Six-week Period Research Articles

231 The Tolerability and Effectiveness of Duloxetine for the Prevention of Persistent Musculoskeletal Pain After Trauma and Injury: A Pilot Three-Group Randomized Controlled Trial

The primary aim was to examine the tolerability of duloxetine as a preventative treatment for emergency department (ED) patients who present with acute musculoskeletal pain after trauma or an injury. Tolerability was measured by drop-out rate and adverse effects. Secondary outcomes assessed drug effectiveness as measured by: (1) the proportion of participants with moderate to severe pain (numerical rating scale (NRS) > 4) at six weeks (pain persistence); (2) average pain by group over the six-week study period. Eligible participants were 18-69 years of age and had acute moderate to severe axial musculoskeletal pain. Exclusion criteria included: fracture, history of coronary artery disease, uncontrolled hypertension, antidepressant use, and chronic pain. Participants who consented were randomized to two weeks of a daily dose of one of the following: placebo (n=27), 30 mg duloxetine (n=24), and 60 mg duloxetine (n=27). Follow-up assessments were completed at days 3, 7, 10, 14, 17, and 21. An in-person assessment was completed at day 42. Descriptive data were examined. We conducted a mixed-effects model to examine pain over time by group and mechanism (traumatic vs. atraumatic). Participants (n=78 at baseline) were recruited from two EDs in the Northeastern USA. 29/78 (37%) presented after a traumatic stress exposure (motor vehicle collision, MVC), 49/78 (63%) were atraumatic (eg, lifting). Drop-out rates were 11.1%, 12.5%, and 25.9% in the placebo, 30mg, and 60mg groups, accordingly. There were no serious adverse events. Six weeks after enrollment, moderate to severe persistent pain was present in 52%, 50%, and 36% of participants in the placebo, 30mg, and 60mg groups, respectively. Among enrollees experiencing MVC, these proportions were 71%, 67%, and 25%, respectively. Mean MVC-related pain scores at six weeks were 5.3 (2.6), 4.2 (2.5), and 3.0 (2.5), respectively, and the proportion of those who remained very anxious getting in a car six weeks after MVC were 57%, 33%, and 13%, respectively. A piecewise trend with a break at 14 days provided the best fit for pain intensity scores amongst the entire sample. After controlling for age, sex, and race there was a significant difference in pain over time for 60mg vs placebo group (B=-.07, p=.03) across the whole sample, but not the 30mg vs placebo group (B=-.02, p=.51). Although patients receiving 60mg duloxetine had higher drop-out rates than placebo, these drop-out rates were similar to those reported for duloxetine in other pain trials, and no serious adverse events were observed. Among all participants, 60mg duloxetine was associated with a reduction in pain intensity at 6 weeks compared to placebo. Duloxetine may be a promising treatment option for reducing the transition from acute to persistent axial pain. Point estimates suggested that duloxetine may be particularly efficacious among individuals with acute pain after traumatic stress exposure/MVC and may also reduce psychological sequelae in such patients. These data are consistent with the role of stress systems in the development of chronic pain after traumatic stress.

Designing for Multilevel Behavior Change: A Father-Focused Nutrition and Physical Activity Program for Mexican-Heritage Families in South Texas Border Communities.

Fathers significantly influence family functioning, as coparents and partners, and must be part of family-based approaches to behavioral health interventions or programs. But little is known regarding how to support Latino fathers in health promotion within their family systems, specifically for Latino families living in border communities. Program development was embedded in a larger community-based grant and part of a longstanding academic-community collaboration. An interdisciplinary research team applied theories related to health behavior, family systems, behavior change, and community engagement to develop a father-focused and family-centered behavioral program for Mexican-heritage fathers and children living near the Texas-Mexico border to support changes in nutrition and physical activity at the individual and family levels. Promotoras de salud (trained community health workers) delivered the program through group sessions, check-in calls, and at-home activities. Group session activities were designed to engage family triads and dyads using experiential education related to nutrition and physical activity, like cooking lessons and active play, over a six-week period. Future research can use the program approach and curricula as a roadmap for designing context-specific and culturally-relevant programs for Latino families. Additional research is needed to explore how approaches like this can support families and their health goals.

Wasted effort or promising approach – Does it make sense to build an engineered spawning ground for rheophilic fish in reservoir cascades?

Anthropogenic alterations such as the construction of dams and reservoirs led to a loss of quantity, quality and connectivity of habitats for riverine fish species. The resulting decline of freshwater fishes has prompted many restoration efforts addressing bottlenecks in their life cycles such as improving spawning habitat quality. Whilst there is a wealth of studies addressing the benefits and challenges of spawning ground restoration for rheophilic fishes in lotic ecosystems, there is a paucity of information on the usefulness of such measures in almost lentic systems. In this study, an engineered spawning ground with areas of different grain sizes, built as a mitigation measure for a hydropower plant construction in a near-stagnant reservoir cascade, was assessed including physical and chemical characterisation, spawning habitat use and recruitment of target species for conservation. During the six-week investigation period, about 4000 larvae and 18,000 eggs of mainly ubiquitous species such as roach (Rutilus rutilus, L.) and European perch (Perca fluviatilis, L.) were detected by drift netting and sampling of the gravel bed. The engineered spawning ground was successfully used for recruitment by the rheophilic gravel spawning cyprinids asp (Leuciscus aspius, L.) and ide (Leuciscus idus, L.). For all species, the highest density of eggs and larvae was found in the area with the highest current velocity directly at the turbine outlet. The findings of this study illustrate the potential of engineered spawning grounds for fish conservation even in heavily modified water bodies such as reservoir cascades. However, evidence of successful reproduction of rheophilic species on the spawning ground alone does not allow any predictions on further population development, since crucial prerequisites in the further ontogeny may pose additional bottlenecks.

Use of Lactobacillus farciminis to improve antioxidant status of Tuj lambs

The aim of this study was to investigate the effects of Lactobacillus farciminis on growth traits and antioxidant status in preweaning and postweaning Tuj lambs. Twenty lambs were divided into four groups, regardless of gender, with a mean live weight of 7.81 ± 0.50 kg. At the start of the experiment, the average age of the lambs was seven days. During the six-week preweaning period, control (C) lambs were fed with colostrum only, and Lactobacillus farciminis was given orally to the treated lambs at 1 g/day/lamb (L1), 2 g/day/lamb (L2) or 4 g/day/lamb (L3). The experiment continued for a total of 22 weeks. During the first six weeks, bodyweight (BW) increased significantly in L1 at the sixth week. Also during this period, bodyweight gain (BWG) in L2 at 2 - 3 weeks and in L3 at 5 - 6 weeks differed from C. In the subsequent period, BW and BWG were not affected by probiotic supplementation. The effects of probiotic supplementation on malondialdehyde (MDA), nitric oxide (NO), superoxide dismutase (SOD), glutathione peroxidase (GPx), and catalase (CAT) were significant throughout the experiment, with the effect on glutathione (GSH) also being important in the first six weeks. Thus, Lactobacillus farciminis provided orally to Tuj breed lambs could be used to improve their antioxidant status without compromising growth.

268An online survey of sexual health, knowledge and behaviour of young South Australians

Abstract Background Since 2010 rates of sexually transmitted infections (STIs-chlamydia, gonorrhoea and syphilis) have been increasing among young Australians. Most STIs are diagnosed in young people aged 16-29 and rates of diagnosis are higher among Aboriginal people than non-Aboriginal people. Little information exists to understand social and behavioural issues associated with increasing rate of STIs, especially in South Australia and among Aboriginal peoples. Methods We undertook an online cross-sectional survey of sexual health, knowledge and behaviour of young South Australians aged 16-29 years during a six-week period in 2019. Descriptive analysis, univariate and adjusted logistic regression models were used to compare Aboriginal and non-Aboriginal participants. Results In total 2,380 South Australians participated in the “Let’s Talk About It” (LTAI-2019); 52% were female, the median age was 20 years (IQR:17-24) and 10% of participants identified as Aboriginal. Regression analysis suggested among both Aboriginal and non-Aboriginal participants being female (aOR 2.41, CI:1.07-3.51, & 3.03, 2.17-4.23 respectively) and not using a condom during last sexual encounter (2.33, 1.03-5.29 & 1.62, 1.15-2.27) were associated with ever being tested for an STI and having two or more sexual partners in the past 12 months (1.37, 0.67-7.45 & 3.13, 1.31-7.45) was associated with testing positive for an STI. Conclusions LTAI-2019 is the first study to describe factors associated with STIs among young South Australians. It is evident that young people are engaged in behaviours which increase their risk of acquiring STIs. Public health action which considers these behaviours particularly those that target young Aboriginal people is required. Key messages LTAI 2019 is the first study to describe current sexual health, knowledge, behaviours and access to health services for STIs and related issues amongst young South Australians. It provides evidence that is useful for informing both public health practice and policy, and the development of STIs preventative health programs.

Effect of glutathione supplementation on swimmers’ performance

Background and Study Aim. Continuously increasing the volume and intensity of the training sessions often leads to overtraining. It has been demonstrated that glutathione supplementation might improve the aerobic metabolism in skeletal muscle and reduce exercise-induced muscle fatigue. The aim of the study was to assess the effect of glutathione supplementation on fatigue, recovery processes, and competitive results of elite swimmers during a six-week training period.
 Material and Methods. Twenty-four elite swimmers (10 women and 14 men) from the Bulgarian national swimming team, with a mean age of 18.7±3.78 years, took part in this double-blind placebo control study. The swimmers from the experimental group were supplemented once a day with a capsule of 250mg glutathione, whilst the swimmers from the control group took a placebo once a day. The urine concentration levels of cortisol and cortisone, as well as the degree of overtraining, were evaluated on the 1st(T1), 14th(T2), 28th(T3), and 42nd(T4) days. Anthropometric measurements and a nutritional assessment were performed at T1 and T4.
 Results. The swimmers showed a gradual decrease of cortisol and cortisone during the study, with significantly lower concentrations in the experimental vs the control group at T4 (19.4 vs 42.5 ng/mL, p < 0.05). At the end of the study, the swimmers from the experimental group showed improvements in their time in 41 out of the 43 swimming events, whilst those from the control group had significantly smaller improvements (-1.66 vs -0.97%, p < 0.05).
 Conclusions. In conclusion, glutathione supplementation at a dose of 250mg/day for six weeks improves the adaptation of elite swimmers towards training schedules, which is likely to lead to better sports results.

Aided language modelling, responsive communication and eye-gaze technology as communication intervention for adults with Rett syndrome: three experimental single case studies

Purpose To examine the effect of a communication intervention package on expressive communication and visual attention in individuals with Rett syndrome. Materials and methods A modified withdrawal (A-B1-A1-B2-A2) single case experimental design with a direct inter-subject replication across three participants was applied. Three women with Rett syndrome participated. The study took place over a six-week period and comprised 32 sessions with each participant. All sessions were video recorded. During the intervention the communication partner used aided language modelling on a gaze-controlled device in combination with using responsive partner strategies. Expressive communication was assessed as synthesised words per minute and unique synthesised words per minute. Visual attention was assessed as rate of focused gazes (1 s or longer) in interaction. Results An intervention effect was found on the rate of unique words for all participants. The rate of words increased for two participants when the intervention was introduced but no withdrawal effect could be seen. An intervention effect on visual attention could be seen for one participant. The intervention appeared to have social validity as reported by caregivers. Conclusion Aided language modelling (ALM), while using responsive partner strategies and a gaze-controlled device may be used with adult individuals with Rett syndrome to increase their rate of expressive communication. Detailed observational measures revealed individual learning patterns, which may provide clinically valuable insights. Implications for Rehabilitation Adults with Rett syndrome may benefit from access to gaze-controlled devices in combination with responsive partner strategies. Responsive partner communication may be effective for some individuals with Rett syndrome to increase their rate of synthesised utterances. Rate of focused gazes may be considered as an outcome measure for individuals with oculomotor difficulties when introducing aided language modelling.

Interaction of substrate muddiness and low irradiance on seagrass: A mesocosm study of Zostera muelleri

Seagrass meadows are important estuarine habitats, and in recent decades, have suffered global declines. Fine sediment pollution is recognised as a major cause of decline, usually attributed to the combined effects of reduction of photosynthetically available radiation (PAR) and burial. However, intruded fine sediment affects the seagrass rhizosphere and this interacts with reduced irradiance to affect seagrass performance. We undertook a 2 × 2 factorial mesocosm experiment, to examine the interaction between substrate muddiness and irradiance on seagrass growth and survival over a six-week period. The seagrass Zostera muelleri was grown on two substrates from the same estuary: (1) an inner estuary substrate with high mud content (42 %) from a location where seagrass formerly grew; and (2) an outer estuary substrate with moderate mud content (20 %) from a location at which seagrass persists. Two irradiance levels were used: (1) low (6.3 mol quanta m−² d−¹) and (2) very low (2.3 mol quanta m−² d−¹) both above a published compensation irradiance (Ec) of 1.9 mol quanta m−² d−¹. Belowground biomass and rhizome growth were significantly reduced by substrate muddiness but not detectably affected by irradiance. Shoot growth, was reduced by both reduced irradiance and increased muddiness, with a significant interaction. We conclude that muddification of substrates imposes an increased irradiance requirement for Z. muelleri to cope with adverse rhizosphere conditions, which should be taken into account when planning seagrass conservation and restoration interventions.

The Effects of Creative Drama on Achievement and Motivation Levels of the 7th Graders in English Language Classes

The aim of the current study was to examine the effects of creative drama method on the 7th graders’ achievement and motivation towards English language course. The study was in quasi-experimental pattern model with pretest and posttest control group. It was conducted with seventy 7th grade students, 36 of whom were assigned as the experimental group and 34 of whom were assigned as the control group. Three units - “Tourist Attractions”, “Our Natural Heritage” and “Computers” - were taught during a six-week period in the experimental group by using a book developed by the researcher, while the same units were taught by using the usual course book in the control group. “English Course Achievement Test” and “Motivation Scale” were conducted in both groups preceding and following the intervention. “Student Interview Form about the Implementation of Creative Drama Method” was conducted with the experimental group to get the students’ opinions on the method following the intervention. It was found that the students’ achievement test scores improved in both groups, and this improvement was higher in the experimental group. However, the difference was not significant. On the other hand, there was a statistically significant difference between average motivation scores of the two groups in favor of the experimental group, and this was supported by student interview forms

Lessons for Workforce Disaster Planning from the First Nosocomial Outbreak of COVID-19 in Rural Tasmania, Australia: A Case Study.

The identification and announcement of the COVID-19 pandemic has been a global issue. Disaster preparedness for internal and external threats is inherent within health care environments and requires agile thinking and swift remediation. Nosocomial infection is a risk for recipients of care, especially in hospital settings, which has implications for workforce planning. The aim of this case study was to examine the community response to the internal disaster of the first nosocomial COVID-19 outbreak within an Australian rural health care environment. A critical discourse analysis method was adopted to generate and analyse data collected from three different media platforms during a six-week period. Four main themes were distilled: actions and intent, loss, well-being and recognising choice, and community action. Phase two of the study interrogated these themes to expose the power positioning of speakers and their relationships to the audiences. Strengthening communication with local communities within health care environments must be a priority in any future rural workforce disaster preparedness planning. Maintenance of trust with health service provision and delivery in rural communities is imperative. The inclusion of a robust communication plan within any risk management strategy that meets the needs of the local users of health services is mandatory.

Effect of Virtual Reality Exercises on the Cognitive Status and Dual Motor Task Performance of the Aging Population.

Aging is a global phenomenon affecting numerous developed and developing countries. During this process, the functional state of the body, especially the cognitive state, declines. This research investigated the impact of virtual reality exercises on the cognitive status and dual-task performance in the elderly of Tabriz city, Iran. Forty men with a mean age of 71.5 were selected and assigned to either the experimental (n = 20) or control groups (n = 20). Both groups completed the Mini-Mental State Examination for cognitive status. The pre-test was performed through the Timed Up and Go test (TUG) along with a countdown of numbers. Then, the experimental group practiced virtual driving for six weeks, while the control group received no treatment. After the treatment, both groups completed the post-test. At each stage, the test was performed as a dual motor task as well. Data were analyzed using the paired t-test and the independent sample t-test to show the intra-group and inter-group differences, respectively. The results showed a significant improvement in the cognitive status and dual-task performance of the elderly men after the six-week training period, which was also significant compared to the control group. Virtual reality driving can be used to improve the cognitive status and dual task performance of elderly men.

Compliance with hygiene practices among healthcare workers at an academic hospital emergency department.

IntroductionHealthcare-associated infections (HCAIs) are an important contributor to patient morbidity and mortality. Healthcare workers (HCWs) hands are the chief mode of transmission of HCAIs. The emergency centre (EC) is frequently the first point of contact for patients within the health care system. The aim of this study is to determine compliance with hygiene practices among healthcare workers at a tertiary hospital EC.MethodsHygiene practices of staff were observed over a six-week period. Data pertaining to compliance rates with hand cleansing and other hygiene practices was collected. Consent was obtained retrospectively to avoid influencing participant behaviour.ResultsFrom a total of 477 potential hygiene opportunities, compliance with hand hygiene was only 34.4% (n = 164). Hand cleansing with an alcohol-based hand rub was observed in 87 (26.7%) of the 326 (68.3%) opportunities where it was indicated, while handwashing with soap and water was observed in 35 (23.2%) of the 151 opportunities where this was indicated. Compliance to each of the six steps of handwashing ranged between 62.2% and 83.5%, with there being a gradual deterioration in compliance from step one through to step six. Compliance with ‘bare below the elbows’ was observed in 242 (50.7%) opportunities while disposable surgical gloves were worn on 85 (44.7%) of the 190 opportunities where this was indicated.ConclusionCompliance with hygiene practices among EC HCWs is suboptimal. Various strategies including ongoing systematic training and regular audits may improve overall hygiene practices among EC staff.

An Attempt to Predict Changes in Heart Rate Variability in the Training Intensification Process among Cyclists.

Individual changes in resting heart rate variability (HRV) parameters were assessed in seven Polish cyclists during a training process consisting of: a six-week period (P1) of predominantly low- and moderate-intensity training (L-MIT) and a six-week period (P2) where the proportion of high-intensity interval training (HIT) increased. Daily recorded HRV parameters included high-frequency spectral power (HF), square root of the mean squared difference between successive normal-to-normal RR intervals (RMSSD), and standard deviation of normal-to-normal RR intervals (SDNN). In each training microcycle, the average values of HFav, RMSSDav, and SDNNav were calculated individually for each participant. In three cyclists, HF was higher in P2 compared to P1, whereas in one cyclist, HF was higher in P1 than in P2. Each of these four cyclists presented an individual correlation between the average daily duration HIT effort in training microcycles (HITav) and HFav. Cyclists with low baseline values of HRV parameters showed increased activity of the parasympathetic nervous system, while in the cyclist with high baseline values of HRV parameters, an opposite change was observed. In conclusion, changes in resting HRV parameters between period P1 and P2 can be individualised. In the investigated group, it was possible to predict how HRV would change as a result of training intensification on the basis of HRV baseline values.

Dehulled Adlay Consumption Modulates Blood Pressure in Spontaneously Hypertensive Rats and Overweight and Obese Young Adults.

High blood pressure is a crucial risk factor for many cardiovascular diseases, and a diet rich in whole-grain foods may modulate blood pressure. This study investigated the effects of dehulled adlay consumption on blood pressure in vivo. We initially fed spontaneous hypertensive rats diets without (SHR group) or with 12 or 24% dehulled adlay (SHR + LA and SHR + HA groups), and discovered that it could limit blood pressure increases over a 12-week experimental period. Although we found no significant changes in plasma, heart, and kidney angiotensin-converting enzyme activities, both adlay-consuming groups had lower endothelin-1 and creatinine concentrations than the SHR group; the SHR + HA group also had lower aspartate aminotransferase and uric acid levels than the SHR group did. We later recruited 23 participants with overweight and obesity, and they consumed 60 g of dehulled adlay daily for a six-week experimental period. At the end of the study, we observed a significant decrease in the group’s systolic blood pressure (SBP), and the change in SBP was even more evident in participants with high baseline SBP. In conclusion, our results suggested that daily intake of dehulled adlay had beneficial effects in blood-pressure management. Future studies may further clarify the possible underlying mechanisms for the consuming of dehulled adlay as a beneficial dietary approach for people at risk of hypertension.

Development and evaluation of a mobile game as an English learning tool for ESL learners

Learning and memorizing irregular verbs are some of the most difficult aspects of the language for non-native English learners. Research concerning games for education reveals that educational games have a large positive impact on learners’ skills and abilities. This research was divided into two phases including 1) the design, development and deployment of a mobile game used as an English learning tool for ESL learners and 2) an evaluation of the outcome. An Android mobile game was developed and then deployed on Google Play. In the evaluation phase, a quasi-experimental set-up with a non-equivalent pre-test and post-test control group design, was used to evaluate the impact of the use of the mobile game. The sample consisted of sixty-four tenth-grade students who studied English in a Thai school. There were two groups; the treatment group (N=32) and the control group (N=32) selected by cluster sampling. Both groups were given a pre-test to measure their prior knowledge. The sample then learned English in the class using conventional methods over a six-week period. During that period, the treatment group used the mobile game as a supplementary tool. Finally, both groups were given a post-test to measure the learning outcome. In this study, an independent t-test at the significance level of 0.01 was conducted. The results revealed that students who used the mobile game as a supplementary tool had statistically significantly higher learning outcomes.

Telephone clinics for follow-up in hand surgery: an effective model after COVID-19?

Introduction Telephone clinics were adopted for follow-up appointments in our plastic hand surgery department during the COVID-19 pandemic. They may pose advantages in cost, efficiency and environmental impact compared with face-to-face consultations. The aim of this study was to assess the success rate of telephone clinics in hand surgery to determine benefit of continuing the practice. Methods A prospective cohort study of all hand surgery follow-up telephone clinics was conducted over a six-week period. The primary outcome measure was success of the consultation, defined as achieving the same outcome as could have been achieved in a face-to-face clinic. Secondary outcome measures included duration and environmental impact. Results During the study period, 177 consultations were scheduled. Twenty-nine patients (16%) were not contactable. Of the remaining 148 consultations, 111 (75%) had a successful outcome. The highest success rate (85%) was achieved for first postoperative consultations when the patient had already received hand therapy. On average, consultations lasted 8 minutes but required an additional 16 minutes of preparation, documentation and administrative work. An estimated 5,939km of patient travel (1.25 tonnes of carbon dioxide emissions) were saved during the study period. Conclusions The rate of successful outcomes following telephone consultation in our cohort of patients was lower than for face-to-face clinics. However, the service was set up with little time for preparation. The success rate and duration could be improved with appropriate patient selection, especially for those who have undergone straightforward operative procedures. The duration of consultations and the ‘did not attend’ rate should reduce as administrative processes improve.

Effect of feed restriction on fatty acid profile, body composition and selected blood parameters of intensive reared pike (Esox lucius)

This study investigated the effects of a six-week starvation period on the fatty acid profile, body composition and blood parameters of intensively reared pike (Esox lucius). 150 pike were stocked in an experimental recirculating aquaculture system (RAS) and feed was completely withdrawn. Body composition, fatty acid composition and blood parameters (serum protein, albumin, triacylglycerol, cholesterol concentration and Lactate dehidrigenase and alkaline phosphatase activity) were measured and somatic indices were calculated. A significant decline in bodyweight, crude fat content and somatic indices was accompanied by a significant decrease of blood triacylglycerol content. The relative proportion of saturated fatty acids in the fillet decreased, while polyunsaturated fatty acids increased. There was also a significant increase in the average chain length and unsaturation index of fatty acids found in the fillet flesh.

The financial lives of female sex workers in Addis Ababa, Ethiopia: Implications for economic strengthening interventions for HIV prevention

ABSTRACT Understanding the financial context of the lives of female sex workers (FSWs) is essential to address structural drivers of HIV risk. We used a financial diary methodology to record daily financial transactions over six weeks from a stratified purposive sample (n = 34) of FSWs in Addis Ababa, Ethiopia. FSWs also provided information on their experience with gender-based violence and condom use. FSWs generated 90.1% of total cash from sex work, with a median weekly income of USD 60.53. They engaged mostly in protected vaginal sex, earning approximately USD 4.57 per act. Food, housing, and clothing represented the largest areas of expenditure. Around 17% of expenses were recorded as costs of sex work (e.g., alcohol). Median weekly expenditures accounted for 62% of median weekly income. Nearly all participants reported depositing money into savings at least once over six weeks, while 71% reported a loan transaction during the six-week period, most as borrowers. Findings suggest that financial literacy and formalized savings activities, with life skills and empowerment training, have potential to build FSW’s economic resilience, mitigating a structural driver of sex work and HIV risk.

The development of the postpartum mobile support application and the effect of the application on mothers' anxiety and depression symptoms

ObjectiveThe study aimed to develop the postpartum mobile support application to support postpartum mothers and to examine the effects of the use of mobile app on mothers' anxiety level and depression symptoms. Research design/settingIt is a parallel group pretest-posttest randomized controlled study carried out between July 2017 and February 2020. The mothers (62 in the experiment and 62 in the control group) who gave birth in full-term at a university hospital in Konya province in Turkey and who had healthy newborns constituted the study group. Data were collected using the Information Form, the STAI State and Continuity Anxiety Scale, and the Edinburgh Postpartum Depression Scale. Mixed pattern variance analysis (mixed anova), t test in dependent groups, t test and chi square analysis in independent groups were used to analyze the data. FindingsMost of the mothers who used the application fed their baby only with breast milk and felt more sufficient about breastfeeding. The depression symptoms of mothers using the postpartum mobile support application was lower than that of the mothers in the control group; however, it was found that the application was not adequate alone to decrease anxiety levels and depression symptoms (p > 0.05). ConclusionsThe postpartum mobile support application is an important and useful source in accessing reliable information; however, it was found to be insufficient to lower anxiety levels and prevent depression symptoms at the end of the six-week postpartum period.

Sharing Indigenous Knowledge through intergenerational digital storytelling: Design of a workshop engaging Elders and youth

ABSTRACT Within many First Nations communities, storytelling, led by Elders recognized as knowledge holders, is a deeply valued aspect of teaching and learning history, language, place, culture, and Indigenous Knowledge. The purpose of this study was to design and evaluate the first iteration of an intergenerational digital storytelling workshop that brought Elders and school children from a First Nations community in Canada together to co-create digital stories and share local Indigenous Knowledge. Using a community-based participatory research approach, the research team, school, and community members designed and implemented a ten-session program held during a six-week period. Thirty-one grade six and seven students were paired with thirteen Elders. Elders told a range of stories including personal experiences, legends, and local knowledge of hunting and medicine. Students created a digital version of the stories, adding images, sound, and music. Students learned about local knowledge, built connections with Elders, and increased their digital literacy. Future recommendations included expanding the program over the full year and integrating it with other classes such as having Carrier language as a key component of the digital stories and incorporating art and music created by the students.