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Nov 2025 DOI 10.14302/issn.2693-1176.ijgh-25-5745
Poole JolyonCorresponding author
Background Healthcare worker stress, anxiety, burnout, and trauma have been widely documented across global healthcare systems. Staff in maternal and neonatal units frequently encounter emotionally distressing events and work under high pressure with limited resources. In Zambia, despite some gains in reducing maternal and neonatal mortality, fatality rates remain above national targets, exposing staff to repeated occupational trauma. Objective(s) This study aimed to assess the psychological well-being of staff in maternal and neonatal intensive care units, identify specific needs and stressors, and develop practical recommendations to improve resilience and support staff mental health. Methods A mixed-methods cross-sectional study was conducted at Ndola Teaching Hospital (NTH) and Arthur Davison Children's Hospital (ADCH), two major tertiary hospitals in Zambia. Data were collected over four days in February 2025. The study included 87 (out of 161) healthcare professionals, including nurses, midwives, and doctors. The Goldberg Anxiety and Depression Scale (GADS) and the Professional Quality of Life Scale Version 5 (ProQOL 5) were used to collect quantitative data, which were analysed using descriptive statistics and 95% confidence intervals (CI). Open-ended survey questions provided qualitative data, which were analysed using thematic analysis. Ethical approval was granted by the hospital ethics committee. Results High rates of clinical symptoms were observed. The overall prevalence of symptoms in the past 30 days was: anxiety (62%), depression (68%), burnout (50%), and secondary traumatic stress (46%). Junior doctors demonstrated the highest rates of depression (83%) and burnout (67%). The obstetrics and gynaecology and labour wards had the highest rates of secondary traumatic stress symptoms. Key qualitative themes identified were professional stressors, team and leadership issues, and the emotional burden of the work. Conclusion This study highlights an urgent need for both psychological and organizational support for maternal and neonatal healthcare staff in Zambia. The findings indicate that burnout and secondary traumatic stress are highly prevalent, particularly among junior doctors and those in high-risk wards. Targeted interventions at both systemic and individual levels are necessary to protect the well-being of healthcare workers and improve patient outcomes.
Mar 2021 DOI 10.14302/issn.2474-3585.jpmc-20-3557
E. ADETONA AdesojiCorresponding author
FWACP (LAB. MED), FMCPath, MPH (Health Policy and Management), MBBS; UCH, Ibadan
Background Breast cancer is one of the most common types of cancer affecting women globally. It has shown increasing morbidity and mortality rates over the past years. Several screening methods ranging from simple breast self-examination to a highly sensitive test procedures for early detection and treatment are available, but uptake is a challenge. Lack of a national screening programme in the country makes available regional screening programme unsuccessful. This study aims to assess the factors affecting the uptake of breast cancer screening programme among female staff in a tertiary hospital, Southwest Nigeria. Method This descriptive cross-sectional study involves 375 participants selected by a stratified random sampling technique, with proportional allocation to population size and the use of a semi-structured questionnaire. Respondents were questioned on their basic knowledge of breast cancer symptoms, risk factors and treatment, over a score of 50 and above, were set as the cut-off mark to determine good knowledge of breast cancer. Patients attitudes towards breast cancer screening as well as factors affecting uptake were also measured. Descriptive statistical analysis was done using SPSS-20 while the predictors of the uptake of screening were determined using logistic regression at p ≤ 0.05. Results There were 360 respondents, comprising of 13.3% clinical and 86.7% non-clinical female staff within the age bracket of 20 to 58 years (38.2±0.42 years). Out of the respondents, 97.8% have heard about breast cancer but only 52.3% had been screened while 65.5% had “Good knowledge” of breast cancer. Positive attitude to breast cancer screening was displayed in 52.5% while over 90% claimed to be practicing breast self-examination. Only 36.1% of respondents above 40 years old have had mammography done. Most frequent barriers to screening uptake include cost, poor accessibility to screening facilities, shyness (unfamiliar screener), unavailability of female doctors, careless attitude, fear of cancer and other more pressing family problems. Using logistic Regression at p ≤ 0.05, females with a negative attitude, young unmarried (less than 30years) and lack of easy accessibility to screening facilities were significant factors affecting uptake of breast cancer screening services. Conclusion Due to knowledge-uptake gap of breast cancer screening revealed in this study. It is therefore obvious from these findings that a concerted effort is needed to actively remove these barriers by repeated education, training and re-training strategies among health workers and to improve their uptake and level of advocacy and campaign for breast cancer screening among their patients and clients.
Dec 2020 DOI 10.14302/issn.2692-1537.ijcv-20-3670
K. Ceesay EbrimaCorresponding author
University of Gambia, Banjul, Gambia
Purpose This paper assess the impact of COVID-19 pandemic on Education, Staff development and Training in Africa. Online Research Methodology/Approach The data use in this paper was generated from online survey questionnaire, in which the participants were asked about certain questions in which covid-19 affect their social-economic situation. The questionnaire was design to help Africa to understand covid-19 impacts on their social and economic live. Results The results of this study reveal that coronavirus pandemic affected Africa in a number of ways; 1) 52.2 percent of the respondents said they should open school now in Africa, while 47.8 percent fear they should not open schools 2) 81 percent said before educational institution are closed there is public or official announcement that institutions must be closed due to pandemic—may be 3 months, ……,,…,, one week it depends on the severity of how covid-19 is spreading across the regions in Africa, 10.7 percent of the respondent said it may be and only 8.3 percent said it is not official announced.3) 65.4 percent of the respondents said government implemented an education response for continue of learning in Africa while educational institutions are closed 4) 61.5 percent said use of online/digital learning platform is the method for continuity of learning is currently available for children affected by closures of educational institutes provided by government, while 50 percent said television, radio, or podcast broadcast and 17.9 percent said assigning reading and exercises for home study. 5) 45.3 percent out of 100 percent said use of online or digital learning platform are the proportion of children affected by education institution closure. 38.7 percent said the proportion of children affect are the one that concentrate of using television, radio or podcast broadcasts to get academic content. 14.7 percent of the respondents are the proportion of the children affected by educational institute closure if they are assigning reading and exercises for home study. 6) 52.6 percent of the respondents from non-government organization, private schools said use of online or digital learning platform is the method for continuity of learning is currently available for children affected by closures of educational institutes, while 61.5 percent said use of online/digital learning platform is the method for continuity of learning is currently available for children affected by closures of educational institutes provided by government. The same thing government said as well. Similar respondents from government as do the non-government or private schools and 35.9 percent respondent said television, radio and podcast broadcast are method for continuity of learning is currently available for children affected by closures of educational institutes-provided by non-governmental organization, private schools etc, whereas 50 percent of the respondents said assigning reading and exercises for home study is the method for continuity of learning is currently available for children affected by closures of educational institutes-provided by government.7) 48.1 percent of the respondents said for the impact of covid-19 pandemic on staff development and training that their enterprise or organization partially suspended operation due to the pandemic and 34.2 percent of the responded said they completely suspended operation because of coronavirus pandemic and 16.5 percent said no closures on in operation for staff development and training because of pandemic. 8)According to the results of this question of the online survey, 49.3 percent said the challenges their enterprise face in delivery staff training programmes and activities using online learning or offline learning during covid-19 was due to infrastructure issues such the problem associated with internet and the like. The survey of the study also confirmed that 32.9 percent twice said limited digital skills of trainers and cost of staff training was a major setback to train staff in their enterprise or organization or department or establishment while 30.1 percent said it is due to limited digital literacy of users are the main challenges face by their department in order to train staff. Policy Implications The implication of the results from this online survey is that it has serious impacts on education closure and staff development and training. As educations are closed due to covid-19 pandemic, it will affect already problems of human capital that are hampering the development of Africa. Due to covid-19 pandemic, the achievement of sustainable development goals on quality education will be seriously halted. The government and the ministry in Africa should work hand in hand to solve the problems of children affected by schools closure after the pandemic by either additional hours or provide more study hours for schools to catch-up with what happened during the pandemic, the study noted. Originality/value The impact of covid-19 on education, staff development and training.
Dec 2020 DOI 10.14302/issn.2474-3585.jpmc-20-3672
M. Chaudhary SanjeevCorresponding author
Associate Professor, Department of Community Medicine, Government Medical College, Akola.
Background Prevalence of Metabolic syndrome is high among Asians including Indians, and is high among those having sedentary occupations. Teaching is one of the important occupations, which demands no strenuous physical activity. However, there is little information available about the prevalence of metabolic syndrome among teaching staff of engineering college. Hence, the present study was conducted to study its prevalence, certain risk factors and co-morbidities among teaching staff of engineering institutes. Methods Teachers from engineering colleges of Nagpur city were the study subjects. Data was collected by interview technique. Clinical examination and laboratory investigations like Fasting blood glucose, High Density Lipoproteins and Serum Triglycerides were done. National Cholesterol Evaluation Programme (NCEP) Adult Treatment Panel Three (ATPIII) criteria were used to study Metabolic syndrome. Blood pressure and anthropometric measurements like height, weight and waist circumference were obtained by standard methods. Results The prevalence of metabolic syndrome was found to be 20.5%. It was 25.32% in females and 19.31% in males. It was more common in subjects of higher age group, muslim religion, and among widows and separated. Alcohol consumption, smoking and sedentary life style was found to be significantly associated with presence of metabolic syndrome. Frozen shoulder, fungal infection and stroke were common co morbidities found among subjects having metabolic syndrome.
Mar 2020 DOI 10.14302/issn.2471-2140.jaa-20-3236
Sanikidze TamarCorresponding author
Tbilisi State Medical University, Tbilisi, Georgia
Objective Search of pathogenetic mechanisms and risk factors of atherosclerosis in the employees of the cleaning service in Tbilisi. Materials and Methods As a result of a preliminary survey and examination of 200 employes of Tbilisi cleaning service aged 25-45 years (2014-2016), 22 patients with angina, hypercholesterolemia, intimae-media thickness > 0.65 mm, were selected into I group, and 23 individuals without these disorders into II group. In the blood plasma of the selected patients the intensity of oxidative metabolism parameters, TAA and MDA were determined. The variance and correlation analysis (АNOVA) was used for conducting the comparative analysis of the levels of studied parameters. Results In the combined group (I+II) there are several reliable correlations between the Age -TCol, Age-MDA, BMI-Tg, BMI-MDA, LDLChol-HDLChol, LDLChol–TChol, HDLChol-TChol, LDLChol-MDA, LDLChol-TAA. no correlation between these parameters in individual groups (I and II) was found. That indicates that we have an imaginary correlation related to the large intergroup difference between the average values of the group indicators, that is the values of various indicators change during the development of the pathological process, but there is no causal relationship between these alterations. The reliable TAA-MDA correlation in the combined group (I+II) is related to the high anticorrelation between these parameters and the significantly higher average value of TAA in the low-risk group (II) in comparison to the high-risk group (I). Conclusion The results analysis indicates both the diagnostic value of redox status indicators and their leading role in the atherogenesis processes. In populations with a high risk of atherosclerosis, monitoring of serum TAA is recommended.
Jul 2019 DOI 10.14302/issn.2997-2108.jcc-19-2889
Adetona A.ECorresponding author
College of Medicine, University of Ibadan / University College Hospital, Ibadan. Nigeria
Background This study aim to assess the factors affecting uptake of cervical cancer screening programmes among female staff of the University College Hospital (UCH), Ibadan in 2014. Method A descriptive cross-sectional study involving 375 participants selected using a stratified random sampling technique with proportional allocation to population size and interviewed using a pre-tested self-administered semi-structured questionnaire. Information on their basic knowledge on cervical cancer were scored to determine good knowledge. Patients’ attitudes toward cervical cancer screening as well as factors affecting uptake were also assessed. Data analysis was done in 2014 using descriptive statistics while screening uptake predictors were determined using logistic regression at p ≤0.05. Results Completed questionnaires were returned by 360 respondents; 13.3% were clinical while 86.7% were non-clinical staff of age range 20 to 58 years (38.2±0.42 years). Majority of the respondents, (95.5%), had heard about cervical cancer with 61.9% having “good knowledge”, but only few (34.2%) had been screened. Averagely, 47.5% displayed positive attitude to cervical cancer screening with Pap smear being the most reported screening procedure. The common barriers to screening uptaking include indecision, inadequate information and feeling of good health. Others were staff hostility, lack of privacy, and cost. Using logistic Regression at p ≤0.05, females with negative attitude and those with children were less likely to uptake cervical cancer screening services. Conclusion The knowledge-uptake gaps of cervical cancer screenings were high as revealed in this study. Therefore, there is a need to further educate eligible women on uptake of cervical cancer screening.
Jul 2018 DOI 10.14302/issn.2641-4538.jphi-18-2160
Mango LucioCorresponding author
Director "Health management" University Master, University of International Studies (UNINT) – Rome, Italy
This short paper aims to identify the key skills required for personnel management that makes it possible a peaceful business climate and a level of excellence in services rendered. Are analyzed particularly emotional skills like e.g. mindfulnessa
May 2017 DOI 10.14302/issn.2574-612X.ijpr-17-1546
Ando MichiyoCorresponding author
St. Mary’s College, St. Mary’s Hospital
Objective: The present study examined effects of music therapy on mood and healing sense of family-caregivers and staffs in a palliative care ward and their relationships in order to elevate well-being. Method: This study is a cross-sectional study. Participants were 25 family caregivers and staffs related to patients in a palliative care ward in Japan. The professional Jazz pianist played piano at live concert once and the audience sang in one session. Participants completed the Japanese UWIST Mood Adjective Check List (JUMACLE) consisted of Tension Arousal (TA) and Energetic Arousal (EA) pre and post music therapy, the Healing questions, and comments of this therapy only post. Results: The TA score significantly decreased from 18.3 to 14.6 (p<0.05), and the EA score significantly increased from 32.1 to 35.1 (p<0.05). The mean healing questions scores was 4.5 point of total 5 point. The healing score significantly correlated with EA (r=.46, p<.05), but not with TA. Conclusion: The music therapy focused on Jazz music decreased tension or anxiety and increased vigor or energy, and healing sense related to vigor. Music therapy in a palliative care for family-caregivers and staffs may be useful to promote their well-being.
May 2026 DOI 10.14302/issn.2693-1176.ijgh-26-6165
Christine Ruth PiloyaCorresponding author
Background Women’s participation in environmental conservation within patriarchal societies is a critical factor for achieving sustainable development and improved community outcomes. Despite this importance, limited research has examined women’s perceptions of their roles and contributions to environmental conservation. The current study aimed to (1) explore women’s perceptions of their roles in environmental conservation within patriarchal structures, and (2) to document the effectiveness of strategies enhancing their participation. Methods This study followed a phenomenological design, using thematic data analysis. Information was gathered through semistructured interviews, focus group discussions (FGDs), and key informant interviews with technocrats, civil servants, local leaders, and NGO staff. The sample size of the study was 30 participants, obtained using the point of saturation principle. The focus group consisted of 24 participants and 06 Key Informants. The study tools were pretested with a small group before the main fieldwork. Participants were selected using purposive sampling. The size of the sample was guided by data saturation. Results The findings show that although women’s representation in local councils and environmental committees has grown due to the 30% quota requirement, their influence remains constrained by systemic barriers. Political interference undermines technical teams’ conservation efforts, while widespread community ignorance of environmental laws limits compliance. Weak enforcement and corruption, with leaders themselves implicated in destructive practices, further erode progress. Critically, inadequate financing such as subcounties allocating only 600,000 shillings for sensitization, leaves many activities unimplemented, forcing reliance on development partners. Conclusion The study concludes that sustainable environmental stewardship requires not only legal reforms and institutional accountability but also adequate financing and communitydriven strategies that amplify women’s voices and foster collective responsibility.
Dec 2023 DOI 10.14302/issn.2998-4785.ijne-23-4798
Belle Jarvis ShivonCorresponding author
Gastric pneumatosis though rare, when seen is cause for concern. It has been associated with fulminant necrotizing enterocolitis (NEC) and gastric outlet obstruction, although other associations have been identified. It is not to be confused with pneumoperitoneum and can be managed conservatively as it is not always a harbinger of intestinal perforation. This case report highlights gastric pneumatosis which occurred in association with necrotizing enterocolitis in two late preterm infants. NEC accounts for 5.4% of our Neonatal Intensive Care Unit admissions, however these are the first two cases of gastric pneumatosis seen in the history of our unit. It is crucial for clinical staff to be cognizant of this pathognomonic sign so that cases are not missed, and for the feeding policy that governs the management of late preterm infants to be revisited. That which specifically predisposes a baby with NEC to developing gastric pneumatosis remains unknown and warrants further research.
Sep 2023 DOI 10.14302/issn.2693-1176.ijgh-22-4255
Alex G. MeelaCorresponding author
Nutrition during pregnancy is of utmost important to ensure positive pregnancy outcomes after delivery. This study examined the utilization of nutrition services provided at health facilities to pregnant women. A cross sectional study design, involving 105 pregnant women and 5 RCH providers from 2 health facilities was used. Structured questionnaires, and structured observations were used in data collection. SPSS software version 25 was used in data analysis. Results showed that, RCH providers had inadequate nutrition knowledge due to limited nutrition courses during nursing training and on job trainings/seminars. All RCH providers advised that, nutrition knowledge is important to pregnant women hence they were responsible for its delivery. In adequate staff and lack of teaching materials contributed to the poor delivery of quality nutrition education to all pregnant women as it was observed that there is variations in nutrition information given to women. More than a half of all pregnant women (63%) started their ANC clinic during their first trimester where they received all nutrition services including education on importance of nutrition during pregnancy which helped them to be aware of the relationship between diet maternal nutrition and birth outcomes (63.8%). Most common food group that has been consumed more by pregnant women was grains, roots and tubers and plantains, while also there was high consumption of fruits and vegetables by all women as they are being more emphasized during routine clinics to prevent anemia. Also, there are some barriers that were identified by the service providers which makes their work difficult such as inadequate teaching materials like brochures, posters and jobs aids, also shortage of staff was found to be the core cause of services being provided occasionally as it is the RCH nurse who provide the education and counselling as there is no any nutritionist hired by government at the facility. Regional and district nutrition officers should coordinate and conduct on job training to health providers on issues related to nutrition in order to update their nutrition knowledge and facilitate clear, accurate and more evidence based nutrition information delivered.
Sep 2023 DOI 10.14302/issn.2693-1176.ijgh-22-4255
Alex. G MeelaCorresponding author
Nutrition during pregnancy is of utmost important to ensure positive pregnancy outcomes after delivery. This study examined the utilization of nutrition services provided at health facilities to pregnant women. A cross sectional study design, involving 105 pregnant women and 5 RCH providers from 2 health facilities was used. Structured questionnaires, and structured observations were used in data collection. SPSS software version 25 was used in data analysis. Results showed that, RCH providers had inadequate nutrition knowledge due to limited nutrition courses during nursing training and on job trainings/seminars. All RCH providers advised that, nutrition knowledge is important to pregnant women hence they were responsible for its delivery. In adequate staff and lack of teaching materials contributed to the poor delivery of quality nutrition education to all pregnant women as it was observed that there is variations in nutrition information given to women. More than a half of all pregnant women (63%) started their ANC clinic during their first trimester where they received all nutrition services including education on importance of nutrition during pregnancy which helped them to be aware of the relationship between diet maternal nutrition and birth outcomes (63.8%). Most common food group that has been consumed more by pregnant women was grains, roots and tubers and plantains, while also there was high consumption of fruits and vegetables by all women as they are being more emphasized during routine clinics to prevent anemia. Also, there are some barriers that were identified by the service providers which makes their work difficult such as inadequate teaching materials like brochures, posters and jobs aids, also shortage of staff was found to be the core cause of services being provided occasionally as it is the RCH nurse who provide the education and counselling as there is no any nutritionist hired by government at the facility. Regional and district nutrition officers should coordinate and conduct on job training to health providers on issues related to nutrition in order to update their nutrition knowledge and facilitate clear, accurate and more evidence based nutrition information delivered.
Jul 2023 DOI 10.14302/issn.2574-450X.jom-23-4654
Hodges StephanieCorresponding author
Background Nearly 40% of the adult population in the United States are considered obese by current standards, which equates to approximately 93 million people. Obesity is a chronic disease that is linked to more than 40 other diseases, including hypertension, heart disease, stroke, diabetes, and at least 13 distinct types of cancers. The direct and indirect costs of obesity have been estimated at up to $210 billion annually. Local Problem In Cumberland County, North Carolina, 34% of the adult population was considered obese. The aim of this quality improvement study was to increase effective care (screening, patient engagement, and referral to treatment) in adult patients with a BMI greater than 30 kg/m2 to 75% within 90 days. Methods A rapid cycle plan-do-study-act framework was used to evaluate four focus areas concurrently over 8 weeks with a small test of change completed in each 2-week cycle. Interventions An expanded screening with a checklist, shared decision-making tools (SDMTs), and a referral to treatment checklist were implemented. Activities from the team engagement plan were initiated. Results The effective care of patients increased by 42 percentage points while engaging both the patients and the staff. Conclusions Utilizing standardized communication, SDMTs, checklists, and management plans improved effective care while motivating and enabling patients to take control of their care and make sustainable lifestyle changes that enhance overall health.
Feb 2023 DOI 10.14302/issn.2641-4538.jphi-23-4452
Mango LucioCorresponding author
Interruptions during pharmacological therapy in a hospital ward can be a source of error. We therefore considered two Operating Units of a hospital by asking the following questions: are the nursing staff who administer drug therapy at the set times able to do so with maximum concentration and without interruptions? If yes, how? If not, why and what for? Furthermore, are there organizational and non-organizational improvement strategies so that nurses are less interrupted during therapy and therefore do not cause adverse drug events that could cause harm to the patient? The results that emerged from the data analysis make us reflect considerably on how much interruptions during therapy are to be paid attention to as a problem to which solution proposals can be found.
Oct 2022 DOI 10.14302/issn.2641-4538.jphi-22-4294
MA AdeniyiCorresponding author
Department of Community Medicine, Federal Teaching Hospital, Ido-Ekiti, Ekiti state
Aim Covid 19 is a pandemic that has ravaged the world resulting in thousands of deaths. This study aims to assess the knowledge, risk perception, and attitude of health care workers (HCWs) to the pandemic. Methodology This was a hospital based descriptive cross sectional study conducted among health care workers who were staff of the hospital. Data collected includes socio demographic characteristics, data on knowledge, risk perception and attitude. Results A total of 288 HCWs participated in the study. Participants had good knowledge at 95.6%, major source of knowledge includes internet/social media 68.8%, radio 34.6% and television 28.3%. About 92.6% of the respondents also had positive attitude while 89.75 of the respondents had a positive risk perception. Conclusion Overall, there was a high level of knowledge, high positive attitude and a high risk perception in the study. Consequently, to ensure that this high level is maintained, there is need for continuous health education and promotion.
May 2021 DOI 10.14302/issn.2641-4538.jphi-21-3824
Munharo StevenCorresponding author
University of Suffolk, Ipswich, UK
Zimbabwe like many other sub-Saharan African states has been struggling to provide a quality health service delivery system. Nations with rampant corruption and ineffective bureaucracy made worse, the response towards the fight against COVID-19, Coronavirus Disease 2019. Despite the Zimbabwean government setting out protocols with international agencies such as WHO, World Health Organization to mount an effective response against COVID-19, the health system has been overstretched with lack of personal protective equipment, shortage of drugs and essential equipment and wanton corruption practices coupled with shortage of staff. Timely delivery of orders is still a challenge due to strict bureaucratic measures when transporting goods and the existing competition between countries. Manufacturers and donors are shifting their focus to their countries leaving the Zimbabwean health service underfunded and under-resourced. However, among the challenges experienced the country has been given a chance to revisit its priorities and strategize how best the government and organizations can move essential medical goods, utilize current trade agreements such as ACFTA, African Continental Free Trade Area and local drug manufacturers to produce essential medicines. Launching an efficient mechanism to end corrupt practices in procurement and supply as well as improve interagency cooperation and communication may help improve efforts to end COVID-19 in Zimbabwe.
Mar 2021 DOI 10.14302/issn.2690-0904.ijoe-21-3736
Neuberger ManfredCorresponding author
Medical University of Vienna, Centre of Public Health; A-1090 Wien, Kinderspitalgasse 15, Austria
In the catering industrytobacco smoke was the primary source of fine and ultrafine particles, which are well known for their health-damaging effects. As shown in studies, attempts to reduce passive smoking in the catering industry of Vienna, like separated smoking rooms, failed to reduce fine and ultrafine particle concentrations effectively. On November 1st 2019, an enlarged non-smoker’s protection law was introduced, including a total smoking-ban in the catering industry. 40 hospitality venues with areas for smokers and non-smokers before the ban had been selected as typical Viennese cafes, pubs, bars and discotheques to be sampled unannounced. Concentrations of fine particle mass (PM10, PM2.5, PM1) and ultrafine particle number (PNC) and lung deposited surface area (LDSA) could be measured before and after the introduction of the smoking-ban in 39 venues at nearly identical locations and under comparable circumstances. Results showed a statistically significant decline in both fine and ultrafine particle concentrations in the former smoking areas for all parameters as well as in the former non-smoking areas for PM2.5, PM1 and LDSA. After the ban concentrations in former smoking areas and non-smoking areas showed no significant differences any more. From these results the smoking-ban successfully removed particles from breathing air of guests and staff, however, some outliers in the study after the ban point to the necessity of repeated controls in Vienna. Also, outside Vienna the compliance with the law should be controlled in the Austrian hospitality industry.
Feb 2021 DOI 10.14302/issn.2690-0904.ijoe-21-3727
Keshavarz VajihehCorresponding author
Department of Occupational Health, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran.
Background and Purpose Providing health care is the basic right of people(1). Diagnostic radiology is one of the main procedures in health care services and proper benefiting from this technology is brought only under well planning and management(1). Supervision of the available condition and its comparison with the recommended standards is a key role in assessing assurance from the benefit of these instruments (2). Data show that more than 80% of patients referring to these hospitals need radiology image (3).Improper service causes repetition of radiography and even wrong diagnosis, as a results threatening health of the patients (3) lack of protective barrier leads to the exposure of the staff to X-ray which is obviously carcinogen us (4). It happens that the instruments are not working properly, like of symmetry in X-ray field, defects in collimators, lack of adjusting ray field and X-ray, low quality or defective developing machine, lack of proper protective barrier, using low quality film and drugs, lack of protective barrier for children, all of which cause severe hazards for the patients and staff (4). Materials and Methods The crucial aim of medical services is to provide the public with their needs which are very important. The sensitivity of such services is to such an extent that in case of lack of care, the hazards are too high. In evaluation of health services, the first thing is to evaluate the device used. Methods, efficiency, profits and their combination for prevention and eradication of diseases are also important. Therefore to gain this goal, it is necessary the obtain results comparable with recommended standards. The purpose of this study was to access the conditions of radiology units at Mazandaran University hospitals and compare them with the standards of ICRU NCRP and ICRP. Radiology unit is the most expensive section of any hospital for its instruments, manpower and space provided. In a study conducted in 51centers on radiology staff, radiography room and protective barrier, ray leakage, the outcome were 89%, 82%, 77% and 37% respectively. It was found that the condition of these centers regarding the protective barriers is very unsuitable due to unawareness of the leakage (5, 6).Considering the mentioned necessities, in this study, the condition of radiography centers affiliated to the Mazandaran University of Medical Sciences was studied for the type and the rate of problem, in order to provide a proper solving method. Results Data were collected through, observation, interviewing and filling questionnaire. Results show that, the situations of the radiology units are for from international standard, to such an extent that it is matched clout 50%. Conclusion The results showed that, none of the dark rooms are standard, and do not have proper alarm signal. In 63% of these units there no tiling system about staff protection from radiation. Defects in radiography room, protective barrier and lack looking rays were 60%, 51% and 47% respectively. Referring to the obtained data, periodic supervision, and obeying of the standards are necessary.
Dec 2020 DOI 10.14302/issn.2998-4785.ijne-20-3617
V N S Sowjanya SCorresponding author
MD Paediatrics and DNB Neonatology, Department of Neonatology, Mehta Multispecialty hospitals Ind Pvt Ltd, Chennai, India
Background Overuse and abuse of antibiotics resulted in emergence of multidrug-resistant organisms (MDRO), increased rates of invasive candidiasis, prolonged hospital stay, NEC (Necrotizing enterocolitis), LOS (Late onset sepsis) or death. Restriction of the prescription, switching to a narrower spectrum and stopping antibiotics when not needed are some of the major approaches to antibiotic stewardship. Methods We identified restricted antimicrobials and devised an antimicrobial justification form. Clinicians needed to fill the form before prescribing restricted antimicrobials thereby comparing the antimicrobial usage pattern before and after the introduction of form. Babies enrolled before the introduction of the justification form were labelled as Group 1, and as Group 2 after justification form. The HIC (hospital infection control) staff nurse paid daily visits to NICU to monitor number of babies started on restricted antibiotics and whether the forms were duly filled or not. Any lag would be intimated to the Head HIC team for rectification. Any change of antibiotic within the restricted group also warranted justification. Culture report notified within 48 – 72 hrs so as to facilitate the stoppage of antibiotics in case of negative culture. Results There was a statistically significant reduction in the usage of restricted antimicrobials in the Group B as compared to Group A 150 (40.54%) vs 190 (49.35%) (p = 0.01). There was a statistically significant increase in the % of babies de-escalated from high end antimicrobials in Group B as compared to Group A 90 (60%) vs 56 (29.47%) (p = <0.0001). Duration of restricted antimicrobials reduced from 13.78 ± 2.7 days in Group A to 9.9 ±1.8 days in Group B (p = <0.0001). No difference in the number of babies started on any antibiotic between both the groups (p = 0.1). Conclusion Introduction of the antibiotic justification form as a part of antimicrobial stewardship program resulted in an overall reduced usage of restricted antimicrobials along with rapid de-escalation.
Aug 2020 DOI 10.14302/issn.2641-5526.jmid-20-3494
I. Kheder SalahCorresponding author
Faculty of Pharmacy, National University, Khartoum, Sudan
Introduction Antimicrobial stewardship (ASP) is of the utmost importance as a way to optimize the use of antimicrobials to prevent the development of resistance and improve patient outcomes. So, it is worthwhile to assess the knowledge, attitude and awareness regarding antimicrobial stewardship in hospitals. Objective The aim of this study is to assess knowledge, attitudes and practices (KAP) of prescribers towards antimicrobial stewardship at hospitals in Khartoum state and to identify the associations between prescriber’s demographic information and their knowledge. Methodology This descriptive cross-sectional study multi-centered study conducted in 10 hospitals at Khartoum state -Sudan, during period from November to December 2018. Study population included all prescribers who is available at study’s hospitals during study period and willing to participate in the study. A self-administered questionnaire addressing participants’ knowledge, attitudes, and practice (KAP) regarding antibiotic resistance and ASP distributed in the selected hospitals among attending house-officers, registrars and consultants completed then analyzed. Results Of the 294 medical staff targeted, 287 responded to the survey (response rate 97.6%). Only (26.4%) were familiar with the term ASP and (31.5%) claimed that it is effective in reducing resistance. (43.0%) of respondents believe that ASP play vital role on antibiotic prescribing. Only (9.5%) had ASP in their hospital and (13.5%) having policy and team. (45.3%) of participants had good level of knowledge about antimicrobial stewardship, but majority show negative attitude (63.1%), and poor practices (92.0%) regarding ASP. There was no observed correlation between knowledge and attitude, knowledge with practice (p-value ≥ 0.05). Only attitude with practice shows significance correlation (P=0.0001), which means that prescribers with positive attitude had the better practices towards antimicrobial stewardship. Age, occupation and experience are the only significant predictors of prescriber's knowledge and attitude towards antibiotic stewardship, while no association between these factors and practice. Conclusion The present study concludes that the knowledge of prescribers regarding ASP is moderate and their attitude is negative. Unfortunately, practices regarding ASP were poor, despite, the good knowledge regarding the effects of ASP on antimicrobial resistance.
Apr 2020 DOI 10.14302/issn.2641-5526.jmid-20-3248
I. Kheder SalahCorresponding author
Faculty of Pharmacy, National University, Khartoum, Sudan
Objective This study conducted to assess health care practitioners’ knowledge and perceptions of hand hygiene among health professional working in clinical settings in Khartoum State - Sudan. with the specific objective of determining the association between their stance on hand hygiene and the general demographic characteristics of these health-care professionals. Methodology This is a cross-sectional study conducted between July and November 2017 using a modified form of WHO questionnaire for knowledge and perception that was included 22 items was sent online to health care workers via social media. The data obtained entered and analyzed by SPSS version 24. Chi-square and test of independence were used as a test of significance. A p-value of < 0.05 was considered statistically significant for all purposes. Result 437 hospital staff were responded to the questionnaire. (99.3%) was found to have good knowledge. 197(45.2%) had good perception and 239(54.8%) had fair perception. Formal hand hygiene training was found to have no association with knowledge levels of hand hygiene, but the fair perception was higher in the respondents who didn’t receive formal training. Conclusion The present study highlights the hand hygiene knowledge and perception. Most health care workers were found to have good knowledge, and the majority was found to have a fair perception. Formal hand hygiene training courses were found to have no association with knowledge but it may be reflected in practice. The importance of training sessions regarding hand hygiene was noticed in the perception level.
Nov 2019 DOI 10.14302/issn.2379-7835.ijn-19-3083
Ververs MijaCorresponding author
Senior Nutritionist/Health Scientist, Emergency Response and Recovery Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
Background In November 2014, the World health Organization (WHO), in collaboration with United Nations Children's Fund (UNICEF), and the World Food Programme, produced interim guidelines (iGL) on providing nutritional support to patients in Ebola treatment units (ETUs). They have been translated into French and issued by the Ministry of Health, UNICEF and WHO in adapted versions to be used in the current outbreak in the Democratic Republic of the Congo (DRC). This paper evaluates the use and usefulness of the 2014 iGL in the West Africa and current DRC Ebola virus disease (EVD) outbreaks and identifies experiences and lessons learned from practitioners on the operational aspects of nutritional care and support in ETUs. Methods Key-informants (n=26), from 12 organizations (Non-Governmental Organizations, United Nations, Red Cross Red Crescent Movement) were interviewed who were actively engaged in the nutritional and/or clinical care of EVD patients. Results There was a consensus among key-informants that the 2014 iGL initially served a guiding purpose. However, the vast amount of learning from the 2014-2016 and current EVD outbreaks indicates that the interim guidelines need to be revised. Practitioners struggled to find operational solutions for nutritional care, and the challenges were plentiful, especially regarding 1) the different perceptions of the importance of nutritional care among ETU staff; 2) the difficulties around food preparation and distribution for EVD patients; 3) how to take into account the patients’ dietary preferences; 4) the nutritional care needed in relation to specific EVD symptoms; 5) who assumed roles in nutritional care in ETUs; 6) if and how feeding support was organized; 7) whether malnutrition needed to be addressed and how; and 8) whether the intake of specific nutrients could contribute to improved treatment outcomes. Information from the key-informants interviews resulted in numerous lessons learned and recommendations for nutritional support during current and future outbreaks. Conclusions This investigation underscored the importance of documenting experiences of practitioners on nutritional care in emerging infectious diseases for which limited scientific evidence exists and for which interim guidelines are produced to fill in knowledge gaps. It also emphasized the importance of nutritional care in ETUs during treatment.
Sep 2019 DOI 10.14302/issn.2574-4518.jsdr-19-2950
I Williams TimCorresponding author
Institute of Education, University of Reading and Priors Court Foundation
Background Children with autism spectrum disorders (ASD) often have difficulties settling to sleep and maintaining asleep through the night. Sleep difficulties are linked to challenging behaviour so understanding the causes of these difficulties is vital. Possible explanations are: (1) that irregular innate cycles lead to difficulties maintaining/initiating sleep at the appropriate times; (2) that children with ASD fail to learn from the contingencies that teach neurotypical children to initiate and maintain sleep. If the cycles are innate then small externally imposed changes in routine will not affect the sleep cycle. Methods The sleep records of 46 children with autism and moderate to profound intellectual impairments attending a residential school were examined to identify the effects of spring time change and weekend leave on 1) the times children went to sleep, 2) the length of their sleep and 3) the number of sleep disruptions. Manual staff recordings of the children’s sleep were conducted and data for these variables were analysed using repeated measures analysis of variance. Results A later sleep time was found in children regarding their sleep onset on Sunday after the time change (average onset was 9:57 p.m. ((s.e. = 8.49 minutes) versus 10:17 p.m. (s.e. = 8.19 minutes), with analysis of variance of sleep onset time showing a significant effect (F (3,41) = 5.02, p = 0.005). However, only two out of three comparison groups showed statistically significant effects (March 23rd versus March 30th mean difference = 0.39, p = 0.003; March 30th April 13th mean difference = 0.36, p = 0.03). No statistical difference was found between March 30th versus April 6th or other sleep parameters in any groups (i.e., sleep duration or night time awakenings). Similarly, no change in any sleep parameters (i.e., sleep onset or awakenings) were found when Sundays sleep parameters were compared to Mondays and/or Tuesdays. Conclusions In this small pilot study, small changes of day/night cycles appear to have few effects on the sleep patterns of children with ASD attending a residential school. While no significant sleep pattern change was found in this population due to change of clock times or weekend visits, larger epidemiological studies addressing other unexamined variables to better delineate changes in ASD are needed.
May 2019 DOI 10.14302/issn.2574-4526.jddd-19-2770
Remy Andre-JeanCorresponding author
Mobile Hepatitis Team, Perpignan Hospital, France
Introduction In France 33% of patients didn’t take care of hepatitis C because there were no diagnosed. Drug injection was main contamination route of hepatitis C virus (HCV) in France. French guidelines were to treat all inmates and drug users, even fibrosis level. Access of HCV screening, care and treatment in drugs users, prisoners and homeless was low in France. They were considered as difficult to treat populations. All these patients need specific support. Hepatitis Mobile Team (HMT) was created in July 2013 to increase screening care and treatment of hepatitis B and C patients. HMT was composed of hepatologist, nurses, social workers and health care worker. Objective increase outreach screening care treatment access and cure of our target population. Patients and methods Target population was drugs users, prisoners, homeless, precarious people, migrants and psychiatric patients. We proposed part or all of our services to our 42 medical and social partners: HCV HBV screening by DBS (dried blood test); outside DBS and FIBROSCAN in converted van; Outreach open center; Drug users information and prevention, Free blood tests in primary care;, Staff training; Social screening and diagnosis; Mobile liver stiffness Fibroscan in site; Advanced on-site specialist consultation; Easy access to pre-treatment commission; Low cost mobile phones for patients; Individual psycho-educative intervention sessions; Collective educative workshops; Peer to peer educational program; Specific one day hospitalizations. All services were free for patients and for partners. Results from 2013 July to 2018 December, we did 8382 DBS for 5382 people (3053 HCV DBS) and 2302 Fibroscan*. HCV new positive rate was 21.3%. Our HCV active file was 651patients included these 24.8% new patients screened by DBS; 98% realized HCV genotype, HCV viral load and FIBROSCAN. DAA treatment was proposed to 96%; 95% started treatment, 4% were lost follow up or refused treatment. After treatment, there was 7 relapse and 3 reinfections by drug injection and cured rate of 94%. Sociological evaluation showed that 4 program qualities for patients: free access, closeness (outside hospital), speed (of the results) and availability (of nurse and social workers). Conclusions: Specific follow-up of drugs users and other HCV high-risk patients including screening, early detection, diagnosis and treatment increase rate of treated and cured patients, with low rate of relapse and reinfections.
Jan 2019 DOI 10.14302/issn.2474-7785.jarh-19-2608
W. Harvey PeterCorresponding author
Conjoint Clinical Professor, Deakin University, School of Medicine, Faculty of Health
In the light of various complaints about the quality of care provided by and operation of aged care facilities across Australia, the Commonwealth Government has announced a Royal Commission into the activities of the sector. As the proportion of Australians over 65 continues to grow with the ageing of the ‘Baby Boomer’ generation, more Australians are seeking secure aged care arrangements to meet their increasingly complex living and healthcare needs. We hear much comment today about the concept of healthy ageing and the importance of older people staying connected to and active in their communities. Not only does this ongoing connectivity support better lifestyles and health status, it provides an avenue for older people to contribute to the support of others once their more formal working lives are concluded. Unfortunately, the gap between the rhetoric and the reality of ageing in Australia is strained and it appears that much about the operations of the aged care sector today is less than satisfactory. While some well-funded retirees can afford comfortable and fulfilling living arrangements, many others are left in less ideal circumstances. With aged care organisations currently building the next generation of ‘hotel’ style living arrangements for cashed up self-funded retirees, others are being left behind financially and in terms of the quality of their care. At the same time, maltreatment and abuse of residents is coming to light, as in the ‘Oakden Nursing Home’ situation in South Australia, for example. Consequently, the Federal Government has now launched a formal inquiry into the activities of organisations running aged care facilities in Australia. The inquiry is designed to assess the operation of this industry with a focus on the economics of aged care centres, the quality of care, the food and recreational activities provided and the challenge of staffing these facilities to keep residents safe and well as they age in dignity.
Nov 2018 DOI 10.14302/issn.2578-8590.ipj-18-2465
Hinzpeter JaimeCorresponding author
Medical Doctor, University of Chile, Clinical Hospital, Santiago Chile
Objective: Soccer has a reduced overall recovery time. If these situations are not properly controlled they can cause the athlete chronic fatigue, an increase in delayed-onset muscle soreness (DOMS) and thus result in a decrease in athletic performance. There are several therapies that have attempted to improve athletic performance, decrease the percentage of injuries and results in soccer. Training and recovery instances are opportunities to find ways to address this issue. Understanding the physiology of recovery is essential to accelerate some processes, with the aim of shortening the times. Subjects: Cryotherapy could improve functional performance tests and decrease pain in soccer players. Our work design is an experimental prospective study. Method: Twenty subjects (10 experimental subjects and 10 control group subjects), between the ages of 17 and 23, who are members of a university men's soccer team, participated in the study. The following variables were controlled: power; the number of jumps, the average height of a jump in a 30-second continuous jump test, and DOMS perception through visual analog scale (VAS). Both groups shall be subjected to a more active recovery as well as elongation carried out by the coaching staff. In addition to this, the experimental group shall also be subjected to ice baths (42-47 °F) for three minutes. Results: We found significant statistical differences in the number of jumps and the power of the same in the control group, thus obtaining improvements. No significant differences were observed in either group for the average jump height and percentage yield variables. In the assessment of DOMS significant differences were observed, with a lower perception of DOMS seen in the experimental group. Conclusion: Ice baths provide favorable results in some aspects of the 30-second continuous jump test, decreasing the perception of leg pain and fatigue, and therefore they can be considered a valid alternative in the management of these athletes.
Aug 2018 DOI 10.14302/issn.2574-612X.ijpr-18-2243
Asadzandi MinooCorresponding author
Assistant Professor, Department of Anesthesiology, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
Background and Objective: Sleep as a sign of the God wisdom and power, is the agent of stability and tranquility. Sleep has a spiritual dimension. Sincere dreams are the continuation of prophecy and guidance of the God. This study aimed to explain the dream theory from the perspective of Islam. Materials and Methods: This evolutionary study has focused on these questions: “what is the process of dreaming in Islam? Can people control their dreams”? Islamic evidences were taken from the verses and narrations related to the words “soul, sleep, dream and death”, using al-Mu’ayyim, authentic Shi’a commentary books, Bihar al-Anwar, Kofi principles, the Book of Resurrection and life after death. The religious and scientific evidences were analyzed based on the Walker and Event content analysis method. Dream theory was extracted from religious evidence. Results: Based on "revelation epistemology" during sleep, the ‘template of a higher universe’ travels to the unseen world and divine guidance can be provided. People with spiritual health) (owners of the Sound heart) can control the type of their dream, and solve problems by the guidance of God. In the perspective of Islam, there are three types of dreams: sometimes is divine guidance and glory from God, sometimes is sorrow from the devil, and sometimes are conflicts of daily living or past events. Conclusion: Regarding the spiritual aspect of sleep and its deep impact on physical and mental health, it is essential for medical staff to become familiar with dream theory from the perspective of Islam. They should explain to patients and family members the importance and impact of sleep on the acceleration of tissue repair and the treatment of anxiety and depression. To those who are willing to enjoy the divine guidance through the dream, they can teach the Islamic method of dream control.
Jun 2018 DOI 10.14302/issn.2574-612X.ijpr-18-2110
Xu WeiCorresponding author
School of Psychology, Nanjing Normal University
Purpose: There are nearly 170,000 new cases of breast cancer in China every year, and this number is showing an increasing trend. Mental health plays an important role in promoting the physical rehabilitation of patients. Therefore, attention paid to their psychological problems needs to be reinforced. The current study aims to investigate the mental health states of the breast cancer patients and provides the references for their psychosomatic rehabilitation in the future work. Methods: A total of 643 breast cancer patients completed the whole study. A questionnaire survey on anxiety, depression, posttraumatic stress disorder (PTSD), and posttraumatic growth (PTG) was conducted in Jiangsu Women and Children Health Hospital. Results: 13.53% breast cancer patients had anxiety; 21.5% had depression; the prevalence of PTSD was 7.15%, while the prevalence of PTG was 26.12%; Anxiety levels in older patients were significantly lower than those in the other two groups; PTG levels in older patients were significantly lower than those in the other two groups. Conclusion: Breast cancer patients have certain emotional distress and stress symptoms, but they also experience psychologically positive changes. And age shows various differences on anxiety and PTG. Clinical medical personnel should pay attention to the patient's psychological rehabilitation when concerning about the physical rehabilitation of patients. Patients in different ages have different mental health problems, thus the medical staff shall provide differential nursing plans for them.
Aug 2017 DOI 10.14302/issn.2470-5020.jnrt-17-1530
Suslo RobertCorresponding author
Gerontology Unit, Public Health Department, Health Sciences Faculty, Wroclaw Medical University,
It is crucial for the society, the government and the medical community to retrieve the full and reliable statistical information on malignant brain neoplasms (C71-C71.9 ICD-10) to adjust the medical financing, staff and equipment properly. In order to retrieve information useful for public health policies, data from the years 2006-2012 concerning relevant cases registered by the Polish public healthcare insurance provider Narodowy Fundusz Zdrowia in Lower Silesia region of Poland (NFZ) and by the Polish national neoplasms registry Krajowy Rejestr Nowotworow (KRN) were analyzed. The number of new malignant brain neoplasms cases registered by the KRN has risen slightly in the years 2006-2012. At the same time the number of cases reported by the NFZ rose dynamically, which means a significant increase in medical care intensity, and thus also workload on the medical facilities and stuff associated with the care for grossly the same amount of brain malignant neoplasms patients and, supposedly, their longer survival times. It indicates that the level of public financing of the malignant neoplasms of brain treatment shall be adjusted adequately. The study revealed growing popularity among reporting Polish physicians of the least specific malignant neoplasms of brain ICD-10 categories, despite the rapid diagnostic techniques development and availability. It is alarming since the medical statistics data quality in the field of malignant brain neoplasms is deteriorating that way and proper evaluation of treatment costs and planning future financial allocations by both the public healthcare insurance provider NFZ and the Polish government becomes difficult.
Jun 2017 DOI 10.14302/issn.3070-5835.jcpn-17-1580
Ronit Calderon-MargalitCorresponding author
Objective. To describe the attitudes and behavior of registered nurses in their professional interaction toward unlicensed assistive personnel (UAPs) and to identify areas to develop policy for an effective nursing development and workforce planning. Background: One of the challenges health care systems have been addressing is the integration of the UAPs into the nursing care delivery systems. Study Design: Aphenomenological study involving registered nurses, staff and managerial positions. Data were collected using an in-depth semi-structured interview. Findings: Nurses report an increased task management workload which may lead to a decline in the quality of nursing care. Structural factors that are related to nurses and to UAPs were mentioned as affecting the quality of their professional and collaborative interaction. Conclusions: Training nurses to work with UAPs while developing their communication and managerial skills may improve the quality of care and increase their level of satisfaction.
Jan 2017 DOI 10.14302/issn.2577-137X.ji-16-1139
O’Connor L.Corresponding author
Health Protection Surveillance Centre, 25-27 Middle Gardiner St., Dublin 1
We describe seasonal influenza-like illness (ILI) outbreaks in long-term care facilities in the Health Service Executive (HSE) East area of Ireland in the 2013/2014 influenza season, risk factors associated with outbreak duration and attack rates, and management challenges. Separate questionnaires were distributed to 28 facilities who reported an outbreak and to public health specialists leading outbreak management, with a 79% response rate. Mean outbreak duration (21 vs 17 days; p=0.046) was longer in facilities with staff vaccination rates of <40%. Facilities with a high attack rate (≥50%) were less likely to have an outbreak plan (p=0.03). Smaller facilities (under 50 residents) had a higher attack rate (50% vs 23%, p=0.003) even when controlled for staff vaccination rate (p=0.01). Prior to the outbreak, resident vaccination rates were high (82%, above the World Health Organization target of 75%) but staff vaccination rates were low (39%). Reported challenges to ILI outbreak management in long term care facilities included visitor restrictions, staff education issues, outbreak notification delays and lack of outbreak lead in facilities. Targeted public health-assisted planning, training and response, comprising of staff vaccination, education, written policies, with early notification and prompt response would facilitate a more co-ordinated approach to the management of outbreaks, and reduction in infection rates and consequent morbidity.
Feb 2014 DOI 10.14302/issn.2324-7339.jcrhap-13-211
Gust D.Corresponding author
Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, United States
Recruitment of couples is important for study success. The multi-centered HPTN 052 clinical trial was designed to evaluate whether immediate versus delayed use of ART by HIV-infected individuals would reduce transmission of HIV to their HIV-uninfected partners. The objective of this study was to retrospectively compare several approaches for community recruitment at our site in Kisumu, Kenya based on a) feedback from recruitment staff, b) associated cost, and c) number of eligible couples enrolled. A secondary objective was to assess the discordant couples’ acceptability of the community recruitment approaches relative to the a) main recruitment venues, b) educational materials, and c) local language best suited for explaining the trial. 241 couples were screened for eligibility using nine recruitment approaches. We compared the approaches used for the 60 couples found to be eligible to those used for the 56 ineligible couples for whom that information was available. Analyses for association were carried out. In-depth interviews were conducted with 20 staff and 29 discordant couples. Records were kept of the costs associated with each approach. Overall, staff interviews revealed that acceptability of the approaches was high. Challenges were present with all approaches ranging from one member of the couple not wanting to reveal their positive HIV status to their partner (Patient Support Center or PSC approach), to not finding people at home (home based counseling and testing or HBCT approach). The PSC and the HBCT recruitment approaches were the most effective in terms of recruiting eligible participants. There was an overall significant difference between the proportion of eligible and ineligible participants among the 9 approaches (χ2 (8) =33.5; p<0.0001). Analyses for association showed that the PSC approach resulted in attracting a greater proportion of couples who were eligible than ineligible (χ2 (1) =6.6; p=0.016). The cost for the PSC approach was less than one-third that of the HBCT approach. All discordant couples interviewed found the two main recruitment venues (PSC and their home) acceptable. Among couples who saw the educational materials, the majority found them useful (poster 72.7%; pamphlet 90.9%; flyer 88.9%). All couples found the language they were told about the study acceptable. The evaluation of recruitment approaches indicated that working with local partners, specifically the PSC staff and HBCT staff, was the most effective way to recruit eligible discordant couples. A focus on collaborations and partnerships between research and clinical organizations will help study recruitment efforts. Disclaimer: The findings and conclusions in this report are those of the authors and do not necessarily represent the views of their respective institutions. Funding for this substudy was provided by the Kenya Medical Research Institute (KEMRI) through a cooperative agreement with the U.S. Centers for Disease Control and Prevention.
Nov 2013 DOI 10.14302/issn.2324-7339.jcrhap-13-200
Sangrar RuheenaCorresponding author
Department of Occupational Science and Occupational Therapy - University of Toronto
Various sporting activities are being used as vehicles for HIV/AIDS education and prevention within the field of sport-for-development (SFD). Kicking AIDS Out! is one SFD program that aims to promote protective attitudes regarding HIV/AIDS amongst youth. This study explored organizers’ perspectives of the use of sporting activities in the Kicking AIDS Out! program in Trinidad and Tobago. Qualitative case study methodology was used to examine the case. Data was generated through semi-structured interviews with seven organizers who were Kicking AIDS Out! staff or volunteer members. Thematic analysis guided data analysis. Generated themes include: Sport to Draw, There’s Something for Everyone, the Emotional Wow, and Beyond Sports. These themes illuminate the idea that sport captivates and attracts youth, and illustrate the use of sport activities to promote engagement in the program as they are tailored to the skills and interests of youth. Sport activities may challenge values and beliefs regarding HIV/AIDS and may promote engagement in new roles, such as those as advocate or caregiver for individuals with HIV/AIDS, and engagement in healthy lifestyle behaviours, such as safe sexual encounters. The findings of this study offer an opportunity for HIV/AIDS prevention programs to consider their use of sporting activities in a manner that achieves these SFD characteristics.