Interventional Observational Studies Research Articles

Yoga and nutritional therapies for promoting health-related quality of life in persons with metabolic syndrome-An interventional observational study.

A group of related risk factors known as central obesity, elevated blood pressure, impaired fasting glucose, elevated triglycerides (TGs), and low levels of high-density lipoprotein (HDL) are collectively referred to as metabolic syndrome (MetS). A low quality of life (QoL) in terms of health is linked to MetS. This study sought to determine how lifestyle modifications affected the health-related quality of life (HRQoL) of primary care patients with MetS. In this study, we randomized 300 subjects diagnosed with MetS as per the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria, into control, yoga, and yoga + diet groups according to their intervention which was given for 6 months. Socio-demographic, anthropometric, and physiological and biochemical parameters were collected at baseline, 3 months, and 6 months. The 36-Item Short Form Health Survey (SF-36) was also used to assess HRQoL. The results of this study indicate that yoga + diet and yoga intervention led to significant decrease in metabolic risk factors, such as waist circumference (WC), systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose (FBG), TGs, and increase in HDL at 3 months and 6 months from baseline. SF-36 score also showed increment (from 0 score to 100) at 3 months and 6 months, which indicates improvement in HRQoL. Dietary changes and yoga are useful strategies for reducing the risk of MetS, which improves QoL in relation to health. Incorporating yoga practices and advocating a balanced diet within primary care systems can significantly benefit individuals with or at risk of MetS.

Effect of patient position on the success rate of placing triple-cuffed double lumen endotracheal tubes: a two-center interventional observational study.

Double-lumen endotracheal tubes (DLT) are essential for one-lung ventilation during thoracic surgery. Bronchoscopy is crucial for correct placement of a DLT to avoid complications such as hypoxemia. This study evaluated the effectiveness of the triple-cuffed DLT (tcDLT) in the supine and lateral positions for correct placement without bronchoscopic guidance. This prospective observational study included 167 patients scheduled for elective thoracic surgery requiring one-lung ventilation. The incidence of successful placement of left-sided tcDLTs was compared between the supine and lateral decubitus positions under bronchoscopic surveillance. Successful tcDLT placement was defined as the placement of the proximal end of the bronchial cuff within 5 mm of the carina. Among 153 patients who completed the study, the successful tcDLT placement rate in the lateral position (70.6%) was significantly higher than that in the supine position (50.3%). The rate of difference was 20.3% (95% confidence interval [CI], 10.6-29.9%). The extended successful placement rate, including slightly deeper placements, showed no significant differences between the positions (88.9%; 95% CI, 83.9‒93.9% in supine, 86.3%; 95% CI, 80.8‒91.7% in lateral). tcDLT facilitates correct tube placement in both the supine and lateral positions, with a higher lateral success rate. This finding supports the idea that tcDLTs offer a reliable alternative for lung separation when bronchoscopy is not feasible.

#2020 The use of the target trial approach in kidney failure: a systematic methodological review

Abstract Background and Aims The concept of target trial emulation has recently been introduced and implemented in nephrology as a complement to when randomized trials may not be feasible. Thereby critical questions in the comparative effectiveness and safety of interventions during kidney failure can be addressed. This methodological systematic review aims to evaluate the scope, validity and robustness of the target trial approach for studying outcomes in patients with kidney disease. Method MEDLINE, Embase, and reference lists were searched up until 1st June 2023 to identify studies on kidney disease patients that use target trial emulation. Dual study selection (AA, PK) was undertaken, with a third reviewer settling disagreements (JP). Interventional observational studies were eligible that used target trial emulation to mimic a hypothetical trial where the conduct of a randomized trial was unfeasible, unethical, or untimely. We included studies across the range of chronic kidney diseases, i.e., predialysis, dialysis and transplantation; studies assessing acute disease states (including acute kidney injury) were excluded as well as non-primary research (i.e., case series/editorials/reports/narrative reviews). The quality of reporting and risk of bias was assessed independently by three reviewers and differences resolved through consensus with a fourth reviewer. The critical appraisal was piloted using a previously published reporting checklist and refined throughout the process. Results The systematic search yielded 2883 studies, of which 649 duplicates were removed. From 2232 studies, 367 full-text studies were assessed for eligibility according to target trial emulation criteria and 74 studies were included. A large number of studies (47) focused on patients with kidney failure undergoing renal replacement therapy, mainly haemodialysis. 30 studies were reported before 2019. Of the 74 studies, 46 focused on pharmacological interventions, six on surgical interventions, four on transplantation and 18 on other interventions. Studies used either registries (41), health administration data (4), insurance data (5), electronic health records (15), study databases (8) or other (1). It should be noted that in multiple instances more than one data source was used. The majority (66) of studies did not explicitly mention target trial emulation in the title or abstract. Only a minority (8) of studies explicitly prespecified a target trial protocol. To mitigate confounding, studies mainly focused on exact matching of the groups by using inverse probability weighting and propensity score matching. Conclusion In the past decade the use of the target trial emulation framework in nephrology has substantially increased. However, reporting and quality of study conduct is variable and shows the clear need for a reporting framework to increase clarity and reliability, and to understand to what extent study findings are generalisable into clinical practice to improve health outcomes

Effectiveness of implementation strategies for increasing clinicians' use of five validated imaging decision rules for musculoskeletal injuries: a systematic review.

Strategies to enhance clinicians' adherence to validated imaging decision rules and increase the appropriateness of imaging remain unclear. To evaluate the effectiveness of various implementation strategies for increasing clinicians' use of five validated imaging decision rules (Ottawa Ankle Rules, Ottawa Knee Rule, Canadian C-Spine Rule, National Emergency X-Radiography Utilization Study and Canadian Computed Tomography Head Rule). Systematic review. The inclusion criteria were experimental, quasi-experimental study designs comprising randomised controlled trials (RCTs), non-randomised controlled trials, and single-arm trials (i.e. prospective observational studies) of implementation interventions in any care setting. The search encompassed electronic databases up to March 11, 2024, including MEDLINE (via Ovid), CINAHL (via EBSCO), EMBASE (via Ovid), Cochrane CENTRAL, Web of Science, and Scopus. Two reviewers assessed the risk of bias of studies independently using the Cochrane Effective Practice and Organization of Care Group (EPOC) risk of bias tool. The primary outcome was clinicians' use of decision rules. Secondary outcomes included imaging use (indicated, non-indicated and overall) and knowledge of the rules. We included 22 studies (5-RCTs, 1-non-RCT and 16-single-arm trials), conducted in emergency care settings in six countries (USA, Canada, UK, Australia, Ireland and France). One RCT suggested that reminders may be effective at increasing clinicians' use of Ottawa Ankle Rules but may also increase the use of ankle radiography. Two RCTs that combined multiple intervention strategies showed mixed results for ankle imaging and head CT use. One combining educational meetings and materials on Ottawa Ankle Rules reduced ankle injury imaging among ED physicians, while another, with similar efforts plus clinical practice guidelines and reminders for the Canadian CT Head Rule, increased CT imaging for head injuries. For knowledge, one RCT suggested that distributing guidelines had a limited short-term impact but improved clinicians' long-term knowledge of the Ottawa Ankle Rules. Interventions such as pop-up reminders, educational meetings, and posters may improve adherence to the Ottawa Ankle Rules, Ottawa Knee Rule, and Canadian CT Head Rule. Reminders may reduce non-indicated imaging for knee and ankle injuries. The uncertain quality of evidence indicates the need for well-conducted RCTs to establish effectiveness of implementation strategies.

Choosing Wisely audit: CT KUB ordering in emergency department renal colic presentations.

Our aim was to safely reduce unnecessary CT KUBs (kidneys, ureters, bladder) in patients with renal colic. This was a before and after intervention observational study of 74 patients in April 2023 and 57 patients in October 2023. Seventy-five per cent of patients with suspected renal colic underwent a CT KUB in the pre-audit period. Following education, an update in the ED Renal Colic Policy, electronic medical record ordering and short stay pathway, a re-audit was undertaken in October 2023 resulting in an absolute reduction of 15% of CT KUBs ordered. Audit interventions can reduce unnecessary CT KUBs in renal colic.

Does social isolation mediate the association between hearing loss and cognition in adults? A systematic review and meta-analysis of longitudinal studies.

There has been extensive research on the relationship between hearing and cognitive impairment in older adults but little examination of the role of mediating factors. Social isolation is a potential mediator, occurring because of hearing loss, and contributing to accelerated cognitive decline. Previous systematic reviews on this topic area have not considered the temporal nature of hearing loss and cognitive impairment exclusively or examined potential mediators within a longitudinal study design. A systematic review was conducted. Electronic searches were performed in Web of Science, PubMed (Medline), Scopus, EMBASE, PsychInfo, and ProQuest (PsychArticles and ProQuest Dissertation and Theses) based on a search string of keywords relating to hearing loss, social isolation, and cognitive impairment/dementia in June 2023. Papers were critically appraised using the CASP checklists for cohort studies. Risk of bias in the selected studies was assessed using the Item Bank for Assessment of Risk of Bias and Precision for Observational Studies of Interventions or Exposures. Eleven of the 15 included studies provide evidence of a dose-dependent association between hearing threshold (40 dB HL or greater) and later cognitive impairment or incident dementia. Only one study included social isolation as a mediator, which was found to not be a significant contributing factor. The meta-analysis of 5 studies pooled hazard ratio for cognitive impairment due to hearing loss is 1.11 (95% CI: 1.06 to 1.15, p < 0.001). The pooled hazard ratio for incident dementia due to hearing loss was HR 1.21 (95% CI: 1.11 to 1.31, p = 0.002). The analysis of included studies indicate that hearing threshold level affects later cognitive status or dementia diagnosis. There is not enough evidence to determine the role of social isolation as a mediator. Future epidemiology studies need to measure different elements of social isolation and ensure that hearing and cognition are measured at multiple time points.

Peer Support in Rheumatic Diseases: A Narrative Literature Review.

Rheumatic diseases are a group of chronic conditions that are associated with significant morbidity, impaired physical function, psychosocial stress, and cost to the healthcare system. Peer support interventions have been shown to have a positive impact on health outcomes in several chronic conditions, but no review has specifically assessed the impact of peer support on rheumatic conditions. The aim of this narrative literature review was to understand how peer support has been applied in the field of rheumatology, with a specific focus on the impact of observational and randomized studies of direct peer support interventions on various outcome measures across rheumatic conditions. We also examined studies exploring patient attitudes and preferences toward peer support. The majority of studies included focused on peer support in rheumatoid arthritis and systemic lupus erythematosus. Generally, patients across the spectrum of rheumatic disease perceive peer support as a useful tool. Peer support interventions, while highly variable, were generally associated with positive impacts on health-related quality of life metrics (both perceived and measured), although these differences were not always statistically significant. Important limitations include variability in study design, selection bias among study participants, and short follow-up periods across most peer support interventions.

Reporting quality of abstracts and inconsistencies with full text articles in pediatric orthopedic publications

Backgrounds should provide a brief yet comprehensive reporting of all components of a manuscript. Inaccurate reporting may mislead readers and impact citation practices. It was our goal to investigate the reporting quality of abstracts of interventional observational studies in three major pediatric orthopedic journals and to analyze any reporting inconsistencies between those abstracts and their corresponding full-text articles.MethodsWe selected a sample of 55 abstracts and their full-text articles published between 2018 and 2022. Included articles were primary therapeutic research investigating the results of treatments or interventions. s were scrutinized for reporting quality and inconsistencies with their full-text versions with a 22-itemized checklist. The reporting quality of titles was assessed by a 3-items categorical scale.ResultsIn 48 (87%) of articles there were abstract reporting inaccuracies related to patient demographics. The study's follow-up and complications were not reported in 21 (38%) of abstracts each. Most common inconsistencies between the abstracts and full-text articles were related to reporting of inclusion or exclusion criteria in 39 (71%) and study correlations in 27 (49%) of articles. Reporting quality of the titles was insufficient in 33 (60%) of articles.ConclusionsIn our study we found low reporting quality of abstracts and noticeable inconsistencies with full-text articles, especially regarding inclusion or exclusion criteria and study correlations. While the current sample is likely not representative of overall pediatric orthopedic literature, we recommend that authors, reviewers, and editors ensure abstracts are reported accurately, ideally following the appropriate reporting guidelines, and that they double check that there are no inconsistencies between abstracts and full text articles. To capture essential study information, journals should also consider increasing abstract word limits.

Fast Pace Sun Salutations (FPSS) Yoga Postures Influence Brain waves Activity in Addition to Heart Rate Variability Pattern: A Pilot Study

ABSTRACT Background: Sun salutation (Surya namaskar) is an ancient yogic exercise, which is a combination of 12 different postures rhythmically. Yoga practitioners perform this procedure in a slow as well as fast pace manner. Aim: We undertook this study to find out the immediate changes in heart rate variability (HRV) and brain waves spectrum after the practice of fast pace sun salutation (FPSS). Settings and Design: This prospective interventional observational study was conducted on 30 male healthy subjects in the 30–45 years age group from September 2021 to December 2021 after approval from the Institutional Ethics Committee. Participants gave their written consent in the prescribed format. Materials and Methods: Fourteen rounds of FPSS were performed in approximately 10 min under the guidance of a yoga expert. Brain Tap Dinamika Machine (Advanced HRV Test System, Moscow, Russia) was used to assess different HRV and brain waves parameters before and after FPSS. Statistical Analysis Used: Statistical analysis was done by Student’s paired t-test using GraphPad online software. Results: All independent variables of time and frequency domain analysis of HRV were found to be increased after the intervention. A significant upsurge in low frequency (LF)% as compared to high frequency (HF)% and very low frequency (VLF)% showed a relative increase in sympathetic activity. In brain waves, delta, theta, and alpha were decreased, whereas activities of beta and gamma waves were found to be increased. Conclusions: Increase in both LF and HF components showed that both sympathetic and parasympathetic components have increased. Brain wave analysis suggested increased mental alertness after FPSS.

Necessity of fixation of fibula in distal tibia fractures

Background: Distal tibia fractures and concomitant fibula fracture associated with soft tissue injury present as common orthopedic problems. This study evaluates the need to fix fibula fractures which are associated with closed distal third tibia fractures. Methods: An interventional observational study was undertaken to analyse the efficacy of fixation of fibula, in a Tertiary care hospital with a sample size of 78 patients which were divided into 2 groups of 39 patients each- one in which fibula was fixed (A)-with nail (A1); with plate (A2) and one in which fibula was not fixed (B). Cases were followed up for a mean period of six months post-operatively. Results: The comparison of functional outcome among both groups showed that combined group A (A1+A2) had 4 (10.25%) excellent functional outcome as compared to 1 in group B (2.56%). Group A shows better functional outcome as compared to group B with significant statistical difference. The mean duration of bone union in Group A1 was 21.26±1.43 weeks, A2 was 21.08±1.38 weeks and in group B was 23.60±2.47 weeks showing a statistically significant difference. Conclusions: Fixation of fibula proved to facilitate ease of reduction of tibia and better rotational and angular stability with a superior ankle range of motion. The method of fixation of fibula did not seem to impact the outcome as long as the alignment, length, rotation were not compromised. Wound complications are not uncommon with precarious skin around the ankle, and should be managed appropriately.

Quality of observational studies of clinical interventions: a meta-epidemiological review

BackgroundThis meta-epidemiological study aimed to assess methodological quality of a sample of contemporary non-randomised clinical studies of clinical interventions.MethodsThis was a cross-sectional study of observational studies published between January 1, 2012 and December 31, 2018. Studies were identified in PubMed using search terms ‘association’, ‘observational,’ ‘non-randomised’ ‘comparative effectiveness’ within titles or abstracts. Each study was appraised against 35 quality criteria by two authors independently, with each criterion rated fully, partially or not satisfied. These quality criteria were grouped into 6 categories: justification for observational design (n = 2); minimisation of bias in study design and data collection (n = 11); use of appropriate methods to create comparable groups (n = 6); appropriate adjustment of observed effects (n = 5); validation of observed effects (n = 9); and authors interpretations (n = 2).ResultsOf 50 unique studies, 49 (98%) were published in two US general medical journals. No study fully satisfied all applicable criteria; the mean (+/−SD) proportion of applicable criteria fully satisfied across all studies was 72% (+/− 10%). The categories of quality criteria demonstrating the lowest proportions of fully satisfied criteria were measures used to adjust observed effects (criteria 20, 23, 24) and validate observed effects (criteria 25, 27, 33). Criteria associated with ≤50% of full satisfaction across studies, where applicable, comprised: imputation methods to account for missing data (50%); justification for not performing an RCT (42%); interaction analyses in identifying independent prognostic factors potentially influencing intervention effects (42%); use of statistical correction to minimise type 1 error in multiple outcome analyses (33%); clinically significant effect sizes (30%); residual bias analyses for unmeasured or unknown confounders (14%); and falsification tests for residual confounding (8%). The proportions of fully satisfied criteria did not change over time.ConclusionsRecently published observational studies fail to fully satisfy more than one in four quality criteria. Criteria that were not or only partially satisfied were identified which serve as remediable targets for researchers and journal editors.

Assessment of Personal Hygiene Attitudes among Primary School Pupils in Umbada Locality, Khartoum state (2018-2020), Sudan

Background: Personal hygiene is the behaviors that must be practiced in daily life, starting from morning to sleep time to protect our health.&#x0D; Objectives: The current study aimed to assess personal hygiene attitudes among Primary School Pupils in Umbada Locality, Khartoum state, Sudan (2018-2020).&#x0D; Materials and methods: An observational interventional study was conducted besides a pre- &amp; post-assessment was done. Pre-test and post-test intervention was used to determine the practices of hygiene among primary school Pupils in some selected schools of Umbada locality Alaemir unit. The targeted populations were primary school Pupils in Government schools only. The study populations were the pupils in the Primary public schools by a total number of 37850 Pupils (grade 5, grade 6 and grade7) distributed among 180 public primary schools in the locality. The sample size consisted of (800) pupils during the period of the study. A pre- and post- questionnaire was carefully prepared, tested and directed to the pupils. It covers pupil’s age, sex, and the classroom., source of water supply and latrine in the house there, and to obtain data regarding knowledge, attitudes, and practices (as regards personal hygiene in both pre and post intervention phases. Data was analyzed using Statistical Package for Social Sciences SPSS Computer Program Version (19.0). &#x0D; Results: The study revealed that the overall attitude of pupils, about personal hygiene was increased from 45.8% to 54.2 % after intervention of health education sessions. &#x0D; Conclusion: Health education has a significant role in promoting attitude of school pupils regarding personal hygiene. The need for more health education concerning personal hygiene to ensure that all children learn at an early age how to protect themselves and others from preventable exposure to illness and other hazards related to poor hygiene. This can be carried out through formal (as a part of the curriculum) and informal health education messages.

Assessment of Personal Hygiene Attitudes among Primary School Pupils in Umbada Locality, Khartoum state (2018-2020), Sudan

Background: Personal hygiene is the behaviors that must be practiced in daily life, starting from morning to sleep time to protect our health.&#x0D; Objectives: The current study aimed to assess personal hygiene attitudes among Primary School Pupils in Umbada Locality, Khartoum state, Sudan (2018-2020).&#x0D; Materials and methods: An observational interventional study was conducted besides a pre- &amp; post-assessment was done. Pre-test and post-test intervention was used to determine the practices of hygiene among primary school Pupils in some selected schools of Umbada locality Alaemir unit. The targeted populations were primary school Pupils in Government schools only. The study populations were the pupils in the Primary public schools by a total number of 37850 Pupils (grade 5, grade 6 and grade7) distributed among 180 public primary schools in the locality. The sample size consisted of (800) pupils during the period of the study. A pre- and post- questionnaire was carefully prepared, tested and directed to the pupils. It covers pupil’s age, sex, and the classroom., source of water supply and latrine in the house there, and to obtain data regarding knowledge, attitudes, and practices (as regards personal hygiene in both pre and post intervention phases. Data was analyzed using Statistical Package for Social Sciences SPSS Computer Program Version (19.0). &#x0D; Results: The study revealed that the overall attitude of pupils, about personal hygiene was increased from 45.8% to 54.2 % after intervention of health education sessions. &#x0D; Conclusion: Health education has a significant role in promoting attitude of school pupils regarding personal hygiene. The need for more health education concerning personal hygiene to ensure that all children learn at an early age how to protect themselves and others from preventable exposure to illness and other hazards related to poor hygiene. This can be carried out through formal (as a part of the curriculum) and informal health education messages.

Overlap Violations in Clustered Observational Studies of Educational Interventions

In education settings, treatments are often non-randomly assigned to clusters, such as schools or classrooms, while outcomes are measured for students. This research design is called the clustered observational study (COS). We examine the consequences of common support violations in the COS context. Common support violations occur when the covariate distributions of treated and control units have substantial areas of non-overlap. Such violations are likely to occur in a COS, especially with a small number of treated clusters. We provide a comprehensive review of methods for overlap violations in the context of COS designs. We provide an overview of diagnostic tests and trimming methods to ensure overlap holds for the distributions of treated and control covariates. We then outline how trimming changes the estimand and how profiling can be used to understand the causal quantity for which overlap holds. Finally, we demonstrate how steps to achieve adequate overlap can result in very narrowly defined causal effects that may have little policy relevance. We use data on Catholic schools to illustrate concepts throughout.

Short-Term Health Outcomes of a Structured Pulmonary Rehabilitation Program Implemented Within Rural Canadian Sites Compared With an Established Urban Site: A Pre-Post Intervention Observational Study

ObjectivesTo evaluate congruence in program delivery and short-term health outcomes of a structured pulmonary rehabilitation (S-PR) program implemented at 11 Canadian rural pulmonary rehabilitation (PR) sites compared with an urban reference site. DesignMulti-center, pre- and post-intervention, comparative, observational study. SettingEleven rural Canadian PR sites and 1 urban reference PR site. ParticipantsAdults with chronic respiratory diseases (CRDs) referred to PR. InterventionClinicians at the reference site worked with local clinicians to implement the S-PR program in rural sites. A PR survey evaluated site congruence with the S-PR components, with congruence defined as delivering program components ≥80% in alignment with the S-PR program. Participants were enrolled in 16 sessions of group education and supervised exercise, offered twice or thrice a week. Health outcomes were tracked using a quality assurance database. Outcome MeasuresMain outcomes were congruence in program delivery and changes in the 6-minute walk (6MW) distance and COPD Assessment Test (CAT). ResultsA total of 555 participants (rural n=204 and reference n=351) were included in the analyses. There was congruence in exercise and group education; however, individual education varied. Following the S-PR program, 6MW distance increased, with greater changes observed at rural sites (51±67 m at rural sites vs 30±46 m at the reference site). CAT score was reduced by -2.6±5.4 points with no difference between reference and rural sites. Changes in 6MW distance and CAT scores were similar for participants at sites that were congruent vs noncongruent with the individual education component, and similar for patients with COPD, asthma, bronchiectasis, and interstitial lung disease. ConclusionThe S-PR program components can be implemented with good congruence in Canadian rural settings, resulting in similar short-term health outcomes as in an established urban site and across CRDs.

Role of Health Education in Promoting Knowledge, to-wards Personal Hygiene Among Primary School Pupils in Umbada locality, Khartoum State, Sudan (2018 - 2020)

Background: Personal hygiene is the behaviors that must be practiced in daily life, starting from morning to sleep time to protect our health.&#x0D; Objectives: This study aimed to assess the role of health education in promoting knowledge of personal hygiene among Primary School Pupils in Umbada locality, Khartoum State Sudan (2018 - 2020)&#x0D; Materials and methods: The study design an observational interventional study was conducted where a pre and post- assessment was done. Pre-test and post-test was used to determine the practices of hygiene among primary school Pupils in some selected schools of Umbada locality al emir unit. The targeted population was primary school Pupils in Government schools only. The study populations were the pupils in the Primary public schools with a total number of 37850 Pupils (grade 5, grade 6 and grade7) distributed among 180 public primary schools in the locality. The sample size consisted of (800) pupils during the period of the study. A pre and post- questionnaire was carefully prepared, tested and directed to the pupils . It covers pupil’s age, sex, and the classroom. , source of water supply and latrine in the house there, and to obtain data regarding knowledge, attitude, and practices (as regards personal hygiene in both pre and post-intervention phases. Data was analyzed using Statistical Package for Social Sciences SPSS Computer Program Version (19.0). &#x0D; Results: The study revealed that the overall knowledge of pupils about personal hygiene was increase from 38.7% to 61.3% after intervention of health education packages.&#x0D; Conclusion: Due to gaps in many items of knowledge, attitude and practice regarding personal hygiene, there is need of the proper health education intervention through framework of schools to the school children, for improvement regarding personal hygiene among them, throughout the nation. Health education has significant role in promoting knowledge of school pupils regarding personal hygiene.

Role of Health Education in Promoting Knowledge, to-wards Personal Hygiene Among Primary School Pupils in Umbada locality, Khartoum State, Sudan (2018 - 2020)

Background: Personal hygiene is the behaviors that must be practiced in daily life, starting from morning to sleep time to protect our health.&#x0D; Objectives: This study aimed to assess the role of health education in promoting knowledge of personal hygiene among Primary School Pupils in Umbada locality, Khartoum State Sudan (2018 - 2020)&#x0D; Materials and methods: The study design an observational interventional study was conducted where a pre and post- assessment was done. Pre-test and post-test was used to determine the practices of hygiene among primary school Pupils in some selected schools of Umbada locality al emir unit. The targeted population was primary school Pupils in Government schools only. The study populations were the pupils in the Primary public schools with a total number of 37850 Pupils (grade 5, grade 6 and grade7) distributed among 180 public primary schools in the locality. The sample size consisted of (800) pupils during the period of the study. A pre and post- questionnaire was carefully prepared, tested and directed to the pupils . It covers pupil’s age, sex, and the classroom. , source of water supply and latrine in the house there, and to obtain data regarding knowledge, attitude, and practices (as regards personal hygiene in both pre and post-intervention phases. Data was analyzed using Statistical Package for Social Sciences SPSS Computer Program Version (19.0). &#x0D; Results: The study revealed that the overall knowledge of pupils about personal hygiene was increase from 38.7% to 61.3% after intervention of health education packages.&#x0D; Conclusion: Due to gaps in many items of knowledge, attitude and practice regarding personal hygiene, there is need of the proper health education intervention through framework of schools to the school children, for improvement regarding personal hygiene among them, throughout the nation. Health education has significant role in promoting knowledge of school pupils regarding personal hygiene.

The potential value of observational studies of elective surgical interventions using routinely collected data

PurposeTo assess the apparent validity of observational studies of elective arthroplasty interventions. MethodsData from the nationwide Dutch Arthroplasty Register were used. The first case study compared surgical approaches for total hip arthroplasty (posterolateral approach vs. straight lateral approach), where allocation of the intervention was assumed to be mostly independent of patient characteristics. The second case study compared fixation methods (cemented vs. uncemented), where choice of fixation method was expected to depend on patient characteristics. The potential for confounding was quantified by differences between intervention groups and the impact of confounding adjustment. ResultsThe study of posterolateral approach versus straight lateral approach included 73,750 and 16,557 patients, respectively, and showed no meaningful differences in patient characteristics between treatment groups (standardized mean differences <0.1) and also no relevant impact of confounding adjustment (Z-scores <1). The study of cemented versus uncemented total hip arthroplasty (THA) included 29,579 and 79,360 patients, respectively. Several meaningful imbalances were observed in patient characteristic between the two treatment groups (standardized mean differences >0.1), as well as a relevant impact of confounding adjustment (Z-scores >2). ConclusionsThis study provides insight in the reasoning behind the credibility of observational studies of surgical interventions using routinely collected data and when confounding is expected to have a major impact and thus additional precautions to limit confounding are needed.

Assessment of Personal Hygiene Practices among Primary School Pupils in Umbada locality, Khartoum state, Sudan (2018-2020)

Background: Personal hygiene is the behaviors that must be practiced in daily life, starting from morning to sleep time to protect our health.&#x0D; Objectives: The current study aimed to assess personal hygiene practices among Primary School Pupils in Umbada Locality, Khartoum state, Sudan (2018-2020).&#x0D; Materials and methods: An observational interventional study was conducted where a pre- and post-assessment was done. Pre-test and post-test intervention was used to determine the practices of hygiene among primary school Pupils in some selected schools of Umbada locality al emir unit. The targeted population was primary school Pupils in Government schools only. The study populations were the pupils in the Primary public schools by a total number of 37850 Pupils (grade 5, grade 6 and grade7) distributed among 180 public primary schools in the locality. The sample size were consist of (800) pupils during the period of the study. A pre- and post- questionnaire was carefully prepared, tested and directed to the pupils. It covers pupil’s age, sex, and the classroom; source of water supply and latrine in the house there, and to obtain data regarding knowledge, attitude, and practices (as regards personal hygiene in both pre and post intervention phases. Data was analyzed using Statistical Package for Social Sciences SPSS Computer Program Version (19.0). &#x0D; Results: The study revealed that the overall practice of pupils, about personal hygiene was increased from 39% to 61% after intervention of health education sessions. &#x0D; Conclusion: Health education has significant role in promoting the practice of school pupils regarding personal hygiene. Moreover, motivational approaches and programs to encourage children about their primacy personal hygiene should be adopted and implemented.

Assessment of Personal Hygiene Practices among Primary School Pupils in Umbada locality, Khartoum state, Sudan (2018-2020)

Background: Personal hygiene is the behaviors that must be practiced in daily life, starting from morning to sleep time to protect our health.&#x0D; Objectives: The current study aimed to assess personal hygiene practices among Primary School Pupils in Umbada Locality, Khartoum state, Sudan (2018-2020).&#x0D; Materials and methods: An observational interventional study was conducted where a pre- and post-assessment was done. Pre-test and post-test intervention was used to determine the practices of hygiene among primary school Pupils in some selected schools of Umbada locality al emir unit. The targeted population was primary school Pupils in Government schools only. The study populations were the pupils in the Primary public schools by a total number of 37850 Pupils (grade 5, grade 6 and grade7) distributed among 180 public primary schools in the locality. The sample size were consist of (800) pupils during the period of the study. A pre- and post- questionnaire was carefully prepared, tested and directed to the pupils. It covers pupil’s age, sex, and the classroom; source of water supply and latrine in the house there, and to obtain data regarding knowledge, attitude, and practices (as regards personal hygiene in both pre and post intervention phases. Data was analyzed using Statistical Package for Social Sciences SPSS Computer Program Version (19.0). &#x0D; Results: The study revealed that the overall practice of pupils, about personal hygiene was increased from 39% to 61% after intervention of health education sessions. &#x0D; Conclusion: Health education has significant role in promoting the practice of school pupils regarding personal hygiene. Moreover, motivational approaches and programs to encourage children about their primacy personal hygiene should be adopted and implemented.