Nevin Manimala

BMC Oral Health. 2022 Jun 28;22(1):262. doi: 10.1186/s12903-022-02289-w.

ABSTRACT

BACKGROUND: Health literacy is a main factor in health for its improvement, allowing the individuals to have a greater capacity to engage and participate in collective health promotion actions. The evaluation of functional health literacy is essential to determine the ability that each individual has to understand basic health information. The present study aimed to perform the translation and cross-cultural adaptation of the Rapid Estimate of Adult Literacy in Dentistry-30 to the Portuguese language and test the reliability and validity of this version.

METHODS: After translation and cultural adaptation, the instrument was applied to a group of individuals that participate in the program Atividade Senior, developed by the municipality of Viseu, Portugal. The final sample was composed by 206 participants that accepted responding to the translated version of the instrument. Statistical validation was accomplished to complete the process and obtain the final instrument. One question was removed for the creation of the final instrument with 29 questions, therefore being named Rapid Estimate of Adult Literacy in Dentistry-29 PT.

RESULTS: The Rapid Estimate of Adult Literacy in Dentistry-29 PT presented good internal reliability. Cronbach’s alpha ranged from 0.89 to 0.90 when words were deleted individually. The analysis of test-retest reliability revealed excellent reproducibility. We can verify that the Rapid Estimate of Adult Literacy in Dentistry-29 PT scale for assessment of oral health literacy among older adults presents an acceptable internal consistency, with a global Cronbach´s alpha of 0.894.

CONCLUSIONS: The new scale can be applied to assess oral health literacy among older Portuguese adults, presenting an acceptable internal consistency and is validated to assess oral health literacy and is crucial in epidemiological studies.

PMID:35764990 | DOI:10.1186/s12903-022-02289-w

BMC Med Educ. 2022 Jun 28;22(1):507. doi: 10.1186/s12909-022-03568-4.

ABSTRACT

BACKGROUND: This research examines the ways in which higher education institutions (HEIs) across the tropEd Network for Education in International Health (tropEd) began to adapt their teaching and learning approaches in response to the COVID-19 pandemic in 2020. Already during this early phase of the pandemic HEIs’ responses demonstrate global health approaches emphasising cooperation and communication, rather than national health driven strategies that emphasise quarantine and control. Key lessons learnt for multiple dimensions of teaching and learning in global health are thus identified, and challenges and opportunities discussed.

METHODS: Data collection includes a cross-sectional online survey among tropEd member institutions (n = 19) in mid-2020, and a complementary set of open-ended questions generating free-text responses (n = 9). Quantitative data were analysed using descriptive statistics, textual data were analysed using a Framework Analysis approach.

RESULTS: While early on in the pandemic the focus was on a quick emergency switch to online teaching formats to ensure short-term continuity, and developing the administrative and didactic competence and confidence in digital teaching, there is already recognition among HEIs of the necessity for more fundamental quality and longer-term reforms in higher education in global health. Alongside practical concerns about the limitations of digital teaching, and declines in student numbers, there is a growing awareness of opportunities in terms of inclusivity, the necessity of cross-border cooperation, and a global health approach. The extent to which the lack of physical mobility impacts HEI programmes in global health is debated.

CONCLUSION: The COVID-19 pandemic has brought about preventive measures that have had a considerable impact on various dimensions of academic teaching in global health. Going forward, international HEIs’ experiences and response strategies can help generate important lessons for academic institutions across different settings worldwide.

PMID:35764985 | DOI:10.1186/s12909-022-03568-4

BMC Pregnancy Childbirth. 2022 Jun 28;22(1):523. doi: 10.1186/s12884-022-04850-5.

ABSTRACT

BACKGROUND: Ethiopia has low skilled birth attendance rates coupled with low quality of care within health facilities contributing to one of the highest maternal mortality rates in Sub-Saharan Africa, at 412 deaths per 100,000 live births. There is lack of evidence on the readiness of health facilities to deliver quality labor and delivery (L&D) care. This paper describes the structural quality of routine L&D care in government hospitals of Ethiopia.

METHODS: A facility-based cross-sectional study design, involving census of all government hospitals in Southern Nations Nationalities and People’s Region (SNNPR) (N = 20) was conducted in November 2016 through facility audit using a structured checklist. Data collectors verified the availability and functioning of the required items through observation and interview with the heads of labor and delivery case team. An overall mean score of structural quality was calculated considering domain scores such as general infrastructure, human resource and essential drugs, supplies, equipment and laboratory services. Summary statistics such as proportion, mean and standard deviation were computed to describe the degree of adherence of the hospitals to the standards related to structural quality of routine labor and delivery care.

RESULTS: One third of hospitals had low readiness to provide quality routine L&D care, with only two approaching near fulfilment of all the standards. Hospitals had fulfilled 68.2% of the standards for the structural aspects of quality of L&D care. Of the facility audit criteria, the availability of essential equipment and supplies for infection prevention scored the highest (88.8%), followed by safety, comfort and woman friendliness of the environment (76.4%). Availability skilled health professionals and quality management practices scored 72.5% each, while availability of the required items of general infrastructure was 64.6%. The two critical domains with the lowest score were availability of essential drugs, supplies and equipment (52.2%); and laboratory services and safe blood supply (50%).

CONCLUSION: Substantial capacity gaps were observed in the hospitals challenging the provision of quality routine L&D care services, with only two thirds of required resources available. The largest gaps were in laboratory services and safe blood, and essential drugs, supplies and equipment. The results suggest the need to ensure that all public hospitals in SNNPR meet the required structure to enable the provision of quality routine L&D care with emphases on the identified gaps.

PMID:35764981 | DOI:10.1186/s12884-022-04850-5

BMC Pediatr. 2022 Jun 28;22(1):374. doi: 10.1186/s12887-022-03417-9.

ABSTRACT

BACKGROUND: In Ethiopia, about 57% of child mortality is associated with acute malnutrition in which the burden is dominant at the rural community. In that regard, the Ethiopian government has been implementing the Outpatient Therapeutic Program (OTP) for managing the uncomplicated sever acute malnutrition among children aged 6 to 59 months at community level by health extension workers. But nothing is known about the implementation status of OTP. Thus, this evaluation aims to evaluate the implementation status of OTP in Dehana district, northern Ethiopia. METHODS: A facility-based cross-sectional evaluation with concurrent mixed-method was employed from 1st February to 30th April 2020. A total of 39 indicators were used to evaluate the availability, compliance and acceptability dimensions of the program implementation. A total of 422 mothers/caregivers for exit interview, 384 children’s (diagnosed with acute malnutrition) record reviews, nine key informants’ interview, and 63 observations were done in this evaluation. A multi-variable logistic regression analysis was used to identify the predictor variables associated with acceptability. Adjusted Odds Ratio (AOR) with 95% confidence interval (CI), and p-value < 0.05 were used to declare statistically significant variables. The qualitative data were tape recorded, transcribed in Amharic and translated into English and finally thematic analysis was done.

RESULTS: The overall implementation of OTP was 78% measured by availability (87.5%), compliance (75.3%), and acceptability (71.0%) dimensions. Trained healthcare providers, Ready to Use Therapeutic Food (RUTF), Mebendazole, and Oral Rehydration Salt (ORS) were available in all health posts, whereas vitamin A and folic acid were stocked out in some health posts. The health care providers complained that interruption of supplies, work overload and improper usage of RUTF by caregivers were the common challenges of program delivery. Rural residence (AOR = 0.18, 95% CI: 0.09-0.39), knowledge on childhood malnutrition and program services (AOR = 2.27, 95% CI: 1.04-4.97), and had malnourished children previously (AOR = 1.82, 95% CI: 1.01-3.30) were significantly associated with the acceptability of OTP program.

CONCLUSION: The overall implementation status of OTP was judged fair. Low achievement was observed on the compliance of health care providers to the standards, and acceptability of program services. Therefore, the program needs great improvement to enhance the outcome of childhood malnutrition management.

PMID:35764979 | DOI:10.1186/s12887-022-03417-9

BMC Ophthalmol. 2022 Jun 28;22(1):283. doi: 10.1186/s12886-022-02495-8.

ABSTRACT

BACKGROUND: Lean methodology helps maximize value by reducing waste, first by defining what value and waste are in a system. In ophthalmology clinics, value is determined by the number of patients flowing through the clinic for a given time. We aimed to increase value using a lean-methodology guided policy change, then assessed its impact on clinic flow using an automated radiofrequency identification (RFID) based real-time locating system (RTLS).

METHODS: A total of 6813 clinical visits occurred at a single academic institution’s outpatient glaucoma clinic between January 5, 2018 to July 3, 2018. Over that period, 1589 patients comprising 1972 (29%) of visits were enrolled, with 1031 clinical visits occurring before and 941 visits after a policy change. The original policy was to refract all patients that improved with pinhole testing. The policy change was not to refract patients with a visual acuity ≥20/30 unless a specific request was made by the patient. Pre-post analysis of an automated time-motion study was conducted for the data collected 3 months before and 3 months after the policy change occurred on March 30, 2018. Changes to process and wait times were summarized using descriptive statistics and fitted to linear mixed regression models adjusting for appointment type, clinic volume, and daily clinic trends.

RESULTS: One thousand nine hundred twenty-three visits with 1588 patients were included in the analysis. Mean [SD] age was 65.9 [14.7] years and 892 [56.2%] were women. After the policy change, technician process time decreased by 2.9 min (p < 0.0001) while daily clinical patient volume increased from 51.9 ± 16.8 patients to 58.4 ± 17.4 patients (p < 0.038). No significant difference was found in total wait time (p = 0.18) or total visit time (p = 0.83).

CONCLUSIONS: Real-time locating systems are effective at capturing clinical flow data and assessing clinical practice change initiatives. The refraction policy change was associated with reduced technician process time and overall the clinic was able to care for 7 more patients per day without significantly increasing patient wait time.

PMID:35764976 | DOI:10.1186/s12886-022-02495-8

BMC Geriatr. 2022 Jun 28;22(1):532. doi: 10.1186/s12877-022-03225-x.

ABSTRACT

BACKGROUND: The aim of this study was to investigate the associations of osteosarcopenic obesity (OSO) and its components with complete blood cell count-derived inflammation indices.

METHODS: In this cross-sectional study, data of 648 participants aged ≥60 years (men/women: 232/416, mean age: 67.21 ± 6.40 years) were collected from January 2018 to December 2020. Areal bone mineral density and body fat percentage were used to define osteopenia/osteoporosis and obesity, respectively. The criteria of the 2019 Asian Working Group for Sarcopenia were used to diagnose sarcopenia. Based on the number of these conditions, participants were divided into four groups: OSO/0, OSO/1, OSO/2, and OSO/3. Logistic regression analysis was conducted to identify associations between blood cell count-derived inflammation indices and the number of disorders with abnormal body composition.

RESULTS: Systemic inflammation response index (SIRI), white blood cells, neutrophil-to-lymphocyte ratio (NLR), aggregate inflammation systemic index (AISI), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR) showed statistically significant differences among the four groups (P < 0.05). Unlike in the OSO/0 group, in all other groups, AISI, SIRI, PLR, and NLR were significantly associated with increased likelihood of having multiple disorders with abnormal body composition after adjustment for confounders (P < 0.0001 for all). However, LMR showed an inverse correlation with the number of these conditions (P < 0.05).

CONCLUSION: Higher SIRI, AISI, NLR, and PLR values and lower LMR values are closely associated with OSO and its individual components-osteoporosis, sarcopenia, and obesity-in older adults, suggesting that the value of these indices in the evaluation of OSO warrants further investigation.

PMID:35764967 | DOI:10.1186/s12877-022-03225-x

BMC Pregnancy Childbirth. 2022 Jun 28;22(1):526. doi: 10.1186/s12884-022-04846-1.

ABSTRACT

BACKGROUND: To evaluate the differences in pregnancy outcomes between assisted reproductive technology (ART) patients and natural pregnant women in Shanghai, China in the past 6 years objectively. And to assess the feasibility of the research method of registry-database linkage in mainland China.

METHODS: This retrospective study was conducted using registry-database linkage. A total of 8102 pregnancies with ART and 8096 parturients with spontaneous conception (SC) from 10 reproductive centers and 111 hospitals composed our retrospective study. The primary outcomes were the rates of obstetric complications (pregnancy-induced hypertention [PIH], gestational diabetes mellitus [GDM], placenta previa, mode of delivery, preterm birth [PTB], low birth weight [LBW], and macrosomia). The prenatal outcomes were compared between ART and SC parturients, frozen-thawed embryo transfer (FET) and fresh embryo transfer, and in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). We calculated odds ratios (ORs) and 95% confidence intervals (CIs).

RESULTS: The final matching rate of the target population was 92% by using registry linkage. ART resulted in a higher rate of multiple birth, PTB, LBW, cesarean section, placenta previa and GDM compared with SC in the singleton cohort. In ART patients, pregnant women with FET had a significantly higher risk of PIH than those with fresh embryo transfer (14.1% Vs 9.3%, AOR1.528, 95% CI 1.303-1.793), but there was no difference between IVF and ICSI. FET is also related to the severity of PIH.

CONCLUSIONS: ART increased the rate of complications during pregnancy, the risk and severity of PIH in patients with FET was higher than that in patients with fresh embryo transfer. The registry-database linkage study is an objective and feasible research method in mainland China.

PMID:35764962 | DOI:10.1186/s12884-022-04846-1

Popul Health Metr. 2022 Jun 28;20(1):15. doi: 10.1186/s12963-022-00292-5.

NO ABSTRACT

PMID:35764959 | DOI:10.1186/s12963-022-00292-5

BMC Nurs. 2022 Jun 28;21(1):168. doi: 10.1186/s12912-022-00938-7.

ABSTRACT

BACKGROUND: Fever is a sign of illness in children and parents should receive educational interventions based on their needs to provide effective care for children. Simulation-based education provided by nurses for managing children’s fever can help improve the quality of parental care. Accordingly, this study aimed to explore the effectiveness of simulation-based education in the management of children’s fever by parents.

METHODS: This quasi-experimental study was conducted using a pretest-posttest design with two groups on 90 parents of children with fever who visited Afzalipour Teaching Hospital in Kerman, Iran. The participants were randomly divided into two groups. The members of the intervention group received simulation-based fever management education and the parents in the control group received routine interventions. A demographic information form and the Parental Fever Management Knowledge and Practice Scale were completed by the participants in both groups before and after the intervention. The collected data were analyzed with SPSS 21 at a significant level of 0.05 (P = 0.05).

RESULTS: The results of the study showed that there was a statistically significant difference between the mean scores of fever management knowledge in the intervention group before and after the intervention (30.51 ± 1.50 vs. 54.79 ± 2.55) (p < 0.05), while the control group showed no statistically significant difference before and after the intervention (29.81 ± 4.1 vs. 29.95 ± 2.80) (p > 0.05). Furthermore, there was a significant difference between the mean scores of fever management practice in the intervention group before and after the intervention (24.32 ± 0.89 vs. 37.51 ± 1.09) (p < 0.05). In contrast, the control group showed no statistically significant difference before and after the intervention (23.03 ± 0.90 vs. 21.98 ± 0.02) in terms of fever management practice (p > 0.05). The results of the independent samples t-test also showed that the mean scores of fever management knowledge and practice were not significantly different between the two groups before the intervention (p > 0.05) while there were significant intergroup differences after the intervention (p < 0.05).

CONCLUSION: The results of the study showed that simulation-based education was effective in improving the parents’ child fever management knowledge and practice. Accordingly, professional care teams can prepare simulation-based education packages to improve parental care at home for children’s fever management.

PMID:35764950 | DOI:10.1186/s12912-022-00938-7

BMC Pregnancy Childbirth. 2022 Jun 28;22(1):529. doi: 10.1186/s12884-022-04748-2.

ABSTRACT

The dominant model of childbirth in most Western countries is medicalized childbirth. Women’s beliefs about whether childbirth should be a medicalized process to a greater or lesser degree may be related, in addition to contextual factors, to internal factors. The objective of the study is to find out if women’s locus of control (LC) and stress coping strategies (CS) are related to having a more favourable or less favourable attitude towards medicalization (ATMC). A cross-sectional study was carried out with the participation of 248 women recruited in primary care centres by their midwives. All the women filled in answers on a mobile phone app with various different measurement instruments: the questionnaire created by Benyamini to evaluate their ATMC; the Spanish version of the Wallston MLC to evaluate their LC; and the Spanish adaptation of the “Revised Prenatal Coping Inventory (NuPCI)” scale for the assessment of their CS. The women presented a favourable attitude towards medicalization, with a mean ATMC score of 3.42. Both the LC and the CS of women during pregnancy are related to this attitude. Specifically, having an internal LC and using preparative CS both lower the probability of presenting a favourable attitude towards medicalization, while the lack of a paid job raises the probability. For each point in internal locus and preparatory coping, the ATMC score decreased by 0.02 and 0.23 points, respectively, while it increased by 0.18 for not having a paid job. The influence of these psychological factors must be taken into account in the development of content and interventions that promote a more natural birth.

PMID:35764947 | DOI:10.1186/s12884-022-04748-2