives for improved nutrition, Knowledge of mothers regarding child Nutrition and Health information can be assessed based on five key Nutrition and Health information as follows: (i) importance of colostrum; (ii) continued breastfeeding; (iii) diarrhea prevention and treatment using oral rehydration solution (ORS); (iv) child immunization and (v) family planning. Aim: To assess knowledge regarding child nutrition and health information among mothers of under six year children in selected areas of Dadra and Nagar Haveli. Methodology: A descriptive survey design was used to collect data with structured interview method from 200 mothers which were selected from non-probability convenient sampling technique. Result: Out of 200 mothers whosever taken part in study, 24.50 % had inadequate knowledge, 64.50 % had moderate knowledge and 11.0 % had adequate knowledge. Age, education of mothers and family monthly income were having significant association with knowledge score at 0.05 level of significance. Conclusion: This study concluded that mothers were having moderate knowledge which is affected by mainly age and education of mothers, hence improving knowledge level of mothers can positively impact growth and development of children.

A STUDY TO ASSESS THE EFFECTIVENESS OF STRUCTURED TEACHING PROGRAMME ON KNOWLEDGE AND PRACTICE REGARDING BIOMEDICAL WASTE MANAGEMENT AMONG HOUSEKEEPING STAFF OF GOVERNMENT DOON MEDICAL COLLEGE HOSPITAL , DEHRADUN

Biomedical waste is defined as the waste segregated from the healthcare system that can be contagious, infective and hazardous. If this type of harmful waste is not managed properly it can lead to various health hazards. Thus, the housekeeping staff that are responsible for maintaining cleanliness in hospital and discarding waste should have keen knowledge about Biomedical waste and its handling. Objective- 1. To assess the pre-test knowledge and practice of housekeeping staff regarding biomedical waste management. 2. To assess the post-test knowledge and practice of housekeeping staff regarding biomedical waste management. 3. To assess the effectiveness of structured teaching programme on knowledge and practice regarding biomedical waste management among housekeeping staff. 4. To find out the correlation between knowledge and practice regarding biomedical waste management among housekeeping staff 5. To find out the association between the pre-test level of knowledge and practice score of housekeeping staff with their selected demographic variable. Methodology- A quantitative research approach with pre-experimental research design was used to assess pre test and post test knowledge and practice of housekeeping staff regarding biomedical waste management. A total of 70 samples were taken by using convenience sampling technique. Self structured questionnaire and practice checklist was used to assess knowledge and practice of housekeeping staff. Results- The findings of our study shows that the mean score and standard deviation of pre test knowledge is 6.91±2.37 and post test knowledge is 13.87±1.96 whereas of pre test practice is 3.90±1.78 and post test practice is 8.46±1.00. The t value of knowledge was 21.87 and of practice was 19.37 which is more than tabulated t value 2.00. p<0.05 which shows that there is significant difference in knowledge and practice after the structured teaching programme among the housekeeping staff regarding biomedical waste management.. Conclusion-The findings indicates significant improvement in level of knowledge and practice regarding biomedical waste management among housekeeping staff of Govt. Doon Medical College Hospital, Dehradun.

Can internet development alleviate energy poverty? Evidence from China

Promoting Internet development and eliminating energy poverty are two important policy agendas for China in the era of digital economy. In the context of “Internet + energy”, there is a need to explore whether the development of the Internet can alleviate energy poverty. The aim of this study is to test the influence and transmission mechanism of the development of Internet on energy poverty in China by using provincial panel data from 2011 to 2019. The study found that: (1) energy poverty is still widespread in China, especially in the central and western regions. And the low energy affordability is its major source; (2) the development of Internet can alleviate energy poverty. On one hand, it can improve energy affordability by promoting economic development and technological progress. On the other hand, it also helps to enhance the availability of energy by promoting technological advances and improving knowledge level; and (3) there are nonlinear and regional heterogeneous effects of the development of Internet on the alleviation of energy poverty. Based on the above results, corresponding policy suggestions for China to alleviate energy poverty are provided.

Knowledge of Younger Adults in the Prevention of Risk of Cardiovascular Disease in a Selected Community of Kannur District, Kerala

A cardiovascular disease (CVD) is an umbrella term used for the conditions that affect the heart and vessels. Cardiovascular diseases have become the number one reason behind morbidity and mortality in most countries among younger adults particularly in reproductive age group. It is emerging as a major health concern in fast-developing economies like India. This study aimed to assess the knowledge regarding the prevention of risk of cardiovascular diseases among younger adults in the selected community of Kannur districts of Kerala. A cross-sectional descriptive survey research design was used to conduct this study. Simple random sampling technique was used to select the 132 samples in a selected community. A QRISK2 standardised tool was used as a basis for the development of a knowledge scale to assess the knowledge regarding the prevention of cardiovascular diseases. The results indicated that 83.3 percent of younger adults have good knowledge and 16.7 percent have average knowledge regarding the prevention of cardiovascular diseases. There was improvement in level of knowledge in the prevention of cardiovascular disease among younger adults in an advanced literate society of Kerala; their lifestyle included physical activities, diet patterns. Relevant risk factors causing risk must be studied to curb the menace of CVDs.

Knowledge and Risk Factors of Hepatitis B Disease Among Women Attending Antenatal Care at Arua Regional Referral Hospital, Arua, Uganda

Background Hepatitis B is a highly infectious disease with a prevalence of 4.3% among people aged 15-64 years, with a prevalence of 5.6% in men compared to 3.1% in women in Uganda. Mother-to-child transmission accounts for nearly 50% of new cases per year, and infants who acquire hepatitis B disease before 5 years have a 90% chance of progressing to chronic hepatitis B infection. Objective The study assessed the knowledge and risk factors of hepatitis B disease among women attending antenatal care (ANC) at Arua Regional Referral Hospital (ARRH), Uganda. Methods A cross-sectional study was carried out at ANC at ARRH. Convenience sampling was used, and a sample size of 384 was calculated. Each participant was evaluated using a structured questionnaire and screened for HBsAg using commercial rapid test kits. Assessment of knowledge was performed using a hepatitis B basic knowledge summary score. Data analysis was carried out using MICROSOFT EXCEL-2013 and STATA version 14 packages. Results Poor knowledge levels of hepatitis B disease stood at 17.9%, while 82.1% of the pregnant women had adequate knowledge. A prevalence of 2.05% was obtained from the participants in the study. None of the assessed risk factors was significantly associated with HBsAg positivity. Conclusions The study participants were knowledgeable to a great extent about hepatitis B disease, with 82.1% exhibiting good knowledge of hepatitis B disease. There are gaps in knowledge, especially among the low educated groups, which need to be addressed to improve knowledge levels of hepatitis B disease among these categories in the community. The results show a relatively healthy population given the low prevalence of 2.05% seen in the participants of the study. The absence of a risk factor associated with hepatitis B disease in this study does not imply that there are no risk factors in the community around ARRH. Further studies are recommended to assess more risk factors for hepatitis B disease in the community

Impact of Educational Interventions on the Awareness Regarding Hospital Infection Control Practices Among the Medical Students

Background: More than 1.4 million people all over the world are suffering from infections acquired during hospital stays . Awareness regarding infection prevention and control techniques are important to reduce the burden of such infections, ensuring better quality healthcare. Infection control education is a core component of infection control programs. Objectives: To assess the knowledge and awareness of Medical students in a tertiary care teaching hospital in Central India and to evaluate the impact of educational interventions in eliminating any existing gaps in the same. Methods: This interventional study based on self-administered questionnaires (Google forms) involved fifty medical Students who were administered a pre-structured validated questionnaire as pre-test and post-test before and after an induction training program on infection prevention & control measures. The impact of the educational intervention was evaluated by determining the learning gain. Result: The study reveals a highly significant improvement in knowledge levels after training sessions (p<0.0001). Before training most of the study subjects (68%) showed poor levels of knowledge, 22% exhibited moderate levels while only 10% were found to have good levels of knowledge. After training 36% of trainees showed good levels of knowledge, 40% exhibited moderate levels while only 24% were left with poor knowledge. Conclusion: While evaluating the impact of training in this study, we have found a statistically significant absolute learning gain and a medium level of class average normalized learning gain. These findings prove the effectiveness of such targeted training sessions as an important strategic tool in preventing healthcare-associated infections.

Responsiveness and Uptake of Sexual Reproductive Health and Rights Education and Information Among Young People 10-24 Years Old: A Case Of ‘Get Up Speak Out’ (GUSO) Program Implementation Period in Western Kenya Region

Young people and girls suffer from some of the worst SRHR outcomes in Kenya such as sexual abuse and violence; STIs including HIV; unintended pregnancies; unsafe abortions; early and forced marriages; obstetric fistula; and maternal mortality. Some of the main causes to these poor outcomes include lack of correct and comprehensive information on key SRHR issues. The GUSO program was implemented in western region of Kenya from 2018-2020 with an aim of aim of increasing uptake of SRHR education and information among young people 10-24 years old through 3 strategies: Capacity development for information providers (SRHR curriculum based trainings); Direct access to SRHR information e.g. Electronic & Media platforms (direct messaging and WhatsApp group discussions); and Community approach (table talks and clarification sessions).The findings show that the number of educators trained increased through the three years. There was incremental in number of young people reached with SRHR information and similarly incremental in program realization over targets, meaning increase in willingness among the young people to utilizing the deployed strategies of direct and indirect SRHR. This also means that the deployed strategy of training of trainers to enhance capacity for young people to access information was effective in creating demand for SRHR information. The findings imply that it is possible to realize desired targets on SRHR information access by young people through capacity building and adopting the correct strategies. This study has identified such approaches to include table talks, clarification sessions, and direct messaging. Therefore, the health sector can indeed, by adopting these strategies improve SRHR service utilization among young people that may have a reducing effect to the now high levels of teenage pregnancies and other related consequences. The study has tested and determined that it is feasible to improve access to SRHR education and information among young people through training of educators and adopting proper strategies through which young people access SRH information. Furthermore, the findings have proved that these approaches lead to improved knowledge level, attitude for and SRHR service seeking behaviour for young people.

Male partners' role in maternal health service utilization: a secondary analysis using 2015-16 National Family Health Survey (NFHS) data

ObjectiveWhile prior research has documented several socio-demographic and policy level determinants of maternal health service utilization, the influence of partners and family on women's decisions to use maternal health services has received limited attention. This study focuses on the role of male partners in antenatal care, and examines the association between male partner attendance at antenatal care and maternal health service utilization. DesignCross-sectional observational study. SettingIndia. ParticipantsThis study utilized data from the 2015-16 National Family Health Survey (NFHS-4). Of all the ever-married women who had at least one live birth in the past five years, a total number of 144,840 respondents were included for the analysis on antenatal care utilization and 146,378 respondents were included for the analysis on institutional delivery. MeasurementsThe key dependent variables used for the study were timing and frequency of antenatal care, and institutional delivery; while the primary independent variable for the study was male partner attendance in antenatal care. Weighted descriptive statistics and multivariable logistic regression models were constructed to examine the association between male partner attendance in antenatal care and maternal health service utilization, controlling for participants’ sociodemographic characteristics. ResultsControlling for all socio-demographic variables, the results showed that women who were accompanied by a male partner during antenatal care contacts were 18% more likely to report initiating antenatal care in the first trimester (OR= 1.18, 95% CI [1.13- 1.23]), 72% more likely to report having 4 or more antenatal care contacts (OR= 1.72, 95% CI [1.64 - 1.80]), 45% more likely to report having 8 or more antenatal care contacts during their pregnancy (OR= 1.45, CI [1.35 - 1.55]) and 40% more likely to have an institutional delivery (OR= 1.40, 95% CI [1.34 – 1.48). Key conclusionsFew studies have examined the role of partners and family in influencing women's maternal health service utilization. The results of this study add to the growing knowledge base in the area of male partner involvement in maternal care by demonstrating that male partner attendance in antenatal care is positively associated with maternal health service utilization. Implications for practiceThese results provide support for interventions that aim at a gender transformative approach to maternal health. Engaging with male partners and educating them in antenatal care could lead to improved knowledge levels among the couple, and increased support and access to maternal health services.

P16 Strengthening surveillance systems for antimicrobial resistance in urinary tract infections in Kenya

BackgroundUrinary tract infections (UTIs) are amongst the most common conditions leading to outpatient visits and are also one of the most common causes of inappropriate antibiotic usage. Addressing antimicrobial resistance (AMR) requires strengthening surveillance system in Kenya where UTI is a problem with health systems having limited capacity for accurate laboratory identification of UTI pathogens. Empirical treatment to manage UTIs is the most common problem due to limited microbiology capacity. These include shortages of suitable training, equipment, quality control procedures and professional expertise to make an accurate clinical interpretation of urine cultures. This leads to reporting normal flora as pathogens.ObjectivesTo deliver training on the identification and antibiotic susceptibility testing of bacterial isolates from urine infections at participating hospitals in the Kenyan AMR surveillance network and measure competency levels in staff participating in the training with the aim of strengthening the Kenyan surveillance system.MethodsA 1 day baseline visit to the five sites was made between October and November 2021 using a standardized checklist to assess laboratory capacity. This was followed by urine processing training conducted between November 2021 and January 2022 in Malindi, Jaramogi, Kitale, Nakuru and Nyeri County Hospitals. Training materials were developed with the input of Aga Khan University Hospital. A 5 day in-person training course was delivered at each of the five hospitals, which targeted an average of 2–3 laboratory staff per hospital. The competencies of the laboratory staff were assessed by written pre-assessment and post-assessment tests. A standardized practical assessment was achieved by use of five different control organisms. The scores were done by doing an average performance score at each hospital laboratory.ResultsOut of 13 trainees, 8 were male and 5 were female. The median number of years since qualification for these staff was 6 (IQR 2–9). The median number of total months of microbiology training time was 2.3 (IQR 1–7). The median pre-training and post-training scores were 46% and 90%, respectively; non-parametric Wilcoxon rank test showed statistical difference (P < 0.0001) between pre-training and post-training. All participants improved from pre-to post- training assessment from the 5 day training with marked improvement amongst from staff with lowest previous level of laboratory training.ConclusionsTraining microbiology staff in the accurate processing of urine sample will be an important activity for a Kenyan AMR surveillance system. These training materials, if delivered by an experienced trainer, can achieve a clear improvement in knowledge levels and practical competence for real-life microbiology identifications.

Effectiveness of Structured Teaching Program on Knowledge Regarding Side Effects of Chemotherapy and its Home Management among Cancer Patients

Introduction: Cancer is a multi-factorial disease in which cellular reproduction process goes out of control. Chemotherapy is a widely used treatment for cancer in which cytotoxic drugs or anti-neoplastic drugs are used to kill or shrink fast-growing cells in the body, but it also result in various side effects which depend on the type of drug, dosage, frequency and its duration of administration. Several home remedies are also used to overcome these side effects. Thus, the study aimed to develop and evaluate the effectiveness of structured teaching program on knowledge regarding side effects of chemotherapy and its home management among cancer patients. Methods: - Quasi experimental, Non- equivalent control group research design was used in the study. Total 60 participants were selected in the study by non-probability purposive sampling technique from Pakistan Institute of Medical Sciences. The data was collected by structured knowledge questionnaire tool with interview method for evaluating knowledge level of cancer patients. Structured teaching program was administered in two days for 1 hour (30 minutes in each day). Result: Result showed that the mean pre test score and standard deviation of knowledge level in experimental group is 10.83± 4.13 and 23.33± 2.64 of post test respectively and mean difference of 12.5 Which is highly significant at p value &lt; 0.05 which means the knowledge level of cancer patients was improved after implementation of the structured teaching program By contrast in control group little difference between pre and post test score of knowledge level among cancer patients which is not significant. There was association found between gender, marital status and previous knowledge (p˂0.05). Conclusion: - The findings of present study showed that the structured teaching program was effective and help in improving knowledge level of cancer patients receiving chemotherapy. Educating the cancer patients will help them to become more knowledgeable about their own health, treatment and also help in managing side effects at home. Keywords: cancer, chemotherapy, home management, knowledge, side effects, structured teaching program

Trans Reform: an initiative for the recognition of transgender rights in a university in Lima, Peru

BackgroundThe Peruvian Government does not recognise the identity of transgender and non-binary citizens. This barrier to access affirming identity documents affects access to education, health, and work. No medical school in the country addresses transgender health. Moreover, the experience of institutional discrimination makes this population one of the most vulnerable. We aimed to implement an institutional reform that allowed trans an non-binary student to change their name and gender in the university's documents. MethodsThe Trans Reform aims at reducing discrimination through allowing transgender students from Universidad Peruana Cayetano Heredia to change their name and gender on official school documentation, making it mandatory for everyone in the institution to be educated on trans rights and health, and implementing neutral bathrooms across campus. The principal goal of this programme is to create, sustain, and continuously upgrade a safe space for transgender and non-binary students. We performed a survey to explore the prevalence of transgender and non-binary people as well as their insight on the Trans Reform. The survey was offered to all students within campus and 387 answers were received. Questions included career and year of studies, gender identity, sexual orientation, whether they agreed the reform was necessary and their perceived safety of campus for trans students. The students who self-identified identified as transgender and non-binary were contacted to participate in a focus group to further explore their experience in university along with their expectations and suggestions of the initiative. We will sustain the reform through educational interventions around gender diversity and feedback from our peers. FindingsIn the survey, five students identified as non-binary and two as transgender men. They reported that the main form of discrimination they faced were insults and mockery from peers and teachers. All of non-cisgender students manifested that they did not feel safe to report past incidents with college authorities. Of all 387 students surveyed, 95% agreed that allowing the name and gender change in databases was necessary and 30% manifested that the university was not a safe space for trans and non-binary students. Two students accepted to participate in a focus group and share their testimonies. One student referred to having to drop for a semester because of not feeling welcomed on campus. Emphasis was put on the anxiety of needing to use campus bathrooms and having to answer to professors who refused to use their chosen name. A student said that a psychologist on campus tried to convince him he was not trans. Our project was approved by the University's Council on August 11, 2021. By February 2022, we have implemented the change of name and gender in the institutional email and the Blackboard platform. These changes apply to the whole university. We are actively working for the other university platforms to apply these changes. A pilot educational module including a webinar and a clinical simulation with a transgender patient directed to 4th year medical students was implemented in the second semester of 2021. Preliminary results showed an improvement in level of knowledge and scores in the Transphobia scale but are pending publication. InterpretationWith this milestone we become the first Peruvian Medical School to institutionally advocate for transgender and non-binary students. The next step is to implement courses on transgender rights and health across the curriculum. Furthermore, we hope our precedent serves to encourage Peruvian universities to actively advocate for their gender diverse students. This uptake would positively impact transgender people's access to education and envision a national health system free of transphobia. However, our initiative is limited by the absence of legislature that protects or recognises gender diversity, which is a breakthrough goal in favour of transgender rights. FundingNone.