Diabetes Self-Care Behaviors and Barriers to Clinical Care During COVID-19 Pandemic for Marshallese Adults

Purpose: The purpose of the study was to explore experiences of Marshallese adults related to diabetes self-care behaviors during the COVID-19 pandemic. Methods: A qualitative descriptive design was utilized to understand participants’ diabetes self-care behaviors during the pandemic. Nine focus groups with 53 participants were held via videoconference and conducted in English, Marshallese, or a mixture of both languages. A priori codes based on diabetes self-care behaviors provided a framework for analyzing and summarizing participant experiences. Results: Both increases and decreases in healthy eating and exercise were described, with improvements in health behaviors attributed to health education messaging via social media. Participants reported increased stress and difficulty monitoring and managing glucose. Difficulty obtaining medication and difficulty seeing their health care provider regularly was reported and attributed to health care provider availability and lack of insurance due to job loss. Conclusions: The study provides significant insight into the reach of health education campaigns via social media and provides important information about the reasons for delays in care, which extend beyond fear of contracting COVID-19 to structural issues.

Quality of Counselling Services for Pregnant Women in Community Clinics

Maternal health service had a potentially critical role in the improvement of reproductive health. This descriptive study was carried out in Tangail district, from 1st January to 31st December, 2019 to find out the quality of counselling of services for pregnant women in community clinics during pregnancy period. Data were collected among 289 respondents by face to face interview who had delivered within last 24 months and respondents were selected purposively. The majority (97.6%) of the respondents were housewife and maximum (72%) of the respondent were below SSC in this study monthly family income mean was taka 16124.00± 10065.480. Majority of the respondents (99.2%) had received antenatal check-up from different health care facilities and highest (87.2%) had received from the community clinic other hands (6.0%) pregnant women got antenatal care from non-government hospital among 250 respondents (94.0%) pregnant women received ANC from CHCP also (4%) pregnant women received ANC from HA. Out of 250 pregnant women (70%) of the respondents were problem suffer during pregnancy. Here majority (59.6%) pregnant women were suffer from nausea and vomiting and only (6.3%) were suffering from constipation. Majority (89.2%) of the respondents had preparation about danger sign during pregnancy. Most 245 (98%) of the respondents of pregnant women had information about ANC and most (85.7%) got information from CHCF on other hand ride got information (2.9%) from neighbour. half (4.8%) of the respondents choice of conduct delivery at upazila health complex followed by (48.8%) only choice of conduct clinics. Most (98%) of the respondents had received TT vaccine and maximum (95.1%) of the respondents had completed TT vaccine. Enough skilled manpower for patient care (98.4%). Health care provider perform ANC check-up (96.8%). Health care provider counselling during pregnancy (96.4%) physical examination (98.0%) explanation of health. (99.2%) health care provider give any advice before departure (70.4%). Continue to follow-up health status over phone (99.2%). Service providers in health care shows that 33.3% was BSc/BA, 42.9% of service providers were masters and above their professional training more than one third (38.1%) of the providers has basic training, 47.6% had basic & CSBA and rest 14.3% had ECT and nutritional training. Majority 100% of the provider’s designation had CHCP, number of staff in two health care had more than half (57.1%) providers.

Information seeking behaviors, attitudes, and beliefs about pregnancy-related nutrition and supplementation: A qualitative study among US women

Background: Maternal behavior during pregnancy is crucial to her own and her infant's health, and as such, it is important to understand the nutrition and supplement habits of women during pregnancy and what informs those behaviors. Aim: We aimed to assess the information seeking habits, attitudes, and beliefs about pregnancy-related nutrition and supplementation among pregnant women in the United States. Methods: Qualitative study using key informant interviews with pregnant and recently pregnant ( n = 21) US women. Themes related to concerns, attitudes, behaviors, and information seeking habits were extracted. Results: The mean age was 31.9 years and all had at least a university degree. Two major themes that emerged: (1) nutrition information-related attitudes and beliefs and (2) food and supplement-related attitudes and beliefs. Pregnant women in the US were underwhelmed with their health care provider experience when receiving information about pregnancy-related nutrition and supplementation. Nutrition was most often addressed in a reactive manner while women desired a more proactive approach. As a result, they conducted their own research using the internet as their primary tool, and ultimately made nutrition and supplement decisions based largely on their own instincts. Conclusion: Women interviewed for this study encountered barriers to pregnancy related nutrition information from a lack of clear communication from their health care provider and ambiguity and inconsistencies in information within and between sources. Women relied on themselves for information seeking and nutrition related decision making throughout their pregnancy.

Telemedicine during COVID-19: India embracing the change

Telemedicine has been around for decades but it has taken foreground in health services recently. When COVID-19 cases started to be reported in the country it brought with itself panic and chaos. At all India level, the adult literacy rate is 77.7%, this could also be linked to unawareness related to the disease in rural areas. The sudden countrywide lockdown imposed was of no help and further worsened the situation for economically weaker section of the society. During the struggle of our nation to overcome the COVID-19 Telemedicine has indeed played a vital role. People in fear of contacting the disease and due to nationwide lockdown were unable to reach their health care provider. People with pre-existing conditions that needs regular monitoring, pregnancy related queries, queries on new symptoms, psychological counselling and many more could not wait for the COVID-19 to be over before they get any help on the issues.­­ Telemedicine shall continue developing and be used in a multitude of settings by more health-care doctors and patients, and these standards of practice will be a crucial driver within this evolution.

Literature Review: Penerapan Prenatal Gentle Yoga Untuk Menurunkan Kecemasan Ibu Hamil Dalam Menghadapi Persalinan

Third trimester pregnant women tend to experience anxiety in facing labour. One method to reduce this anxiety is by doing prenatal gentle yoga. This study aimed to examine the implementation of prenatal gentle yoga to reduce the anxiety of pregnant women in facing labour. The design of this study was literature review by analyzing three articles published in Google Scholar with the keywords “pregnant women”, “anxiety”, and “prenatal gentle yoga”, in the form of fulltext articles, and published during 2016-2020. The respondents of the three articles were 92 pregnant women. The results showed that before the intervention, 39.67% respondents felt moderate anxiety at 40,21% and severe anxiety at 39,13%. Meanwhile, after the intervention, only 9.78% respondents felt the anxiety. In conclusion, prenatal gentle yoga could reduce anxiety experienced by third trimester pregnant women. Therefore health care provider are supposed to be able to lead and train pregnant women doing prenatal gentle yoga.Keywords: Pregnant Women; anxiety; prenatal gentle yoga therapy; third trimester AbstrakIbu hamil trimester III cenderung mengalami kecemasan dalam menghadapi persalinan. Salah satu upaya untuk menurunkan kecemasan dalam menghadapi persalinan yaitu dengan prenatal gentle yoga. Artikel ini bertujuan untuk menelaah penerapan prenatal gentle yoga untuk menurunkan kecemasan ibu hamil dalam menghadapi persalinan berdasarkan literature review. Desain Artikel ini berupa literature review dengan mencari 3 artikel yang dipublikasikan di jurnal penelitian ilmiah di laman google cendekia dengan kata kunci “ibu hamil”, “kecemasan”, “prenatal gentle yoga” berupa article fulltext, terbit tahun 2016-2020. Karakteristik responden dari ketiga artikel menunjukkan jumlah responden sebanyak 92. Nilai rata-rata kecemasan sebelum dilakukan intervensi sebagian besar responden mengalami cemas sedang sebesar 40,21 dan cemas berat sebanyak 39,13% dan setelah dilakukan intervensi cemas turun menjadi 9,78%. Kesimpulannya adalah prenatal gentle yoga dapat menurunkan kecemasan pada ibu hamil trimester III. Saran bagi pelayanan kesehatan untuk melaksanakan pelatihan prenatal gentle yoga agar tenaga keperawatan menjadi terlatih untuk menerapkannya pada ibu hamil.Kata Kunci: Ibu hamil; kecemasan; terapi prenatal gentle yoga; trimester III

Promising Interventions to Prevent Liver Cancer in Idaho

Introduction: The Idaho Comprehensive Cancer Control Program (ICCCP) collaborated with the Idaho Immunization Program (IIP) to plan and implement activities to increase knowledge and awareness of liver cancer prevention through tailored hepatitis B immunization messaging to the Idaho community and health care providers. Purpose and Objectives: In this article, we report findings from an evaluation of these activities. Interventions Approach: The two programs implemented liver cancer prevention activities between May 2017 and December 2017; strategies included a social media vaccination awareness campaign and health care provider education. Evaluation Methods: Facebook Insights was used to report, and descriptive statistics were used to analyze, data from the social media campaign. Descriptive statistics were used to analyze data collected from a retrospective pre–post survey for the health care provider presentations and paired t-tests were conducted to detect differences between pre- and postexposure. Results: For the social media campaign, ICCCP and IIP posted a total of 32 liver cancer and hepatitis B vaccination posts on their respective Facebook pages, which reached 42,804 unique users. For the health care provider presentations, there was a statistically significant increase in awareness, knowledge, ability, and intention among health care providers. Implications for Public Health: Our evaluation serves as an example of how public health social media can reach consumers and how educating providers can raise awareness on the importance of hepatitis B vaccination as a means of preventing liver cancer.

Delayed Tuberculosis Diagnosis in a Low Incidence Country and its Effect on Cost of Care

Background Tuberculosis elimination (TB) is a global priority that requires high-quality timely care to be achieved. In low TB incidence countries such as Ireland, delayed diagnosis is common. Despite cost being central to policy making, it is not known if delayed care affects care cost among TB patients in a low-incidence setting. Methods Health care records of patients with signs and symptoms of TB evaluated by a tertiary service in Ireland between July 1st 2018 and December 31st 2019 were reviewed to measure and determine predictors of patient-related delays, health care-provider related delay and the cost of TB care. Benchmarks against which the outcomes were compared were derived from the literature. Results Thirty-seven patients were diagnosed with TB and 51% (19/37) had pulmonary TB (PTB). The median patient-related delay was 60 days among those with PTB, greater than the benchmark derived from the literature (38 days). The median health care provider-related delay among patients with PTB was 16 days and, although similar to the benchmark (median 22 days, minimum 11 days, maximum 36 days) could be improved. The health care-provider related delay among patients with EPTB was 66 days, greater than the benchmark (42 days). The cost of care was €8298, and while similar to that reported in the literature (median €9,319, minimum €6,486, maximum €14,750) could be improved. Patient-related delay among those with PTB predicted care costs. Conclusion Patient-related and health care-related delays in TB diagnosis in Ireland must be reduced. Initiatives to do so should be resourced.

Characterizing health care provider knowledge: Evidence from HIV services in Kenya, Rwanda, South Africa, and Zambia

Background Identifying approaches to improve levels of health care provider knowledge in resource-poor settings is critical. We assessed level of provider knowledge for HIV testing and counseling (HTC), prevention of mother-to-child transmission (PMTCT), and voluntary medical male circumcision (VMMC). We also explored the association between HTC, PMTCT, and VMMC provider knowledge and provider and facility characteristics. Methods We used data collected in 2012 and 2013. Vignettes were administered to physicians, nurses, and counselors in facilities in Kenya (66), Rwanda (67), South Africa (57), and Zambia (58). The analytic sample consisted of providers of HTC (755), PMTCT (709), and VMMC (332). HTC, PMTCT, and VMMC provider knowledge scores were constructed using item response theory (IRT). We used GLM regressions to examine associations between provider knowledge and provider and facility characteristics focusing on average patient load, provider years in position, provider working in another facility, senior staff in facility, program age, proportion of intervention exclusive staff, person-days of training in facility, and management score. We estimated three models: Model 1 estimated standard errors without clustering, Model 2 estimated robust standard errors, and Model 3 estimated standard errors clustering by facility. Results The mean knowledge score was 36 for all three interventions. In Model 1, we found that provider knowledge scores were higher among providers in facilities with senior staff and among providers in facilities with higher proportions of intervention exclusive staff. We also found negative relationships between the outcome and provider years in position, average program age, provider working in another facility, person-days of training, and management score. In Model 3, only the coefficients for provider years in position, average program age, and management score remained statistically significant at conventional levels. Conclusions HTC, PMTCT, and VMMC provider knowledge was low in Kenya, Rwanda, South Africa, and Zambia. Our study suggests that unobservable organizational factors may facilitate communication, learning, and knowledge. On the one hand, our study shows that the presence of senior staff and staff dedication may enable knowledge acquisition. On the other hand, our study provides a note of caution on the potential knowledge depreciation correlated with the time staff spend in a position and program age.