Questionnaire Return Research Articles

Mini-open transverse flexor crease incision versus limited longitudinal palmar incision carpal tunnel release: A short term outcome study

ObjectiveTo compare the outcome of carpal tunnel release using the limited longitudinal palmar incision technique and mini open transverse flexor crease incision technique. Materials and methodslBetween October 2017 and September 2019, we performed Carpal Tunnel release procedures on 122 consecutive patients with unilateral idiopathic CTS. Patients in Group A (64 patients) had a palmar mini open longitudinal incision at wrist. Patients in Group B (58 patients) had a small flexor crease transverse incision. In the non palmar transverse incision group, we used a blunt ended facelift scissors to cut the flexor retinaculum after placing a dural retractor between the retinaculum and median nerve. The preoperative and postoperative (2 weeks,6 weeks,3 months, 6 months and 1 year) patient statuses were evaluated with the Boston Carpal Tunnel Syndrome Questionnaire (BCTSQ) scores, VAS, grip strength and return to work days. ResultsThe BCTSQ symptom severity scale and functional status scale showed significant improvement following surgery in Group B compared to Group A at 2 weeks,6 weeks and 3 months (p < 0.05). At 6 months and 1 year follow up, both the symptom severity and functional status scale were comparable in both the groups. Grip strength, pillar pain and scar tenderness showed significant improvement in transverse flexor incision group compared to longitudinal palmar incision group at 6 weeks and 3 months and were comparable later on. ConclusionWe conclude that the mini open transverse flexor crease incision technique using the conventional instruments is simple, safe and cost-effective mode of treatment of idiopathic CTS when compared to the limited palmar incision technique. Though the long term outcomes are comparable in both groups, the flexor crease transverse incision group patients had better pain relief, better cosmesis and shorter recovery period than the palmar incision group

Preffered Methods of Treating Obesity in Late Adulthood and Senior Age

Objective: To identify preferred solutions – therapy - for over- weight and obesity in older adults and seniors Participants: Atotal of 110 respondents were contacted, out of which 14 refused to cooperate or filled in the questionnaire incor- rectly. The return of questionnaires was 96, i.e. 100%. The group of respondents consisted of individuals of both sexes, aged 50 and over, living in anatural social environment or in one of the se- lected institutions. Due to the fact that - in our opinion - arela- tively large amount of attention is paid to the senior age group while the group of people in the age range of 50-64 is forgotten, we have not chosen the senior age respondents exclusively. Methods: The data obtained by the processing of the question- naires were analytically evaluated. For statistical processing apro- gram StatisticaCz version 9 was chosen, adescriptive analysis of the data was performed, followed by analysis by comparing av- erages and particular tests of statistical significance (Chi-square test, Kruskal Wallis, KendalovoTau). Results: An adjustment of the diet as apart of the solution of the overweight and obesity therapy would be chosen by the most re- spondents, 75 (46.5%) of them. 44 (27.0%) respondents would choose sport or other physical activity. 11 (6.7%) respondents would deal with overweight and obesity pharmacologically - with the help of medications, and only 25 (15.3%) respondents would choose surgery as away of dealing with overweight and obesity. On the contrary, only 8 (4.9%) respondents were not interested in dealing with the weight gain. 24 (25.0%) respondents would choose the surgical way of solving obesity. Ananswer“possibly yes”was chosen by13 (13.5%) respondents. 21 (21.9%) individu- als inclined to the “rather not” variant. 33 (34.4%) respondents chose the “certainly not”answer. An answer“I don't know” was chosen by 5 (5.2%) respondents. Conclusion:Obesity is aglobal social problem which is not to be solved just in healthcare and it is certainly not an issue of an individual.

Assessment of Factors Contributing to Delayed Surgeries in Enlarged Prostate Patients: A Survey at Kisumu County Referral Hospital

Enlarged prostate, also known as Benign Prostatic Hyperplasia (BPH) is the enlargement of the prostate gland in men resulting in frequent urination, weak urine stream, and inability to completely empty the bladder. Prostate cancer is the second most commonly occurring cancer in men and the fourth most commonly occurring cancer overall. There were 1.3 million new cases of prostate cancer globally in 2018. Although there is a scarcity of information on the disease in African men, past studies have revealed that the disease can be managed if detected in its early stages. The purpose of the study was to assess the factors contributing to delayed surgeries in enlarged prostate patients at Kisumu County Referral hospital. Specific objectives were to determine the level of knowledge and awareness on enlarged prostate; assess institutional factors hindering surgeries in enlarged prostate and determine socio-economic factors of the patients’ hindering surgeries in enlarged prostate at Kisumu County Referral hospital. A descriptive survey design was adopted for the study. The study targeted enlarged prostate patients and top management of the Kisumu County Referral Hospital from which a sample of 50 respondents was selected using the inclusion-exclusion criteria to participate in the study. The study adopted structured questionnaires for data collection. Data were analysed using descriptive statistics with both qualitative and quantitative analysis and the findings were presented in frequency distribution tables and percentages. The study achieved a questionnaire return rate of 94% with the majority of the respondents, 45%, earning a monthly income ranging from 10,000 to 20,000. Findings revealed that 91%, had knowledge of prostate cancer with 83% stating that the medium through which they learned of the disease was the media, friends, relatives, and at the workplace. Unwillingness to be screened for prostate cancer was due to a lack of knowledge (53%). The study established the hospital was crowded, 78%, and thus the available resources were not sufficient to cater to the population seeking medical attention. Institutional factors related to doctors’/nurses’ workmanship were the common contributors to delayed surgeries and medical attention in terms of negligence, 66%, poor communication channels hence conflicting information, 72%, and doctors’/nurses’ competence at work, 42%. Evidently, the family plays a major role in one’s health decisions especially pertaining to chronic diseases such as cancer, 66%. Lack of finances limits access to quality and timely healthcare with 83% and 87% respectively. Conclusively, the majority of the delays in surgeries in enlarged prostate patients at the hospital were due to the institution’s inability in terms of resources, facilities, and qualified and competent personnel. Socio-economic factors also contributed to delayed surgeries in enlarged prostate patients at Kisumu County Referral Hospital. The study recommends mobilization and sensitization to create awareness and increase the knowledge of prostate cancer, the government should intervene through improving the facilities, resources, and staff as a measure to manage the ever-increasing population seeking medical care at the hospital and to find ways of reducing medical costs, especially for cancer patients, so as to enable victims’ access medical care with ease.

ACTUAL PROBLEMS OF PROFESSIONAL AND PERSONAL DEVELOPMENT QUALIFIED PERSONS RESPONSIBLE FOR QUALITY OF MEDICINAL PRODUCTS FOR HUMAN USE

The aim of the study is to investigate topical problems of the professional and personal development of qualified persons responsible for quality of medicinal products for human use.Materials and methods. In the period from April 6 to May 10, 2020, an online survey of leading employees in the field of quality assurance of Russian manufacturers was conducted. 176 people took part in the survey; the return of questionnaires was about 17.9%.Results. From the standpoint of D. Super’s theory of professional development, the largest number of respondents was at the maintenance stage, holding their achieved positions (53.2%). All respondents, regardless of age, were motivated for professional development. Most often qualified persons had chemical engineering (27.3%) and pharmaceutical education (22.2%). Most of them had a working experience in 1–2 divisions of the enterprise, and combined the functions of qualified persons with managerial positions (74.5% and 71.9%, respectively). The majority of the qualified persons (86.4%) indicated the sufficiency of the available knowledge and the lack of knowledge on certain issues. Knowledge and skills in the quality risk management, specific GMP issues and statistical methods (59.0%, 49.2 and 44.2%, respectively); communication and interpersonal skills and, in particular, stress management, emotion management and the art of negotiation (49.4%, 41.3% and 40.9%, respectively), were most popular. About 36% of respondents notified the need for the digital economy competencies, while only 5.1% notified the presence of an electronic batch production record at the enterprise. Finally, only half of the respondents (50.5%) had a formal training plan for qualified persons.Conclusion. This pilot study revealed the need for the revision of the Exemplary Additional Professional Training Program for Qualified Persons and the professional standard, the urgent need for the regulatory body to develop a scheme and principles for the continuous professional development of qualified persons, and showed the direction of further research in this area.

Enhance Volunteering Education Through Overseas Volunteer Service

This study aimed to determine how the learning stimulation and intrinsic motivation of students affect their culture sharing in volunteering via general altruism and intention. Stratified random sampling was used, and 850 invitation questionnaires were sent to participants, of whom 264 returned valid questionnaires (return rate, 31.06%), which were analyzed with the partial least squares method. It was found that students’ intrinsic motivation for overseas volunteering increases their understanding of global issues. Thus, schools or organizations should develop a mechanism for volunteering students to interact with others within a professional virtual community in order to enhance their volunteering experience and inspire their continuous learning from overseas volunteering.

Visual Screening Programs in British Columbia Schools

The purpose of this investigation was to deter­mine whether changes had occurred in visual screening procedures used in British Columbia schools during the last five years. The findings were obtained from a 95% return of questionnaires sent to the 75 school districts in British Columbia. A majority of districts continued to rely primarily on the use of far-point acuity testing by means of an eye-chart. Greater use of learning assistance teachers and of community vision specialists - optometrists and ophthalmologists - appears now to be made when children have reading difficulties.

Using pens as an incentive for questionnaire return in an orthopaedic trial: an embedded randomised controlled retention trial

Background: We did a ‘study within a trial’ (SWAT), evaluating the effectiveness of the inclusion of a pen with a postal questionnaire, compared to no pen being included, on the retention rate in a large orthopaedic trial. Methods: The SWAT was embedded in the KReBS trial. The primary outcome was the proportion of 12-month questionnaires returned. Secondary outcomes were the proportion of questionnaires completed and time to questionnaire return. Binary data were analysed using logistic regression and time to return using Cox proportional hazards regression. Odds ratios (OR) and hazard ratios (HR) are presented, with associated 95% confidence intervals and p-values. Results: In total, 2305 participants were randomised into the SWAT. In the pen group, 1020/1145 (89.1%) of participants returned a questionnaire, compared to 982/1147 (85.6%) in the no pen group. The absolute difference in questionnaire return rate was 3.5% (95% CI: 0.8% to 6.2%; p=0.01). There were statistically significant differences in questionnaire return rate (OR 1.36; 95% CI: 1.06 to 1.74; p=0.02), questionnaire completion rate (OR 1.40; 95% CI: 1.11 to 1.78; p&lt;0.01) and time to questionnaire return (HR 1.17; 95% CI: 1.07 to 1.27; p&lt;0.01) favouring the pen group. Conclusion: This SWAT adds to the growing evidence base for whether pens are effective as an incentive for retention, and indicates their potential effectiveness. Registration: KReBS trial registered on 20 February 2019, ID ISRCTN87127065; SWAT registered on 1 April 2019, ID SWAT92.

Evaluation of the effectiveness of an incentive strategy on the questionnaire response rate in parents of premature babies: a randomised controlled Study Within A Trial (SWAT) nested within SIFT

BackgroundLoss to follow-up resulting in missing outcomes compromises the validity of trial results by reducing statistical power, negatively affecting generalisability and undermining assumptions made at analysis, leading to potentially biased and misleading results. Evidence that incentives are effective at improving response rates exists, but there is little evidence regarding the best approach, especially in the field of perinatal medicine. The NIHR-funded SIFT trial follow-up of infants at 2 years of age provided an ideal opportunity to address this remaining uncertainty.MethodsParticipants: parents of infants from participating neonatal units in the UK and Ireland followed up for SIFT (multicentre RCT investigating two speeds of feeding in babies with gestational age at birth < 32 weeks and/or birthweight < 1500 g). Interventions: parents were randomly allocated to receive incentives (£15 gift voucher) before or after questionnaire return. The objective was to establish whether offering an unconditional incentive in advance or promising an incentive on completion of a questionnaire (conditional) improved the response rate in parents of premature babies. The primary outcome was questionnaire response rate. Permuted block randomisation was performed (variable size blocks), stratified by SIFT allocation (slower/faster feeds) and single/multiple birth. Multiple births were given the same incentives allocation. Parents were unaware that they were in an incentives SWAT; SIFT office staff were not blinded to allocation.ResultsParents of 923 infants were randomised: 459 infants allocated to receive incentive before, 464 infants allocated to receive incentive after; analysis was by intention to treat. Allocation to the incentive before completion led to a significantly higher response rate, 83.0% (381/459) compared to the after-completion group, 76.1% (353/464); adjusted absolute difference of 6.8% (95% confidence interval 1.6% to 12.0%). Giving an incentive in advance is the more costly approach, but the mean difference of ~£3 per infant is small given the higher return.ConclusionsAn unconditional incentive in advance led to a significantly higher response rate compared to the promise of an incentive on completion. Against a backdrop of falling response rates to questionnaires, incentives can be an effective way to increase returns.Trial registrationSIFT (ISRCTN76463425). Registered on March 5, 2013.; SWAT registration (SWAT 69 available from http://www.qub.ac.uk/sites/TheNorthernIrelandNetworkforTrialsMethodologyResearch/FileStore/Filetoupload,864297,en.pdf). Registered on June 27, 2016.

Evaluating virtual role play based learning to improve the confidence and competence of Junior Doctors undertaking on call shifts in inpatient Psychiatry

AimsTo enable junior doctors to practice their clinical skills in managing psychiatric emergencies via virtual role plays, and to gain confidence and competence in their skills in acute psychiatry. Lecture based learning about psychiatric emergencies is a part of the induction programme for all junior doctors starting their placements however practical learning and practice of skills in this area is not. The COVID-19 pandemic has further exacerbated this issue by providing an additional challenge to the delivery of face to face teaching for junior doctors both in clinical and educational settings.MethodThe author offered a virtual role play based teaching session to two cohorts of Junior Doctors (GP trainees and foundation trainees) who were starting their psychiatric hospital placements at Surrey and Borders Partnership. The virtual sessions were conducted over Microsoft teams. This session had been run once before as face to face teaching (F2F) in January 2019 (N = 9) prior to the COVID-19 pandemic. Data from this session were compared to data obtained from the virtual sessions in November 2020 and January 2021 (N = 16).Pre and post study questionnaires were administered via Microsoft Forms. Each session lasted 1 hour and consisted of 3 different role play scenarios based around acute psychiatric emergencies. One junior doctor volunteer acted as the ‘patient’ in each scenario and another volunteer as the ‘doctor’. The other participants all acted as observers. Each scenario lasted 10 minutes with ten minutes for feedback from the researcher afterwards using the ALOBA framework.Categorical, ordinal data were collected using a Likert scale and general qualitative feedback was also gathered.ResultThe questionnaire return rate was 100% for F2F teaching and 57% for virtual teaching. 100% of participants felt that F2F role play was an acceptable way to practice skills in acute psychiatry vs 75% of participants who felt this about virtual role play. 100% of participants found that F2F role play was ‘quite’ or ‘very’ effective in improving their confidence and perceived competence in acute psychiatry vs 88% of participants who felt this about virtual role play.ConclusionVirtual role play based learning is an acceptable and effective method in improving the confidence and perceived competence of junior doctors undertaking on call shifts in inpatient psychiatry but it appears to be less effective than face to face role play based learning. The researcher will act upon the qualitative feedback obtained which suggested ways in which the virtual session could be improved.

Effect of patient-led cooperative follow-up by general practitioners and community pharmacists on osteoporosis treatment persistence.

Osteoporosis is a major risk factor for fractures. Poor persistence with osteoporosis medication hampers outcomes. This study assessed whether encouraging the formation of patient-led follow-up cooperatives between general practitioners (GPs) and community pharmacists improved medication persistence. All consecutive patients who attended an osteoporosis patient education program were invited to participate. They were given a logbook containing questionnaires they would bring to 6-monthly visits to their GP and pharmacist. The effect of this 3-year cooperative follow-up on persistence with medication and lifestyle changes was assessed. In total, 121 patients (average age, 67years; 93% female) participated. Poor cooperation between GPs and pharmacists was noted. Nevertheless, medication persistence ranged from 83% to 91% over the 6 visits. However, since patient drop-out rates were high and questionnaire return rates were low, a post-study medical chart review was performed. This confirmed that persistence was high (74%-83%) at 3years post-enrollment, even for oral bisphosphonate-treated patients (73%-76%). However, adoption of anti-osteoporosis lifestyle changes was poor throughout the study: one- to two-thirds of the patients did not alter their diet, physical activity, or surroundings to prevent falls. One study goal, namely, to encourage GPs and pharmacists to cooperate in patient follow-up, was not achieved. However, high medication persistence was observed. This may reflect the education program, patient empowerment, personalized attention from study personnel, and being in a study. Patient-centered approaches can thus significantly increase medication persistence in osteoporosis. Ongoing education may be needed to improve patient adoption of and persistence with lifestyle changes.

Using a behavioural approach to explore the factors that affect questionnaire return within a clinical trial: a qualitative study based on the theoretical domains framework

ObjectivesTo identify barriers and enablers to participant retention in trials requiring questionnaire return using the theoretical domains framework (TDF).Study design and settingWe identified and subsequently invited participants who did not...

Impact of preoperative education on ostomy patients quality of life

Human well-being is directly related to his health. Preoperative training of patients and selection of the optimal stoma location are probably the most important factors influencing the postoperative quality of life of stoma patients.&#x0D; Study aim - to determine the impact of preoperative training on the quality of life of stoma patients.&#x0D; Study methods. The analysis of the scientific literature and quantitative research was used for the survey, which was carried out by a written questionnaire. The patients interviewed were both inpatient and patients arriving for outpatient consultation. The survey was conducted in June-November, 2020, with the oral consent of the respondents. 150 questionnaires were distributed, 144 questionnaires were returned, but 6 of them were incomplete. Return of questionnaires - 92 percent.&#x0D; Results. The study found that patients, with whom the optimal bowel stoma location was not discussed before surgery, were significantly more likely to have poor quality of life, it also turned out that as many as one-fifth of patients did not receive any information about the stoma and were not acquainted with the peculiarities of intestinal stoma care, and almost half of the respondents received this information after the stoma opera-tion.&#x0D; Conclusions. Preoperative patient training and collaboration are directly related to patients’ quality of life after bowel stoma formation surgery.

Analysis of organizational commitment in determining the success of Accounting Information Systems (AIS) in the banking sector

This study aims to examine the effect of organizational commitment on the success of accounting information systems (AIS). The unit of analysis in this study was Regional Development Banks (Indonesian: Bank Pembangunan Daerah / BPD) throughout Indonesia. Data collected by using a questionnaire. The respondents were BPD employees as the AIS users. The total research sample used was 275, while the questionnaire return rate was 64% (176). The data were processed and analyzed using the Partial Least Square SEM method. The results proved that organizational commitment has no effect on the success of accounting information system. In general, BPD employees’ commitment to the organization is at the “adequate” level, which means that they are not fully committed to supporting the success of the accounting information system. The results of this study do not support the theory and results of previous studies which state that organizational commitment affects the success of the accounting information systems.

ANALYSIS OF INDUSTRIAL PRACTICE OF DRUG QUALITY RISK MANAGEMENT IN RUSSIAN PHARMACEUTICAL ENTERPRISES

The aim of the research was to study the current industrial practice of drug quality risk management in Russian pharmaceutical enterprises, including the assessment of the main problems during the implementation of the risk management system and its compliance with the accepted international approaches.Materials and methods. In the period from 6 April to 10 May 2020, an online survey of the leading employees in the field of quality assurance of Russian manufacturers was conducted. In the survey, the questionnaire was based on the results of the authors’ analysis of the national regulatory legal acts of the Russian Federation, the European Union countries, international guidelines of the EAEU, ICH and WHO in this area. 111 people took part in the survey, the return of questionnaires was 11.5%.Results. The data obtained indicate the prevalence of a superficial approach to quality risk management in the Russian pharmaceutical industry, the presence of objective and subjective reasons that hinder the effective implementation of these methods, the fragmentation of the systems used and, in most cases, their ineffective use. The respondents believe that the most significant reasons for the difficulties in implementing this methodology, are the lack of recommendations from the Ministry of Industry and Trade of Russia on creating an effective quality risk management system and a shortage of the specialists who are ready to work in the area of this industry. The survey revealed rather large gaps in the deployment of a risk management system at the enterprise and separation from the established international practice.Conclusions. The data obtained indicate the extreme urgency of developing recommendations for a quality risk management system, which should be based upon and supported by Russian regulatory legal acts and international experience in this area. The authors propose highlights for these recommendations.

Socio-economic Factors Affecting Uptake of Banana Value Addition among Smallholders in Chuka Sub-county, Tharaka Nithi County, Kenya

Banana farmers in most parts of Kenya have not embraced value addition despite its accrued economic benefits and emphasis by stakeholders. A study was done in Chuka Sub-County, Tharaka Nithi County to identify the socio-economic factors affecting uptake of banana value addition by farmers. The study was based on the diffusion of innovations theory to establish the relationship between farming experience, group membership, access to credit and uptake of banana value addition. The study adopted a descriptive research design whereby frequency tables were generated whilst both qualitative and quantitative data was collected. The target population was 20,180 banana farming households in Chuka Sub-County and 3 key informants. Purposive sampling, Random sampling and snowballing techniques were used to select the 156 banana farmers. A pilot study of 24 (15% of sample size) households was done in Imenti South and the questionnaire was found to be reliable (Cronbach alpha value, α˂0.785). With a 90% questionnaire return rate, the data collected was analyzed using SPSS version 25 and presented using frequency tables. Binary logistic regression was used to test the levels of significance of variables and the model through the Hosmer &amp; Lemeshow test of the goodness of fit suggested that the it was good for fit to the data as p=0.480 (&gt;0.05) while ANOVA analyses were used to check the presence of multicollinearity. It was observed that only 31.9% of farmers uptake banana value addition and there were no banana value addition technologies identified with 35.6% and 64.4% of those who uptake doing banana ripening for sale and bulk packaging respectively. The results [P=0.05] showed that group membership [p=0.019] and access to credit [p=0.004] had a positive and significant effect on the uptake of banana value addition by farmers at varying levels. It was observed that farming experience had a positive effect on the uptake, but was statistically insignificant. The study recommended that; farmers should be encouraged to form cooperatives on value addition and the government and other stakeholders in conjunction with financial institutions need to streamline policies to enhance farmer’s access credit for effective farming among others.

Knowledge, Attitudes, and Practices Regarding Tick-Borne Diseases Among People Living in Niigata Prefecture, Japan

Background: A recent comprehensive study identified Niigata prefecture, Japan, as an emerging endemic area for tick-borne diseases (TBDs). This study examined the knowledge, attitude, and practices (KAP) of people living in Niigata prefecture regarding TBDs and preventive strategies. Methods: The KAP was assessed using a questionnaire consisted of 17 items. Statistical tests such as student’s t-test, chi-square test, and multiple logistic regression were performed using SPSS version 27. Results: In total, 186 responses were received. Among the respondents, 130 (69·9%) were men, and the mean age was 51.1 (14·3). Nine (4·8%) respondents reported having experienced tick bites. Internet and television were the primary sources of information. Of the respondents, 44 (44·4%) knew about both scrub typhus and severe fever with thrombocytopenia syndrome, while 156 (83·9%) and 71 (38·2%) recognized limiting skin exposure and use of insect repellents as preventive measures, respectively. The attitudes towards TBDs: being worried about tick bites (p=0·018) and interested in preventing TBDs (p=0·001), were significantly higher among women than men. About 75% of the respondents reported taking preventive measures against tick bites, and limiting skin exposure was the most frequently applied method (69·9%). Insect repellents were used by 58 (31·2%) respondents. Age (p=0·049), being worried about tick bites (p=0·046), and knowledge of ticks score (p=0·024) were the significant independent predictors of practicing countermeasures. Interpretation: We identified gaps in knowledge and practices regarding TBDs. Public health interventions should be implemented to improve public awareness of TBDs. Funding Statement: This work was supported by JSPS KAKENHI, Japan [Grant number 16K00569]. Declaration of Interests: The authors have no relevant conflicts of interest to declare. Ethics Approval Statement: Ethical clearance was obtained from the Ethical Review Committee on research involving human subjects in Niigata University, Japan (No. 2017-0140). Each participant received an explanation about the study and the opt-out to respond/ return the questionnaire. The return of the completed questionnaire was considered as the consent.

Public perceptions and experiences of the minor ailment service in community pharmacy in Scotland.

Background:The Minor Ailment Service (MAS) in Scottish community pharmacy allows eligible people to gain improved access to care by providing free treatment for self-limiting conditions.Objective:To determine the perceptions and experiences of individuals using MAS and to quantify the potential impact on usage of other healthcare services.Methods:A cross-sectional survey was conducted of patients accessing MAS across Scotland during June and July 2018. Questionnaire items included reasons for choosing treatment through MAS, which other services they may have accessed had MAS not been available, experiences of consultation, overall satisfaction, and perceived effectiveness of treatment. Those accessing MAS were given a study pack including an information sheet, pre-piloted questionnaire, and pre-paid return envelope. Participants had the option to consent to an optional one-week follow up questionnaire that focused on perceived effectiveness of treatment after seven days and any further access to healthcare services such as general practice, emergency departments or repeat pharmacy visits.Results:There were 1,121 respondents to the initial questionnaire. Most reported ‘convenient Location’ as the main reason for their access to community pharmacy (n=748; 67.1%). If MAS had not been available, 59% (n=655) of participants reported that they would have accessed general practice for treatment of their minor ailment. Experience of consultations was also rated highly with all ten outcome measures scoring ‘Excellent’ overall. Satisfaction was reported positively with most participants reporting full satisfaction with the overall experience (n=960; 87.2%). At one-week follow up, 327 participants responded, over 85% (n=281) did not require further access to care to treat their minor ailment and 99.7% (n=326) said they would use MAS again.Conclusions:Positive perceptions and experiences of those using MAS demonstrate a highly regarded service in terms of satisfaction and experience of consultation. The capacity for MAS to impact on the use of higher-cost healthcare services is evidenced through the number of participants who reported these services as a point of access to care should community pharmacy not be available. This national evaluation demonstrates MAS to be a positively experienced service and outlines the factors determining access for treatment of minor ailments.

Use of the nursing process for patient care in a Ghanaian Teaching Hospital: A cross sectional study

BackgroundThe nursing process is an evidenced-based tool that guides the sequence of clinical reasoning and the delivery of quality nursing care. Nursing practice authorities worldwide, including Ghana, make it a standard of practice in the clinical setting for professional nurses. Despite this, only a few studies have attempted to assess the use of the nursing process in the country. This study, sought to assess the knowledge level, extent of use, as well as, barriers associated with the use of the nursing process at the Tamale Teaching Hospital in Ghana. MethodA quantitative cross-sectional survey of 286 registered nurses and midwives, chosen by stratified random sampling, was undertaken using a questionnaire with a Cronbach’s alpha of 0.83. Data was fed into SPSS version 24 for analysis. A questionnaire return rate of 98.6% was realized. Descriptive statistics, as well as, Kruskal-Wallis H test of association was used to check for the presence of statistically significant associations between some selected independent variables and the use of the nursing process. ResultsKnowledge level of the nursing process was high (71.0%), while use of the nursing process was low (32.3%). Major barriers were stressful work environment (96.8%), absence of nursing process policy (94.7%), lack of further nursing process training (91.5%), inadequate supply of consumables (81.2%) and lack of nursing process clinical skills (42.9%). Participants age (p = 0.020), academic qualification (p = 0.038), work experience (p = 0.033), rank (p = 0.011) and the possession of nursing process clinical skills (p = 0.016) were significantly associated with the use of the nursing process for patient care. ConclusionA nursing process theory–practice gap exist in the hospital, occasioned by a high level of theoretical knowledge but low level of use of the nursing process in the hospital. Barriers such as stressful work environment, absence of nursing process policy, lack of further nursing process training, inadequate supply of consumables and lack of nursing process clinical skills also existed in the hospital. There is the need for the hospital management and health authorities to develop a nursing process policy, supply adequate quantities of consumables and conduct periodic nursing process clinical skills training for all nurses to enhance its use for improved patient outcomes.

EMPLOYMENT OF YOUTH IN KENYA IN RELATION TO COVID 19: A CASE OF TRANS NZOIA COUNTY

The purpose of the study was to investigate the effects of COVID 19 on employment of youth in Trans Nzoia County. The study was guided by the following objectives: establish employment status of youth in Trans Nzoia County in relation to COVID 19, examine the demerits of youth joblessness, determine measures that can be fronted by the county government of Trans Nzoia to quell the issue of unemployment among the youth .The study was guided by youth livelihood and empowerment theory of change by M Carson (1979) on the disadvantages of youth not engaged .The study explains the repercussion after the youth involve themselves in activities that go against the social norms . The study employed mixed research method and design where the researcher used quantitative and qualitative data forming triangulation design. The sample size to facilitate the study was arrived by use of the formulae whose proponent is Israel G D (2009) no matter how big the population is you will land at four hundred. The research was carried out in Trans Nzoia County one of the forty-seven counties that forms this great nation Kenya after the promulgation of the new constitution in August 2010. There are quite a number of research instruments that could be employed but in this case the researcher settled on questionnaire research tool. Respondents were considered in terms of gender, age, level of education and experience. Pilot data collection was done to ensure the study does not lose focus. The questionnaire return rate from the five categories ranged between 75% and 95% hence considered excellent in line with recommendation by Mugenda and Mugenda (1999). The study established that the escalating situation in terms of job scarcity is championed by a number of positions created in the job market. The wave of corruption has limited chances offered to those who have a formidable financial muscle. Lack of employment has plunged many youths into abuse of drugs, anti social activities such as prostitution and more so enticed to join terrorist groups such as alkaida, alshabab whose main business is to rock peace and stability in any given community. Many people have succumbed in the hands of those merciless gangs. Parents have lost hope in their children this has actually interfered with family linage for many youth are not willing to enter into marriage. The system of education has been diluted hence falling below international standard. Therefore the youth can land a job elsewhere. Possible measures to be employed by the community in partnership with the government to adapt a curriculum that will prepare the young for any eventuality. If they cannot land job in the market then create one of their own that will evade them from being idle hence lured to join fundamentalist groups.

Current status of newborn deafness gene screeningin parts of China

Objective:To analyze the current status of newborn deafness gene screening from 2016 to 2017 in multiple regions of China, and to provide a reference for further promotion and application. Method:The "newborn deafness gene screening questionnaire" was sent to 41 institutions in eastern, central and western China after expert demonstration. The survey content included status of genetic screening, screening methods, the number of screenings, and the status of positive detections from January 1st, 2016 to December 31th, 2017. Each institution returned the questionnaire, the investigator conducted data verification and quality sampling. Finally, we performed analysis of screening methods and the positive detection rate of each gene on questionnaires with complete data. Result:Forty-one questionnaires were sent out and 41 were returned, the questionnaire return rate was 100%, in which 12 questionnaires were complete. Of the 41 institutions, 15 carried newborn deafness gene screening, with a rate of 36.59%（15/41）. The highest rate was in the east（72.22%, 13/18）, and the differences among the regions were statistically significant. As for the screening methods, among 12 questionnaires with complete data, 9 variants in 4 genes and 20 variants in 4 genes accounted for the highest proportion, both with the rate of 33.33%（4/12）, followed by 15 variants in 4 genes（25%, 3/12） and 5 variants in 3 genes（8.34%, 1/12）. A total of 340, 521 neonates were included in the study, and 17, 036 were positive for screening, with a positive rate of 5.00%. Among them, the single heterozygous mutation rate of GJB2 gene was 2.43%（8269/340, 521）, the biallele mutation rate was 0.02%（56/340, 521）,the single heterozygous mutation rate of SLC26A4 gene was 1.99%（6771/340, 521）, the biallele mutation rate was 0.01%（39/340, 521）,the single heterozygous mutation rate of GJB3 gene was 0.33%（1140/340, 521）, the mitochondrial 12SrRNA gene mutation rate was 0.22%（746/340, 521） and the double-gene heterozygous mutation rate was 0.004%（15/340, 521）. Conclusion:From 2016 to 2017, the newborn deafness gene screening is more extensive in the eastern region of China than in the central and western regions. In institutions that have carried out deafness gene screening, 9 variants in 4 genes and 20 variants in 4 genes are widely used; the GJB2 gene and SLC26A4 gene mutations are the most common. The results could provide references for areas where deafness gene screening is about to be performed.