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Narra J Apr 2024Respiratory droplets, naturally produced during expiration, can transmit pathogens from infected individuals. Wearing a face mask is crucial to prevent such... (Randomized Controlled Trial)
Randomized Controlled Trial
Respiratory droplets, naturally produced during expiration, can transmit pathogens from infected individuals. Wearing a face mask is crucial to prevent such transmission, yet the perception of dyspnea and uncomfortable breathing remains a common concern, particularly during epidemics. The aim of this study was to investigate the impact of face mask use on the perception of dyspnea, cardiopulmonary parameters, and facial temperature during physical activity. A randomized crossover study was conducted on healthy adults at a physiology laboratory located in the Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia, in November 2022. Participants underwent five stages of physical exercise tests based on the Bruce Protocol under three conditions: without any face mask (control), wearing a surgical mask, and an N95 mask, forming the study's main groups. Dyspnea perception (measured by the Modified Borg Dyspnea Scale), cardiopulmonary parameters (heart rate, oxygen saturation, respiratory rate, blood pressure, and mean arterial pressure) and facial temperature were measured before the exercise test (pre-workout), at the end of stage 1, 2, 3, 4, 5, and after the whole exercise test (post-workout). A two-way repeated measures ANOVA was conducted, considering two factors: the type of mask (control, surgical mask, N95 mask) and the various stages of the exercise test. A total of 36 healthy adults were included in the study. We found that dyspnea perception was much worse in the N95 mask group, particularly during vigorous exercise. There was no significant difference between groups in cardiopulmonary parameters. However, participants wearing N95 had a greater supralabial temperature than those wearing surgical masks or no mask at all. It is recommended to undertake a more in-depth evaluation of cardiopulmonary physiological measures.
Topics: Humans; Masks; Dyspnea; Male; Female; Cross-Over Studies; Adult; Heart Rate; Body Temperature; Indonesia; Healthy Volunteers; Perception; Exercise Test; Young Adult; Exercise; Blood Pressure; Respiratory Rate
PubMed: 38798847
DOI: 10.52225/narra.v4i1.574 -
International Journal For Equity in... May 2024Accommodating chronic care into the everyday lives of individuals diagnosed with non-communicable chronic conditions often poses significant challenges. Several studies...
BACKGROUND
Accommodating chronic care into the everyday lives of individuals diagnosed with non-communicable chronic conditions often poses significant challenges. Several studies in public health literature that addressed the question of non-adherence to treatment by turning their gaze towards individual's perception of their own health restricted the use of perception exploration to visceral states and corporeality without adequately acknowledging the mutual permeance of socio-biological worlds. This study explored the socio-economic genealogies of individuals, to understand the role of structural and intermediate factors that determine health perceptions, by attempting to answer the question 'how do individuals with non-communicable chronic conditions perceive their health as healthy or ill'?.
METHODS
This study was conducted in a low-income neighbourhood called Kadugondanahalli in India using qualitative research methods. A total of 20 in-depth interviews were conducted with individuals diagnosed with non-communicable chronic conditions. Individuals were recruited through purposive and snowball sampling.
RESULTS
The participants predominantly perceived their health as being healthy and ill in an episodic manner while adhering to their treatment and medications for chronic conditions. This was strongly determined by the factors such as presence of family support and caregiving, changes in work and occupation, changes in lifestyle, psychological stress from being diagnosed, and care-seeking practices. This episodic perception of illness led to the non-adherence of prescribed chronic care.
CONCLUSIONS
Due to the episodic manner in which the participants experienced their illness, the paper recommends considering health and illness as two different entities while researching chronic conditions. It is important for the health system to understand and fix the healthy and ill episodes, which often lead to switching between controlled and uncontrolled states of diabetes and hypertension. To do so, it is important to consider the social, economic, behavioural and psychological factors in an individual's health outcome. The interplay between these factors has socialized health perception and various related practices from the individual to the community level. Therefore, the health system needs to re-strategize its focus from individual to community level interventions to address the determinants of health and NCD risk factors by strengthening the NCD prevention approach.
Topics: Humans; Male; Female; Chronic Disease; Adult; Middle Aged; India; Qualitative Research; Noncommunicable Diseases; Perception; Health Status; Aged
PubMed: 38797834
DOI: 10.1186/s12939-024-02188-2 -
BMJ Open Respiratory Research May 2024People with chronic obstructive pulmonary disease (COPD) are more likely to adopt a sedentary lifestyle. Increased sedentary behaviour is associated with adverse health...
BACKGROUND
People with chronic obstructive pulmonary disease (COPD) are more likely to adopt a sedentary lifestyle. Increased sedentary behaviour is associated with adverse health consequences and reduced life expectancy.
AIM
This mixed-methods systematic review aimed to report the factors contributing to sedentary behaviour in people with COPD.
METHODS
A systematic search of electronic databases (Medline, CINAHL, PsycINFO and Cochrane Library) was conducted and supported by a clinician librarian in March 2023. Papers were identified and screened by two independent researchers against the inclusion and exclusion criteria, followed by data extraction and analysis of quality. Quantitative and qualitative data synthesis was performed.
RESULTS
1037 records were identified, 29 studies were included (26 quantitative and 3 qualitative studies) and most studies were conducted in high-income countries. The most common influencers of sedentary behaviour were associated with disease severity, dyspnoea, comorbidities, exercise capacity, use of supplemental oxygen and walking aids, and environmental factors. In-depth findings from qualitative studies included a lack of knowledge, self-perception and motivation. However, sedentarism in some was also a conscious approach, enabling enjoyment when participating in hobbies or activities.
CONCLUSIONS
Influencers of sedentary behaviour in people living with COPD are multifactorial. Identifying and understanding these factors should inform the design of future interventions and guidelines. A tailored, multimodal approach could have the potential to address sedentary behaviour.
PROSPERO REGISTRATION NUMBER
CRD42023387335.
Topics: Humans; Sedentary Behavior; Pulmonary Disease, Chronic Obstructive; Exercise Tolerance; Exercise
PubMed: 38789283
DOI: 10.1136/bmjresp-2023-002261 -
Behavioral Sciences (Basel, Switzerland) Apr 2024In 2020, healthcare providers were expected to provide care to individuals with coronavirus disease 2019 (COVID-19), putting them at risk of acquiring COVID-19. The...
BACKGROUND
In 2020, healthcare providers were expected to provide care to individuals with coronavirus disease 2019 (COVID-19), putting them at risk of acquiring COVID-19. The possibility of acquiring poorly understood infectious diseases while providing care may have an impact on the mental health of providers. We conducted a study to explore the effects of COVID-19 on the mental health of healthcare providers.
METHODS
Between April and August 2021, we conducted in-depth interviews with 60 healthcare providers in the infectious disease unit (IDU) and other units of the hospital (non-IDU). The healthcare providers completed an online self-administered survey form with demographic data (age, sex, average income, and known contact with a COVID-19 patient). We used semi-structured interview guides to understand the healthcare providers' lived experiences of stress, anxiety, depression, and their associated factors. We transcribed the interviews verbatim and coded and analyzed the transcripts to derive thematic concepts related to mental health experiences.
RESULTS
The healthcare providers had a median age of 37 years [IQR 20.0-58.0], and 56.7% were female, 30.0% nurses, 18.3% medical doctors, and 11.7% laboratory technologists. The healthcare providers reported increased stress during the pandemic, attributed to the high demand for patient care, changes in social life, and fear of COVID-19 infection. They also reported experiences of anxiety and depression as a result of limited knowledge at the beginning of the pandemic and the perception that "COVID-19 resulted in death". Testing positive for COVID-19, high exposure to COVID-19 risks, and the death of patients and colleagues reportedly affected the healthcare providers' mental health. Additionally, the healthcare providers reported mental health support through debriefing meetings, peer-to-peer support, and psychological counseling, with privacy and confidentiality concerns.
CONCLUSIONS
Healthcare providers faced mental health issues such as stress and anxiety while taking care of COVID-19 patients. An effective mental health response requires institutional practices that address context-specific challenges such as privacy and confidentiality.
PubMed: 38785842
DOI: 10.3390/bs14050351 -
Cureus Apr 2024Background and objective The objective of this study is to evaluate and compare the surrogate and true end points following surgical periodontal therapy using the Oral...
Background and objective The objective of this study is to evaluate and compare the surrogate and true end points following surgical periodontal therapy using the Oral Health Impact Profile-14 (OHIP-14) questionnaire. Materials and methods The study included a total of 30 participants, comprising 15 males and 15 females aged between 25 and 50 years. All individuals who had undergone periodontal flap surgery for generalized chronic periodontitis at the Department of Periodontology, Saveetha Dental College and Hospitals were included in the study. The OHIP-14 questionnaire was used to assess the patient-centered outcomes (true end points) pre- and post-flap surgery at baseline and six months. Surrogate end points such as the clinical attachment level (CAL), probing pocket depth (PPD), and gingival index (GI) were recorded at baseline and six months pre- and post-flap surgery. Results Clinical parameters such as the GI (p=0.03*), CAL (p=0.03), and PPD (p=0.02*) showed a statistically significant improvement after surgery. Patient-centered outcomes showed statistically significant differences in terms of taste perception, reduction in pain sensation, improvement in self-consciousness and reduction in anxiety levels, diminution of the feeling of embarrassment and enhancement in the ability to relax due to problems associated with gums, and improvement in the workplace (p<0.05) post-operatively. Conclusion Surgical periodontal therapy plays a pivotal role in improving oral health-related quality of life (OHRQoL) among patients with chronic periodontal disease. Utilizing OHIP-14 as an assessment tool enables a comprehensive evaluation of treatment outcomes, encompassing various dimensions of oral health impact. Patient-centered outcomes such as psychological discomfort and functional limitations can be achieved only by an interdisciplinary approach.
PubMed: 38784346
DOI: 10.7759/cureus.58792 -
F1000Research 2024Critical thinking is considered as the essential set of skills for medical practice, particularly during emergencies. However, there is lack of conceptual clarity around...
Critical thinking is considered as the essential set of skills for medical practice, particularly during emergencies. However, there is lack of conceptual clarity around it and it was not explicitly included in the undergraduate medical curriculum in India. The present study has been planned to assess the critical thinking disposition and clinical reasoning skills among medical undergraduate students in a medical college in West Bengal, India. The perceived definition and attributes of critical thinking in medical education will be explored and the contexts where application of critical thinking skills may be crucial for medical practice will be identified. The content validity index, test-retest agreement; internal consistency and construct validity of the Critical Thinking Disposition Assessment Questionnaire (CTDAQ) will be assessed through step-by-step procedure. CTDAQ and the case-based objective-type questions for the clinical reasoning skills will be applied to around 200 medical undergraduate students. Their perception and experience on critical thinking in medical education will be assessed with structured open-ended questions. In-depth interviews with medical teachers of the second and third phases of undergraduate medical curriculum will be conducted to assess their perception and experiences on critical thinking. The quantitative analysis will be conducted with MS excel and R software using the relevant packages. The qualitative data will be transcribed and translated in English, close to the participants' verbatim. The thematic analysis will be conducted with inductive coding and memoing. The study will be conducted maintaining ethical standards for epidemiological studies. The present study, one of the first a few studies in India, will help to meet the conceptual gap in understanding the attributes of critical thinking, its association with clinical reasoning and the contexts of preferred application in medical practice.
Topics: India; Humans; Education, Medical, Undergraduate; Thinking; Students, Medical; Clinical Reasoning; Surveys and Questionnaires; Curriculum; Clinical Competence
PubMed: 38779311
DOI: 10.12688/f1000research.146009.1 -
BMJ Open May 2024To explore the experience and challenges health professionals face during breaking bad news (BBN) to patients with cancer in the oncology centre of Black Lion...
OBJECTIVE
To explore the experience and challenges health professionals face during breaking bad news (BBN) to patients with cancer in the oncology centre of Black Lion Specialized Hospital (BLSH), Addis Ababa, Ethiopia 2019.
DESIGN
An exploratory qualitative phenominological study using in-depth interviews was carried out in the only radiotherapy integrated oncology centre in Ethiopia during March 2019. Purposeful maximum variation sampling was used to select participants. OpenCode (V.4.02) assisted thematic analysis approach was employed to analyse the data.
PARTICIPANTS
Eleven oncology health practitioners (oncologists, residents and nurses) working at the oncology centre were interviewed. Repeated interviews and analysis were done until theoretical saturation.
RESULTS
All participants were cognisant of the positive outcome of proper and effective practice of BBN. However, they were practicing it empirically, no standardised protocols or guidelines were in place. Four dimensions of challenges were mentioned: (1) setup centric: unconducive environment, lack of protocols or guidelines, inaccessible treatment, and psychotherapy or counselling services; (2) health care centric, such as inadequate expertise, inadequate time due to patient load,treatment backlog, and referral system; (3) patients/family centric: poor medical literacy level, poor compliance, and family interference; and (4) sociocultural: wrong perception of families on BBN and treatment modalities, and opposition from religious leaders.
CONCLUSION
BBN is challenging for professionals caring for patients in the oncology centre of BLSH. Hence, there is a critical need to improve practices. Change efforts may focus on the development of contextualised, content and context specific practice oriented training programmes and curriculum interventions. Raising awareness of the community and religious leaders regarding the nature and treatment of cancer may also be a helpful adjunct.
Topics: Humans; Ethiopia; Qualitative Research; Truth Disclosure; Male; Female; Neoplasms; Adult; Medical Oncology; Attitude of Health Personnel; Interviews as Topic; Health Personnel; Middle Aged
PubMed: 38777584
DOI: 10.1136/bmjopen-2024-087977 -
Brain and Behavior May 2024Visual field defects (VFDs) represent a debilitating poststroke complication, characterized by unseen parts of the visual field. Visual perceptual learning (VPL),... (Randomized Controlled Trial)
Randomized Controlled Trial
INTRODUCTION
Visual field defects (VFDs) represent a debilitating poststroke complication, characterized by unseen parts of the visual field. Visual perceptual learning (VPL), involving repetitive visual training in blind visual fields, may effectively restore visual field sensitivity in cortical blindness. This current multicenter, double-blind, randomized, controlled clinical trial investigated the efficacy and safety of VPL-based digital therapeutics (Nunap Vision [NV]) for treating poststroke VFDs.
METHODS
Stroke outpatients with VFDs (>6 months after stroke onset) were randomized into NV (defective field training) or Nunap Vision-Control (NV-C, central field training) groups. Both interventions provided visual perceptual training, consisting of orientation, rotation, and depth discrimination, through a virtual reality head-mounted display device 5 days a week for 12 weeks. The two groups received VFD assessments using Humphrey visual field (HVF) tests at baseline and 12-week follow-up. The final analysis included those completed the study (NV, n = 40; NV-C, n = 35). Efficacy measures included improved visual area (sensitivity ≥6 dB) and changes in the HVF scores during the 12-week period.
RESULTS
With a high compliance rate, NV and NV-C training improved the visual areas in the defective hemifield (>72 degrees) and the whole field (>108 degrees), which are clinically meaningful improvements despite no significant between-group differences. According to within-group analyses, mean total deviation scores in the defective hemifield improved after NV training (p = .03) but not after NV-C training (p = .12).
CONCLUSIONS
The current trial suggests that VPL-based digital therapeutics may induce clinically meaningful visual improvements in patients with poststroke VFDs. Yet, between-group differences in therapeutic efficacy were not found as NV-C training exhibited unexpected improvement comparable to NV training, possibly due to learning transfer effects.
Topics: Humans; Double-Blind Method; Male; Female; Middle Aged; Aged; Visual Fields; Stroke; Visual Perception; Virtual Reality; Stroke Rehabilitation; Learning; Vision Disorders
PubMed: 38773793
DOI: 10.1002/brb3.3525 -
Journal of Cataract and Refractive... Jun 2024
Topics: Humans; Visual Acuity; Depth Perception; Corneal Wavefront Aberration; Lens Implantation, Intraocular
PubMed: 38773716
DOI: 10.1097/j.jcrs.0000000000001404 -
Malaria Journal May 2024Perennial malaria chemoprevention (PMC) aims to protect children at risk from severe malaria by the administration of anti-malarial drugs to children of defined ages... (Observational Study)
Observational Study
BACKGROUND
Perennial malaria chemoprevention (PMC) aims to protect children at risk from severe malaria by the administration of anti-malarial drugs to children of defined ages throughout the year. Sulfadoxine-pyrimethamine (SP) has been widely used for chemoprevention in Africa and a child-friendly dispersible tablet formulation has recently become available.
METHODS
This qualitative non-interventional observational study was conducted in Benin, Côte d'Ivoire, and Mozambique between February and June 2022. Prototype blister packs, dispensing boxes and job aids designed to support dispersible SP deployment for PMC were evaluated using focus group discussions (FGD) and semi-structured in-depth individual interviews (IDI) with health authorities, health personnel, community health workers (CHWs) and caregivers. The aim was to evaluate knowledge and perceptions of malaria and chemoprevention, test understanding of the tools and identify gaps in understanding, satisfaction, user-friendliness and acceptability, and assess the potential role of CHWs in PMC implementation. Interviews were transcribed and imported to ATLAS.ti for encoding and categorization. Thematic content analysis used deductive and inductive coding with cross-referencing of findings between countries and participants to enrich data interpretation. Continuous comparison across the IDI and FGD permitted iterative, collaborative development of materials.
RESULTS
Overall, 106 participants completed IDIs and 70 contributed to FGDs. Malaria was widely recognised as the most common disease affecting children, and PMC was viewed as a positive intervention to support child health. The role of CHWs was perceived differently by the target groups, with caregivers appreciating their trusted status in the community, whereas health authorities preferred clinic-based deployment of PMC by health professionals. Empirical testing of the prototype blister packs, dispensing boxes and job aids highlighted the context-specific expectations of respondents, such as familiar situations and equipment, and identified areas of confusion or low acceptance. A key finding was the need for a clear product identity reflecting malaria.
CONCLUSION
Simple modifications profoundly affected the perception of PMC and influenced acceptability. Iterative quantitative investigation resulted in PMC-specific materials suited to the local context and socio-cultural norms of the target population with the aim of increasing access to chemoprevention in children most at risk of severe malaria.
Topics: Mozambique; Benin; Malaria; Antimalarials; Chemoprevention; Humans; Cote d'Ivoire; Drug Combinations; Pyrimethamine; Sulfadoxine; Child, Preschool; Female; Male; Drug Packaging; Infant; Child; Adult
PubMed: 38773567
DOI: 10.1186/s12936-024-04977-0