Quasi-experimental Research Articles

Funeral support services for socio-economically deprived bereaved people in Hong Kong: An exploratory study of their effectiveness

This study aimed to explore the effectiveness of funeral support services for socio-economically deprived bereaved people in Hong Kong. Via a questionnaire, service users were asked to report their psychosocial status in different domains before and after the services. A quasi-experimental design was also used to compare service users with non-service users in different psychosocial domains after the funerals had taken place. Findings showed that service users indicated positive changes after the use of the services, such as reduced negative emotions and enhanced understanding of how post-death matters/funerals could be handled. This study provides preliminary evidence of the benefits of funeral support services and suggests the importance of funeral support for socio-economically deprived bereaved people. Findings may help reflect on the provision and accessibility of funeral support services in the community and give insights into the way formal bereavement service providers may better support bereaved people in the community.

The impact of educational intervention based on the theory of planned behavior on preventive behaviors for gastric cancer in obese and smoking individuals

BackgroundGastric cancer remains a significant global health issue due to its aggressive nature and high heterogeneity, making early detection and prevention critical. Obesity and smoking are established risk factors that significantly contribute to the development of gastric cancer. Despite the clear links between these risk factors and the disease, there is a lack of targeted educational interventions that address these behaviors. This study aims to fill this gap by investigating the impact of an educational intervention based on the Theory of Planned Behavior (TPB) on promoting preventive behaviors for gastric cancer among obese and smoking individuals.MethodsThis quasi-experimental study was conducted in 2021–2022 on 150 obese or overweight individuals, more than 25 years old who smoked (cigarettes and hookah) in Fasa city, Iran. From six urban health centers, two centers were randomly selected (one as the experimental group and the other as the control group). Data collection tools included a demographic characteristics questionnaire based on the TPB model (a researcher-made questionnaire). Based on pre-test results, the educational intervention for the experimental group included 12 educational sessions for 50 min, following the TPB model, through lectures, Question and Answers, group discussions, practical demonstrations, video clips, and PowerPoint presentations. The questionnaires were completed by both groups before and six months after the intervention. Data were analyzed using SPSS 22 and descriptive and analytical statistical methods (paired t- test, McNemar test, Chi-square test, and independent t-test) (p < 0.05).ResultsThe results showed no significant difference between the two groups before the educational intervention. However, six months after the intervention, the experimental group showed a significant increase in TPB model cues (awareness, attitude, subjective norms, perceived behavioral control, behavioral intention, and behavior) (P < 0.001).ConclusionThe findings of the present study indicate that the educational intervention based on the TPB model is useful in improving gastric cancer screening and preventive behaviors. It can also be used in planning and implementing appropriate programs to prevent and treat this disease.

A Study on the Response of Concurrent Chemoradiation with Gemcitabine Versus Cisplatin in Patients with Locally Advanced Cervical Carcinoma

Introduction Cervical cancer is the most common cause of cancer death in women. Currently, platinum-based concurrent chemoradiation therapy is the standard of care for locally advanced cervical cancer but treatment results are disappointing, particularly for women with bulky tumors. Several non-platinum-based agents with concurrent chemoradiation have been evolved to improve this result. Objective To compare the response between concurrent chemoradiation with gemcitabine and cisplatin followed by intracavitary radiotherapy in patients with locally advanced cervical carcinoma. Material and methods This was a quasi-experimental study, where 66 patients with untreated invasive squamous cell carcinoma of the cervix of stage IIB to stage IVA were enrolled from the Radiation Oncology Department of Rajshahi Medical College Hospital from April 2019 to March 2020. The duration of the study was 2 years. In each arm 33 patients were assigned to receive 150 mg/m² of gemcitabine (arm A) or received 40mg/m2 of cisplatin (arm B) weekly along with external beam radiation therapy (EBRT). EBRT dose was 50 Gy in 25 daily fractions followed by intracavitary radiotherapy (ICRT) of 21 Gy in 3 fractions. Results The mean age was 45.4 years &amp; 47.3 years in arm A &amp; B respectively. Most patients were in the stage IIB group (59.1% patients) and most were moderately differentiated (62.1% patients) in both arms. After 3 months of treatment, the complete response was found in 81.8% &amp;72.7% of patients and partial response was seen in 12.1% &amp; 18.2% of patients in arm A &amp; B respectively (p=0.678). The grade 2 and 3 hematological toxicities (anemia, neutropenia, thrombocytopenia) were more common in arm A compared to arm B (p&lt;0.05). The grade 2 and 3 proctitis &amp; skin toxicity were higher in arm A &amp; renal toxicity was higher in arm B (p=0.163). Conclusion Concurrent chemoradiation with gemcitabine can be used as an alternative to cisplatin when cisplatin is contraindicated. However, further large, randomized study is needed to reach any form of conclusion.

Utilizing Propensity Score Matching Analysis to Examine the Effects of Postsecondary Education on the Employment Outcomes of Young Adults with Mental Illnesses

Background Helping young adults with mental illnesses attend college will increase their chances of being employed with benefits, which can pave the way for a successful career and a middle-class life. Objective This study sought to examine whether receiving vocational rehabilitation (VR) services of four-year college or university training would lead to improved employment outcomes for young adults with mental illnesses. Methods Based on the Rehabilitation Services Administration (RSA)-911 data, a propensity score matching technique was employed to create a comparison group of young adults with mental illnesses who did not receive college or university training and a treatment group of those who did. The quasi-experimental design investigated differences in the employment outcomes between the two groups. Results Analyses revealed that the group who received college or university training was more likely to be engaged in competitive integrated employment upon exit from the VR program than the matched comparison group who did not receive the training. Participants with mental illnesses who received college or university training and had secured competitive integrated employment at the time of exit not only had significantly higher hourly wages and worked more hours per week than did non-college or university training recipients, they were also more likely to obtain employer-subsidized health insurance benefits. Conclusions College and university training is positively related to employment outcomes for young people with mental illnesses. Implications for state VR counsellors are discussed.

Role of regular medical visits in mitigating increased suicide risk during the early COVID-19 pandemic in Kobe, Japan

BackgroundJapan has one of the lowest COVID-19 death rates, while the annual suicide rate in 2020 has risen for the first time since 2007. This study aimed to identify high-risk populations and assess the impact of medical visits on suicide trends post-COVID-19 pandemic in Japan.MethodThis quasi-experimental study analyzed a population-based database from Hyogo Prefecture (2012–2022). Interrupted time-series analyses identified level and trend changes in monthly suicide rates per 1 million population during the exposure period (2020–2022) versus the control period (2012–2019). Regular visits to primary care and psychiatry stratified analysis.Results2181 cases were analyzed, with two-thirds male and a median age of 54. Primary care physicians and psychiatric history were present in 69% and 40% of patients. The study found significant level changes in suicide rates overall (4.14, 95% CI: 1.70, 6.58) among individuals without regular primary care physician visits (2.83, 95% CI: 1.35, 4.32) and without psychiatric visits (2.85, 95% CI: 0.56, 5.14). In contrast, no significant changes were observed in individuals with regular primary care (0.99, 95% CI: -0.78, 2.76) or regular psychiatric visits (0.59, 95% CI: -0.98, 2.16). The trend changes were not significant in any of the groups.ConclusionThis study suggests that a history of attending a medical institution may have prevented the rapid increase in suicides during the early stages of the COVID-19 pandemic.

P1251 A Care Pathway for Inflammatory Bowel Disease can Reduce Healthcare Costs and is Cost-Effective

Abstract Background Hospitals in the southwest of the Netherlands collaborate to improve inflammatory bowel disease (IBD) care. As part of this initiative, a standardised care pathway (CP) for the treatment of IBD with biologics and small new molecules has been developed. The CP addresses initiation, switching, and discontinuation of therapy, as well as diagnostic testing and treatment follow-up. The CP has been implemented in six of the eight hospitals to improve patient outcomes, standardise care and reduce healthcare costs. This natural experiment provides an opportunity to evaluate the cost-effectiveness of the CP using a quasi-experimental design. We aimed to estimate the causal effect of CP implementation on costs and health outcomes. Methods A cost-utility analysis with a societal perspective was conducted. Adult patients with an IBD diagnosis for at least 3 months and treated with biologics and small new molecules were eligible for inclusion. Costs were assessed for both standard care (December 2020 - December 2021) and the CP over a one-year period (March 2022 – March 2023), without discounting costs and effects and standardizing costs to 2022. Missing data were handled using single imputation nested within a bootstrap procedure. The analysis employed a difference-in-differences (DiD) approach to estimate causal effects of the CP implementation, controlling for pre-existing differences between hospitals and general time trends that would have occurred without the intervention. For the cost-effectiveness analysis, we utilized the cumulative incremental costs and mean incremental quality adjusted life years (QALYs) from the post-intervention DiD effects. The DiD-derived incremental costs and QALYs were used to calculate the incremental cost-effectiveness ratio (ICER) and construct cost-effectiveness acceptability curves using normal approximation. Results Approximately 25% of the eligible population was included. At baseline, patients in intervention (n=842) and control hospitals (n=331) had comparable characteristics in terms of age, sex, diagnosis and comorbidities. The DiD-analysis showed cost savings primarily driven by reduced hospital costs (-€1,107; 95%CI: -€2,130 to -€109) while maintaining quality of life (QALY difference: 0.01; 95%CI: -0.02 to 0.04). The ICER was located in the southeast corner of the cost-effectiveness plane, indicating that the treatment with the CP is a dominant strategy compared to standard care (Figure 1). Conclusion A CP for the treatment of IBD with biologics and small new molecules was developed to improve IBD care and reduce healthcare costs. Our results showed that standardising IBD care is effective for reducing healthcare costs, while maintaining quality of life.

The role of patterning skills in early mathematical development: an analysis of all dimensions of visual perception

ABSTRACT In the early stages of mathematical development, the primary objective is to develop pattern recognition skills by mastering fundamental techniques like sorting and comparison. Numerous pattern structures, such as visual, auditory and spatial patterns, can be created. In this study, we examined the effects of PO-MEP, a pattern-focused mathematics education program for preschool children, on children’s visual perception. The “Pattern-Oriented Mathematics Education Program (PO-MEP)” was developed, and compatible original materials were designed. The program is structured around repeating and growing patterns. Its impact was assessed using a quasi-experimental design, including a pretest, posttest and follow-up test, and a control group. The results show that it had a statistically significant impact on the development of all sub-dimensions of visual perception: hand-eye coordination, figure-ground perception, form constancy, position in space, and spatial relationships. In sum, the program developed the children’s visual perception. Further research may be conducted using different methodologies and age groups to strengthen these findings.

Comparison of Aerobics Teaching to Combines Online and Offline Learning with Traditional Teaching of Guangdong Vocational College Students in China

Background and Aim: China Education Modernization 2035 means In 2019, the Central Committee of the Communist Party of China (CPC) and the State Council released China Education Modernization 2035, which addresses current problems in education, proposes the construction of intelligent campuses, and promotes the views of education information change, among other things. There is no modernization without informatization, and informatization in education will certainly become a powerful means to improve the quality of teaching and learning. The integration of network teaching methods (such as TED, MOOC, etc.) has arisen because of the combination of informatization and education. Studying the literature the research decided to study research on the use of online and offline teaching modes in aerobics teaching, which is the trend of the times. Through statistical data and experimental research, we know that the application of hybrid teaching methods is growing year by year in foreign education and teaching. The hybrid teaching method is in line with the current trend of the times, in the trend of the times, the hybrid teaching method is undoubtedly the most suitable teaching method for higher education at this stage. Materials and Methods: The research has 4 steps: Step 1 Study general information literature and consult an expert study advisor. Step 2: Creating teaching tools. Step 3: Results of the study of online and offline teaching and normal teaching. And Step 4. Results of comparing normal teaching with online and offline teaching, divided into a control group and an experimental group. Result: This research study is quasi-experimental research combining aerobics teaching using normal teaching and comparing it with online and offline teaching to study the results of normal and online offline teaching to be compared for 14 weeks, divided into the experiments, which had a control group and an experimental group, were statistically analyzed using a computer program. Conclusion: Using a quasi-experimental design, this study compares the efficacy of offline, online, and traditional aerobics teaching methods over 14 weeks. A statistical analysis was conducted on the data, taking into account the control and experimental groups.

Enhancing wellbeing among pre-service teachers through a mindfulness-based social and emotional learning curriculum: a quasi-experimental study in China

BackgroundIntegrating mindfulness practices and Social and Emotional Learning (SEL) into teacher education can significantly enhance educators’ wellbeing, resilience, and effectiveness. However, the cultural specificity of such interventions, particularly in the Chinese educational context, requires careful adaptation and examination.ObjectiveThis study aims to design, implement, and evaluate a culturally adapted MBSEL curriculum for Chinese pre-service teachers. It investigates the program’s effectiveness in improving mindfulness, self-compassion, and life satisfaction, contributing to the literature on integrating mindfulness and SEL in teacher education within a specific cultural setting.MethodsEmploying a quasi-experimental design, the study involved a sample of 41 Chinese pre-service teachers divided into an experimental group (n = 22) and a control group (n = 19). The MBSEL program’s impact on participants’ mindfulness, self-compassion, and life satisfaction was assessed using pre- and post-intervention measures.ResultsThe results of repeated measures analyses of variance indicated significant improvements in mindfulness, self-compassion, and life satisfaction among participants in the experimental group compared to the control group. These outcomes underscore the effectiveness of the culturally adapted MBSEL program in enhancing key aspects of pre-service teachers’ wellbeing and professional readiness.DiscussionThe study demonstrates that a culturally adapted MBSEL curriculum effectively enhances mindfulness, self-compassion, and life satisfaction among Chinese pre-service teachers. This emphasizes the necessity of cultural sensitivity in developing mindfulness and SEL interventions for teacher education. Moreover, the success of the MBSEL program suggests its potential for global integration, urging policymakers and educators to prioritize culturally tailored approaches to enhance teacher wellbeing and educational outcomes.

Looking under the hood of a hybrid two-way texting intervention to improve early retention on antiretroviral therapy in Malawi: an implementation fidelity evaluation

BackgroundWhile key to interpreting findings and assessing generalizability, implementation fidelity is underreported in mobile health (mHealth) literature. We evaluated implementation fidelity of an opt-in, hybrid, two-way texting (2wT) intervention previously demonstrated to improve 12-month retention on antiretroviral therapy (ART) among people living with HIV (PLHIV) in a quasi-experimental study in Lilongwe, Malawi.MethodsShort message service (SMS) data and ART refill visit records were used to evaluate adherence to 2wT content, frequency and duration through the lens of the Conceptual Framework for Implementation Fidelity. Message delivery and 2wT participant interactions were considered across four core 2wT components: 1) weekly motivational SMS messages; 2) proactive SMS appointment reminders; 3) SMS reminders after missed appointments; and 4) interactive messaging with 2wT staff about transfers and appointment rescheduling. Using mixed-effects logistic regression models adjusted for participant demographics, we examined the effect of core 2wT component fidelity on a) on-time appointment attendance and b) timely return to care after a missed appointment, presenting adjusted odds ratios (aORs) and 95% confidence intervals (CIs).ResultsThe 468 2wT participants had a median of 52 study weeks (interquartile range [IQR] 34 – 52) with 6 ART appointments (IQR 4—7) of which 2 (IQR 1 – 3) were missed. On average, participants received a motivation message for 75% (IQR 56%—83%) of enrolled weeks, a reminder before 83% (IQR 67%—100%) of appointments, and after 67% (IQR 0%—100%) of missed appointments. Participants reported 9 transfers and rescheduled 46 appointments through 2wT prompts; 196 appointments were changed via unprompted interaction. Participants with 10% higher expected motivation message delivery were more likely to attend clinic appointments on time (aOR: 1.08; 95%CI: 1.01 – 1.16, p = 0.03). Receiving and responding to an appointment reminder in any way were also associated with increased on-time appointment attendance (aOR: 1.35; 95%CI: 1.03 – 1.79, p = 0.03 and aOR: 1.47, 95%CI: 1.16 – 1.87, p = 0.001, respectively). No associations were found for 2wT messages and timely return to care following a missed appointment.ConclusionGreater 2wT implementation fidelity was associated with improved care outcomes. Although implementation fidelity monitoring of mHealth interventions is complex, it should be integrated into study design.

Medication reconciliation: impact of an educational intervention on the knowledge, attitude and practices of healthcare professionals - a prospective quasi-experimental study in a Saudi referral hospital

BackgroundMedication reconciliation has been acknowledged as a key intervention against medication errors. More than half of the medication errors that happen during care transitions are caused by unjustified medication discrepancies and up to one-third of these mistakes may be harmful. The study aimed to evaluate the knowledge, attitude and practices (KAP) of health care providers in on medication reconciliation process, pre and post educational intervention.MethodsA hospital-based prospective quasi-experimental pre-post intervention study was conducted from November 2023 to February 2024 among 346 healthcare professionals (medical doctors, pharmacists and nurses) practicing in King Saud Hospital (KSH), Unayzah, Saudi Arabia. The subjects were recruited using the convenience sampling method.An educational intervention workshop was conducted among the healthcare professionals. The KAP was assessed before and after the educational intervention using a content and face validated self-administered questionnaire. The statistical analyses were conducted using the Statistical Package for Social Sciences (SPSS). Wilcoxon Signed Rank Test was used to differentiate the mean response scores for knowledge, attitude, and practice domains, between pre and post intervention. Kruskal Wallis Test followed by Dunn’s post hoc test was used to compare the mean response scores for knowledge, attitude and practice domains based on educational qualification and practicing experience for the pre and post-test period. The level of significance is determined at P < 0.05.ResultsThere was a significant improvement in the participants’ knowledge, attitude and practice after the educational intervention with mean scores of 0.72 (SD = 1.67, p < 0.0001*), 0.76 (SD = 1.97, p < 0.0001*), and 0.56 (SD = 2.05, p = 0.001*) respectively. The overall KAP scores showed a statistically significant enhancement after the education intervention with a mean score difference of 2.04 (SD = 4.76, p < 0.0001*).Our study upholds that MedRec is highly valued by the participants due to its significant role in reducing medication errors and enhancing patient safety, and that it has the ability to recognize medication discrepancies and reduce adverse drug events.ConclusionThe education intervention effectively influenced the knowledge, attitude and practice of healthcare professionals regarding medication reconciliation. This study underscores the importance of continuous education and training for healthcare professionals to minimize medication discrepancies and improve patient care.

Effects of empathy mapping and mini-simulation on second-year nursing students’ empathy and communication self-confidence: a quasi-experimental study

BackgroundEmpathy and communication are critical abilities for nursing students, and in recent years, scenario-based teaching has played a crucial role in fostering empathy and professional skill development. However, novice nursing students in basic nursing education often lack prior experience in patient communication, making it challenging for them to prepare adequately for scenarios and effectively handle difficulties in real-life situations. This deficiency also hampers participants’ or observers’ ability to engage in deep reflection, feedback, and learning. Consequently, students frequently experience anxiety in patient communication, and the effectiveness of empathy building remains limited. The aim of the study was to use empathy mapping and mini-simulation in learning to enhance nursing students’ empathy and self-confidence in communication.MethodsA prospective quasi-experimental research design was employed, targeting second-year students in the four-year nursing program at our institution, specifically in the Basic Nursing and Experimentation II class. The students were randomly divided into two groups: an experimental group and a control group, with a total of 98 students (52 in the experimental group and 46 in the control group). The experimental group received instruction using empathic communication digital materials and engaged in empathy mapping exercises, while the control group underwent conventional scenario-based teaching. Pre-test and post-test data were collected from both groups.ResultsA total of 98 students participated in the study, with 46 students in the control group and 52 students in the experimental group. The average age of the participants was 19.19 ± 0.53 years, with a predominance of females (82.7%). At the end of the semester, there was no significant difference in the average empathy levels between the two groups. However, the communication confidence levels of students in the control group (40.20 ± 6.54) were significantly lower than those in the experimental group (43.88 ± 6.35) (P = 0.006).ConclusionsThis teaching approach facilitated deeper and broader student learning, enhancing both empathy and communication confidence. The teaching materials developed in this study can be employed in future courses to teach empathy and patient communication effectively.

Effectiveness of Cognitive Emotion Regulation Strategies Training on Increasing Mental Vitality of Junior High School Students

Introduction: Mental vitality has been considered as one of the components of well-being and one of the most important psychological needs of humans. The aim of this study was to investigate the effectiveness of cognitive emotion regulation strategies training on increasing mental vitality among junior high school students in Neka city. Methods: This quasi-experimental study was conducted with a pretest-posttest design with a control group. The statistical population included all junior high school students in Neka city during the academic year 2022-2023 (N=1732). Through purposive sampling, 60 students were selected and were randomly assigned to two groups. One group (n=30) received cognitive emotion regulation strategies training, while the control group (n=30) received no intervention. The Subjective Vitality Scale (SVS), a 7-item questionnaire, was used to measure mental vitality. The intervention consisted of 10 educational sessions, 60 minutes each twice a week. Data were analyzed using univariate analysis of covariance (ANCOVA) and SPSS-26 software. Results: The results showed significant differences between mean scores of social competence and school avoidance in pretest, posttest, and follow-up stages compared to the control group (P&lt;0/05). Conclusion: Results indicated a significant difference between the two groups in mental vitality posttest scores, demonstrating the positive and significant effect of cognitive emotion regulation strategies training on mental vitality of junior high school students. The training led to increased mental vitality among junior high school students.

P1000 A quasi-experimental study evaluating effectiveness of partial enteral nutrition combined with exclusion diet in patients with mild to moderately severe ulcerative colitis

Abstract Background We designed this trial to evaluate efficacy of partial enteral nutrition (PEN) combined with exclusion diet (ED) in patients with mild to moderately active ulcerative colitis (UC). Methods In this quasi-experimental study, patients with mild-to-moderate UC (SCCAI=3-11) were allowed to choose either PEN+ED along with standard of care (SOC) or SOC alone. Disease activity was measured using simple clinical colitis activity index (SCCAI). Primary outcome was clinical remission (SCCAI≤2) 4 weeks. In addition, fecal microbiota analysis was performed at baseline and after week 4 in ten responders and four non-responders in PEN+ED arm. Results Sixty UC patients were included (PEN+ED=30; SOC=30). In the intervention group, 23 patients completed 4 weeks of PEN, 3 took a lower than prescribed dose, and 4 stopped after one week but continued ED. At week 4, 66.7% (20/30) patients in the PEN+ED arm achieved clinical remission at week 4 compared to 83.3% (25/30) receiving SOC. The proportion of patients with stool frequency score≤1 was similar between the two arms (90% vs 93.3%, p&amp;gt;0.99), however proportion of patients with rectal bleeding score ‘0’ was lower in patients receiving PEN+ED (56.7% vs 86.7%, p=0.01) at week 4. A numerically higher number of patients required steroids in SOC arm compared to PEN+ED arm, but it was not significant (23.3% vs 16.7%, p=0.748). At the microbiome level, PEN+ED was associated with a significant enrichment of ‘healthy-gut’ associated taxa (Figure 1) at week 4 compared to baseline and a concomitant-significant reduction in median Kendall distance to reference healthy Indian controls (p-value ≤1e-5), indicating the treatment shifts the microbiomes of patients towards controls. Conclusion Although PEN+ED does not appear to have additional clinical benefit to SOC at week 4, it was associated with significant improvement in gut microbiota. Long-term benefits of this therapy should be explored in future trials. Table 1: Baseline characteristics of included patients Figure 1: Figure showing change in the composition of the top 20 taxa across baseline and week4 with parenteral nutrition and exclusion diet in ulcerative colitis patients

Effect of intravitreal Bevacizumab on coagulation profile of patients with diabetic retinopathy

Objectives: Intravitreal injections of Bevacizumab are widely used all over the world to treat Diabetic Retinopathy. However, there are thromboembolic events reported with its use. As blood coagulation is related with thromboembolism, the purpose of this study was to determine the effect of intravitreal injection of Bevacizumab on the coagulation profile of diabetic patients. Methods: It was a quasi-experimental study, conducted at Department of Ophthalmology, Lahore General Hospital from January 2023 to August 2023. Patients with treatment naïve proliferative DR and diabetic macular edema were included and those with renal disease, hypertensive retinopathy, chronic liver disease, ischemic heart disease, previous history of stroke, retinal vascular occlusion, any malignancy, history of using anti coagulants and aspirin and the patients who lost to follow up and did not complete the blood work up after injection were excluded. Patients’ Prothrombin time, bleeding time, clotting time, international normalized ratio and activated partial thromboplastin time were checked before and one week after intravitreal injection of Bevacizumab. Paired t test was used for analysis and p &lt; 0.05 was set for significance. Results: There were 138 patients who fulfilled the inclusion criteria (92 males and 46 females). The mean age was 55±8 years. There was statistically insignificant difference between the coagulation profile before and after intravitreal injection of Bevacizumab. Conclusion: Coagulation profile is not affected after one intravitreal injection of Bevacizumab. Other factors must be taken into account while injecting Bevacizumab in patients with history of thromboembolic events. doi: https://doi.org/10.12669/pjms.41.2.10289 How to cite this: Khalid I, Malik TG, Tariq H, Sajid U. Effect of intravitreal Bevacizumab on coagulation profile of patients with diabetic retinopathy. Pak J Med Sci. 2025;41(2):355-358. doi: https://doi.org/10.12669/pjms.41.2.10289 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Health Promotion Intervention to Improve Public Knowledge on Coronary Heart Disease in Yogyakarta, Indonesia: A Quasi-experimental Study

Objectives A lack of public knowledge about coronary heart disease [CHD] contributes to the elevated incidence of delayed onset symptoms to the first medical contact and major adverse cardiac events. Health promotion intervention should be the first option in order to direct individuals toward adopting healthy behaviors to avert CHD, and improve their knowledge and attitude in handling CHD-related symptoms. Therefore, this study aimed to observe the impact of educational programs on the improvement of public knowledge about CHD in Yogyakarta, Indonesia. Methods A quasi-experimental approach was implemented utilizing a questionnaire developed by the researchers, which included pharmacists and cardiologists and was based on the BASNEF model. An hour-long educational program was carried out three times a month by inserting the program into the community's routine agenda. A descriptive analysis, t-test, and multivariate regression were performed to evaluate the influence of the program on participants' knowledge regarding CHD. Results A higher proportion of participants with a smoking environment [79.6%], diabetes mellitus [88.9%], abnormal waist circumference [61.9%] and abnormal 2 h postprandial blood glucose [77%] among 113 were involved in this study. Significant improvement was observed among the overall results of pre-test [75.59±15.29] and post-test [86.05±8.99] with p-value &lt;0.001. Older participants and participants with acute coronary syndrome history [ACS] significantly improved their knowledge of CHD after the health promotion program with p-values of 0.022 and 0.008, respectively. Conclusion These findings suggest that educational interventions could increase participants' knowledge of CHD. Local health officials should implement more health promotion to significantly enhance public knowledge of CHD.

Impact of the WHO safe childbirth checklist on birth attendant behavior and maternal-newborn outcomes: A systematic review and meta-analysis.

The intrapartum period is critical for reducing maternal and perinatal morbidity and mortality. The WHO's Safe Childbirth Checklist (SCC) was designed as a reminder of the most critical, evidence-based practices (EBPs) to improve quality care and reduce preventable complications and deaths. To assess the impact of SCC on birth attendant behavior and maternal and newborn health outcomes. A systematic review and meta-analysis was performed searching across five databases from 2009 to 2023. We included randomized controlled trials, quasi-experimental studies, and pre/post studies. A meta-analysis yielded a pooled estimate ofrelative risk (RR) for adherence to and effectiveness of the SCC. Of 1070 articles identified, 16 were included. Use of the SCC increased adherence to EBPs by 65% (RR 1.65; 95% confidence interval [CI]1.34-2.02). The behaviors that improved the most were danger sign counseling (RR 12.37; 95% CI 1.95-78.52; P = 0.008) and pre-eclampsia management (RR 3.43; 95% CI 1.33-8.88; P = 0.011). There was moderate evidence for stillbirth reduction (RR 0.89; 95% CI 0.80-0.99; P = 0.034). There is moderate evidence demonstrating the effectiveness of the SCC in reducing stillbirths and improving adherence to EBPs.

Benefit of Lemongrass and lemon on Sleep Quality and Elimination Pattern of Postpartum Mothers

Every breastfeeding mother needs adequate sleep to maintain the quantity of breast milk produced. According to WHO, breastfeeding mothers need sleep breaks to avoid fatigue, stress, mood disorders, appetite disorders, and lack of concentration. Sleep problems and elimination patterns often affect the viability of breastfeeding mothers. Some experts recommend consuming lemongrass and lemon to improve sleep and elimination patterns. This research method is Quasi experiment with Case-control design. The purpose of the study was to determine the effectiveness of lemongrass and lemon on sleep quality and elimination patterns of post partum mothers. The results of data analysis using Chi-square showed that there was a relationship between the benefits of lemongrass and lemon drinks given with sleep quality and elimination patterns in postpartum mothers. This is evidenced by the mean value before and after being given herbal drinks. Where the mean value on sleep quality increased by 0.70 points while in the elimination pattern there was a mean increase of 0.67 points. Based on the results of the dependent T test, both variables obtained a p-value of 0.0001 or p &lt; 0.05.

P1254 The impact of vitamin D supplementation on clinical outcomes in Inflammatory Bowel Disease: a regression discontinuity analysis

Abstract Background Vitamin D deficiency is prevalent among patients with Inflammatory Bowel Disease (IBD) and is associated with adverse clinical outcomes. While vitamin D's immunomodulatory and anti-inflammatory properties suggest potential therapeutic benefits, its effect on IBD management remains uncertain. This study evaluates the impact of vitamin D supplementation on corticosteroid use, emergency department (ED) visits, and hospitalisations using a quasi-experimental regression discontinuity design (RDD). Methods A retrospective cohort of IBD patients within the United States Veterans Health Administration was analysed from 2000–2024. Patients prescribed vitamin D within three months after a serum 25-hydroxyvitamin D assay were included, excluding those with prior supplementation or subtherapeutic dosing (&amp;lt;1,000 IU/day). Outcomes were assessed 3–15 months post-assay. Using the 30 ng/mL vitamin D threshold, RDD was employed to estimate causal effects, adjusting for covariates (age, gender, and IBD type). Statistical analysis was performed with the RDrobust statistical package. Results Among 5,021 IBD patients (median age 63 years; 89% male; 58% Ulcerative Colitis, 39% Crohn’s Disease, 3% Indeterminate Colitis), the median vitamin D level was 23 ng/mL. Approximately 41% of patients were prescribed vitamin D. Patients with vitamin D levels just below the 30 ng/mL threshold were significantly more likely to receive supplementation compared to those above the threshold (35% vs 24%, p = 0.02)(Fig 1A). Vitamin D supplementation demonstrated a 36% absolute risk reduction (ARR) in corticosteroid use at the 30 ng/mL threshold (95% CI: [-0.72, 0.00], p = 0.05)(Fig 1B). Trends towards reduced ED visits (ARR 17%) and hospitalisations (ARR 3%) were observed, though these findings did not achieve statistical significance. Conclusion Vitamin D supplementation at levels near the 30 ng/mL threshold significantly reduces corticosteroid use in IBD patients. While trends towards reduced ED visits and hospitalisations were not statistically significant, the directionality supports potential broader benefits. This study highlights the utility of vitamin D as a low-cost, accessible adjunct therapy in IBD management, particularly for those with deficiency. Further prospective studies are warranted to confirm these findings, optimise dosing strategies, and establish the ideal therapeutic targets for vitamin D in this population.

Environmental shocks and migration among a climate-vulnerable population in Bangladesh

Various studies predict large migration flows due to climatic and other environmental changes, yet the ex post empirical evidence for such migration is inconclusive. To examine the causal link between environmental changes and migration for a population residing along the Jamuna River in Bangladesh, an area heavily affected by floods and riverbank erosion, I relate the respondents’ self-reported affectedness by environmental changes, their migration aspirations, and their capability to move to their migration likelihood. The analysis relies on a unique quasi-experimental research design based on original survey panel data of 1604 household heads. I find that erosion significantly and substantively increases the likelihood to migrate, leading to more than a doubling of the migration likelihood compared to the unaffected control group. Flooding has a significant effect only if it causes severe and irreversible impacts. Moreover, erosion affectedness increases the likelihood of moving permanently, with the whole household, and to a rural location. Individual, temporary moves to urban locations, by contrast, are primarily driven by low socio-economic status. Those who move with the whole household migrate mostly less than five kilometers. These findings call for a more nuanced understanding of the complex environment-migration nexus.