Parallel Design Research Articles

What Difference does it Make if they have Children? A Mixed Methods Study of the Impact of Children on Service Providers’ Perception of Mandatory Reporting of Intimate Partner Violence

Abstract Purpose Whether professionals consider children to be an important factor regarding mandatory reporting of intimate partner violence (MR-IPV) remains unknown. In the present study, we examined to what extent the presence of children had an impact on service providers’ decision making when faced with IPV, and the parents’ reported consequences of MR-IPV for the children. Methods The present study is a mixed methods study combining quantitative (N = 374 service providers and N = 86 IPV victims) and qualitative (N = 59 service providers and N = 10 IPV victims) data in a convergent parallel design. Descriptive analyses and Kruskal- Wallis H-tests from the quantitative data were used. The analytic process for the qualitative analyses was informed by Braun and Clarke’s thematic analysis. Results The service providers found it easier to set aside confidentiality in IPV cases when the purpose was safeguarding children. The findings indicated some confusion about the difference and interface between the obligation to notify the child welfare service and to report under MR-IPV to the police. IPV victims who had experienced MR-IPV reported mixed consequences for their children. However, more than half reported that their children were better off after the MR-IPV. Conclusions The recognition of the impact of IPV on children in practice, research and policy-making might lead to some inconsistencies and contradictions in how service providers respond to IPV. Accordingly, service providers must take into account the challenges in situations where MR-IPV might be applicable in order to protect both the child(ren) and the victimized adult from IPV.

Impact of Fee Free Education on Teaching Resources for Students with Special Needs in Public Primary Schools in Bukoba Municipality, Tanzania

This study sought to assess impact of fee free education on teaching resources for students with Special needsin special public primary schools in Bukoba municipality, Tanzania. Pragmatic paradigm was employed. Moreover, a mixed-methods approach was used supported by a convergent parallel design. A sample of 50 respondents (3 HTs and 47 normal teachers) was drawn using purposive and simple random sampling techniques from a population of 56 respondents. Questionnaires, observation, documentary reviews and interview were used to collect data. Descriptive statistics for quantitative data and thematic analysis for qualitative data were used as data analysis tools. The study found that, trained and specialised teachers for students with Special needs are inadequate. In regard to the state of instructional resources, findings show that, taped text books and computers with extended keyboards are available while overhead projectors and acoustic rooms were lacking. Concerning strategies adopted by the administration to encounter challenges in special schools, findings indicate that, the school administration involves various education stakeholders in strategic planning of school activities and in decision-making process, and establishes school generating projects. Based on the findings this paper recommends that, the local government authorities should maximise adequate instructional resources and specialised teachers. It is concluded that, trained and specialised teachers and instructional materials for students with Special needsare inadequate. Involvement of various education stakeholders in order to encounter challenges pertaining to these schools should be enhanced.

FIT as a Comparator for Evaluating the Effectiveness of New Non-invasive CRC Screening Test.

Randomized Controlled Trials (RCT) demonstrated that guaiac-based fecal occult blood test (gFOBT), sigmoidoscopy, or colonoscopy are effective at reducing colorectal cancer (CRC) risk and mortality. Even if the impact of fecal immunochemical test (FIT) has not been evaluated within population-based RCT with mortality as the outcome, the results of comparative analyses with gFOBT provide strong indirect evidence of its effectiveness. Extensive information is also available on sensitivity and specificity of FIT, compared with gFOBT. FIT has almost universally replaced gFOBT in organized screening programs worldwide. Using FIT as a comparator is an efficient way to evaluate the effectiveness of new tests, with respect to test performance and relevant intermediate outcomes such as rates of interval cancer and late-stage cancer incidence. Direct comparison with FIT in the pre-screening evaluation of the accuracy of the new test will guide selection of the cut-off of the new test, and document the potential gain in sensitivity. Comparison in cross-sectional single-round screening evaluation can either use paired or parallel designs. Only parallel designs allow direct comparisons ofparticipation rates. Relative accuracy can be derived in both designs with an assumption of similar colorectal cancer and precursor prevalence between groups in parallel designs. Finally, multiple-rounds prospective comparison will document potential effect on risk of CRC and precancerous lesions, and on absolute reductions in late-stage incidence as a proxy of mortality. This paper provides an overview of evidence and rationale for using FIT as a comparator for evaluating new non-invasive tests with repeated testing at short intervals.

Efficacy of Antidepressants in Depression in Breast Cancer: A Systematic Review and Meta-analysis

Background: Breast cancer is the most common malignancy in women worldwide. Depression is a common psychological issue among these patients as they experience significant stress, and it impacts their quality of life. In this regard, the efficacy of antidepressants in depression for breast cancer is not studied. Objective: The objective of the study was to study the efficacy of antidepressants in the management of depression in breast cancer. Methods: Our databases included PubMed, MEDLINE, PsycINFO, Cochrane, Scopus, and Gray literature published in English. Studies included were randomized, placebo-controlled, double-blind trials of antidepressants for women diagnosed with breast cancer and depression. Studies were excluded if they were nonrandomized trials, had an active comparator, or if the antidepressant drug was not primarily used for depression. The severity of depressive symptoms was measured using standardized rating scales for depression. The risk of bias was assessed using the Cochrane risk of bias 2 tool. Covidence and Microsoft Excel were used for data extraction and RevMan 5.4.1 for efficacy outcome estimates, heterogeneity, and sensitivity analysis. Results: Of a total of 155 studies, 13 studies (9 parallel design and 4 crossover) met the inclusion criteria for systematic review and seven for meta-analysis involving 595 participants. The risk of bias assessment showed that five studies had low risk, four studies had some concerns, and four studies had high risk of bias. The antidepressants noted to have a favorable outcome were fluoxetine, paroxetine, mianserin, and mirtazapine. The pooled analysis (standardized mean difference [SMD] −0.28 [confidence interval = −0.56, 0.01] z = 1.87 [P = 0.06]) and subgroup analysis (selective serotonin reuptake inhibitor) did not favor antidepressants (SMD = −0.23 [−0.52, 0.07], z = 1.51, [P = 0.13]). Sensitivity analysis did not show a significant difference in outcome measures between antidepressants and placebo. Considerable heterogeneity, with a value of 69%, was found to be statistically significant (P = 0.003). Conclusion: We conclude that based on the available research, there was no evidence that antidepressants were superior to placebo in the management of depression in breast cancer. The possible reasons for heterogeneity are variations in the duration of study periods and antidepressant administration, different stages of breast cancer, and different scales used for assessing depression in RCTs.

Effect of Male Partner-Targeted Breastfeeding Education and Support Interventions on Optimal Breastfeeding Practices in Central Ethiopia: A Cluster Randomized Controlled Trial.

A male partner or husband is the most influential person in the family, especially in Ethiopia. The role of a male partner or husband in promoting and supporting breastfeeding has hardly been investigated in low- and middle-income countries, including Ethiopia. Therefore, the objective of this study was to evaluate the effect of breastfeeding education and support interventions that focus on male partners, with the goal of promoting optimal breastfeeding practices in central Ethiopia. A two-arm parallel design cluster randomized controlled trial was carried out among couples in a community setting in the Hadiya Zone, Central Ethiopia. Fathers and mothers in the intervention group received breastfeeding education and support via social events, home visits and using printed materials, while those in the control group received existing routine care. A total of 408 couples from 16 clusters were randomly assigned to either the intervention group (n = 204) or the control group (n = 204). A Generalized Estimating Equation (GEE) model was used to evaluate the effectiveness of the interventions. At the end of the interventions, the proportion of optimal breastfeeding practice increased by 19.5% in the intervention group and by 2% in the control group. The differences-in-difference in optimal breastfeeding practice between the intervention and control groups was 17.5% [95% CI: 13.8%-21.2%; p = 0.001]. In the GEE model, babies born to mothers in the mother-father pair group had a 38% higher likelihood [RR = 1.38, 95% CI (1.106, 1.723)] of being optimally breastfed at the sixth month compared with babies born to mothers who received standard care. Breastfeeding education and support interventions targeting male partners in low-resource settings improve optimal breastfeeding practices, highlighting the need to give due emphasis to integrating breastfeeding promotion and counselling for male partners into existing maternal and child health services. Trial Registration: ClinicalTrials.gov identifier (NCT number): NCT05173454, First registered on 30/12/2021.

Investigating the role of the principal's individualized consideration and intellectual stimulation in shaping the academic performance of students in the secondary schools of Sidama Region, Ethiopia

The study sought to investigate the principal's perceptions and actions regarding individualized consideration and intellectual stimulation and their implications for students' academic progress. The study was guided by the following research question: How do school principals' transformational leadership strategies improve students' academic progress in Ethiopia's Sidama region? The study used a convergent parallel mixed research design. The data collection strategy was sound, with a modified questionnaire based on the MLQ used in the quantitative phase and an open-ended semi-structured interview in the qualitative phase. The study's dependent variable was student academic performance, while the independent variable was transformational leadership's individualized consideration (IC) and intellectual stimulation (IS) behaviors. The study's target participants were 95 principals and 5956 teachers. The survey used an appropriate sample approach, with 362 teachers and 91 principals from 24 public secondary schools. The qualitative phase involved ten principals and twenty teachers. The acquired data was analyzed using descriptive and inferential statistics. The study found that principals comprehend and practice transformational leadership behaviors. The study also revealed that the principal's individualized consideration and intellectual stimulation practices significantly impacted students' academic progress. The principal's self-assessment was r =.760 (p<.01), whereas the teachers' perception was r =.583 (p<.01).

Reevaluating antibiotic prophylaxis: insights from a network meta-analysis on dry socket and surgical site infections.

Three databases (MEDLINE, Cochrane Library, and Scopus) were searched in December 2021 for 16 Randomised Clinical Trials (RCTs). Three reviewers reviewed the articles on oral antibiotic prophylaxis (ABP) for the prevention of surgical site infection (SSI) and dry socket (DS) after lower third molar (L3M) extraction using the PICO framework. From 1999 to 2021, RCTs involving healthy patients undergoing L3M extraction with ABP, placebo, or no therapy were included. Adverse effects (AEs) associated with antibiotic usage, along with the main outcomes (DS and SSI), were also documented. Three independent investigators selected articles based on pre-established inclusion criteria, with any disagreements resolved by consensus or additional researchers. PRISMA guidelines were followed, involving initial title and abstract screening, followed by full-text evaluation. Exclusion reasons were documented, and the most recent report was included when multiple reports on the same patients were found, with no language restrictions applied. Two investigators evaluated studies quality and quality of evidence respectively using the Cochrane Collaboration tool and GRADEpro GDT. They independently extracted data, focusing on the type of extraction and the number of extracted L3M. They also detailed the use of antibiotics, including dosage, dosage regimen, timing, and duration. Among 16 articles, 15 used a parallel arm design, while one used a crossover design. The antibiotics studied included Amoxicillin+Clavulanic acid (7 articles), Amoxicillin (6), Metronidazole (2), Azithromycin (1), and Clindamycin (2), all compared with no treatment or placebo. A pairwise meta-analysis was used to combine studies with equivalent treatment (direct estimation), and a network meta-analysis compared outcome variables across different treatments (indirect comparison). Two included articles had a low risk of bias and the level of evidence was low according to GRADE. Pooled results supported the use of antibiotics to reduce DS and SSI following L3M extraction with a number needed to treat 25 and 18, respectively. Despite the fact that ABP reduces the risk of DS and SSI, it is recommended to consider systemic conditions and individual patient risk factors before prescribing antibiotics, due to global health threat.

Olive Leaf Extract Supplementation Improves Postmenopausal Symptoms: A Randomized, Double-Blind, Placebo-Controlled Parallel Study on Postmenopausal Women.

Menopause negatively impacts women's health. Objectives: The aim of this study was to investigate whether an olive leaf extract (OLE) improves postmenopausal symptoms, body composition, handgrip strength and blood lipid profile in postmenopausal women. In a randomized, double-blinded parallel study design, 60 healthy postmenopausal women aged 47-70 years received either OLE (250 mg/day) or placebo supplementation for 12 weeks. Postmenopausal symptoms were assessed with the Menopause-Specific Quality of Life Questionnaire (MENQoL), the Hot Flash Interference scale (HFI), and body composition and bone mineral density (BMD) with a DXA scan; the lipid profile was measured in the blood serum. After six and twelve weeks of OLE supplementation, the overall MENQoL score significantly improved (estimated mean difference [95% CI]: -0.2 [-0.4-0.2], p = 0.027) compared to the placebo. A significant improvement (+0.017 [0.003, 0.030], p = 0.019) was recorded in the BMD in the right arm in the OLE group compared to the placebo. The intervention did not affect other body composition outcomes. TG concentrations and the TG/HDL-C ratio were significantly decreased (-0.1 [-0.2, 0.0], p = 0.010; -0.1 [-0.2, -0.0], p = 0.029, respectively) in the OLE group compared to the placebo. Twelve weeks of daily OLE supplementation improved postmenopausal symptoms. Further studies are needed to elucidate the mechanisms underlying the observed effects.

Wear and use of prostheses in sport by adolescents with upper limb absence: A preliminary mixed-methods study

Background: There is minimal research on sports participation in adolescents with upper limb absence (ULA) and specifically on the impact of prosthesis provision. Objectives: This study explored using activity monitoring sensors and interviews to gain insight into levels of sport participation and associated prosthesis use in active adolescents with ULA. Study design: A mixed methods study using a convergent parallel design. Methods: Semi-structured interviews and activity diaries were used to investigate sports and related activities undertaken during a 2-week period. Prosthesis wear/use were determined via accelerometers worn on the anatomical and prosthetic wrists throughout; interview data added context. For comparison, accelerometer data and activity diaries were captured from similar aged anatomically intact (AI) participants. Results: Three adolescents with unilateral transradial ULA and 4 AI adolescents were recruited. Two ULA participants wore prostheses during sport (16.2% and 56.5% of the time). The third rarely wore their prosthesis. The ability to participate in sport has a powerful influence on participants' lives, and prostheses were used when participants felt they offered specific benefits. In contrast to AI participants, who showed similar reliance on each of their arms throughout, when wearing a prosthesis, users were heavily reliant on the anatomical arm, including during periods playing sports. Conclusions: Prosthesis use facilitated access to some sports, although they were only used by 2 out of 3 participants for short periods. The methods were acceptable to adolescent individuals with ULA.

Transitional Care Support for Medicaid-Insured Patients With Serious Mental Illness: Protocol for a Type I Hybrid Effectiveness-Implementation Stepped-Wedge Cluster Randomized Controlled Trial.

People diagnosed with a co-occurring serious mental illness (SMI; ie, major depressive disorder, bipolar disorder, or schizophrenia) but hospitalized for a nonpsychiatric condition experience higher rates of readmissions and other adverse outcomes, in part due to poorly coordinated care transitions. Current hospital-to-home transitional care programs lack a focus on the integrated social, medical, and mental health needs of these patients. The Thrive clinical pathway provides transitional care support for patients insured by Medicaid with multiple chronic conditions by focusing on posthospitalization medical concerns and the social determinants of health. This study seeks to evaluate an adapted version of Thrive that also meets the needs of patients with co-occurring SMI discharged from a nonpsychiatric hospitalization. This study aimed to (1) engage staff and community advisors in participatory implementation processes to adapt the Thrive clinical pathway for all Medicaid-insured patients, including those with SMI; (2) examine utilization outcomes (ie, Thrive referral, readmission, emergency department [ED], primary, and specialty care visits) for Medicaid-insured individuals with and without SMI who receive Thrive compared with usual care; and (3) evaluate the acceptability, appropriateness, feasibility, and cost-benefit of an adapted Thrive clinical pathway that is tailored for Medicaid-insured patients with co-occurring SMI. This study will use a prospective, type I hybrid effectiveness-implementation, stepped-wedge, cluster randomized controlled trial design. We will randomize the initiation of Thrive referrals at the unit level. Data collection will occur over 24 months. Inclusion criteria for Thrive referral include individuals who (1) are Medicaid insured, dually enrolled in Medicaid and Medicare, or Medicaid eligible; (2) reside in Philadelphia; (3) are admitted for a medical diagnosis for over 24 hours at the study hospital; (4) are planned for discharge to home; (5) agree to receive home care services; and (6) are aged ≥18 years. Primary analyses will use a mixed-effects negative binomial regression model to evaluate readmission and ED utilization, comparing those with and without SMI who receive Thrive to those with and without SMI who receive usual care. Using a convergent parallel mixed methods design, analyses will be conducted simultaneously for the survey and interview data of patients, clinicians, and health care system leaders. The cost of Thrive will be calculated from budget monitoring data for the research budget, the cost of staff time, and average Medicaid facility fee payments. This research project was funded in October 2023. Data collection will occur from April 2024 through December 2025. Results are anticipated to be published in 2025-2027. We anticipate that patients with and without co-occurring SMI will benefit from the adapted Thrive clinical pathway. We also anticipate the adapted version of Thrive to be deemed feasible, acceptable, and appropriate by patients, clinicians, and health system leaders. ClinicalTrials.gov NCT06203509; https://clinicaltrials.gov/ct2/show/NCT06203509. DERR1-10.2196/64575.

Influence of Electronic Procurement Processes on Procurement Performance of Uasin Gishu County Government, Kenya

This study aimed to investigate the influence of electronic procurement processes (e-procurement) on procurement performance in Uasin Gishu County, Kenya. The growing importance of web-based procurement models and information communication technology (ICT) in enhancing supply chain value generation is the backdrop for this research. Although prior studies have indicated the advantages of e-procurement in terms of reduced processing time, cost savings, enhanced data accuracy, and increased efficiency, several gaps and limitations exist in the existing literature. This study addresses these gaps by providing a comprehensive exploration of the impact of various e-procurement dimensions on procurement performance, with a specific focus on a devolved government entity in Kenya. This examination evaluated the influence electronic on performance of Uasin Gishu County, Kenya. The study sought to establish the effect of electronic sourcing and ordering on procurement performance within the county government. The study drew on theoretical frameworks, including the Disruptive Innovation Theory and the Diffusion of Innovation Theory, to determine extent to which electronic procurement influence the performance of procurement unit. A concurrent parallel mixed design was employed to facilitate an in-depth analysis of the research variables. The target population comprises of supply chain officers, user department heads, and accounting officers in Uasin Gishu County Government, totaling 96 respondents. A census sampling method was employed due to the relatively small population size. Data was collected through questionnaires and analyzed quantitatively. The analysis included descriptive statistics such as frequency distributions, means, and standard deviations. The study findings were presented using tables and figures for clarity and easy interpretation. The study concluded that integrating electronic payment into Uasin Gishu County’s e-procurement framework enhances efficiency by speeding up transactions and reducing manual effort and electronic sourcing strengthens supplier engagement, ensures clear communication of requirements, and enables effective performance tracking. The study recommended that adopting electronic invoicing accelerated payments, reduce errors, and improve accuracy. Additionally, investing in an integrated e-procurement system will facilitate seamless communication among departments involved in procurement.

Virtual Coach-Guided Online Acceptance and Commitment Therapy for Chronic Pain: Pilot Feasibility Randomized Controlled Trial.

Veterans are disproportionately affected by chronic pain, with high rates of pain diagnoses (47%-56%) and a 40% higher rate of prevalence of severe pain than nonveterans. This is often accompanied by negative functional outcomes and higher mortality. Combined with research suggesting medical treatments for chronic pain are often insufficient, there is an urgent need for nonmedical pain self-management programs. An interactive online platform to deliver an efficacious treatment for chronic pain such as acceptance and commitment therapy (ACT) could be a valuable option to assist veterans with pain care at home. This study aims to evaluate the virtual coach-guided Veteran ACT for Chronic Pain (VACT-CP) online program compared to a waitlist and treatment as usual (WL+TAU) control group through a small pilot feasibility randomized controlled trial. The primary aim was to evaluate the feasibility and acceptability of VACT-CP and study procedures, such as ease of recruitment, treatment receptivity, attrition and retention, sustained participation, system usability, and assessment of trial procedures. Secondary aims explored differences in the VACT-CP and WL+TAU groups on pre- and posttest (week 7) outcome measures for pain, mental health, functioning, and ACT processes. Veterans with chronic pain were recruited and randomized to either the VACT-CP (n=20) or the WL+TAU (n=22) group in a parallel group trial design. Self-report surveys were administered to participants at baseline (week 0), at the intervention midpoint (week 3), immediately after the intervention (week 7), and at the 1-month follow-up (week 11). We used Wilcoxon signed rank tests with the intention-to-treat sample to describe changes in secondary outcomes from pre- to postintervention within each group. Study procedures showed good feasibility related to recruitment, enrollment, randomization, and study completion rates. Participants reported that VACT-CP was easy to use (System Usability Scale: mean 79.6, SD 12.8; median 82.5, IQR 70-87.5); they completed an average of 5 of the 7 total VACT-CP modules with high postintervention satisfaction rates. Qualitative feedback suggested a positive response to program usability, content tailoring, veteran centeredness, and perceived impact on pain management. Although the pilot feasibility trial was not powered to detect differences in clinical outcomes and significant findings should be interpreted with caution, the VACT-CP group experienced significant increases in chronic pain acceptance (P<.001) and decreases in depressive symptoms (P=.03). VACT-CP showed encouraging evidence of feasibility, usability, and acceptance, while also providing promising initial results in improving a key process in ACT for chronic pain-chronic pain acceptance-after online program use. A full-scale efficacy trial is needed to assess changes in clinical outcomes. ClinicalTrials.gov NCT03655132; http://clinicaltrials.gov/ct2/show/NCT03655132. RR2-10.2196/45887.

Reconfigurable cable-driven parallel mechanism design: physical constraints and control

Abstract The cable-driven parallel mechanism (CDPM) is known as an interesting application in industry to pick and place objects owing to its advantages such as large workspaces. In addition to the advantages of this mechanism, there are some challenges to improving performance by considering constraints in different components, such as the behavior of cables, shape, size of the end effector and base, and model of pulleys and actuators. Moreover, the impact of online geometry reconfiguration must be analyzed. This paper demonstrates the impact of these constraints on the performance of reconfigurable CDPM. The methodology is based on the systematic review and meta-analysis guidelines to report the results. The databases used to find the papers are extracted from Scopus and Google Scholar, using related keywords. As a result, the impact of physical constraints on system performance is discussed. A total of 90 and 37 articles are selected, respectively. After removing duplicates and unrelated papers, 88 studies that met the inclusion criteria are selected for review. Even when considering the physical constraints in modeling the mechanism, simplifications in designing a model for the reconfigurable CDPM generate errors. There is a gap in designing high-performance controllers to track desired trajectories while reconfiguring the geometry, and the satisfaction of physical constraints needs to be satisfied. In conclusion, this review presents several constraints in designing a controller to track desired trajectories and improve performance in future work. This paper presents an integrated controller architecture that includes physical constraints and predictive control.

Effects of Kinesio tape on individuals with carpal tunnel syndrome: a randomized controlled study.

Carpal tunnel syndrome (CTS) is a common neuromuscular disorder with an incidence rate of 4.9%. Research on the impact of Kinesio taping (KT) on electroneurography in individuals with CTS is limited, highlighting a significant gap in the literature. This study aimed to evaluate the effects of KT on palm numbness, pain intensity, hand grip strength, and median nerve electroneuromyography in individuals with mild to moderate CTS. This was a randomized, controlled, parallel design study. Twenty-seven participants diagnosed with CTS through hospital outpatient clinics were randomly assigned to either the control or KT group. The outcome measurements included hand grip strength, the Boston Carpal Tunnel Questionnaire (BCTQ), and electroneurography, assessed at baseline and after 6 weeks of intervention. The statistical method used was non-parametric analysis, comparing differences with the median and interquartile range (IQR). Both the KT and control groups significantly improved the numbness grades, hand grip strength, and the BCTQ. The kinesio-taping group demonstrated an improvement in grip strength with a median increase of 2.21 kg (IQR: 0.65-3.79 kg), compared to the control group, which showed a median increase of only 0.70 kg (IQR: 0.22-1.45 kg). Statistical analysis revealed a significant difference between the two groups (p = 0.039), with an effect size of r = 0.33. This study suggested that KT can be a supplementary treatment to relieve pain intensity, enhance hand grip strength, and improve sensory conduction velocity, motor latency, and motor amplitude. https://doi.org/10.1186/ISRCTN82192319, ISRCTNregistry (No. ISRCTN82192319).

Emergence of African Traditional Medicine: Understanding the Learning Process and Pedagogic Implications for Adolescents of the North West Region of Cameroon

This article examines the global debates about indigenous knowledge and Africa’s traditional medicine from the pedagogy perspective. This study investigated the emergence of African traditional medicine with keen attention on understanding the learning/apprenticeship process and deducing pedagogic implications for adolescents’ learners in the North west Region of Cameroon. Specifically, the paper examined the extent, traditional medicine influence the development of cognitive skills in adolescents. The development of cognitive skills in late adolescents is marked by social competence, decision making, and problem solving. A conceptual review of the major concepts was done. Theoretically, the article was anchored on the social learning theory of Bandura (1977). A convergent parallel mixed method research design was used. The sample of the study emerged through purposive and convenient sampling techniques. A pilot study was done with 10 participants. Interviews were conducted with 15 elders and a questionnaire for 150 adolescents drawn from 6 villages in Oku Subdivision, namely: Elak, Jikijem, Lui, Manchok, Keyon and Simonkoh. Quantitative data was entered using EpiData Version 3.1 (EpiData Association, Odense Denmark, 2008) and analysed using the Statistical Package for Social Sciences (SPSS) Standard version, Release 21.0 (IBM Inc. 2012). Interviews and focus group discussions were transcribed verbatim. Each interview or focus group was prepared as a single primary document and assigned for coding and analysis in Atlas.Ti 5.2 software (Atlas.ti Scientific Software Development GmbH, Berlin, Germany). Statistically the weight of traditional medicine = 80.3%; Traditional medicine (R=0.382; P=0.000);. These are marked by alertness, critical thinking, decision making, social competence, problem solving, imagination, mathematical abilities, etc. From the study it is recommended that indigenous practices be taught formally in schools and that indigenous medicines be studied more keenly and upgraded.

The transition from cigarette smoking to the exclusive or partial use of e-cigarettes: A multi-stage mixed methods study among French university students

BackgroundFew studies have estimated the frequency of e-cigarette use by smoking status among French young adults, and how those who smoke tobacco start and continue to use e-cigarettes. Our aim was to describe e-cigarette use among students who smoked tobacco. MethodsA multi-stage, mixed methods study was conducted at the University of Bordeaux between September 2018 and March 2020. The study consisted of three different sub-studies: 1) a cross-sectional study across five campuses (n = 211), 2) a qualitative study (n = 30), and 3) an online cross-sectional study (n = 415). These were combined to form an explanatory sequential design (stage 1) and then a convergent parallel design (stage 2). ResultsAlthough 41 % of students had tried e-cigarettes at least once in their lifetime, only 7 % were current users. Both e-cigarette experimentation and current use (i.e. occasional or daily use) were mainly found among current and former smokers. Student smokers started using e-cigarettes out of curiosity, with other vapers. Two main factors were identified as intervening in the transition from smoking to sustained vaping: the perception of smoking as problematic and personal commitment to e-cigarette use (i.e. by buying their own device, acquiring technical skills, and increasing the frequency of use). Among current vapers, exclusive vapers and dual users differed in terms of their smoking goals, the role they attributed to e-cigarettes, their identity development and their perceived social or personal benefits. ConclusionThis study highlighted the complexity of the decision-making process for transitioning from smoking to sustained vaping among university students. This required a socially supportive environment and some intrinsic factors, of which the problematization of smoking and personal commitment to vaping were key factors.

Physiological, Performance and Perceptual Effects of Acute Intake of an L-Arginine and L-Citrulline Beverage Prior to a Repeated Bout of Intensive Running Among University Soccer Players

The purpose of this study was to determine whether a combined L-arginine and L-citrulline beverage can enhance total nitric oxide (NOx), as well as physiological (cardiopulmonary metrics) and perceptual (rate of perceived exertion) responses to a repeated bout of high-intensity exercise among university soccer players. Thirty male soccer players were included in a randomized double-blind, placebo-controlled, parallel design. Participants performed two bouts of high-intensity running, spaced two hours apart. Forty minutes before the second bout only, participants consumed a 500 mL beverage containing 6 g L-arginine and 6 g L-citrulline (n = 15) or placebo (n = 15). Blood NOx concentration was measured immediately before and after both bouts. There was no significant increase in NOx or significant interaction effects for physiological, performance, or perceptual variables between the L-arginine/L-citrulline and placebo groups. The peak volume of oxygen uptake of the L-arginine/L-citrulline group was significantly higher in the second compared with the first exercise bout (54.92 ± 4.81 vs. 50.54 ± 9.22 mL/kg/min; p = 0.01). In the second bout of exercise, time to exhaustion in the L-arginine/L-citrulline group increased by 8.5% (~60 s) compared to the first. In conclusion, these results suggest that a single dose of L-arginine/L-citrulline beverage did not increase NOx yet seemed to impact aerobic metabolism in university soccer players.

Effects of Qualitative Interview Participation on Muslim American Identity Integration: A Mixed-Method Investigation

ABSTRACT Participation in research studies about one’s identity has been found to act as a form of counseling intervention. This mixed-method convergent parallel design study sought to examine whether participating in a 45-minute one-on-one semi-structured interview on Muslim American identity integration affected participants’ views of their identity one year later. Participants included 29 ethnically diverse second-generation Muslim Americans residing in the U.S. Midwest who were retained at one-year follow-up from a semi-structured identity interview of 53 participants. Participants completed a survey with measures of identity, identity integration, and open-ended questions inquiring how the study influenced them. Descriptive quantitative analyses and thematic analysis of qualitative data were used to examine the participants’ perceptions of the interview. Qualitative responses displayed five themes (Self-Understanding and Reflection, Affirmation, Connecting With In-Group, “Normal” Conversation Topic, and No Change) aligning with the three primary domains incorporated in ethnic identity development. The blendedness of the participants’ Muslim and American identities, American centrality, and participants’ self-reported positive private regard toward their American identity were lower at Time 2 compared to Time 1. More research is needed regarding the influence of participating in identity-based mixed-methods studies on Muslim American identity formation.

Impact of Informative Videos on Proxy Consent by Parents for Pediatric Surgery: A Randomized Controlled Trial

ABSTRACT Background: Consent is never truly exercised in children as parents act as their proxy and often do not understand the advantages, disadvantages, risks, and benefits of the procedure. Their high anxiety state is mirrored in the child, leading to slower recovery. Hence, this study was designed to understand if an intervention can impact the effect of consent on parents’ anxiety, satisfaction, and knowledge. Methodology: A two-arm, parallel design, randomized controlled trial was conducted from March 2020 to March 2022 to analyze the effect of an educational video in comparison to an informational leaflet in parents giving proxy consents for various listed pediatric surgical procedures. Results: Parents in the video group had a higher mean knowledge score (6.97 vs. 6.77, P = 0.40), comparable satisfaction scores (27.45 vs. 27.58, P = 0.88), and statistically insignificant difference between anxiety scores. We noted highest score of satisfaction (28.5/40) in the parents educated up to High School level or less. Knowledge scores were lowest in pelvic-ureteric junction obstruction (5.1/10) patients. Conclusions: Our study done over a period of 2 years included a variety of diagnoses, and the videos and information leaflets were self-designed. It showed comparable anxiety, knowledge, or satisfaction in parents. Studies with more participants would be needed to take this research forward.

Mobile Heart Rate Variability Biofeedback for Work-Related Stress in Employees and the Influence of Instruction Format (Digital or Live) on Training Outcome: A Non-Randomized Controlled Trial.

Work-related stress is a major health issue in most industrialized countries. Heart rate variability biofeedback (HRV-BfB) can promote resilience and stress coping capacity. Mobile HRV-BfB could contribute to stress prevention in the workplace. Little is known about whether the type of training, with digital or live instruction, has an impact on the training outcome. This study analyzes the psychophysiological effects of four-week workplace resilience training with mobile HRV-BfB and the influence of instruction format (digital or live) on training success. This was a prospective, three-arm, non-randomized controlled trial with parallel group design. 73 employees of a bearing and seal manufacturer (58.9% male, 86.3% full-time employment, 67.1% office workers) attended resilience training with HRV-BfB, live (n = 24) or digital (n = 19) format, or served as waitlist controls (n = 30). HRV-BfB training spanned four weeks. Participants applied resilience techniques to increase HRV using visual biofeedback. Data were collected at baseline (T0), post-intervention (T1), and another four weeks later (T2). Primary outcome measure was the Burnout scale of the Copenhagen Psychosocial Questionnaire (COPSOQ) at T1. Secondary outcome measures included further COPSOQ scales, self-reported sleep quality (Pittsburgh Sleep Quality Index, PSQI), and HRV parameters. Burnout parameters decreased significantly in HRV-BfB and waitlist. The decrease (T0-T1 and T0-T2) showed higher effect sizes in HRV-BfB (Cohen's d: 0.63; 0.69) than in waitlist (d: 0.27; 0.36). Sleep quality improved in HRV-BfB with small effect sizes (no change for waitlist). SDNN (standard deviation of beat-to-beat intervals) increased in HRV-BfB between T0 and T1 (d: 0.23;). In subgroup analysis, digital reached higher effect sizes for improvement in burnout (d: 0.87; 0.92) and sleep quality (d: 0.59; 0.64) than live learning (burnout: d: 0.43; 0.51; sleep quality: d: 0.28; 0.22). HRV-analysis revealed no differences between subgroups. Four-week mobile HRV-BfB resilience training reduced stress and burnout symptoms in employees. No significant differences were found between HRV-BfB digital or live. Hence, companies should choose the approach that fits their company profile or, if possible, offer both formats to accommodate the different needs of employees. However, findings were nonhomogeneous and should be verified by further studies.Trial Registration: ClinicalTrials.gov , NCT04897165, 05/18/2021, retrospectively registered.